table of contents
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Meloxicam comes in 5 mg, 7.5 mg, 10 mg, and 15 mg dosages. A dose of 15 mg is the maximum daily dose of this medication.
The pain associated with osteoarthritis (OA) and rheumatoid arthritis (RA) can be managed with 15 mg doses of meloxicam—though patients will be started on a lower dose at the beginning (FDA, 2012).
Even though this is a higher dose of meloxicam, it still may take some time to feel its effects. People with RA may begin to feel relief as early as three weeks into treatment on either 7.5 mg or 15 mg dosages (Reginster, 1996).
Those with OA may feel the drug’s effects sooner. Researchers found evidence that meloxicam worked after two weeks in patients given daily doses of 7.5 mg or 15 mg (Yocum, 2000).
Meloxicam is also used short-term to manage post-operative pain for certain procedures, and 15 mg doses may be used. Single doses of 15 mg meloxicam have been shown in multiple studies to reduce the pain following certain surgical procedures (Kurukahvecioglu, 2007; Aghadavoudi, 2015).
For other procedures, such as tooth extractions, 15 mg meloxicam is taken once daily for less than a week (Calvo, 2006).
How long can 15 mg meloxicam be used?
Although 15 mg meloxicam is approved for the management of arthritis-related joint pain, it’s not recommended for long-term use.
There is a U.S. Food and Drug Administration (FDA) black box warning about the side effects of meloxicam.
The FDA’s warning underscores that meloxicam may increase the risk of heart attack and stroke, especially in people with heart disease or other cardiovascular risk factors. This risk may be higher if you use meloxicam long-term. These cardiovascular events can happen without warning and may be fatal (NIH-a, 2020).
What is meloxicam used for?
Meloxicam can treat a wide range of pain and swelling but is frequently used for conditions like OA and RA.
It can also be used off-label (in a way not specifically approved by the FDA) to treat a condition called gout. All of these conditions are characterized by inflammation in the joints. Though none of these conditions can be cured, NSAIDs such as meloxicam can manage the pain.
- Osteoarthritis: OA is a condition that can make it hard to function on a day-to-day basis. It causes swelling, redness, pain, and deformities of the joints. More than 43 million people around the world suffer from OA, and it becomes more common as we age. Signs of this disease are present in more than 80% of people over the age of 60. Genetics, history of injury, increased body weight, other underlying conditions may increase your risk of developing OA (Sen, 2020).
- Rheumatoid arthritis: RA is caused by the immune system inappropriately attacking certain areas of the body, including the joints, lungs, and other tissues. While rest often improves symptoms of OA, it exacerbates pain and stiffness associated with RA. Meloxicam helps treat RA by quelling the body’s immune response and alleviating pain.
- Gout: Meloxicam also manages pain and swelling from gout flare-ups. Signs of gout include sudden pain, redness, and swelling of joints. It may affect any joint in the body, although it commonly affects the big toe. Gout often results from a buildup of uric acid in the body, but behavioral factors can trigger flare-ups or attacks in susceptible individuals (Jin, 2012). These factors include certain foods, like shellfish and red meat, and drugs like aspirin and certain diuretics (ACR, 2019).
- Ankylosing spondylitis (AS): Meloxicam has also been used off-label to manage the pain associated with AS, a rare chronic inflammatory condition that affects the spine (Song, 2008). There’s cure for AS, but NSAIDs such as meloxicam can help manage the pain.
Meloxicam side effects
The most common side effects of meloxicam are diarrhea, indigestion, and flu-like symptoms (FDA, 2012).
Other side effects include headache, dizziness, skin rash, and other digestive issues such as gas, heartburn, and nausea (DailyMed, 2019).
The U.S. Food and Drug Administration (FDA) has a black box warning about serious potential side effects on the gastrointestinal system. Meloxicam can increase your risk of bleeding, ulceration, and perforations in the stomach or intestines. These conditions may occur without warning and may be fatal.
Older people and those with a prior history of GI problems using meloxicam are at higher risk for adverse effects (FDA, 2012). Note that this drug does not need to be taken by mouth to cause digestive problems and does the same when administered as an injection.
Non-steroidal anti-inflammatory drugs (NSAIDs) act on different parts of the inflammation pathway to decrease symptoms such as swelling. Meloxicam also slows clotting time, which may increase the risk of bleeding (Rinder, 2002; Martini, 2014).
When to seek medical attention
You should seek medical attention immediately if you experience severe abdominal pain, black or bloody stool, dizziness, or loss of consciousness.
