Coxicam Tablet

Generic Name(s): Meloxicam

Why it's used

Coxicam Tablet is used for the short-term treatment of symptoms of acute attacks of degenerative joint disease (also called as osteoarthritis). This medicine works by blocking the activity of chemicals released by the body that may cause fever, inflammation, and pain. Coxicam is also used for the long-term treatment of symptoms of pain, swelling, and inflammation in the joints (rheumatoid arthritis) and inflammation of the backbone (ankylosing spondylitis), and to treat sign and symptoms of joint inflammation (juvenile rheumatoid arthritis) in children 2 years or older.
When not to use
Coxicam cannot be used to treat pain before or after the surgical procedures of heart (coronary artery bypass graft surgery).
Nonsteroidal Anti-inflammatory Drugs
Coxicam is a prescription medicine that belongs to a class of medicines called Nonsteroidal Anti-inflammatory Drugs. Nonsteroidal anti-inflammatory drugs, also called as NSAIDs, help reduce fever, decrease pain, and prevent clotting of blood. NSAIDs also reduce inflammation in the body when used in higher doses.

How to use

Read the medicine guide provided by your pharmacist, your doctor, or the medicine company. If you have any questions related to Coxicam, ask your doctor or pharmacist. Use Coxicam Tablet as per the instructions provided by your doctor.
Coxicam is consumed with or without food. Coxicam should be placed in the mouth on the tongue and allowed to dissolve slowly for five minutes. Never chew or swallow the tablet, on the other hand, dissolve the Coxicam tablets slowly for over 5 minutes. Swallow the Coxicam with 240 ml of water, which further helps to moisten the dry mouth.
The typical dose of Coxicam for adults is 7.5-15 mg/day (not more than 15 mg/day). The usual dose for children is 0.125 mg/kg (0.056 mg/lb) once daily (not more than 7.5 mg/kg (3.4 mg/lb) once daily). The maximum dose for adult patients of Coxicam is 15 mg/day per day. Coxicam is commonly used at the same time every day.
This medicine is to be used for longer periods of time. Coxicam may be prescribed for the long-term use for the treatment of symptoms of pain, swelling, and inflammation in the joints (rheumatoid arthritis) and inflammation of the backbone (ankylosing spondylitis).
Discuss with your doctor if your condition persists or worsens or if you develop new symptoms. Discuss with your doctor if increased levels of liver enzymes, and worsening of high blood pressure conditions. If you have any kidney disease, No dose reduction is needed for patients with mild to moderate kidney problems. In dialysis patients with severe kidney failure, the maximum daily dose should be given as 7.5 mg/day.
Your doctor may prescribe a lower starting dose of this medicine to understand the impact on the body. Please follow your doctor's recommendations. Taking a higher dose of this medicine may increase the risk of side-effects. A lower dose of this medicine may be recommended to reduce the risk of side-effects. Older patients may see an increase in the incidence of side-effects. As a result, a lower dose may be recommended for older patients.
If you are giving Coxicam Tablet to a child, be sure to use a product that is for use in children. Use the child's weight or age to find the right dose from the product package or medicine label. If there is no information specified, consult with your doctor and follow their recommendation on pediatric dosage.
If using the liquid form of this medicine, measure the dose using the provided measuring cup, spoon, or dropper. Before pouring the medicine into the measuring device, you should check the measurement markings carefully. Then, pour the dose amount into the device. After use, clean and store the measuring device in a safe place for your next use. You should not use a tablespoon or teaspoon as the dose measuring devices since it can result in an incorrect dose. If indicated on the product package, shake the medicine before use.
Avoid consuming alcohol together with Coxicam.
Your doctor may request that specific lab tests be performed before you start using Coxicam Tablet. Your doctor may ask you to undergo Blood Pressure test. Blood pressure should be checked before starting the treatment because high blood pressure can happen during the therapy.
Medicines may be recommended for uses other than those listed in the medicine guide. You should not use Coxicam Tablet for conditions or symptoms for which it was not prescribed. Do not give Coxicam Tablet to other people, even if they have the same conditions or symptoms that you have. The use of this medicine without the advice of a doctor may cause harm.
Follow storage instructions on the product package if available. Store Coxicam Tablet at 25°C (77°F), excursions permitted to 15°C-30°C (59°F-86°F), and away from moisture. Store this medicine away from children and pets.

