Symptoms: Symptoms following acute NSAID overdose are usually limited to lethargy, drowsiness, nausea, vomiting and epigastric pain, which are generally reversible with supportive care. Gastrointestinal bleeding can occur. Severe poisoning may result in hypertension, acute renal failure, hepatic dysfunction, respiratory depression, coma, convulsions, cardiovascular collapse and cardiac arrest.
Anaphylactoid reactions have been reported with therapeutic ingestion of NSAIDs and may occur following an overdose.
Treatment: There is no known antidote to meloxicam, therefore, treatment of overdose is symptomatic and supportive. Cholestyramine administration, 4 g 3 times daily, may enhance the elimination of meloxicam. Antacids and H2-receptor antagonists may be used for the treatment of severe gastrointestinal lesions. In cases of acute overdose, gastric lavage followed by activated charcoal is recommended. Gastric lavage performed >1 hr after overdose has little benefit in the treatment of overdose. Administration of activated charcoal is recommended for patients who present 1-2 hrs after overdose. For substantial overdose or severely symptomatic patients, activated charcoal may be administered repeatedly. Forced diuresis, alkalinization of urine, haemodialysis or haemoperfusion may not be useful due to high protein-binding of meloxicam.