Allergic reactions to meloxicam are possible. Signs of an allergic reaction include hives, trouble breathing, shortness of breath, or a blistering skin rash. If you experience any of these symptoms, get medical help immediately (DailyMed, 2019).
Meloxicam tablets are available in 5 mg, 7.5 mg, 10 mg, and 15 mg dosages, but there are multiple forms of this medication. Meloxicam comes as an oral suspension (7.5 mg/5 ml), a disintegrating tablet (7.5 mg and 15 mg dosages), and an intravenous (IV) solution (30 mg/mL). IV meloxicam is used in a hospital setting.
Meloxicam is available under the brand name Mobic and as a generic drug. A 30-day supply costs between $4 to over $400, depending on the strength and whether it’s generic or brand name (GoodRx.com). Many insurance plans cover meloxicam.
Most people on meloxicam take one pill by mouth daily. If you miss a dose, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and take your next one as usual. Don’t take a double dose.
Meloxicam tablets should be stored at room temperature and out of the reach of children.
Meloxicam may increase the risk of heart attack and stroke, especially in people with heart disease or other cardiovascular risk factors.
This risk may be higher if you use meloxicam long-term. Do not use meloxicam to treat pain right before or after heart surgery, like a coronary artery bypass graft (CABG) procedure. Meloxicam can also increase your risk of bleeding, ulceration, and holes (perforations) in the stomach or intestines (FDA, 2012).
NSAIDs such as meloxicam should also not be taken after the second trimester of pregnancy. These medications may interfere with how the fetus’s heart develops and redirect blood flow in the fetus’s body, which may lead to heart problems later on (Bloor, 2013; Enzensberger, 2012).
Talk to a healthcare professional before taking meloxicam if you’re nursing. We don’t know how much meloxicam gets into breast milk, but your healthcare provider can help you weigh the risks and benefits of taking it while breastfeeding (FDA, 2012).
NSAIDs may also make it harder for the embryo to implant (Bermas, 2014). If you take meloxicam regularly, talk to your healthcare provider if you’re trying to conceive or plan to start trying.
Meloxicam drug interactions
Meloxicam may affect how well blood pressure medications work. The drug may make medications that lower high blood pressure like ACE inhibitors, angiotensin receptor blockers (ARBs), and beta-blockers less effective (Fournier, 2012; Johnson, 1994).
Meloxicam may have this effect on other medications such as diuretics (aka “water pills”), which are drugs that affect fluid retention. Meloxicam may make loop diuretics such as furosemide and thiazide diuretics such as hydrochlorothiazide (HCTZ) not work as well. If taken together, these medications may also worsen kidney function, potentially causing kidney failure (DailyMed, 2019).
Combining certain medications with meloxicam may increase your risk of bleeding. Blood thinners (such as the anticoagulant warfarin) and antiplatelet agents (such as aspirin) should not be taken with meloxicam for this reason (DailyMed, 2019). Smoking while taking meloxicam also increases your risk of bleeding problems (FDA, 2012).
Combining meloxicam with other NSAIDs (such as over-the-counter NSAIDs, naproxen, or ibuprofen) increases the chance of developing gastrointestinal problems, like bleeding or ulcers.
- American College of Rheumatology (ACR). (2019). Gout. Retrieved on Sep. 16, 2020 from https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Gout
- Bloor, M. & Paech, M. (2013). Nonsteroidal Anti-Inflammatory Drugs During Pregnancy and the Initiation of Lactation. Anesthesia & Analgesia, 116(5), 1063-1075. doi:10.1213/ane.0b013e31828a4b54. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23558845/
- Bermas, B. L. (2014). Non-steroidal anti inflammatory drugs, glucocorticoids and disease modifying anti-rheumatic drugs for the management of rheumatoid arthritis before and during pregnancy. Current Opinion in Rheumatology, 26(3), 334-340. doi:10.1097/bor.0000000000000054. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24663106/
- DailyMed. (2019). Meloxicam tablet. Retrieved on Sep. 16, 2020 from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d5e12448-1ca1-46a4-8de4-e8b94567e5a8