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How to take Coxicam

The dose and frequency of using Coxicam will depend on the following factors:
  • age of the patient
  • the weight of the patient
  • patient's health
  • the health of the patient's liver
  • medicines recommended by the doctor
  • any other medicines being used
  • herbal supplements being used
  • response to the medicine

Coxicam Dosage

Dosage for for the relief of the signs and symptoms of degenerative joint disease (also called as osteoarthritis)

Adult
  • Recommended: 7.5 mg once daily
  • Maximum: 15 mg/day

Dosage for pain, swelling, and inflammation in the joints (rheumatoid arthritis) and inflammation of the backbone (ankylosing spondylitis)

Adult
  • Recommended: 7.5 mg once daily
  • Maximum: 15 mg once daily
Older Adults
  • Recommended: 7.5 mg/day

Dosage for inflammation of the joints in children (juvenile rheumatoid arthritis)

Adult (children 2 years or older)
  • Recommended: 0.125 mg/kg (0.056 mg/lb) once daily
  • Maximum: 7.5 mg/5ml in one day for suspension

Forms

Oral suspension
Strength: 7.5 mg/5 ml or 15 mg/10 ml
Tablet
Strength: 7.5 mg, 15 mg
Capsule
Strength: 5 mg, 7.5 mg, 10 mg, 15 mg

Special Instructions

Oral suspension
Shake the suspension well before use.

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed one.

Overdose

What to do if you overdose on Coxicam?
Treatment according to the symptoms (symptomatic) and supportive care should be given in patients who have taken more than the recommended dose of Coxicam. If the overdose has happened within the last 1-2 hour, the harmful effect can be reduced by taking activated charcoal. Activated Charcoal is a form of carbon that has small, low-volume pores. These pores help trap chemicals as in the case of poisoning. In case of overdose, forced diuresis, blood purify process (hemodialysis and hemoperfusion), and alkalinization of urine may not be useful due to high protein binding. Also, Cholestyramine can be given for the treatment of overdose.
Symptoms of an overdose of Coxicam
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
  • acute kidney failure
  • coma
  • convulsions
  • drowsiness
  • epigastric pain
  • heart collapse
  • high blood pressure
  • lack of energy
  • life-threatening allergic reaction (anaphylactoid reactions)
  • liver dysfunction
  • nausea
  • slow and ineffective breathing
  • stomach and intestinal bleeding
  • sudden, unexpected loss of heart function (cardiac arrest)
  • vomiting
If you think you have overdosed on Coxicam Tablet, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Coxicam

