Drug Interaction Report

MONITOR: Coadministration with CYP450 2C9 inhibitors may increase the plasma concentration of meloxicam, which has been shown to be primarily metabolized by this isoenzyme. In a study of healthy volunteers, voriconazole, a weak CYP450 2C9 inhibitor increased the systemic exposure of meloxicam by 47% and prolonged the average meloxicam half-life by 51%.

MANAGEMENT: The potential for an interaction should be considered during concomitant 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.

ADJUST DOSING INTERVAL: Food may reduce the oral absorption and bioavailability of zafirlukast. In two separate studies, one using a high-fat and the other a high-protein meal, administration of zafirlukast with food reduced the mean bioavailability by approximately 40%.

MANAGEMENT: To ensure maximal oral absorption, zafirlukast should be administered at least 1 hour before or 2 hours after meals.