- Enzensberger, C., Wienhard, J., Weichert, J., Kawecki, A., Degenhardt, J., Vogel, M., & Axt-Fliedner, R. (2012). Idiopathic Constriction of the Fetal Ductus Arteriosus. Journal of Ultrasound in Medicine, 31(8), 1285-1291. doi:10.7863/jum.2012.31.8.1285. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22837295/
- Food and Drug Administration (FDA). (2012). Mobic (meloxicam) tablets and oral suspension. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/012151s072lbl.pdf
- Fournier, J. P., Sommet, A., Bourrel, R., Oustric, S., Pathak, A., Lapeyre-Mestre, M., & Montastruc, J. L. (2012). Non-steroidal anti-inflammatory drugs (NSAIDs) and hypertension treatment intensification: a population-based cohort study. European Journal of Clinical Pharmacology, 68(11), 1533–1540. doi:10.1007/s00228-012-1283-9. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22527348/
- Gaffo, A. L. (2019, December 4). Treatment of gout flares. Retrieved Sep. 18, 2020, from https://www.uptodate.com/contents/treatment-of-gout-flares/
- GoodRx.com. (n.d.). Meloxicam. Retrieved Sep. 16, 2020 from https://www.goodrx.com/meloxicam
- Huskisson, E. C., Ghozlan, R., Kurthen, R., Degner, F. L., & Bluhmki, E. (1996). A Long-Term Study to Evaluate the Safety and Efficacy of Meloxicam Therapy in Patients with Rheumatoid Arthritis. Rheumatology, 35(Suppl 1), 29-34. doi:10.1093/rheumatology/35.suppl_1.29. Retrieved from https://academic.oup.com/rheumatology/article/35/suppl_1/29/1782379
- Jin, M., Yang, F., Yang, I., Yin, Y., Luo, J. J., Wang, H., & Yang, X. F. (2012). Uric acid, hyperuricemia and vascular diseases. Frontiers in Bioscience (Landmark edition), 17, 656–669. doi:10.2741/3950. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3247913/
- Johnson, A. G., Nguyen, T. V., & Day, R. O. (1994). Do nonsteroidal anti-inflammatory drugs affect blood pressure? A meta-analysis. Annals of Internal Medicine, 121(4), 289–300. doi:10.7326/0003-4819-121-4-199408150-00011. Retrieved from https://pubmed.ncbi.nlm.nih.gov/8037411/
- Martini, A. K., Rodriguez, C. M., Cap, A. P., Martini, W. Z., & Dubick, M. A. (2014). Acetaminophen and meloxicam inhibit platelet aggregation and coagulation in blood samples from humans. Blood Coagulation & Fibrinolysis, 25(8), 831-837. doi:10.1097/mbc.0000000000000162. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25004022/
- National Institutes of Health (NIH-a). (2020, April 15). Meloxicam: MedlinePlus Drug Information. Retrieved Sep. 23, 2020 from https://medlineplus.gov/druginfo/meds/a601242.html
- National Institutes of Health (NIH-b). (2020, August 17). Ankylosing spondylitis – Genetics Home Reference. Retrieved Sep. 22, 2020 from https://medlineplus.gov/genetics/condition/ankylosing-spondylitis/
- Reginster, J. Y., Distel, M., & Bluhmki, E. (1996). A Double-Blind, Three-Week Study to Compare the Efficacy and Safety of Meloxicam 7.5 mg and Meloxicam 15 mg in Patients with Rheumatoid Arthritis. Rheumatology, 35(Suppl 1), 17-21. doi:10.1093/rheumatology/35.suppl_1.17. Retrieved from https://www.researchgate.net/profile/Erich_Bluhmki/publication/14569192_A_Double-Blind_Three-Week_Study_to_Compare_the_Efficacy_and_Safety_of_Meloxicam_75_mg_and_Meloxicam_15_mg_in_Patients_with_Rheumatoid_Arthritis/links/599d516745851574f4b258e4/A-Double-Blind-Three-Week-Study-to-Compare-the-Efficacy-and-Safety-of-Meloxicam-75-mg-and-Meloxicam-15-mg-in-Patients-with-Rheumatoid-Arthritis.pdf
- Rinder, H. M., Tracey, J. B., Souhrada, M., Wang, C., Gagnier, R. P., & Wood, C. C. (2002). Effects of Meloxicam on Platelet Function in Healthy Adults: A Randomized, Double-Blind, Placebo-Controlled Trial. The Journal of Clinical Pharmacology, 42(8), 881-886. doi:10.1177/009127002401102795. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12162470/
- Song, I. H., Poddubnyy, D. A., Rudwaleit, M., & Sieper, J. (2008). Benefits and risks of ankylosing spondylitis treatment with nonsteroidal antiinflammatory drugs. Arthritis & Rheumatism, 58(4), 929-938. doi:10.1002/art.23275. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1002/art.23275
- Yocum, D. (2000). Safety and Efficacy of Meloxicam in the Treatment of Osteoarthritis. Archives of Internal Medicine, 160(19), 2947-2954. doi:10.1001/archinte.160.19.2947. Retrieved from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/485487
Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.