Before you use Coxicam Tablet, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic to aspirin, or other non-steroidal anti-inflammatory drugs.
Before you use Coxicam, tell your doctor of your medical history including allergic to Coxicam, aspirin, and other non-steroidal-anti-inflammatory drugs, history of asthma, nasal polyps, stomach or intestinal ulcers, bleeding disorders, bleeding in the stomach, intestine, and brain, severe liver diseases, severe kidney failure and are not receiving dialysis, heart failure, galactose intolerance, disturbed absorption of glucose-galactose, inflammation of the lining of the digestive tract (Crohn´s disease), ulcers in the digestive tract (ulcerative colitis), pain after surgical procedures of heart, abnormal functioning of the kidney, dehydration, high level of lipids in the blood, high blood sugar levels, addiction to smoking, swelling in the esophagus (oesophagitis), or inflammation in the stomach (gastritis). Patients with a history of stomach and intestinal events are at higher risk of bleeding while using Coxicam. The use of Coxicam in patients with a history of allergic conditions may cause severely fatal life-threatening allergic reactions. Patients with heart diseases are at increased risk of blood clotting events such as stroke and heart attack. Before having any surgery when using Coxicam, tell your doctor and dentist about all the medicinal products you use including prescription and non-prescription medicines, and any herbal supplements.
The use of this medicine may change weight. The use of Coxicam may either increase or decrease the body weight.
The use of Coxicam Tablet may change blood pressure. The use of Coxicam may cause worsening of high blood pressure conditions.
The use of this medicine may change platelet function. Coxicam may reduce the platelet aggregation which may lead to prolong bleeding and ultimately blood loss.
The use of this medicine may change liver enzymes (alanine transaminase, aspartate transaminase, gamma-glutamyltransferase, and increased bilirubin). Use of Coxicam may increase the levels of liver enzymes in the blood.
Avoid the consumption of alcohol with Coxicam Tablet. Drinking alcohol may cause bleeding in the stomach and intestine tract.
Coxicam Tablet should be used in pregnancy only when required. Use of Coxicam may lead to an increased risk of miscarriage, heart defects and birth defect related to the formation of intestine outside the baby's body (gastroschisis) in early pregnancy. So in the first and second trimester of pregnancy, Coxicam should only be given if potential benefit justify the risk to the fetus. Coxicam Tablet belongs to the NSAID class of medicines. NSAIDs should not be taken after 29 weeks of pregnancy as these medicines may cause serious harm to the unborn baby. Coxicam Tablet should be used while breastfeeding only when required. It is unknown whether Coxicam may pass into breast milk or not. But as other NSAIDs may pass into breast milk and cause serious harmful effect to the newborn baby, so a decision has to be made to discontinue the drug or discontinue breastfeeding only after considering the importance of this medicine to the mother. Use of Coxicam may lead to a reversible delay in ovulation in women who are facing difficulties in conceiving, or who are undergoing from the condition of infertility. So, women who are planning to get pregnant, the dose should be kept as low and duration of treatment as short as possible to avoid the harmful effects.
Coxicam Tablet can make you feel sleepy. Be careful while driving, using machinery, or doing any other activity that needs you to be alert. The consumption of alcohol with Coxicam Tablet can make you feel more sleepy. Coxicam Tablet may cause seizures in some people. Discuss with your doctor if you perform activities where a loss of consciousness may cause you or others harm.
This medicine can cause stomach bleeding. The use of alcohol/tobacco with Coxicam may increase your stomach bleeding risk. If you drink alcohol or smoke regularly, please discuss with your doctor. This medicine may increase your sensitivity to sunlight. If this happens, limit your time outdoors and do not tan to prevent sunburns. Cover your skin when you are outdoors or use a sunscreen. In case you get a sunburn, consult with your doctor.
Coxicam Tablet may cause an increased risk of side-effects in younger patients. Children using this medicine may see an increased risk of abdominal pain, vomiting, diarrhea, headache, and fever.
Coxicam Tablet may increase side-effects in older patients. Elderly patients may see an increased risk of ulceration and bleeding in the stomach and intestine, rupturing of the walls of stomach and intestine, kidney failure, and decreased kidney blood flow.
Patients using Coxicam for the long-term treatment may experience kidney cells damage (renal papillary necrosis), kidney failure, kidney injury, swelling, bleeding, ulcer and rupture in the walls of the stomach, large intestine, or small intestine, and low red blood cells (anemia). Such patients may also experience blood clotting events (arterial thrombotic events) such as heart attack and stroke.

What precautions should be taken during Pregnancy and Nursing, and administering Coxicam to Children or the Older Adults?

Pregnant Women

Only when required
Warning: Coxicam should only be used if potential benefit justify the risk to the fetus.

Breastfeeding

Only when required
Warning: It is unknown whether Coxicam may pass into breast milk or not. But as other NSAIDs may pass into breast milk and cause serious harmful effect to the newborn baby, so a decision has to be made to discontinue the drug or discontinue breastfeeding only after considering the importance of this medicine to the mother.

Younger Adults Population

Only When Necessary
Warning: 

Older Adults Population

Management or monitoring precaution
Warning: The use of Coxicam may cause an increased risk of serious stomach and intestinal tract events such as ulceration, bleeding and rupture in the walls of the stomach or intestine. Elderly patients may experience a dose-dependent decrease in the prostaglandin formation, kidney blood flow which may lead to sudden kidney failure.

