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Concomitantly use with angiotensin converting enzyme (ACE) inhibitors, or angiotensin II antagonists may diminish the antihypertensive effect of such drugs.
Concomitantly use with aspirin increases the plasma concentration of Meloxicam, therefore increases adverse drug reactions, especially gastrointestinal ulcers. Coadministration of aspirin or Meloxicam with other NSAIDs is not recommended. Meloxicam is not a substitute for aspirin for cardiovascular prophylaxis.
Concomitantly use with bile acid sequestrants such as cholestyramine can increase plasma clearance of Meloxicam.
Concomitantly use of NSAIDs and diuretics such as furosemide or thiazide can reduce renal blood flow because of decreased prostaglandin synthesis. It is also found reduced natriuresis in some patients. Drug interaction between Meloxicam and furosemide is not found, though. Concomitantly use with diuretics requires closely observing of sign of renal failure as well as diuretic efficacy.
Concomitantly use with lithium increases lithium plasma concentration, following the inhibition of prostaglandin synthesis and decreased renal blood flow, resulting in reduced elimination of lithium.
Closely monitor for sign of lithium toxicity when Meloxicam is introduced, adjusted, or withdrawn.
Concomitantly use of methotrexate and other NSAIDs may increase risk of methotrexate toxicity. Though drug interaction of Meloxicam and methotrexate has not been found, concomitantly use with caution.
Concomitantly use of the drug, as well as other NSAIDs, and warfarin or antiplatelets or anticoagulants, increases the risk of gastrointestinal hemorrhage, and other bleeding. Use with caution and closely monitor prothrombin time and INR, particularly in a first few days after initiating or changing Meloxicam therapy in such patients.
Concomitantly use of the drug, as well as other NSAIDs, with cyclosporine is risk the cyclosporine toxicity; use with caution.
Concomitantly use of the drug and cimetidine or digoxin does not affect pharmacokinetics among the drugs.
