Tolerability of meloxicam in patients with histories of adverse reactions to nonsteroidal anti-inflammatory drugs

Ann Allergy Asthma Immunol. 2000 Jun;84(6):613-7. doi: 10.1016/S1081-1206(10)62412-X.


Background: Adverse reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) are frequent, particularly among patients with chronic urticaria or asthma. The need to identify an alternative drug that is safe and reliable is a common problem in clinical practice.

Objective: To assess the tolerability of meloxicam, a new NSAID that selectively inhibits the inducible isoform of cyclooxygenase, in a group of NSAID-sensitive patients.

Patients and methods: We studied 177 patients who had suffered adverse reactions to one or more NSAIDs. Cutaneous reactions were reported by 83.1% of the subjects (urticaria in 55, angioedema in 52, urticaria/angioedema in 39, and maculopapular rash in 1), respiratory symptoms by 3.9%, both cutaneous and respiratory symptoms by 9%, Stevens-Johnson's syndrome by 2.3%, and anaphylactoid reactions by 1.7%. All subjects underwent a single-blind, placebo-controlled oral challenge with divided therapeutic doses of meloxicam (1.9 mg + 5.6 mg 1 hour later = cumulative dose 7.5 mg).

Results: Positive reactions were observed in only two cases (1.1%), both manifested exclusively by cutaneous symptoms (urticaria/angioedema in one case and maculopapular rash/facial edema in the second).

Conclusion: Meloxicam seems to be well tolerated by NSAID-sensitive subjects whose reactions are manifested by urticaria/angioedema. Additional study is needed for a more complete assessment of its tolerability in patients with aspirin-induced asthma and other severe manifestations of NSAID sensitivity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anaphylaxis / chemically induced
  • Angioedema / chemically induced
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Asthma / drug therapy
  • Chronic Disease
  • Cyclooxygenase Inhibitors
  • Drug Eruptions / etiology*
  • Female
  • Forced Expiratory Volume / drug effects
  • Humans
  • Male
  • Meloxicam
  • Middle Aged
  • Thiazines / adverse effects*
  • Thiazoles / adverse effects*
  • Urticaria / drug therapy


  • Anti-Inflammatory Agents, Non-Steroidal
  • Cyclooxygenase Inhibitors
  • Thiazines
  • Thiazoles
  • Meloxicam