Meloxicam (Metacam)
Dosage & Administration Guidelines
| Species | Route | Dose | Frequency | Duration & Clinical Notes |
|---|---|---|---|---|
| Dog | PO (oral tablet or suspension) | 0.2 mg/kg on day 1 (loading dose), then 0.1 mg/kg once daily | Once daily (q24h) | Duration: For osteoarthritis: chronic use as needed; for postoperative pain: 3-7 days Notes: Administer with food to reduce GI upset. For long-term use, use the lowest effective dose. Injectable solution can be used for initial dose (0.2 mg/kg SC) followed by oral maintenance. |
| Cat | PO (oral suspension or tablet) | 0.05 mg/kg once daily (for chronic use); for acute pain: 0.1 mg/kg once daily (off-label) | Once daily (q24h) | Duration: For chronic osteoarthritis: long-term; for postoperative pain: 3-5 days Notes: Use only the oral suspension for cats (5 mg/mL) to ensure accurate dosing. Do not use the 1.5 mg/mL dog formulation. Administer with food. Monitor renal function in chronic use. |
| Horse | PO (oral paste) or IV (injectable solution) | 0.6 mg/kg IV once daily; oral paste: 0.6 mg/kg once daily | Once daily (q24h) | Duration: For musculoskeletal pain: 3-14 days; for colic: single dose or up to 3 days Notes: IV injection should be given slowly. Oral paste is administered directly into the mouth. Use with caution in dehydrated or hypovolemic horses. |
| Cattle | SC or IV (injectable solution) | 0.5 mg/kg SC or IV once | Single dose; may be repeated once after 48 hours if needed | Duration: Usually single dose; for respiratory disease, may be repeated once Notes: For calves, use SC route. Do not use in animals with known hypersensitivity. Observe withdrawal times for meat and milk. |
| Small Ruminants (Sheep, Goats) | PO or SC (off-label) | 0.5 mg/kg PO or SC once daily | Once daily (q24h) | Duration: 3-5 days Notes: Extra-label use; consult a veterinarian. Use with caution in pregnant animals. |
| Rabbit | PO (oral suspension) or SC (injectable) | 0.2-0.3 mg/kg PO once daily; 0.2 mg/kg SC once daily | Once daily (q24h) | Duration: 3-5 days Notes: Use with caution; rabbits are sensitive to NSAIDs. Ensure adequate hydration. |
| Bird/Poultry | PO (oral suspension) or IM (injectable) | 0.1-0.2 mg/kg PO once daily; 0.1 mg/kg IM once daily | Once daily (q24h) | Duration: 3-5 days Notes: Limited data; use with caution. For poultry, observe withdrawal times for eggs and meat. |
| Exotic/Other (e.g., Ferret, Guinea Pig) | PO (oral suspension) | 0.1-0.2 mg/kg PO once daily | Once daily (q24h) | Duration: 3-5 days Notes: Extra-label use; consult a veterinarian. Monitor for GI and renal effects. |
Clinical Indications & Species Uses
- Pain and inflammation associated with acute or chronic musculoskeletal disorders
- Postoperative pain management
- Fever reduction in inflammatory conditions
- Management of pain and inflammation associated with osteoarthritis
- Postoperative pain and inflammation (e.g., orthopedic and soft tissue surgery)
- Acute musculoskeletal disorders
- Pyrexia (fever) of inflammatory origin
- Management of pain and inflammation associated with chronic musculoskeletal disorders (e.g., osteoarthritis)
- Postoperative pain and inflammation (e.g., ovariohysterectomy, onychectomy)
- Acute pain and inflammation (off-label in some countries)
- Management of pain and inflammation associated with musculoskeletal disorders (e.g., lameness, osteoarthritis)
- Postoperative pain and inflammation
- Colic pain (as adjunctive therapy)
- Management of pain and inflammation associated with respiratory disease (e.g., bovine respiratory disease complex)
- Management of pain and inflammation associated with diarrhea (e.g., calf diarrhea)
- Postoperative pain (e.g., dehorning, castration)
- Reduction of fever in acute respiratory disease
- Management of pain and inflammation (off-label in many countries)
- Postoperative pain (e.g., castration, dehorning)
- Management of pain and inflammation (off-label)
- Postoperative pain (e.g., dental procedures, soft tissue surgery)
- Management of pain and inflammation (off-label)
- Postoperative pain (e.g., wing clipping, fracture repair)
- Management of pain and inflammation in small mammals (e.g., ferrets, guinea pigs) and reptiles (off-label)
Pharmacology & Mechanism of Action
Drug Class: Non-Steroidal Anti-Inflammatory Drug (NSAID) | Pharmacological Group: Oxicam derivative
Mechanism of Action: Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) of the oxicam class. It exerts its therapeutic effects primarily by inhibiting the cyclooxygenase (COX) enzymes, with preferential inhibition of COX-2 over COX-1. COX-2 is induced at sites of inflammation and produces prostaglandins that mediate pain, inflammation, and fever. By selectively inhibiting COX-2, meloxicam reduces the synthesis of pro-inflammatory prostaglandins while sparing COX-1-derived prostaglandins that are important for gastrointestinal mucosal protection, renal blood flow, and platelet function. This selectivity contributes to its favorable safety profile compared to non-selective NSAIDs, though at higher doses or in susceptible individuals, COX-1 inhibition may occur.
