Ischaemic colitis in a patient taking meloxicam.
The safety of cyclo-oxygenase 2 (COX-2) preferential inhibitors such as meloxicam is debated. We describe a patient who presented with bloody diarrhoea after 15 mg meloxicam daily for 10 days for osteoarthritis. The endoscopic and histological features were consistent with the diagnosis of ischaemic colitis. Symptoms and endoscopic lesions quickly regressed within 1 week of meloxicam withdrawal. There was no evidence of another cause of colonic ischaemia. We suggest that meloxicam might have intestinal toxic effects when taken in high doses, because of reduced COX-2 selectivity.
Garcia
B
B
Ramaholimihaso
F
F
Diebold
M D
MD
Cadiot
G
G
Thiéfin
G
G
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D017091:Colitis, Ischemic / Q000139:chemically induced*; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000037:antagonists & inhibitors*; D000077239:Meloxicam; D008565:Membrane Proteins; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy*; D011451:Prostaglandin-Endoperoxide Synthases; D013843:Thiazines / Q000008:administration & dosage / Q000009:adverse effects*; D013844:Thiazoles / Q000008:administration & dosage / Q000009:adverse effects*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D013843:Thiazines; D013844:Thiazoles; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D000077239:Meloxicam