Melocam is a selective COX-2 inhibitor that provides strong anti-inflammatory, analgesic, and antipyretic effects without the side effects of COX-1 inhibitors like non-selective NSAIDs. It has high bioavailability, a long half-life, and reaches therapeutic concentrations in synovial fluid. Melocam demonstrates efficacy in arthritis pain relief comparable to other NSAIDs but has a better safety profile with fewer gastrointestinal and renal side effects. It also does not affect platelet aggregation like other NSAIDs. Melocam's pharmacokinetics allow for once daily dosing, improving compliance, and it is cost-effective for long-term arthritis treatment.

2. Melocam(meloxicam)
..belongs to the oxicam derivatives and it
is one of the most strong NSAIDs.
..as a selective inhibitor for COX-2,
retains the anti-inflammatory, analgesic
& antipyretic actions without the harmful
side effects of COX-1 inhibitors.

3. Membrane Phospholipids
Phospholipase A2
Arachidonic F.A.
Cyclooxygenase (COX)
Prostaglandins
Thromboxan A2
Prostacyclins

4. cylooxygenase
(COX)
COX-1
Maintains normal
physiological functions
COX-2
Involved in
inflammation &
pain

5. 
Non-Selective NSAIDs
COX-1
Side effects
Stomach
Kidney
Platelets
COX-1
Therapeutic effects
Anti-inflammatory
Analgesic
Antipyretic

6. pharmacokinetic profile of meloxicam
..Prolonged and complete absorption after oral
administration.
..Bioavailability of 89%.
..Not affected by concomitant intake of food.
..More than 99 % bound to plasma protein.

7. ..Elimination half-life is 20-24 hours.
..During distribution, meloxicam penetrates the
synovial fluid, reaching concentrations are 45-57% of
those in plasma.
..Meloxicam was found in synovial fluid 1 hour after
administration and reached peak concentrations at
approximately 6 hours.

8. …Intramuscular meloxicam is rapidly absorbed, reaches
Cmax at 1.5 hours after injection, and its absolute
bioavailability is 100%.
..90% of the Cmax is reached within 30 min of injection.
..Concentrations tend to remain stable for at least 5-6
hours, these data support the use of intramuscular
meloxicam in patients with acute arthropathies, since
it provides a fast relief of pain and inflammation.

9.  pharmacokinetic profile of meloxicam is not altered in :
 elderly patients
 mild to moderate renal impairment
 mild hepatic impairment

10. Indications
Immunological
Rheumatoid arthritis
Ankylosing spondylitis
Degenerative
Osteoarthritis
Musculoskeletal injuries:Skeletal trauma
Fracture
Dislocation & subluxation
Sprains & Strains
Tendinitis & bursitis
Muscle strains
Melocam Ampoules
Acute pain of any origin

11. efficacy
safety

12. Melocam is a selective Cox2 inhibitor which
shows high anti-inflammatory & analgesic
potency in the management of arthritis.
..Due to its selectivity on Cox 2 enzyme,
Melocam doesn't create the usual
problems of classic NSAIDs

14. How to solve this chronic
problem
without creating problems?

15. Proven Efficacy
….A multicentre, double-blind, study was conducted in
patients with osteoarthritis (OA) of the hip or knee in
order to compare the efficacy of Meloxicam, with
Diclofenac sodium.
…336 patients were treated with oral Meloxicam 7.5 mg
once daily or Diclofenac 100 mg slow release once daily for
6 months,
-meloxicam (n = 169)
-diclofenac (n = 167)

16. Thus, Meloxicam is beneficial for patients suffering from this
chronic and disabling condition & demonstrates similar
efficacy in pain relief & more rapid stiffness relief

17. 

18. GI effects
{analysis of double-blind studies in rheumatoid
arthritis (RA) and osteoarthritis (OA)}
Method
Meloxicam 7.5 and 15 mg
(n = 893 and 3282)
Piroxicam 20 mg
(n = 906)
 Diclofenac 100 mg SR
(n = 324)
Naproxen 750–1000 mg
(n = 243).

19. Result
 When examining non-serious GI events (dyspepsia,
abdominal pain), severe GI events (perforation, bleeding)
 Both meloxicam doses were significantly better than
comparator non-steroidal anti-inflammatory drugs
(NSAIDs) in most cases.

20. Renal Effect
Cycloxygenase inhibitors prevent the synthesis
of prostaglandins that are responsible for
maintaining renal blood flow.
…..In several trials, the percentage of patients recording
abnormal elevations in the levels of serum urea &
creatinine was significantly lower in Melocam®
(meloxicam) groups versus diclofenac & piroxicam.

21. so
No need for dose adjustment in
patients with mild to moderate
renal failure.

22. In Geriatric patients
Pharmacokinetic Profile
Elderly men exhibited pharmacokinetic profile similar to
young men.
In a long term study to evaluate the safety
& efficacy of Melocam® (meloxicam) 15
mg once daily in patients with
rheumatoid arthritis, for age up to 84
years old, proves to be effective &
tolerable.

23. No Effect on Platelet Aggregation
…..As a result of the decrease in TXA2
inhibitors, platelet aggregation is
producing a prolonged bleeding time.
by Cox
reduced,

24. Platelet aggregation was almost completely inhibited
by indomethacin (-87%) as compared to control
(100%), but remained unaffected by meloxicam (-1% )
Conclusions:
….Meloxicam 7.5 mg per day is COX-1
sparing & has no effect on platelet
aggregation & bleeding time.

25. In Acute Arthropathies
 This study was done to compare the
efficacy & the local tolerability of an
i.m. Meloxicam with i.m. Piroxicam
 patients 210 with RA & OA.
 -Meloxicam 15 mg (n = 144)
 -Piroxicam 20 mg (n = 66)
 -Duration= 7 days.

26. 1-Efficacy
In patients with RA, global efficacy was rated
as 'very good' or 'rather good' by 91% of those
treated with Meloxicam and only 71% treated
with Piroxicam
The corresponding ratings in patients with
OA were achieved by 86% of those treated
with Meloxicam and 82% treated with
Piroxicam.

28. Conclusion
Melocam i.m. is effective & tolerable for the
treatment of acute rheumatic pain and shows
superiority over Piroxicam

29. Cost Effective
 Melocam (once daily) is cost-effective
versus vs classic NSAIDs in
management for chronic arthritis

30. Once daily
Which maintain compliance in patients
receiving chronic treatment.

31. Dosage & administration
In rheumatoid arthritis
15 mg once daily.
According to the response, dose could be
reduced to 7.5 mg once daily.
In acute exacerbations of osteoarthritis
7.5 mg increased to a maximum of 15 mg
Once
In cases of acute pain
Start with ampoule form (1 ampoule /day) and
then maintain treatment with tablets or
suppositories.
e daily.