Clinical pharmacokinetics of meloxicam - A cyclo-oxygenase-2 preferential nonsteroidal anti-inflammatory drug

Meloxicam [4-hydroxy-2-methyl-N-(5-methyl-2-thiazolyl)-2H-1,2-benzothiazine -3-carboxamide-1,1-dioxide] is a nonsteroidal anti-inflammatory drug (NSAID ) of the oxicam class which shows preferential inhibition of cyclo-oxygenas e-2. Meloxicam has a plasma half-life of approximately 20 hours, making it conve nient for once-daily administration. Meloxicam is eliminated after biotrans formation to 4 pharmacologically inactive metabolites, which are excreted i n urine and faeces. Meloxicam and its metabolites bind extensively to plasm a albumin. Substantial concentrations of meloxicam are attained in synovial fluid, the proposed site of action in chronic inflammatory arthropathies. Neither moderate renal nor hepatic insufficiency significantly alter the ph armacokinetics of meloxicam. Dosage adjustment is not required in the elder ly. Drug-drug interaction studies are available for some commonly co-prescr ibed medications. Concentration-dependent therapeutic and toxicological eff ects have yet to be extensively elucidated for this NSAID.