Meloxicam with Itraconazole Interaction Details
Brand Names Associated with Meloxicam
- Meloxicam
- Mobic®
Brand Names Associated with Itraconazole
- Itraconazole
- Onmel®
- Sporanox®
- Tolsura®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 11, 2023
Interaction Effect
Reduced meloxicam exposure
Interaction Summary
Concomitant administration of itraconazole with meloxicam may lead to reduced meloxicam levels and potentially decrease the effectiveness of meloxicam. Meloxicam dose increase may be necessary. In an open-label, randomized, three-phase crossover study of 12 male patients, coadministration of itraconazole and meloxicam decreased the mean meloxicam AUC (0 to 72 hours) by 63% and the mean Cmax by 36% when compared to control values. The combination also resulted in a decline in thromboxane B2 inhibition compared to meloxicam alone. Dosing adjustments and monitoring for potential decreased effectiveness may be appropriate .
Severity
Moderate
Onset
Rapid
Evidence
Established
How To Manage Interaction
Coadministration of itraconazole and meloxicam may lead to reduced meloxicam levels and potentially decreased effectiveness. Dosing adjustments and increased monitoring may be appropriate.
Mechanism Of Interaction
Unknown
Literature Reports
A) An open-labeled, randomized, three-phase crossover study of 12 male patients (ages 19 to 39 years) demonstrated decreases in plasma concentrations when meloxicam was coadministered with itraconazole. The subjects were given either no pretreatment (control), pretreatment with voriconazole (400 mg every 12 hours on day 1 and 200 mg every 12 hour on day 2) or pretreatment with itraconazole (200 mg/day in the morning for 4 days) in random order with a 4 week washout period between phases. One hour following the last dose of either voriconazole or itraconazole, meloxicam 15 mg was administered. Plasma samples were drawn at scheduled times following meloxicam administration. Participants showed a decrease in mean meloxicam AUC (0 to 72 hours) by 63% (p less than 0.001) and mean Cmax by 36% (p less than 0.001) when coadministered with itraconazole compared with control values. The median Tmax with itraconazole was reached at 24 hours compared to 4 hours with the control and the half-life was increased to 27 hours from 17.4. Within the first 24 hours, meloxicam (with itraconazole) did not demonstrate any impact on thromboxane B2 synthesis. At 48 hours, thromboxane B2 synthesis was inhibited by 29%, a value consistent with the degree of inhibition seen 5 hours after meloxicam 7.5 mg is administered without itraconazole .
Meloxicam Overview
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Meloxicam is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). Meloxicam is also used to relieve the pain, tenderness, swelling, and stiffness caused by juvenile rheumatoid arthritis (a type of arthritis that affects children) in children 2 years of age and older. Meloxicam is in a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by stopping the body's production of a substance that causes pain, fever, and inflammation.
Itraconazole Overview
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Itraconazole capsules (Sporanox, Tolsura) are used to treat fungal infections in the lungs that can spread throughout the body. Itraconazole capsules (Sporanox) are also used to treat fungal infections of the fingernails and toenails. Itraconazole oral solution (liquid) is used to treat yeast infections of the mouth and throat or of the esophagus (tube that connects the throat to the stomach). Itraconazole is in a class of antifungals called triazoles. It works by slowing the growth of fungi that cause infection.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.