Drug interactions
Lithium + Meloxicam
Severity: Major
Lithium and Meloxicam: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Meloxicam can raise serum lithium concentrations, which may lead to lithium toxicity with tremor, confusion, gastrointestinal upset and potentially seizures or arrhythmias. Because lithium has a narrow therapeutic range, even a modest rise can be clinically important.
What this interaction means in plain words
Lithium and Meloxicam can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Lithium belongs to Central Nervous System; Meloxicam belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandins reduces renal blood flow and lithium clearance, increasing lithium retention.
What to do
Measure lithium levels before starting and within the first week or so after starting or stopping meloxicam, and reduce the lithium dose as needed. Prefer paracetamol where suitable, and counsel patients to report signs of toxicity.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Meloxicam
- Ketorolac intranasal + Meloxicam Contraindicated
- Ketorolac + Meloxicam Contraindicated
- Aceclofenac + Meloxicam Major
- Acemetacin + Meloxicam Major
- Acetylsalicylic acid + Meloxicam Major
- Alteplase + Meloxicam Major
Other interactions of Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Lithium with Meloxicam?
MediHelp rates the interaction as major. Lithium and Meloxicam can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Meloxicam can raise serum lithium concentrations, which may lead to lithium toxicity with tremor, confusion, gastrointestinal upset and potentially seizures or arrhythmias. Because lithium has a narrow therapeutic range, even a modest rise can be clinically important.
How serious is the interaction between Lithium and Meloxicam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Measure lithium levels before starting and within the first week or so after starting or stopping meloxicam, and reduce the lithium dose as needed. Prefer paracetamol where suitable, and counsel patients to report signs of toxicity.
What other medicines interact with Meloxicam?
MediHelp also lists interactions of Meloxicam with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Meloxicam page.
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