Pharmacodynamics: Meloxicam produces dose-dependent anti-inflammatory, analgesic, and antipyretic effects. In veterinary species, it has been shown to reduce inflammation and pain associated with musculoskeletal disorders, postoperative pain, and other acute or chronic conditions. Its analgesic potency is comparable to other NSAIDs, and its duration of action is prolonged due to its long half-life in some species. In dogs, meloxicam has a half-life of approximately 24 hours, allowing once-daily dosing. In cats, the half-life is longer (approximately 15-24 hours) but with careful dosing to avoid accumulation. The drug also has some chondroprotective properties in vitro, but clinical significance is not fully established.
β‘ Pharmacokinetics Summary
Available Formulations & Strengths
Contraindications & Clinical Warnings
- Known hypersensitivity to meloxicam or other NSAIDs
- Active gastrointestinal ulceration or bleeding
- Renal insufficiency or severe renal disease
- Hepatic insufficiency or severe hepatic disease
- Dehydration, hypovolemia, or hypotension
- Concurrent use of other NSAIDs or corticosteroids
- Pregnancy (especially in the last trimester) unless benefits outweigh risks
- Lactating animals (unless specifically indicated and withdrawal times observed)
- In cats: do not use the 1.5 mg/mL dog formulation; use only the 5 mg/mL cat formulation
- In horses: do not use in foals less than 6 weeks of age
- In cattle: do not use in animals with known bleeding disorders
- Use with caution in animals with pre-existing renal, hepatic, or cardiac disease
- Monitor renal function and hydration status during therapy, especially in geriatric animals or those on long-term treatment
- Administer with food to reduce gastrointestinal irritation
- In cats, chronic use requires careful monitoring; use the lowest effective dose and avoid use in cats with renal disease
- In horses, avoid use in dehydrated or hypovolemic animals; ensure adequate fluid intake
- In cattle, do not exceed the recommended dose; observe withdrawal times
- Use with caution in young animals (e.g., puppies, kittens) due to immature renal function
- Avoid concurrent use with other NSAIDs, corticosteroids, or anticoagulants
- In food animals, follow extra-label drug use regulations and withdrawal times
- Do not use in animals with a history of gastrointestinal ulceration or bleeding
- In birds and exotic pets, use with caution due to limited safety data
Adverse Effects & Reactions
Common:
- Gastrointestinal upset (vomiting, diarrhea, decreased appetite)
- Increased thirst (polydipsia)
- Lethargy or sedation
- Injection site reactions (pain, swelling) after SC/IM administration
Serious / Severe:
- Gastrointestinal ulceration, perforation, or bleeding
- Renal toxicity (acute kidney injury, renal papillary necrosis)
- Hepatic toxicity (elevated liver enzymes, jaundice)
- Bone marrow suppression (rare)
- Hypotension or shock in severe cases
- Seizures (rare, with overdose)
Rare:
- Allergic reactions (urticaria, angioedema, anaphylaxis)
- Blood dyscrasias (thrombocytopenia, leukopenia)
- Neurological signs (ataxia, tremors)
- Photosensitivity (in some species)
- Corneal ulceration (in cats with topical use, but not systemic)
Key Drug Interactions
| Interacting Drug / Class | Clinical Effect & Mechanism | Severity |
|---|---|---|
| Other NSAIDs (e.g., carprofen, flunixin) | Additive risk of gastrointestinal ulceration, renal toxicity, and bleeding | High |
| Corticosteroids (e.g., prednisone, dexamethasone) | Increased risk of gastrointestinal ulceration and renal toxicity | High |
| Anticoagulants (e.g., warfarin, heparin) | Increased risk of bleeding due to platelet inhibition | High |