Coxicam Side-effects

The following side-effects may commonly occur when using Coxicam Tablet. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
The following side-effects may commonly occur in older patients on the use of Coxicam Tablet. Discuss with your doctor if any of these side-effects last for a long time or are severe:
  • bleeding in the stomach and intestine
  • kidney failure
  • rupture in the lining of the wall of stomach and intestine (gastrointestinal perforation)
  • ulcer formation in the stomach and intestinal area
The following side-effects may commonly occur in children when using Coxicam Tablet. Discuss with your doctor if any of these side-effects last for a long time or are severe:
Rarely, the use of Coxicam Tablet may cause the following side-effects:
  • abnormal vision
  • back pain
  • backflow of stomach acid in the food pipe (gastroesophageal reflux)
  • blood during vomiting (haematemesis)
  • burning or prickling sensation
  • chest pain (angina pectoris)
  • coughing
  • dark sticky faeces (melaena)
  • decreased weight
  • difficulty in expelling urine from the bladder (micturition frequency)
  • disorientation
  • dizziness
  • dry mouth
  • expelling gas from the stomach through the mouth
  • fainting
  • falls
  • fatigue
  • feeling of discomfort
  • flushing/hot flushes
  • hair loss
  • hives
  • increase number of eosinophils in the blood (eosinophilia)
  • increased appetite
  • increased blood urea nitrogen (BUN)
  • increased sweating
  • increased weight
  • inflammation and scarring of the intestine (Crohn's disease)
  • insomnia
  • irregular heart beat
  • joints pain
  • kidney inflammation (interstitial nephritis)
  • kidney insufficiency
  • liver function disorders
  • mood altered
  • nervousness
  • nightmares/abnormal dreaming
  • presence of protein (albumin) in urine (albuminuria)
  • rash
  • red or purple discolored spots on the skin
  • ringing in the ears
  • severe itching
  • sodium and potassium imbalances (sodium and water retention)
  • swelling of the face
  • swelling of the limb
  • taste perversion
  • tremor
  • vertigo
The following severe side-effects may also occur when using Coxicam Tablet:
  • heart and blood vessels related blood clotting events (possibly fatal)
    Symptoms: increased blood pressure, irregular heartbeat, heart failure, heart attack, low blood pressure inflammation of the blood vessels (vasculitis)
    Inform the patients about the symptoms of a serious heart and blood vessels related blood clotting events.
  • eye disorders
    Symptoms: blurred vision inflammation of the eye (conjunctivitis)
  • mental and nervous system disorders (possibly fatal)
    Symptoms: confusional state, drowsiness, anxiety, depression stroke
    Inform the patients about the symptoms of severe brain and blood vessels related blood clotting events.
  • immune system disorders such as life-threatening allergic reactions (anaphylactoid reaction/anaphylactic shock/anaphylaxis)
    Symptoms: difficulty in breathing swelling of the face or throat
    Patients should take immediate medical attention if such symptoms occur. Inform the patients about the signs of a life-threatening allergic reaction.
  • Symptoms: lack of red blood cells (anemia), decrease in the number of leukocytes, low levels of thrombocytes decrease in the number of granulocytes
    If signs or symptoms of anemia occur while using Coxicam, patients should be monitored for blood levels (hemoglobin or hematocrit).
  • stomach and intestinal disorders (possibly fatal)
    Symptoms: stomach or intestinal bleeding, inflammation in the digestive tract (colitis), inflammation of the esophagus (oesophagitis), inflammation of the pancreas (pancreatitis), painful swelling and sores inside the mouth, inflammation of the lining of the stomach (gastritis), stomach and duodenal ulcer (gastroduodenal ulcer), rupture in the walls lining of stomach and intestine (gastrointestinal perforation), bleeding from the duodenal ulcer (hemorrhagic duodenal ulcer rupture in the wall of duodenal ulcer (perforated duodenal ulcer)
    Use of Coxicam should be discontinued, if a serious stomach and intestinal adverse event occur.
  • liver disorders such as harmful effects to the liver due to drugs (possibly fatal)
    Symptoms: liver cell damage, liver failure, increased level of liver enzymes (alanine aminotransferase, alkaline phosphatase, increased blood bilirubin (bilirubinemia), jaundice, increased number of eosinophils in the blood (eosinophilia), rash, nausea, fatigue, lack of energy (lethargy), severe skin itching, flu-like symptoms inflammation of the liver (hepatitis)
    Use of Coxicam should be discontinued immediately, If these symptoms occur and patients should take immediate medical therapy.
  • kidney and urinary disorders
    Symptoms: urinary tract infection, acute kidney failure, acute kidney damage, excessive excretion of protein in the urine (nephrotic syndrome), kidney cells damage, blood in the urine (hematuria), inability to completely or partially empty the bladder, increased creatinine levels, drug induce harmful effects of the kidney, kidney injury high potassium levels
    Coxicam should be discontinued until the patients recover from the harmful effect of the kidney.
  • metabolic and nutritional disorders
    Symptoms: dehydration
  • skin disorders (possibly fatal)
    Symptoms: swelling of the skin, life-threatening skin allergic reaction (Stevens-Johnson Syndrome), skin allergic reaction caused by infection (erythema multiforme), life-threatening drug-induced skin reaction, increased sensitivity to sunlight, redness and peeling of the skin (bullous dermatitis/exfoliative dermatitis), skin rash, skin blisters fever
    Use of Coxicam should be discontinued at the first occurrence of skin rash and any other sign of allergic reaction. Informed the patients about the symptoms of serious skin allergic reactions.
Your doctor has prescribed this Coxicam because they have judged that the benefits outweigh the risks posed by side-effects. Many people using this medicine do not have serious side-effects. This is not a complete list of possible side-effects for Coxicam.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Coxicam by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:

Severe Side-effects

Following are the severe side-effects of this medicine:

Side-effects in Older Adults

Following are the side-effects of this medicine in elderly patients:

Side-effects in Children

Following are the side-effects of this medicine in young patients:

Mild Allergic Reactions

Following are the symptoms of mild allergic reactions to this medicine:

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
Use of Coxicam should be discontinued at the first occurrence of skin rash and any other sign of allergic reaction. Inform the patients about the symptoms of serious skin reactions.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Patients with long-term treatment of Coxicam

Patients with long-term treatment of Coxicam are at an increased risk. Long-term use of Coxicam may cause severe stomach or intestinal ulcerations and bleeding. The Coxicam should not be used, if systemic events such as increased number of white blood cell (eosinophilia) or rash occur if clinical symptoms of liver disease develop and if abnormal liver function tests worsen or persist.

Patients on long-term corticosteroid therapy

Discontinuation of corticosteroids may lead to worsening of corticosteroid insufficiency. Patients should discontinue corticosteroids slowly when discontinuation of corticosteroids is necessary.

Masking of inflammation and fever

The use of Coxicam in patients with complications of presumed painful and noninfectious conditions may reduce the utility of diagnostic sign of fever and inflammation.

Patients with blood vessel related heart and brain disease

Patients with high blood pressure, heart failure, heart disease, narrowing of blood vessels leading to reduced blood flow to the limbs (peripheral arterial disease) and blood vessel related brain disease (cerebrovascular disease) are at an increased risk when using this medicine. Using Coxicam in these patients may cause fluid retention and excessive fluid build up in the body. When non-steroidal anti-inflammatory drugs are used at high doses for the long term, it may increase the risk of heart attack and stroke. Proper monitoring of blood pressure should be done while starting Coxicam therapy in such patients. Careful consideration should also be made in patients with risk factors such as high blood pressure, smoking, high blood sugar, or high levels of fat particles in the blood before starting long-term treatment with Coxicam.

Serious skin reactions

Patients on Coxicam therapy are at an increased risk. Patients using Coxicam may experience serious skin adverse events such as life-threatening skin reaction (Stevens-Johnson Syndrome), redness and peeling of the skin (exfoliative dermatitis) and life-threatening drug-induced skin reaction, which can be fatal. Inform the patients about the symptoms of skin rash, fever, blisters, or other signs of allergic reaction such as itching. The Coxicam should not be used at the first occurrence of skin rash and any other sign of allergic reaction.

Kidney effects

Patients with kidney disease, using non-steroidal anti-inflammatory drugs for long-term or dehydrated patients are at increased risk. Kidney inflammation (interstitial nephritis), swelling of the tiny filters in the kidneys (glomerulonephritis), kidney cell damage, or excretion of too much protein in the urine (nephrotic syndrome) may occur in patients using non-steroidal anti-inflammatory drugs. Patients with abnormal functioning of the kidney or liver, kidney failure, volume depletion, too much protein in the urine (nephrotic syndrome), inflammation of the kidney (lupus nephropathy), heart failure, liver dysfunction, taking angiotensin-converting enzyme inhibitors, diuretics, or angiotensin II receptor antagonists, and elderly patients are at higher risk of this reaction. Non-steroidal anti-inflammatory drug therapy should not be used in patients with kidney failure or increased levels of the kidney parameters. It is advised first to rehydrate the patients and then to initiate the therapy with # NAME#. Caution and monitoring should also be considered in patients with abnormal functioning of the kidney and kidney disease.

