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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Symbravo
Generic Name
Meloxicam, Rizatriptan
Active Ingredient
MeloxicamCategory
Nonsteroidal Anti-inflammatory Drug [EPC]
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 20 mg/1 | TABLET | ORAL | 81968-020 |
Detailed information about Symbravo
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Symbravo, you must consult a qualified healthcare professional.
Meloxicam is a potent nonsteroidal anti-inflammatory drug (NSAID) used primarily to treat pain and inflammation associated with arthritic conditions. It belongs to the oxicam class and is known for its relatively long half-life, allowing for once-daily dosing.
The goal of Meloxicam therapy is to use the lowest effective dose for the shortest duration possible to minimize the risk of serious side effects.
Meloxicam is approved for the treatment of Juvenile Rheumatoid Arthritis (JRA) in children who weigh at least 60 kg (approximately 132 lbs).
Patients with mild to moderate renal (kidney) impairment typically do not require a dose adjustment. However, Meloxicam is not recommended for patients with severe renal impairment (CrCl < 20 mL/min). In patients undergoing hemodialysis, the maximum daily dose should not exceed 7.5 mg, as the drug is not dialyzable and can accumulate in the system.
No dose adjustment is generally necessary for patients with mild to moderate hepatic (liver) impairment (Child-Pugh Class A and B). Meloxicam has not been adequately studied in patients with severe hepatic impairment (Child-Pugh Class C), and caution is advised in this population.
Older adults are at a higher risk for serious GI and renal complications from NSAIDs. Healthcare providers often start elderly patients at the lowest possible dose (7.5 mg) and monitor kidney function closely.
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and return to your regular schedule. Do not double the dose to catch up, as this significantly increases the risk of toxicity and stomach irritation.
Symptoms of a Meloxicam overdose may include extreme lethargy, drowsiness, nausea, vomiting, and epigastric pain (pain in the upper abdomen). In severe cases, overdose can lead to gastrointestinal bleeding, hypertension (high blood pressure), acute renal failure, respiratory depression, and coma.
If an overdose is suspected, contact your local poison control center or seek emergency medical attention immediately. There is no specific antidote for Meloxicam. Treatment is supportive and may involve gastric lavage (stomach pumping) or the administration of activated charcoal if the overdose occurred recently.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or stop the medication without medical guidance, as this could lead to a return of inflammatory symptoms or increased risk of side effects.
Most side effects associated with Meloxicam are related to the gastrointestinal system. Common symptoms include:
These side effects are often mild and may diminish as your body adjusts to the medication. If they persist, your doctor may suggest taking the medication with food.
> Warning: Stop taking Meloxicam and call your doctor immediately if you experience any of these serious symptoms.
Prolonged use of Meloxicam increases the cumulative risk of several conditions:
Meloxicam carries the strictest FDA warning, known as a Black Box Warning, for two major categories of risk:
Report any unusual symptoms to your healthcare provider immediately. Regular blood work is often recommended for those on long-term therapy to monitor for these risks.
Meloxicam is a powerful medication that requires careful oversight. Patients should be aware that while it is effective for pain, it does not cure the underlying cause of arthritis and must be managed as part of a broader treatment plan. You should always inform every healthcare provider you visit that you are taking an NSAID, especially before any surgical or dental procedures.
Cardiovascular Thrombotic Events: Clinical trials of several COX-2 selective and nonselective NSAIDs of up to three years duration have shown an increased risk of serious cardiovascular (CV) thrombotic events, myocardial infarction, and stroke, which can be fatal. All NSAIDs, both COX-2 selective and nonselective, may have a similar risk. Patients with known CV disease or risk factors for CV disease may be at greater risk.
Gastrointestinal Bleeding, Ulceration, and Perforation: NSAIDs, including Meloxicam, cause an increased risk of serious gastrointestinal (GI) adverse events including inflammation, bleeding, ulceration, and perforation of the stomach, small intestine, or large intestine, which can be fatal. These events can occur at any time during use and without warning symptoms.
Because of the risks associated with long-term Meloxicam use, healthcare providers typically require periodic monitoring:
While Meloxicam does not typically cause significant sedation, some patients may experience dizziness, vertigo, or visual disturbances. If you experience these side effects, do not drive or operate heavy machinery until you know how the medication affects you.
Combining alcohol with Meloxicam significantly increases the risk of stomach bleeding and ulcers. It is generally advised to avoid or strictly limit alcohol consumption while taking any NSAID.
Meloxicam does not typically cause a 'withdrawal' syndrome, but stopping it suddenly may cause a rapid return of arthritis symptoms, including severe pain and stiffness. If you need to stop the medication, discuss a management plan with your doctor to control the underlying inflammation.
