Meloxicam

NSAID (COX-2 preferential)·Analgesia - Simple & NSAIDs

Symptomatic treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis

PBSNSAIDMobic, Moxicam7.5 mg tabletS4+1

Max Dose

15 mg/day

Half-life

15-20 h

GI Bleed

LOWER RISK

Renal Risk

HIGH

Rapid Summary

Overview

Preferential COX-2 inhibitor. Highly effective for osteoarthritis and rheumatoid arthritis. Provides a middle ground between the GI toxicity of traditional NSAIDs and the cardiovascular risk of pure COX-2 inhibitors.

Maximum Dose

Max 15 mg/day.

Clinical Focus

Highly bound to plasma proteins. Extremely long half-life allows once-daily dosing, but increases the risk of accumulation in renal impairment.

Bottom Line

Meloxicam is a preferential COX-2 NSAID with once-daily dosing for osteoarthritis and rheumatoid arthritis, but carries the same cardiovascular and renal risks as non-selective NSAIDs.

Formulation & Access

Brand Names

Mobic, Moxicam

Oral Routes

Tablets (7.5 mg, 15 mg).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Symptomatic treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis.

Clinical Place

Excellent choice for chronic arthritic pain due to once-daily dosing and slightly better GI tolerance than Diclofenac or Naproxen.

Quick reference

Class & Role

NSAID (COX-2 preferential) — Preferential COX-2 inhibitor.

Route / Formulation

Tablets (7.5 mg, 15 mg). (Mobic, Moxicam)

Usual Dose & Max

PO 7.5 - 15 mg OD (Take with food). Max 15 mg/day.

Key Indication Doses

Osteoarthritis / Rheumatoid Arthritis: PO 7.5 - 15 mg OD (Take with food). Elderly / Frail: Max 7.5 mg OD. Renal Impairment: Avoid entirely if eGFR < 30. (Reduces renal prostaglandins, causing severe AKI).

Best Uses

Meloxicam is a preferential COX-2 NSAID with once-daily dosing for osteoarthritis and rheumatoid arthritis, but carries the same cardiovascular and renal risks as non-selective NSAIDs.

Avoid / Cautions

Active GI bleeding, severe heart failure, eGFR < 30. Pregnancy Category C. Contraindicated in 3rd trimester.

Key Risks

Gastrointestinal: Peptic ulceration, GI bleeding. (Safer than Naproxen at 7.5mg, but identical risk at 15mg). Renal: Acute Kidney Injury (AKI), fluid retention, hyperkalemia. Cardiovascular: Hypertension, mild increased risk of thrombotic events.

Key Interactions

NSAID + ACEi/ARB + Diuretic = AKI. Anticoagulants (DOACs/Warfarin). Massive GI bleeding risk. Lithium and Methotrexate (Reduces their renal clearance, causing toxic spikes).

Monitoring

Take strictly with food. Co-prescribe a PPI (Pantoprazole) in vulnerable patients. Check U&E and eGFR if used long-term.

Clinical Pearl

At 7.5mg, Meloxicam is relatively COX-2 selective and gentle on the stomach. At 15mg, it loses this selectivity and behaves exactly like a traditional, harsh NSAID like Diclofenac. Respect the 7.5mg dose in the elderly.

Access

Mobic, Moxicam7.5 mg tablet

Brand: Mobic, Moxicam
Formulation: Tablets (7

Meloxicam

NSAID (COX-2 preferential)·Analgesia - Simple & NSAIDs

Symptomatic treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis

PBSNSAIDMobic, Moxicam7.5 mg tabletS4+1

Max Dose

15 mg/day

Half-life

15-20 h

GI Bleed

LOWER RISK

Renal Risk

HIGH

Rapid Summary

Overview

Maximum Dose

Max 15 mg/day.

Clinical Focus

Highly bound to plasma proteins. Extremely long half-life allows once-daily dosing, but increases the risk of accumulation in renal impairment.

Bottom Line

Meloxicam is a preferential COX-2 NSAID with once-daily dosing for osteoarthritis and rheumatoid arthritis, but carries the same cardiovascular and renal risks as non-selective NSAIDs.

Formulation & Access

Brand Names

Mobic, Moxicam

Oral Routes

Tablets (7.5 mg, 15 mg).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Symptomatic treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis.

Clinical Place

Excellent choice for chronic arthritic pain due to once-daily dosing and slightly better GI tolerance than Diclofenac or Naproxen.

Quick reference

Class & Role

NSAID (COX-2 preferential) — Preferential COX-2 inhibitor.

Route / Formulation

Tablets (7.5 mg, 15 mg). (Mobic, Moxicam)

Usual Dose & Max

PO 7.5 - 15 mg OD (Take with food). Max 15 mg/day.

Key Indication Doses

Best Uses

Meloxicam is a preferential COX-2 NSAID with once-daily dosing for osteoarthritis and rheumatoid arthritis, but carries the same cardiovascular and renal risks as non-selective NSAIDs.

Avoid / Cautions

Active GI bleeding, severe heart failure, eGFR < 30. Pregnancy Category C. Contraindicated in 3rd trimester.

Key Risks

Key Interactions

NSAID + ACEi/ARB + Diuretic = AKI. Anticoagulants (DOACs/Warfarin). Massive GI bleeding risk. Lithium and Methotrexate (Reduces their renal clearance, causing toxic spikes).

Monitoring

Take strictly with food. Co-prescribe a PPI (Pantoprazole) in vulnerable patients. Check U&E and eGFR if used long-term.

Clinical Pearl

Access

Mobic, Moxicam7.5 mg tablet

Brand: Mobic, Moxicam
Formulation: Tablets (7