Pregnant women

Pregnant women are at an increased risk when using this medicine. The use of Coxicam during early pregnancy may increase the risk of miscarriage, defects of the abdominal wall and heart. Using Coxicam during the third trimester of pregnancy may increase the harmful effect of the heart (high blood pressure or premature closure of the ductus arteriosus) and kidney failure with deficiency of amniotic fluid in the fetus (oligohydramnios). At the end of pregnancy, Coxicam may also cause inhibition of uterine contractions in pregnant mother which can lead to delayed or prolonged labour and prolongation of bleeding time in mother and baby. This medicine should not be used in the third trimester of pregnancy.

Life-threatening allergic reaction (anaphylactoid reactions)

Patients receiving Coxicam therapy are at an increased risk. Patients receiving Coxicam therapy may see an increased risk of a life-threatening allergic reaction (anaphylactoid reactions). This symptom worse typically in asthmatic patients who experience swelling of the nasal passages complicated by non-cancerous growth in the lining of the nose, fatal difficulty in breathing (bronchospasm), after taking aspirin or other NSAIDs. Patients should take immediate medical attention if such symptoms occur. Inform the patients about the signs of a life-threatening allergic reaction such as difficulty breathing, swelling of the face or throat.

Blood-related effects

Patients receiving Coxicam therapy are at an increased risk. Patients receiving Coxicam therapy may experience anemia, and this may be due to excess fluid build up in the body, stomach or intestinal blood loss, or an incomplete production of red blood cells (erythropoiesis). If signs or symptoms of anemia occur while using long-term therapy of Coxicam, proper monitoring of blood levels (hemoglobin or hematocrit) should be done.

Patients with asthma

Patients with asthma are at an increased risk when using this medicine. Patients with asthma may have experience aspirin-sensitive asthma. The use of aspirin and other NSAIDs in these patients may cause a fatal difficulty in breathing (bronchospasm). Take the necessary precautions while using this medicine in asthmatic patients. The Coxicam should not be used in patients with aspirin sensitivity.

Heart-related blood clotting problems

Patients taking Coxicam and non-steroidal anti-inflammatory drugs therapy for more than three years are at an increased risk. These patients are at increased risk of heart and blood vessels disorders such as heart attack and stroke, which can be possibly fatal. Patients with heart disease are at higher risk. The lowest effective dose for a short period should be used in such patients. Patients should be notified about the symptoms of heart disease events and essential measures to take if symptoms occur.

Patients with a recent history of heart bypass surgery (coronary artery bypass graft or CABG)

Patients with a recent history of heart bypass surgery are at an increased risk when using this medicine. Such patients are at an increased risk of heart attack and stroke when taking cyclooxygenase- 2 selective nonsteroidal anti-inflammatory drugs within the first 10 to 14 days following heart surgery. Coxicam therapy should not be used in such patients.

Bleeding, ulcers, or rupture in the wall of the stomach and intestinal tract

Patients with a history of stomach or intestinal bleeding, ulcer disease, or a rupture in the wall of the digestive tract are at an increased risk. Such patients are at ten-fold greater risk for developing stomach and intestinal tract bleeding. Take necessary precautions while using Coxicam with protective agents (proton pump inhibitors or misoprostol) in these patients. A lowest effective dose of Coxicam for a short period should be used in such patients.

Liver effects

Patients taking Coxicam are at increased risk. Such patients may experience jaundice, fatal swelling of the liver, liver cell damage (liver necrosis), liver failure, and increased level of liver enzymes. Patients with abnormal liver test or with signs and symptoms of an abnormality in the functioning of the liver should be examined for more severe liver reaction while on Coxicam therapy. Dose modification is not required in patients with an abnormality in the functioning of the liver. Take necessary precautions while using Coxicam in such patients.

