Meloxicam was patented in 1977 and approved for medical use in the United States in 2000. It was developed by Boehringer Ingelheim, however is also available as a generic medication. In the United States the wholesale cost per dose is less than US$0.02 as of 2018[update]. In the United Kingdom it costs about 0.13 pounds as of 2018[update]. In 2016, it was the 36th most prescribed medication in the United States with more than 21million prescriptions.
A pooled analysis of randomized, controlled studies of meloxicam therapy of up to 60 days duration found that meloxicam was associated with a statistically significantly lower number of thromboembolic complications than the NSAID diclofenac (0.2% versus 0.8% respectively) but a similar incidence of thromboembolic events to naproxen and piroxicam.
Persons with hypertension, high cholesterol, or diabetes are at risk for cardiovascular side effects. Persons with family history of heart disease, heart attack, or stroke must tell their treating physician as the potential for serious cardiovascular side effects is significant.
NSAIDs cause and increase the risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. Elderly patients are at greater risk for serious gastrointestinal events.
Meloxicam concentrations in synovial fluid range from 40% to 50% of those in plasma. The free fraction in synovial fluid is 2.5 times higher than in plasma, due to the lower albumin content in synovial fluid as compared to plasma. The significance of this penetration is unknown, but it may account for the fact that it performs exceptionally well in treatment of arthritis in animal models.
The bioavailability of meloxicam is decreased when administered orally compared to an equivalent IV bolus dose. Use of oral meloxicam following a high-fat breakfast increases the mean peak drug levels by about 22%, however, the manufacturer does not make any specific meal recommendations. In addition, the use of antacids does not show pharmacokinetic interactions.
Meloxicam is extensively metabolized in the liver by the enzymes CYP2C9 and CYP3A4 (minor) onto four inactive metabolites. Peroxidase activity is thought to be responsible for the other two remaining metabolites.
Meloxicam is predominantly excreted in the form of metabolites and occurs to equal extents in the urine and feces. Traces of unchanged parent drug are found in urine and feces. The mean elimination half-life ranges from 15 to 20 hours.
Use of meloxicam is not recommended in people with peptic ulcer disease or increased gastrointestinal bleed risk, including those over 75 years of age or those taking medications associated with bleeding risk. Adverse events have been found to be dose-dependent and associated with length of treatment.
In healthy dogs given meloxicam, no perioperative adverse effects on the cardiovascular system have been reported at recommended dosages. Perioperative administration of meloxicam to cats did not affect postoperative respiratory rate nor heart rate.
A peer-reviewed journal article cites NSAIDs, including meloxicam, as causing gastrointestinal upset and, at high doses, acute renal failure and CNS signs such as seizures and comas in cats. It adds that cats have a low tolerance for NSAIDs.
In dogs, the absorption of meloxicam from the stomach is not affected by the presence of food, with the peak concentration (Cmax) of meloxicam occurring in the blood 7–8 hours after administration. The half-life of meloxicam is approximately 24 hours in dogs.
In 2003, meloxicam was approved in the U.S. for use in dogs for the management of pain and inflammation associated with osteoarthritis, as an oral (liquid) formulation of meloxicam. In January 2005, the product insert added a warning in bold-face type: "Do not use in cats." An injectable formulation for use in dogs was approved by the Food and Drug Administration (FDA) in November 2003.
In October 2004, a formulation for use in cats was approved for use prior to surgery only. This is an injectable meloxicam, indicated for as a single, one-time dose only, with specific and repeated warnings not to administer a second dose.
In 2005, the U.S. Food and Drug Administration (FDA) sent a Notice of Violation to the manufacturer for its promotional materials which included promotion of the drug for off-label use.
In Europe, where the product has been available since the early 1990s, it is licensed for other anti-inflammatory benefits including relief from both acute and chronic pain in dogs. In June 2007, an oral version of meloxicam was licensed for the long-term relief of pain in cats.
Meloxicam is also licensed for use in horses, to relieve the pain associated with musculoskeletal disorders.
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^"Client Information Sheet For Metacam (meloxicam) 1.5 mg/mL Oral Suspension"(PDF). Food and Drug Administration (FDA). January 2005. Archived from the original(PDF) on 15 November 2017. Metacam is a prescription non-steroidal anti-inflammatory drug (NSAID) that is used to control pain and inflammation (soreness) due to osteoarthritis in dogs. Osteoarthritis (OA) is a painful condition caused by “wear and tear” of cartilage and other parts of the joints that may result in the following changes or signs in your dog: Limping or lameness, decreased activity or exercise (reluctance to stand, climb stairs, jump or run, or difficulty in performing these activities), stiffness or decreased movement of joints. Metacam is given to dogs by mouth. Do not use Metacam Oral Suspension in cats. Acute renal failure and death have been associated with the use of meloxicam in cats.