Equis ISSN 2398-2977

Meloxicam

Contributor(s): Adam Auckburally, Ruth Morgan

Introduction

Name

  • Meloxicam.

Class of drug

  • Non-steroidal anti-inflammatory drug; COX-2 preferential.
  • Enolic acid.

Description

Chemical name

  • 4-hydroxy-2-methyl-N-(5-methyl-2-thiazolyl)-2H-1,2-benzothiazine-3-carboxamide-1,1-dioxide.

Molecular formula

  • C14H13N3O4S2.

Molecular weight

  • 351.403 g.

Physical properties

  • Solution for injection is clear and pale yellow, containing 20 mg/ml meloxicam with 150 mg ethanol.
  • Oral suspension is a yellow viscous substance containing 15 mg/ml meloxicam with 1.5 mg sodium benzoate.

Storage requirements

  • <25°C.
  • Solution for injection should be discarded after 28 days of opening.
  • Oral solution must be used within 6 months of opening.

Uses

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Indications

  • Licensed in the UK for alleviation of inflammation and relief of pain in both acute and chronic musculoskeletal disorders in horses.
  • For the treatment of horses with abdominal pain Abdomen: pain - adult.
  • Further work is needed, but there is some evidence that meloxicam has less of an effect on recovery of ischemic bowel than flunixin Flunixin meglumine.
  • May be used for other inflammatory conditions off-license.
  • Its administration must be justified using the Cascade.

Administration

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Pharmacokinetics

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Precautions

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Interactions

with other drugs

  • Do not administer with other NSAIDs or corticosteroids Therapeutics: anti-inflammatory drugs.
  • May compete for protein binding sites, leading to increased plasma concentrations of free drug and toxic effects. Reported examples of highly protein bound drugs which may be displaced by NSAIDs are oral anticoagulants, glucocorticoids, sulfonamides Therapeutics: sulfonamides, methotrexate Methotrexate, valproic acid and phenytoin Phenytoin.
  • Concurrent administration of other nephrotoxic drugs should be avoided.
  • Avoid co-administration with anticoagulant drugs.

Adverse Reactions

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource
  • Burns P J, Morrow C, Gilley R M et al (2010) Evaluation of pharmacokinetic-pharmacodynamic relationships for BioRelease meloxicam formulations in horses. J Eq Vet Sc 30 (10), 539-544.
  • De Grauw J C, van der Lest C H A, Brama P A J et al (2009) In vivo effects of meloxicam on inflammatory mediators, MMP activity and cartilage biomarkers in equine joints with acute synovitis. Eq Vet J 41 (7), 693-699 PubMed.
  • Little D, Brown S A, Campbell N B, Moeser A J, Davis J L & Blikslager A T (2007) Effects of the cyclooxygenase inhibitor meloxicam on recovery of ischemia-injured equine jejunum. Am J Vet Res 68 (6), 614-624 PubMed.
  • Friton G M, Phillip H, Kleemann R et al (2006) Investigation of the clinical efficacy, safety and palatability of meloxicam (Metacam®) treatment in horses with musculoskeletal disorders. Pferdeheilkunde 22 (4), 420-426.
  • Sinclair M D, Mealey K L, Matthews N S, Peck K E, Taylor T S & Bennett B S (2006) Comparative pharmacokinetics of meloxicam in clinically normal horses and donkeys.Am J Vet Res 67 (6), 1082-1085 PubMed.
  • Toutain P L, Reymond N, Laroute V et al (2004) Pharmacokinetics of meloxicam in plasma and urine in horses. Am J Vet Res 65 (11), 1542-1547 PubMed.
  • Lees P, Sedgewick A D, Higgins A J et al (1991) Pharmacokinetics and pharmacodynamics of miloxicam in the horse. Br Vet J 147 (2), 97-108 PubMed.

Other sources of information

  • Plumb D C (2011) Veterinary Drug handbook. 7th edn. Wiley-Blackwell, USA.
  • Hanson P D & Maddison J E (2008) Non-steroidal anti-inflammatory drugs and chondroprotective agents. In: Small Animal Clinical Pharmacology. 2nd edn. Eds: Maddison J E, Page S W & Church D B. Saunders Elsevier, USA. pp 287-309.

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