Heart failure, high blood pressure, or swelling of the skin

Patients with fluid retention, high blood pressure, cardiac failure, or swelling of the skin, taking Coxicam, antihypertensive medicines (angiotensin-converting enzyme inhibitors, thiazides, loop diuretics), are at increased risk. Such patients may experience an increased risk of heart disease events. Also, induction of potassium, sodium and water retention may occur while taking non-steroidal anti-inflammatory drugs. Precaution and monitoring should be considered in such patients. In patients with high blood pressure, close monitoring of the high blood pressure should be done while starting and during non-steroidal anti-inflammatory drugs therapy.

Interactions with Coxicam

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
Coxicam Tablet may interact with antihypertensives agents (diuretics such as furosemide and thiazides, angiotensin-converting enzyme inhibitors, beta blockers, and angiotensin-II antagonists), which are used to treat high blood pressure. When Coxicam is used with antihypertensives agents, it may decrease the blood pressure lowering effect of these medicines. In patients with reduced functioning of the kidney, dehydration or elderly patients using Coxicam with antihypertensive agents causes abnormality in the functioning of the kidneys and kidney failure. Non-steroidal anti-inflammatory drugs with furosemide or diuretics may decrease the sodium excretion of these medicines. Take necessary precautions while using Coxicam in such patients primarily in the elderly. Appropriate monitoring of the functioning of the kidney, production of the urine and adequate hydration should be done during and after starting the treatment.
There may be an interaction of Coxicam with non-steroidal anti-inflammatory drugs and aspirin, which are used to treat pain, fever and inflammation. When Coxicam is used in combination with non-steroidal anti-inflammatory drugs or aspirin, it may increase the risk of stomach and intestinal tract events such as bleeding, swelling, ulceration and rupturing of the wall of the stomach, large intestine, or small intestine, which can be fatal. Coxicam should not be used with low-dose acetylsalicylic acid at doses more than or equal to 3 gram as the total daily amount or more than or equal to 1 gram as single intake.
Coxicam Tablet interacts with lithium, which is used to treat depression. When Coxicam is used with lithium, it may decrease the excretion and increase the levels of the lithium in the blood which may lead to harmful levels of lithium in the blood. Coxicam should not be used in combination with lithium. If necessary, then proper monitoring for the signs of harmful effects of the lithium while starting, during dose adjustment or stopping the Coxicam treatment should be done.
Special instructions need to be followed while taking this medicine along with methotrexate, which is used to treat cancer. Non-steroidal anti-inflammatory drugs may decrease the elimination of methotrexate which may lead to harmful effects of methotrexate. Take necessary precautions in patients using Coxicam with methotrexate. Patients who are on high dosages of methotrexate should not use non-steroidal anti-inflammatory drugs due to the increased levels of methotrexate in the blood. Risk should also be considered in patients with an abnormality in the functioning of the kidney when using non-steroidal anti-inflammatory drugs with a low dose of methotrexate.
Your doctor's guidelines may need to be followed while taking this medicine along with calcineurin inhibitors (cyclosporine, tacrolimus), which are used to prevent organ rejection. The use of Coxicam may affect the kidney prostaglandins effect. When Coxicam is used in combination with calcineurin inhibitors, it may increase the harmful effects of the kidney. Precaution should be taken in these patients. Also, careful monitoring of the functioning of the kidney should be considered in such patients.
Coxicam Tablet may interact with anticoagulants (heparin and warfarin), thrombolytics, and antiplatelets, which are used to prevent heart attack, and blood clotting. Using non-steroidal anti-inflammatory drugs with anticoagulants, warfarin, thrombolytics, antiplatelets or heparin may increase the risk of bleeding and mucosal damage of the stomach and intestinal tract. Elderly patients or patients taking a therapeutic dose of heparin should not use non-steroidal anti-inflammatory drugs with heparin or anticoagulants. If necessary, precaution along with careful monitoring of the international normalized ratio should be considered in such patients.
There may be an interaction of Coxicam with sodium polystyrene sulfonate, which is used to treat high levels of potassium in the blood. When Coxicam is used in combination with sodium polystyrene sulfonate, it may cause intestinal cell damage, which can be possibly fatal. Patients should not use Coxicam with sodium polystyrene sulfonate.
Coxicam Tablet interacts with corticosteroids (glucocorticoids), which are used to treat pain, swelling, and inflammation in the joints. When Coxicam is used with corticosteroids, it may increase the risk of bleeding or stomach and intestinal tract ulcers. Take necessary precautions while using Coxicam in combination with corticosteroids.
Special instructions need to be followed while taking this medicine along with selective serotonin reuptake inhibitors (SSRIs), which are used to treat depression. Using Coxicam with selective serotonin reuptake inhibitors increases the risk of stomach and intestinal bleeding.
Your doctor's guidelines may need to be followed while taking this medicine along with intrauterine devices, which are used to prevent pregnancy. Non-steroidal anti-inflammatory drugs decrease the efficacy of the intrauterine devices.
Coxicam Tablet may interact with cholestyramine, which is used to lower high cholesterol levels. Cholestyramine increases the elimination of Coxicam.
This page does not contain all the possible interactions of Coxicam Tablet. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Interactions of Coxicam by Severity

