Generic Name: meloxicam (Oral route)
NSAIDs cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use. Meloxicam is contraindicated in the setting of CABG surgery. NSAIDs also cause an increased risk of serious gastrointestinal (GI) adverse events, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. Elderly patients and those with a prior history of peptic ulcer disease or GI bleeding are at a greater risk for serious GI events .
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Analgesic
Pharmacologic Class: NSAID
Chemical Class: Oxicam
Uses For Vivlodex
Meloxicam is an nonsteroidal anti-inflammatory drug (NSAID) used to relieve the symptoms of arthritis (juvenile rheumatoid arthritis, osteoarthritis, and rheumatoid arthritis), such as inflammation, swelling, stiffness, and joint pain. However, this medicine does not cure arthritis and will only help you as long as you continue to take it.
This medicine is available only with your doctor's prescription.
Before Using Vivlodex
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of meloxicam oral liquid or tablets in children with juvenile rheumatoid arthritis 2 years of age and older.
Appropriate studies have not been performed on the relationship of age to the effects of meloxicam capsules in the pediatric population. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of meloxicam in the elderly. However, elderly patients are more likely to have serious stomach, heart, or kidney problems, which may require caution and an adjustment in the dose for patients receiving this medicine.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amtolmetin Guacil
- Bismuth Subsalicylate
- Choline Magnesium Trisalicylate
- Choline Salicylate
- Dabigatran Etexilate
- Ethacrynic Acid
- Flufenamic Acid
- Magnesium Salicylate
- Mefenamic Acid
- Niflumic Acid
- Nimesulide Beta Cyclodextrin
- Pentosan Polysulfate Sodium
- Phenyl Salicylate
- Protein C
- Salicylic Acid
- Sodium Polystyrene Sulfonate
- Sodium Salicylate
- Tiaprofenic Acid
- Tolfenamic Acid
- Trolamine Salicylate
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Azilsartan Medoxomil
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Anemia or
- Asthma or
- Bleeding problems or
- Congestive heart failure or
- Dehydration or
- Edema (fluid retention or body swelling) or
- Heart attack, history of or
- Heart or blood vessel disease or
- Hyperkalemia (high blood potassium) or
- Hypertension (high blood pressure) or
- Kidney disease or
- Liver disease or
- Stomach ulcers or bleeding, history of or
- Stroke, history of—Use with caution. May make these conditions worse.
- Aspirin-sensitive asthma or
- Aspirin sensitivity, history of—Should not be used in patients with these conditions.
- Heart surgery (eg, coronary artery bypass graft [CABG])—Meloxicam should not be used for pain right before or after the surgery.
Proper Use of meloxicam
This section provides information on the proper use of a number of products that contain meloxicam. It may not be specific to Vivlodex. Please read with care.
For safe and effective use of this medicine, do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Taking too much of this medicine may increase the chance of side effects.
This medicine should come with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.
Shake the oral liquid well before each use. Measure the dose with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.
Swallow the capsule or tablet whole. Do not crush, break, or chew it.
You may take this medicine with or without food.
Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way. If you refill your medicine and it looks different, check with your pharmacist.
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage form (capsules):
- For osteoarthritis:
- Adults—At first, 5 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 10 mg per day.
- Children—Use and dose must be determined by your doctor.
- For osteoarthritis:
- For oral dosage forms (suspension or tablets):
- For juvenile rheumatoid arthritis:
- Children 2 years of age and older—Dose is based on body weight and must be determined by your doctor. The dose is 0.125 milligram (mg) per kilogram (kg) of body weight once a day. Your doctor may increase the dose as needed. However, the dose is usually not more than 7.5 mg once a day.
- Children younger than 2 years of age—Use and dose must be determined by your doctor.
- For osteoarthritis or rheumatoid arthritis:
- Adults—At first, 7.5 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 15 mg once a day.
- Children—Use and dose must be determined by your doctor.
- For juvenile rheumatoid arthritis:
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Precautions While Using Vivlodex
It is very important that your doctor check your or your child's progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.
This medicine may increase your risk of having a heart attack or stroke. This is more likely to occur in people who already have heart and blood vessel disease and who are using this medicine for a long time. Check with your doctor right away if you are having chest pain or discomfort, nausea or vomiting, pain or discomfort in the arms, jaw, back, or neck, shortness of breath, slurred speech, or weakness.
Meloxicam may cause bleeding in your stomach or intestines. This problem can happen without warning signs. This is more likely to occur if you or your child have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, if you are over 60 years of age, are in poor health, or are using certain other medicines (such as steroids or a blood thinner).
Liver problems may occur while you are using this medicine. Check with your doctor right away if you or your child are having more than one of these symptoms: abdominal or stomach pain or tenderness, clay-colored stools, dark urine, decreased appetite, fever, headache, itching, loss of appetite, nausea and vomiting, skin rash, swelling of the feet or lower legs, unusual tiredness or weakness, or yellow eyes or skin.