| ACE inhibitors (e.g., enalapril, benazepril) | Reduced renal blood flow, increased risk of renal toxicity | Moderate |
| Diuretics (e.g., furosemide) | Reduced renal perfusion, increased risk of renal toxicity and decreased diuretic efficacy | Moderate |
| Aminoglycoside antibiotics (e.g., gentamicin) | Additive nephrotoxicity | Moderate |
| Methotrexate | Reduced renal clearance of methotrexate, increased toxicity | Moderate |
| Cyclosporine | Increased risk of nephrotoxicity | Moderate |
Overdose & Toxicity Management
Signs of Toxicity:
- Vomiting, diarrhea (possibly with blood)
- Lethargy, depression
- Loss of appetite
- Increased thirst and urination
- Abdominal pain
- Ataxia or incoordination
- Seizures (in severe cases)
- Acute kidney injury (decreased urine output, elevated BUN/creatinine)
- Gastrointestinal ulceration or perforation
Emergency Treatment Protocol: Treatment of meloxicam overdose is primarily supportive and symptomatic. Induce vomiting if ingestion was recent (within 2 hours) and the animal is conscious. Administer activated charcoal to reduce absorption. Provide intravenous fluid therapy to maintain renal perfusion and correct dehydration. Use gastroprotective agents such as sucralfate, H2 antagonists (e.g., famotidine), or proton pump inhibitors (e.g., omeprazole) to reduce gastrointestinal irritation. Monitor renal function (BUN, creatinine, urine output) and liver enzymes. In severe cases, consider blood transfusions if bleeding occurs. There is no specific antidote for meloxicam overdose. Forced diuresis may be helpful but is not always effective due to high protein binding. In cases of acute kidney injury, aggressive fluid therapy and possibly dialysis may be required. Prognosis depends on the dose and timeliness of treatment.
Food Animal Withdrawal Times
Withdrawal times are for cattle (label indication). For other food animals (sheep, goats, pigs, poultry), extra-label use requires extended withdrawal times; consult a veterinarian. In cattle: meat 15 days, milk 5 days. In swine: meat 5 days (if used off-label). In poultry: eggs not established; meat 7 days (off-label). Always follow local regulations.
Storage, Handling & Regulatory Information
Storage Temperature: Store at controlled room temperature 20-25Β°C (68-77Β°F), with excursions permitted between 15-30Β°C (59-86Β°F).
Handling & Special Conditions: Protect from freezing. Keep the oral suspension tightly closed. Do not remove from the outer carton until ready to use. Store away from direct heat and moisture.
Dispensing Status: Prescription Required (Rx Only)
Approval Status: FDA-approved for use in dogs (oral tablets, oral suspension, injectable), cats (oral suspension, injectable), and cattle (injectable). Not approved for horses in the US, but may be used extra-label.
Extra-Label (Off-Label) Use: In the US, meloxicam is approved for use in dogs and cats (oral suspension and injectable) and cattle (injectable). Extra-label use in other species (e.g., horses, small ruminants, rabbits, birds) is permitted under the Animal Medicinal Drug Use Clarification Act (AMDUCA) provided there is a valid veterinarian-client-patient relationship, and withdrawal times are extended. In the EU, meloxicam is approved for dogs, cats, horses, cattle, pigs, and rabbits. Always follow label directions and consult regulatory authorities for specific rules.
Clinical Pearls & Practice Notes
References & Literature
- π Plumb's Veterinary Drug Handbook
- π Papich Veterinary Pharmacology and Therapeutics
- π Compendium of Veterinary Products (CVP)
- π FDA Animal & Veterinary Drug Approvals
- π European Medicines Agency (EMA) product information