Drug Interactions between meloxicam and sulfamethoxazole

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with CYP450 2C9 inhibitors may increase the plasma concentrations of meloxicam. The proposed mechanism is inhibition of the CYP450 2C9-mediated metabolism of meloxicam, which has been shown in vitro to be primarily metabolized by this isoenzyme, and, to a lesser extent, by CYP450 3A4. In a study involving healthy volunteers, voriconazole (a weak CYP450 2C9 inhibitor) increased meloxicam's systemic exposure by 47% and extended its average half-life by 51%. Patients who are known or suspected poor CYP450 2C9 metabolizers may be at increased risk for elevated plasma levels due to decreased metabolic clearance of meloxicam. Clinical data on the use of meloxicam with other, more potent CYP450 2C9 inhibitors are lacking.

MANAGEMENT: The potential for an interaction should be considered during concomitant use. Some manufacturers advise against their combined use. If coadministration is required, monitor patients for NSAID-related side effects and toxicity, including gastrointestinal bleeding or perforation. Dose adjustment of meloxicam may be warranted. Refer to the prescribing information for each medication for additional guidance.