Severe

The following medicines are usually not to be taken together without consulting with your doctor or pharmacist.

Serious

The following medicines may interact when taken together and can cause harmful effects in the body. Please consult with your doctor or pharmacist before taking these medicines together.

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Coxicam be not used?

Allergic to Coxicam, aspirin, or other non-steroidal anti-inflammatory drugs

This medicine should not be used in patients who are allergic to Coxicam, aspirin, or other non-steroidal anti-inflammatory drugs. Patients may experience an increased risk of life-threatening allergic reactions and severe skin reactions. These patients may have the following symptoms if they use this medicine:
  • swelling of the lower layer of the skin
  • life-threatening skin reaction (Stevens-Johnson Syndrome)
  • skin allergic reaction caused by infection (erythema multiforme)
  • life-threatening drug-induced skin reaction
  • increased skin sensitivity to the sunlight
  • redness and peeling of the skin (bullous dermatitis/exfoliative dermatitis)
  • skin rash
  • skin blisters
  • fever
  • difficulty breathing
  • swelling of the face or throat
  • severe itching
  • hives
  • fainting
  • shortness of breath

Patients with a history of asthma, hives, or allergic-type reactions after taking non-steroidal anti-inflammatory drugs or aspirin

This medicine should not be used in such patients. Such patients may experience a life-threatening allergic reaction, aspirin-sensitive-asthma which include swelling of the nasal passages complicated by non-cancerous growth in the lining of the nose, fatal difficulty in breathing (bronchospasm), intolerance to aspirin or non-steroidal anti-inflammatory drugs.

Perioperative pain after coronary artery bypass surgery (CABG)

This medicine should not be used for the treatment of peri-operative pain in patients having heart surgery (coronary artery bypass graft (CABG) surgery). Such patients may experience an increased risk of heart attack and stroke. It can be possibly fatal.

Bleeding or rupture (perforation) in the wall of the stomach and intestine, related to prior NSAIDs therapy

This medicine should not be used in patients with a history of bleeding or rupture (perforation) in the wall of the stomach and intestine due to previous non-steroidal anti-inflammatory drugs therapy.

Stomach ulcer or bleeding

This medicine should not be used in patients with active or a history of stomach ulcer or bleeding. Such patients may experience an increased risk of bleeding, ulcers, and rupture (perforation) in the wall of the stomach and intestine.

Active intestinal inflammatory disease such as Crohn´s disease, ulcerative colitis

The use of this medicine is not recommended in patients with an active intestinal inflammatory disease such as inflammation of the digestive tract (Crohn's disease or ulcerative colitis).

Patients with non-dialysed severe kidney, liver, and heart failure

This medicine should not be used in patients with non-dialysed severe kidney, liver, and heart failure. Using Coxicam in patients with heart failure may experience an excess buildup of fluid in the body and swelling of the skin. The use of Coxicam in patients with kidney failure may cause the body to excrete too much protein in the urine (nephrotic syndrome), swelling in between the kidney tubules (interstitial nephritis), kidney cell damage, and inflammation of the tiny filters in the kidneys (glomerulonephritis).

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Coxicam is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Coxicam Tablet .
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