Other inhibitors of prostaglandin synthesis, including glucocorticoids and salicylates, while concomitant administration with meloxicam increases the risk of ulceration in the gastrointestinal tract and gastrointestinal bleeding (due to synergism of action) and is therefore not recommended.
Simultaneous reception with other NSAIDs Not recommended.
Selective serotonin reuptake inhibitors - increased risk of gastrointestinal bleeding.
Lithium preparations - NSAIDs increase the concentration of lithium in the plasma, by reducing the excretion of it by the kidneys. It is recommended to monitor the concentration of lithium during the period of administration of meloxicam, with a change in the dose of lithium preparations and their cancellation.
Methotrexate - NSAIDs reduce the tubular secretion of methotrexate, thereby increasing its plasma concentration and hematological toxicity, the pharmacokinetics of methotrexate remain unchanged. In this regard, the simultaneous administration of meloxicam and methotrexate in a dose of more than 15 mg / week is not recommended. With the simultaneous use of drugs, the risk of increasing the toxicity of methotrexate increases.
The risk of developing interaction between NSAIDs and methotrexate may also occur in patients using methotrexate in low doses, especially in patients with impaired renal function. Therefore, constant monitoring of the number of blood cells and the function of the kidneys is necessary.
Contraception - with simultaneous use with intrauterine contraceptives, the effectiveness of the latter may be reduced.
Mifepristone - in connection with the theoretical risk of changing the effectiveness of mifepristone under the influence of inhibitors of prostaglandin synthesis, NSAIDs should not be prescribed earlier than 8-12 days after the withdrawal of mifepristone.
Diuretics - the use of NSAIDs in case of dehydration of patients is accompanied by a risk of acute renal failure.
Antihypertensives (beta-blockers and angiotensin-converting enzyme inhibitors, vasodilators, diuretics) - NSAIDs reduce the effect of antihypertensive drugs, due to the inhibition of prostaglandins, which have vasodilating properties.
Angiotensin II receptor antagonists when combined with NSAIDs increase the decrease in glomerular filtration, which can lead to the development of acute renal failure, especially in patients with impaired renal function.
NSAIDs, acting on renal prostaglandins, can enhance nephrotoxicity cyclosporine.
When used in conjunction with meloxicam drugs that have a known ability to inhibit CYP2C9 and / or CYP3A4 (or metabolized with the participation of these enzymes), the possibility of pharmacokinetic interaction should be taken into account.
At simultaneous reception meloxicam can strengthen the action tableted antidiabetics, thus there is a risk of hypoglycemia.
Meloksikam can weaken the action of qIgoxin, cortisone, diuretics.