> Important: Discuss all your medical conditions, especially heart disease, high blood pressure, or a history of stomach ulcers, with your healthcare provider before starting Meloxicam.
Several supplements have natural anti-platelet properties and can increase bleeding risk when taken with Meloxicam:
Meloxicam does not typically interfere with standard laboratory tests, but its effect on the kidneys can cause temporary elevations in Serum Creatinine and Blood Urea Nitrogen (BUN). It may also cause a false-positive result in some fecal occult blood tests if the drug has caused minor GI irritation.
For most interactions, the management strategy involves:
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking. Even 'natural' supplements can have dangerous interactions with Meloxicam.
There are several scenarios where Meloxicam must NEVER be used due to the high risk of fatal complications:
These are conditions where the risks of Meloxicam may outweigh the benefits, requiring a careful risk-benefit analysis by a physician:
There is a high rate of cross-sensitivity between Meloxicam and other oxicams (like piroxicam). If you have had a severe skin reaction or allergic response to one oxicam, you should avoid the entire class. Additionally, cross-reactivity with aspirin and other NSAIDs (ibuprofen, naproxen, diclofenac) is common in patients with respiratory-related aspirin sensitivity.
> Important: Your healthcare provider will evaluate your complete medical history, including any previous reactions to pain medications, before prescribing Meloxicam.
There is limited data on the presence of Meloxicam in human breast milk. However, because it is highly protein-bound, the amount transferred to the infant is likely low. Because of the potential for serious adverse reactions in nursing infants from Meloxicam, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Meloxicam is FDA-approved for the treatment of Juvenile Rheumatoid Arthritis (JRA) in children aged 2 years and older. The safety and effectiveness in children younger than 2 or for conditions other than JRA have not been established. Growth monitoring is generally recommended for children on long-term NSAID therapy, although NSAIDs are not typically associated with growth suppression like corticosteroids.
Elderly patients (65 and older) are at the highest risk for NSAID-related complications.
> Important: Special populations require individualized medical assessment. Always disclose your pregnancy status or any age-related health concerns to your doctor.
Meloxicam is a member of the oxicam family of NSAIDs. Its primary mechanism of action is the inhibition of the enzyme cyclooxygenase (COX). Specifically, it inhibits the conversion of arachidonic acid into prostaglandins, which are the primary mediators of inflammation, pain, and fever.
At the molecular level, Meloxicam fits into the active site of the COX enzyme. While most traditional NSAIDs are non-selective (inhibiting both COX-1 and COX-2 equally), Meloxicam demonstrates a 'preferential' inhibition of COX-2. COX-2 is primarily responsible for producing prostaglandins at sites of inflammation, whereas COX-1 produces prostaglandins that protect the stomach lining and aid kidney function. However, this selectivity is dose-dependent; at higher doses (15 mg), the selectivity for COX-2 diminishes, and the inhibition of COX-1 increases, which explains the higher rate of GI side effects at the 15 mg dose compared to the 7.5 mg dose.
| Parameter | Value |
|---|---|
| Bioavailability | ~89% |
| Protein Binding | 99.4% (Primarily Albumin) |
| Half-life | 15–20 hours |
| Tmax (Time to Peak) | 4–12 hours |
| Metabolism | Hepatic (CYP2C9, CYP3A4) |
| Excretion | Renal 50%, Fecal 50% |
Meloxicam is classified as a Nonsteroidal Anti-inflammatory Drug (NSAID) within the Oxicam subclass. Related medications in the same subclass include Piroxicam (Feldene), though Piroxicam is much less selective for COX-2 and generally has a higher rate of GI side effects.
Common questions about Symbravo
Meloxicam is primarily used to treat the chronic pain, swelling, and stiffness associated with various types of arthritis. It is FDA-approved for osteoarthritis, rheumatoid arthritis, and juvenile rheumatoid arthritis in children aged two and older. By reducing the production of prostaglandins, it helps manage the daily discomfort that comes with joint inflammation. It is also sometimes used off-label for other musculoskeletal conditions like ankylosing spondylitis. Because of its long-lasting effects, it is particularly useful for patients who prefer a once-daily medication schedule. Always use it under the guidance of a healthcare professional.
The most frequently reported side effects of Meloxicam involve the digestive system, including indigestion (dyspepsia), nausea, stomach pain, and diarrhea. Some patients also experience headaches, dizziness, or mild swelling in the hands and feet due to fluid retention. These symptoms are often mild and may improve as your body adjusts to the medication. However, if you notice black, tarry stools or severe stomach pain, you should contact your doctor immediately as these could be signs of a serious gastrointestinal bleed. Taking the medication with food can often help mitigate the milder stomach-related side effects. Always report new or worsening symptoms to your provider.
