Meloxicam injection is a non-steroidal anti-inflammatory drug (NSAID) indicated for the management of moderate to severe pain in adults. Understanding its indications and the key precautions throughout the entire course of therapy helps patients achieve analgesic benefits while minimizing risks to the cardiovascular, gastrointestinal, and renal systems to the greatest extent possible.

I. Indications and Appropriate Clinical Scenarios

1. Core Indications

(1) Meloxicam injection is indicated for the management of moderate to severe pain in adults.

(2) It may be used alone or in combination with non-NSAID analgesics.

(3) It is commonly used clinically for short-term analgesia in postoperative pain, orthopedic surgeries (e.g., hallux valgus correction, abdominoplasty, knee or hip replacement), and soft tissue trauma.

2. Role in Combination Therapy

Because this product has a slow onset of action, during the emergence from anesthesia or after the regression of local anesthetic effects, if rapid analgesia is required, a fast-acting non-NSAID analgesic should be used as a rescue measure.

3. Not Suitable as Sole Therapy for Rapid Analgesia

(1) This product is not appropriate as the sole agent for situations requiring rapid pain control.

(2) A faster-acting analgesic regimen should be prioritized, and this product may be considered for subsequent maintenance based on changes in pain status.

4. Limited Duration of Therapy

(1) This product is intended only for short-term treatment; the duration should be as short as possible, consistent with the shortest period needed to achieve individual patient pain control goals.

(2) It is not indicated for chronic pain or long-term daily use.

II. Key Safety Measures During Administration

1. Adequate Hydration Before Administration

(1) To reduce the risk of renal injury, patients must be adequately hydrated before dosing.

(2) Healthcare providers should assess fluid intake and output before administration and, if necessary, administer intravenous fluids beforehand.

2. Inspection of the Solution

(1) The solution should be visually inspected prior to administration.

(2) It is normally a clear, pale yellow to yellow solution. If discoloration, turbidity, or particulates are observed, the vial should be discarded immediately and not used.

3. Strategies for Delayed Onset

(1) Patients' pain responses should be continuously monitored after administration.

(2) If pain worsens or is not adequately relieved during the 24‑hour dosing interval, a short‑acting immediate‑release non-NSAID analgesic may be used as rescue, but the next meloxicam dose should not be given early.

4. Fixed Once‑Daily Dosing

(1) The recommended dose is 30 mg once daily, administered as an intravenous bolus over 15 seconds.

(2) It is recommended to administer at the same time each day to maintain stable plasma concentrations, with a dosing interval of no less than 24 hours.

5. Vigilance for Asymptomatic Serious Adverse Events

(1) Serious cardiovascular events (myocardial infarction, stroke) and gastrointestinal bleeding, ulceration, or perforation can occur without warning symptoms.

(2) During therapy, even in the absence of obvious discomfort, patients should be alert to signs such as chest pain, shortness of breath, weakness, black or tarry stools, or hematemesis.

(3) Elderly patients and those with a history of ulcer disease should be particularly vigilant.

III. Contraindications and Precautions in Specific Populations

1. Absolute Contraindications

(1) Hypersensitivity to meloxicam or any excipient of this product.

(2) History of asthma, urticaria, or allergic reactions after using aspirin or other NSAIDs.

(3) Aspirin‑sensitive asthma patients.

(4) Perioperative period of coronary artery bypass graft surgery (before, during, and within 14 days after surgery).

(5) Moderate to severe renal insufficiency with concomitant volume depletion.

(6) History of severe skin reactions related to NSAID use.

2. Conditions Requiring Caution or Avoidance

(1) Recent myocardial infarction or severe heart failure, unless the anticipated benefit clearly outweighs the risk.

(2) Uncontrolled hypertension.

(3) Active gastrointestinal ulcer or bleeding.

(4) Moderate to severe renal impairment is not recommended.