Meloxicam and Ezetimibe Co-Prescription Guidelines

Drug Information and Compatibility

Ezetimibe, a cholesterol absorption inhibitor, works by inhibiting the NPC1L1 protein in the small intestine, reducing cholesterol absorption, and has documented drug-drug interactions with cyclosporine, fibrates, and bile acid sequestrants, but not with NSAIDs like meloxicam, according to the American College of Cardiology 1, 2, 3
The American College of Cardiology recommends that ezetimibe has no clinically significant interactions with meloxicam, a nonsteroidal anti-inflammatory drug (NSAID) that selectively inhibits cyclooxygenase-2 (COX-2) enzyme 1, 2, 3

The American College of Cardiology states that ezetimibe is generally well tolerated with common adverse effects including upper respiratory tract infection, diarrhea, arthralgia, sinusitis, and pain in extremities, and is not recommended in patients with moderate to severe hepatic impairment 1, 2, 3
Persistent elevations in hepatic transaminases may occur with concomitant statin therapy, requiring monitoring, and cases of myopathy and rhabdomyolysis have been reported when ezetimibe was used alone or with statins, but not with NSAIDs, according to the American College of Cardiology 1, 2, 3

When prescribing both medications together, the American College of Cardiology recommends monitoring for hepatic function, especially if the patient is also on statin therapy, and gastrointestinal symptoms, as both medications can independently cause GI effects 1, 2, 3

The American College of Cardiology recommends that ezetimibe is administered as 10 mg orally once daily, with or without food 1, 2, 3

The American College of Cardiology states that both medications should be used with caution during pregnancy due to limited safety data 1, 2, 3
In elderly patients, standard doses of ezetimibe can be used, while meloxicam should be started at the lower dose range (7.5 mg daily), according to the American College of Cardiology 3