MajorNSAID, COX-2 preferential, oxicam derivative×Vitamin K antagonist anticoagulants
Updated · Methodology
Mechanism
Meloxicam (preferential COX-2 NSAID) inhibits platelet aggregation less than non-selective NSAIDs but still injures the gastric mucosa. On warfarin, bleeding risk rises moderately.
Symptoms
Gum bleeding, epistaxis, bruising without trauma, blood in urine or stool, menorrhagia. Severe cases include gastrointestinal or intracranial haemorrhage. Risk rises in patients over 65 and with prior peptic ulcer disease.
Management
When unavoidable, use the minimum effective meloxicam dose for short courses under pantoprazole cover. Check INR at 1 week. For chronic needs, celecoxib or paracetamol are preferable.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Meloxicam tablet (Terrain Pharmaceuticals, Inc.) – Prescribing Information section 7 (2012)– ; DailyMed setid b603255e-1fcf-42ec-ab62-9aa321cb7ac6
- AEMPS: Ficha técnica: Meloxicam (nº registro 66400), sección 4.5 (2023)– AEMPS, CIMA, nº registro 66400, revisión 11/2023, sección 4.5