Meloxicam / Rizatriptan Dosage

Medically reviewed by Drugs.com. Last updated on Apr 15, 2025.

Usual Adult Dose for Migraine

Recommended dose: Meloxicam 20 mg-rizatriptan 10 mg (1 tablet) orally as needed for acute migraine
Maximum daily dose: Meloxicam 20 mg-rizatriptan 10 mg (1 tablet) orally as a single dose

Comments:

• It is recommended to use this drug for the shortest duration consistent with individual treatment goals.
• Safety/efficacy have not been established for administration of a second dose for the same migraine attack or for treating more than 7 headaches (on average) in a 30-day period.
• Ensure benefit outweighs risk if used in older adults; administer therapy for fewest total days per month.
• Limitations of use: Therapy should only be used when a clear diagnosis of migraine has been established. If a patient has no response after treatment for the first migraine attack, reconsider diagnosis prior to using this drug to treat any subsequent attacks.
• Therapy is not indicated for the preventive treatment of migraine attacks or for the treatment of cluster headache.

Use: For the acute treatment of migraine with or without aura

Renal Dose Adjustments

Mild renal dysfunction: The manufacturer makes no recommendations.
Moderate to severe renal dysfunction: Use is not recommended

• In patients at risk for renal failure due to volume depletion: Contraindicated

End-stage renal disease on hemodialysis: Contraindicated

Liver Dose Adjustments

Liver dysfunction: Caution recommended.

Comments:

• Monitor for adverse reactions during use in patients with severe liver dysfunction; meloxicam is significantly metabolized by the liver and hepatotoxicity may occur.

Precautions

US BOXED WARNINGS:

• CARDIOVASCULAR RISK: Non-steroidal anti-inflammatory drugs (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. This drug is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.
• GASTROINTESTINAL (GI) RISK: NSAIDs cause an increased risk of serious GI adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Older patients and those with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.

CONTRAINDICATIONS:

• Known hypersensitivity (e.g., anaphylactic reactions and angioedema seen) to the active components (meloxicam, rizatriptan), NSAIDs, or any of the ingredients
• Ischemic coronary artery disease (angina pectoris, history of myocardial infarction, or documented silent ischemia), or other significant underlying cardiovascular disease
• Coronary artery vasospasm including Prinzmetal's angina
• In the setting of CABG surgery
• History of stroke or transient ischemic attack
• Hemiplegic or basilar migraine.
• Peripheral vascular disease (PVD)
• Ischemic bowel disease
• Uncontrolled hypertension
• Concomitant use of propranolol
• Recent use (i.e., within 24 hours) of an ergotamine-containing medication, ergot-type medication (such as dihydroergotamine or methysergide), or another 5-HT1 agonist (e.g., another triptan)
• Concurrent administration or recent discontinuation (i.e., within 2 weeks) of a MAO-A inhibitor
• History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Severe, sometimes fatal anaphylactic-like reactions to NSAIDs have been reported in such patients
• Moderate to severe renal insufficiency in patients who are at risk for renal failure due to volume depletion or who are on dialysis

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Contraindicated

Comments:

• Meloxicam it is highly bound to plasma proteins and efficient removal via dialysis is unlikely.
• No data available on hemodialysis or peritoneal dialysis with rizatriptan.

Other Comments

Administration advice:

• For oral use; may administer with or without food
• Swallow each tablet whole; do not crush, divide, or split.

Storage requirements:

• Store in the original bottle at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F).

General:

• It is not recommended to substitute this drug with similar dose strengths of other oral formulations of meloxicam or rizatriptan products; systemic exposure is not equivalent.
• Health care providers should review the manufacturer product information prior to prescribing; this product has extensive warnings and contraindications.

Monitoring:

• Cardiovascular: Cardiovascular evaluation (at baseline in patients with risk factors); blood pressure (at baseline and periodically during therapy, especially in patients treated for hypertension); for worsening disease in patients with heart failure (during therapy); for cardiac ischemia in patients with recent MI (during therapy)
• Gastrointestinal: For GI ulceration and bleeding especially with concomitant NSAID, aspirin, or anticoagulants use (during therapy)
• General: Chemistry profile (during long-term NSAID therapy); for adverse effects in older adults or poor CYP450 2C9 metabolizers (during therapy)
• Hematologic: Hemoglobin and hematocrit in patients with symptoms of anemia (during therapy); complete blood count (during long-term NSAID therapy)
• Hepatic: For signs and symptoms of hepatotoxicity such as nausea, fatigue, lethargy, diarrhea, pruritus, jaundice, right upper quadrant tenderness, and "flu-like" symptoms (during therapy)
• Metabolic: Volume status and/or for hypovolemia (prior to and during therapy)
• Other: Chest/throat/neck/jaw pain, tightness, pressure, or heaviness in at-risk patients (during therapy)
• Renal: Kidney function in patients with renal/hepatic impairment, heart failure, dehydration, or hypovolemia (during therapy)
• Respiratory: For asthma changes or exacerbations in patients with asthma (during therapy)

Patient advice:

• Read the US FDA-approved patient labeling (Medication Guide).
• Seek immediate medical attention if an anaphylactic reaction occurs and seek emergency help.
• Know that use of acute migraine drugs for 10 or more days per month may cause headache exacerbation.
• Recognize and report any symptoms of the following to your health care provider:
• GI adverse events including bleeding and/or ulceration
• Cardiovascular thrombotic events or signs/symptoms of adverse cardiovascular events
• Warning signs and/or symptoms of hepatotoxicity
• New or worsening heart failure
• Fever or rash
• Understand that combined use of SSRIs or SNRIs may increase risk of serotonin syndrome.
• Discuss use of low-dose aspirin or other NSAIDs with your health care provider prior to concomitant use.
• Speak to a healthcare provider if you become pregnant, intend to become pregnant, or are breastfeeding.

See also:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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