It is generally recommended that you avoid or strictly limit alcohol consumption while taking Meloxicam. Both alcohol and NSAIDs like Meloxicam can irritate the lining of the stomach and intestines. When used together, they significantly increase the risk of developing stomach ulcers and life-threatening gastrointestinal bleeding. Even moderate alcohol consumption can increase the strain on your kidneys and liver when combined with this medication. If you have a history of heavy alcohol use, you must discuss this with your doctor before starting Meloxicam. Safety is the priority when managing chronic pain.
Meloxicam is generally not recommended during pregnancy, especially as you approach the later stages. The FDA warns against using NSAIDs like Meloxicam starting at 20 weeks of pregnancy because it can cause rare but serious kidney problems in the fetus, leading to low amniotic fluid levels. Furthermore, taking Meloxicam during the third trimester (after 30 weeks) is strictly contraindicated because it can cause a vital blood vessel in the baby's heart to close prematurely. This can lead to permanent heart and lung damage in the newborn. If you are pregnant or planning to become pregnant, talk to your doctor about safer alternatives for pain management. Always consult your obstetrician before taking any new medication.
The time it takes for Meloxicam to work depends on the type of relief you are seeking. You may feel some minor pain relief within the first 24 to 48 hours of starting the medication. However, for conditions like rheumatoid arthritis or osteoarthritis, the full anti-inflammatory benefits—such as reduced joint swelling and improved range of motion—usually take one to two weeks of consistent daily use to become fully apparent. Because Meloxicam is absorbed slowly by the body, it is not an ideal medication for treating sudden, acute pain that requires immediate relief. Consistency is key to achieving the best results with this medication. Do not increase your dose if you don't feel immediate relief; wait for the medication to build up in your system.
You can physically stop taking Meloxicam suddenly without experiencing a 'withdrawal' syndrome like those associated with opioids or certain antidepressants. However, because Meloxicam manages the symptoms of chronic conditions like arthritis, stopping it abruptly will likely cause a rapid return of your pain, stiffness, and inflammation. If you have been taking it for a long time, your doctor might suggest a gradual reduction or provide an alternative therapy to ensure your symptoms remain controlled. It is always best to consult your healthcare provider before stopping any chronic medication. They can help you determine the best way to transition off the drug safely. Never stop the medication if you are taking it for an active inflammatory flare-up without medical advice.
If you miss a dose of Meloxicam, take it as soon as you remember. If it is already close to the time for your next scheduled dose, skip the missed dose entirely and continue with your regular once-daily schedule. You should never take two doses at the same time to 'make up' for a missed one, as this significantly increases your risk of stomach irritation and other side effects. Because Meloxicam has a long half-life, missing one dose is unlikely to cause an immediate return of severe symptoms, but consistency is important for long-term inflammation control. Setting a daily alarm can help you stay on track. If you frequently forget your doses, discuss strategies with your pharmacist.
Meloxicam does not typically cause weight gain in the form of increased body fat. However, like many NSAIDs, it can cause the body to retain sodium and water, which may lead to 'fluid weight' gain. This often manifests as swelling (edema) in the ankles, feet, or hands. If you notice a sudden, significant increase in weight over a day or two, or if the swelling is accompanied by shortness of breath, you should contact your doctor immediately. This could be a sign that the medication is affecting your heart or kidney function. Most fluid retention associated with Meloxicam is mild and manageable. Monitoring your salt intake can sometimes help reduce this effect.
Meloxicam has several significant drug interactions that must be carefully managed. It should not be taken with other NSAIDs like ibuprofen or naproxen, as this increases the risk of stomach ulcers and kidney damage. It can also interact dangerously with blood thinners like warfarin, increasing the risk of bleeding, and with certain blood pressure medications, making them less effective. Additionally, Meloxicam can increase the levels of lithium or methotrexate in your blood, potentially leading to toxicity. Always provide your doctor and pharmacist with a complete list of all medications, including over-the-counter drugs and herbal supplements. They can check for interactions and adjust your treatment plan accordingly.
Yes, Meloxicam is widely available as a generic medication, which makes it a very cost-effective option for long-term arthritis management. The generic versions are bioequivalent to the original brand-name drug, Mobic, meaning they contain the same active ingredient and work the same way in the body. Generic Meloxicam is available in several strengths, most commonly 7.5 mg and 15 mg tablets. Most insurance plans cover the generic version of Meloxicam with a low copay. While there are some specialized brand-name versions like Vivlodex or Qmiiz ODT, the standard generic tablet is the most frequently prescribed form. Talk to your pharmacist to ensure you are getting the most affordable version for your needs.
Other drugs with the same active ingredient (Meloxicam)