Serious side effects can occur during treatment with this medicine. Sometimes serious side effects can occur without warning. However, possible warning signs often occur, including severe stomach pain, black tarry stools, and/or vomiting of blood or material that looks like coffee grounds, skin rash, swelling of the face, fingers, feet, and/or lower legs. Also, signs of serious heart problems could occur such as chest pain, tightness in the chest, fast or irregular heartbeat, or unusual flushing or warmth of the skin. Check with your doctor immediately if you or your child notice any of these warning signs.
Meloxicam may cause a serious type of allergic reaction called anaphylaxis. Although this is rare, it may occur often in patients who are allergic to aspirin or other nonsteroidal anti-inflammatory drugs. Anaphylaxis can be life-threatening and requires immediate medical attention. The most serious signs of this reaction are very fast or irregular breathing, gasping for breath, or fainting. Other signs may include changes in skin color of the face, very fast but irregular heartbeat or pulse, hive-like swellings on the skin, puffiness or swelling of the eyelids or around the eyes. If these effects occur, get emergency help at once. Ask someone to drive you to the nearest hospital emergency room. Call an ambulance, lie down, cover yourself to keep warm, and prop your feet higher than your head. Stay in that position until help arrives.
Serious skin reactions can occur during treatment with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you or your child are using this medicine.
Using this medicine during the later part of a pregnancy can harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away.
This medicine may cause a delay in ovulation for women and may affect their ability to have children. If you plan to have children, talk with your doctor before using this medicine.
Tell your doctor if you have unexplained weight gain or edema (fluid retention or body swelling) with this medicine.
Mobic® oral liquid contains sorbitol which may cause a very serious bowel problem when taken with sodium polystyrene sulfonate (Kayexalate®). Do not take the oral liquid together with Kayexalate®.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Vivlodex Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:Less common
- Arm, back, or jaw pain
- bleeding gums
- blood in the urine
- blurred vision
- burning upper abdominal or stomach pain
- canker sores
- chest tightness or heaviness
- cloudy urine
- dark urine
- decreased frequency or amount of urine
- difficult or labored breathing
- dilated neck veins
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- general tiredness and weakness
- hives or welts
- increased blood pressure
- increased sensitivity of the skin to sunlight
- increased thirst
- irregular breathing
- itching, redness, or other discoloration of the skin
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- light-colored stools
- loss of appetite
- lower side or back pain
- noisy breathing
- pain or discomfort in the arms, jaw, back, or neck
- painful or difficult urination
- pains in the stomach, side, or abdomen, possibly radiating to the back
- pinpoint red or purple spots on the skin
- pounding in the ears
- redness, soreness, or itching skin
- severe and continuing nausea
- severe sunburn
- shakiness in the legs, arms, hands, or feet
- skin blisters
- sore throat
- sores, ulcers, or white spots on the lips or tongue or inside the mouth
- sores, welting, or blisters
- stomach bloating, burning, cramping, tenderness, or pain
- swelling or puffiness of the face
- swollen glands
- trembling or shaking of the hands or feet
- trouble breathing
- unusual bleeding or bruising
- upper right abdominal or stomach pain
- watery or bloody diarrhea
- weight gain or loss
- yellow eyes or skin
- Area rash
- blistering, peeling, or loosening of the skin
- bloody or black, tarry stools
- clay-colored stools
- cold, clammy skin
- continuing vomiting
- cough or hoarseness
- cracks in the skin
- difficulty with swallowing
- fast, weak pulse
- fever with or without chills
- greatly decreased frequency of urination or amount of urine
- joint or muscle pain
- loss of heat from the body
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- red skin lesions, often with a purple center
- red, irritated eyes
- red, swollen skin
- scaly skin
- severe stomach pain
- tightness in the chest
- unpleasant breath odor
- unusual tiredness or weakness
- vomiting of blood or material that looks like coffee grounds
- Difficulty with speaking
- double vision
- inability to move the arms, legs, or facial muscles
- inability to speak
- pains in the chest, groin or legs, especially the calves
- severe headaches of sudden onset
- slow speech
- sudden loss of coordination
- sudden onset of shortness of breath for no apparent reason
- sudden onset of slurred speech
- sudden vision changes
Get emergency help immediately if any of the following symptoms of overdose occur:Symptoms of overdose
- Blue lips, fingernails, or skin
- convulsions (seizures)
- pain in the chest, upper stomach, or throat
- severe stomach pain
- skin rash
- slow or fast heartbeat
- swelling around the eyes, face, lips, or tongue
- weight gain (rapid)
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- Abdominal or stomach pain
- abnormal dreaming
- appetite increased
- bad, unusual, or unpleasant after taste
- bloated or full feeling
- burning feeling in the chest or stomach
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- burning, dry, or itching eyes
- change in taste
- changes in vision
- continuing ringing or buzzing or other unexplained noise in the ears
- decreased urination
- dry mouth
- excess air or gas in the stomach
- excessive tearing
- feeling of constant movement of self or surroundings
- feeling sad or empty
- general feeling of discomfort or illness
- hair loss
- hearing loss
- hot flushes
- loss of interest or pleasure
- nausea or vomiting
- pain or burning in the throat
- rapid breathing
- redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
- sensation of spinning
- stomach upset
- sunken eyes
- tenderness in the stomach area
- thinning of the hair
- trouble concentrating
- trouble sleeping
- wrinkled skin
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
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Other brands: Mobic