Contraindications and Precautions for Meloxicam Use

Absolute Contraindications

The American Academy of Allergy, Asthma, and Immunology recommends that meloxicam is contraindicated in patients with known hypersensitivity to meloxicam or other components of the formulation 1
The American Academy of Allergy, Asthma, and Immunology also recommends that meloxicam is contraindicated in patients with a history of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs 1, 3
The American Geriatrics Society recommends that meloxicam is contraindicated in patients with active peptic ulcer disease 4
The American Academy of Family Physicians recommends that meloxicam is contraindicated in patients with severe hepatic failure 2, 4
The American Academy of Family Physicians also recommends that meloxicam is contraindicated in patients with severe renal impairment 4
The American College of Obstetricians and Gynecologists recommends that meloxicam is contraindicated in the third trimester of pregnancy 2
The American Academy of Allergy, Asthma, and Immunology recommends that meloxicam is contraindicated in patients with a history of NSAID-induced Stevens-Johnson syndrome or toxic epidermal necrolysis 1, 3

The American Heart Association recommends that meloxicam should be used with caution in patients with heart failure with reduced ejection fraction (HFrEF) 2, 5
The American Heart Association also recommends that meloxicam should be used with caution in patients with hypertension 2
The American College of Cardiology recommends that meloxicam should be used with caution in patients with a history of myocardial infarction 5
The American Heart Association recommends that meloxicam should be used with caution in patients with increased risk of cardiovascular events 2

The American Gastroenterological Association recommends that meloxicam should be used with caution in patients with a history of gastrointestinal bleeding or ulceration 2
The American Gastroenterological Association also recommends that meloxicam should be used with caution in patients with Helicobacter pylori infection 4
The American Gastroenterological Association recommends that meloxicam should be used with caution in patients taking concomitant corticosteroids or selective serotonin reuptake inhibitors (SSRIs) 4

The American Geriatrics Society recommends that meloxicam should be used with caution in elderly patients (>65 years) due to increased risk of adverse effects 2, 5
The American Geriatrics Society also recommends that meloxicam should be used with caution in patients with chronic alcohol abuse 4
The American Heart Association recommends that meloxicam should be used with caution in patients taking anticoagulants due to increased bleeding risk 2
The American Academy of Allergy, Asthma, and Immunology recommends that meloxicam should be used with caution in patients with mastocytosis 1
The American Academy of Family Physicians recommends that meloxicam should be used with caution in patients with renal impairment 2, 4
The American Association for the Study of Liver Diseases recommends that meloxicam should be used with caution in patients with hepatic insufficiency 4

The American Geriatrics Society recommends that meloxicam should be used with extreme caution in patients >75 years due to significantly increased risk of gastrointestinal bleeding 2, 5
The American Geriatrics Society also recommends that lower doses should be considered in elderly patients 2

The American Academy of Allergy, Asthma, and Immunology recommends that meloxicam should be avoided in patients with aspirin-exacerbated respiratory disease (AERD) 1, 6

The American Geriatrics Society recommends that concomitant use of meloxicam with other NSAIDs, including aspirin, should be avoided 4
The American Heart Association recommends that concomitant use of meloxicam with anticoagulants should be used with caution due to increased bleeding risk 2
The American Thoracic Society recommends that meloxicam may have potential interactions with drugs that prolong QT interval 7
The American Academy of Family Physicians recommends that meloxicam may reduce effectiveness of antihypertensive medications 2
The American Academy of Family Physicians also recommends that meloxicam may increase risk of methotrexate toxicity 2

The American Geriatrics Society recommends regular assessment for gastrointestinal and renal toxicity in patients taking meloxicam 4
The American Heart Association recommends monitoring for hypertension and signs of heart failure in patients taking meloxicam 4
The American Association for the Study of Liver Diseases recommends monitoring liver function tests in long-term use of meloxicam 2
The American Geriatrics Society recommends assessing for drug-drug and drug-disease interactions in patients taking meloxicam 4

The American Academy of Allergy, Asthma, and Immunology recommends that although meloxicam is a preferentially selective COX-2 inhibitor, it is not as selective as celecoxib and still carries risks associated with NSAIDs 8
The American Gastroenterological Association recommends that patients requiring meloxicam who have a history of gastrointestinal risk factors should receive concomitant gastroprotection with a proton pump inhibitor or misoprostol 4
The American Academy of Allergy, Asthma, and Immunology recommends that meloxicam belongs to the oxicam class of NSAIDs, which has been associated with higher risk of severe cutaneous adverse reactions compared to other NSAID classes 1, 3