Meloxicam Injection

Brand Name(s): Anjeso®; also available generically

WHY is this medicine prescribed?

Meloxicam injection is used alone or in combination with other pain medications for the short-term relief of moderate to severe pain in adults, usually after surgery. Meloxicam is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.

HOW should this medicine be used?

Meloxicam injection comes as a solution (liquid) to inject intravenously (into a vein). It is usually given once a day as needed for pain by a healthcare provider in a hospital.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before using meloxicam injection,

• tell your doctor and pharmacist if you are allergic to meloxicam, aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), any other medications, or any of the ingredients in meloxicam injection. Ask your doctor or pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: amiodarone (Nexterone, Pacerone); angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Epaned, Vasotec, in Vaseretic), fosinopril, lisinopril (in Zestoretic), moexepril, perindopril (in Prestalia), quinapril (Accupril, in Accuretic, in Quinaretic), ramipril (Altace), and trandolapril (in Tarka) ; angiotensin receptor blockers such as azilsartan (Edarbi, in Edarbyclor), candesartan (Atacand, in Atacand HCT), eprosartan, irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor, in Benicar HCT, in Tribenzor), telmisartan (Micardis, in Micardis HCT, in Twynsta), and valsartan (Diovan, in Entresto, in Diovan HCT, in Exforge, in Exforge HCT); beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Kapspargo sprinkle, Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, Innopran); cholestyramine (Prevalite); cyclosporine (Gengraf, Neoral, Sandimmune); diuretics ('water pills'); fluconazole (Diflucan); lithium (Lithobid); methotrexate (Otrexup, Rasuvo, Reditrex, Trexall, Xatmep); pemetrexed (Alimta); and phenytoin (Dilantin, Phenytek). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have kidney disease or if you have or recently have had severe vomiting or diarrhea or think you may be dehydrated. Your doctor may not want you to receive meloxicam injection.
• tell your doctor if you have or have ever had any of the conditions mentioned in the IMPORTANT WARNING section; asthma, especially if you have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose); heart failure; high levels of potassium in the blood; swelling of the hands, feet, ankles, or lower legs; or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant; or are breast-feeding. Meloxicam injection may harm the fetus and cause problems with delivery if it is used around 20 weeks or later during pregnancy. Do not use meloxicam injection around or after 20 weeks of pregnancy, unless you are told to do so by your doctor. If you become pregnant while receiving meloxicam injection, call your doctor.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?

Meloxicam injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• constipation
• diarrhea
• pain or itching at injection site

• fever
• blisters
• rash
• skin blisters or peeling
• hives
• itching
• swelling of the eyes, face, tongue, lips, or throat
• difficulty breathing or swallowing
• pale skin
• fast heartbeat
• shortness of breath or difficulty breathing
• unexplained weight gain,
• swelling in the abdomen, ankles, feet, or legs
• nausea
• excessive tiredness
• lack of energy
• yellowing of the skin or eyes
• pain in the right upper part of the stomach
• flu-like symptoms
• cloudy, discolored, or bloody urine
• back pain
• difficult or painful urination

Meloxicam injection may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• lack of energy
• drowsiness
• nausea
• vomiting
• stomach pain
• bloody, black, or tarry stools
• vomit that is bloody or looks like coffee grounds
• difficulty breathing
• coma

What OTHER INFORMATION should I know?

Ask your doctor or pharmacist any questions you have about meloxicam injection.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

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