Table of CONTENT
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 tablets come in four dosages: 5 mg, 7.5 mg, 10 mg, and 15 mg. Generally, healthcare providers prescribe 5 mg doses when people with osteoarthritis (OA) or rheumatoid arthritis (RA) start treatment with meloxicam. U.S. Food and Drug Administration (FDA) also approves meloxicam to manage the pain associated with juvenile rheumatoid arthritis (JRA) (RA in children ages two and older). Children may be prescribed 7.5 mg of meloxicam if their symptoms are not controlled on lower doses (DailyMed, 2018).
Though 7.5 mg is enough to manage pain in many patients, it may take time to feel the full effects of meloxicam. Research shows that those 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).
Individuals prescribed meloxicam for osteoarthritis may feel the effects even sooner. Researchers found evidence that meloxicam was working after just two weeks in patients given daily doses of either 7.5 mg or 15 mg of the prescription drug (Yocum, 2000).
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What is meloxicam used for?
Meloxicam can be used to treat a wide range of pain and swelling but is frequently prescribed to alleviate specific types of joint pain in conditions like OA and RA, which we’ll get into below. People can also use it off-label to treat a joint condition called gout. All of these conditions are characterized by inflammation in the joints. While there is no cure for these conditions, NSAIDs such as meloxicam can manage the pain.
- Osteoarthritis (OA) is a condition typically associated with wear and tear on the joints. It causes swelling, redness, pain, and deformities of the joints that can make it hard to function on a day-to-day basis. OA becomes more common as we age, with signs of the disease present in more than 80% of people over 60. Still, other factors contribute, including genetics, history of injury, increased body weight, and the presence of other underlying conditions. More than 43 million people around the world suffer from moderate-to-severe osteoarthritis (Sen, 2020).
- Rheumatoid arthritis (RA) is caused by the immune system inappropriately attacking certain areas of the body, including the joints, the lungs, and other tissues. And while rest often improves the symptoms of osteoarthritis, it exacerbates the pain and stiffness associated with rheumatoid arthritis. Treatment for rheumatoid arthritis involves the use of NSAIDs like meloxicam to quell the immune response and alleviate pain and other immune-suppressing drugs like steroids.
- Meloxicam can also be used off-label to manage the pain and swelling associated with gout flare-ups, a condition characterized by sudden pain, redness, and swelling of joints. Gout commonly affects one joint in the big toe but may affect any joint in the body. This condition often results from a buildup of uric acid in the body, but many 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 (“water pills”), which increase the levels of uric acid in the body (ACR, 2019). Meloxicam can help manage gout symptoms (Gaffo, 2019).
- Meloxicam has also been used off-label to help with the pain associated with ankylosing spondylitis (AS), a rare, chronic inflammatory condition that affects the spine (Song, 2008). Like OA and RA, we do not have a cure for AS, but NSAIDs such as meloxicam can help manage the pain.
Side effects of meloxicam
The most common side effects of meloxicam are diarrhea, indigestion (dyspepsia), and flu-like symptoms (FDA, 2012). Other possible side effects include headache, dizziness, skin rash, and other gastrointestinal issues such as heartburn, nausea, and gas (DailyMed, 2019).
The FDA issued a “black box” warning about this medication’s serious potential side effects on the digestive system. A black box warning is the FDA’s most serious advisory. 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 these adverse effects (FDA, 2012). Meloxicam comes in different forms and does not need to be taken by mouth to cause digestive problems. It 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 increases the time it takes your blood to clot, which may increase your risk of bleeding (Rinder, 2002; Martini, 2014).
When to seek medical attention
If you’re taking meloxicam and experiencing sudden and severe stomach pain that won’t go away, black or bloody stool, dark urine, dizziness, or loss of consciousness, seek medical attention immediately.
Meloxicam may cause severe allergic (hypersensitivity) reactions. Signs of an allergic reaction include hives, trouble breathing, shortness of breath, or skin reactions such as a blistering skin rash. If you experience any of these symptoms, get medical help immediately (DailyMed, 2019).
One of the reasons that meloxicam is not available over the counter is that it can increase your risk of having a heart attack or stroke, especially if you have a history of heart disease or other risk factors. This risk may be higher if you use this prescription drug long-term (FDA, 2012).
Meloxicam should not be used to treat pain right before or after heart surgery, like a coronary artery bypass graft (CABG) procedure (commonly referred to as “bypass”), because the use of NSAIDs increases the risk of heart attack or stroke following these procedures (Kulik, 2015).
NSAIDs such as meloxicam should also not be taken during the third trimester of pregnancy.
If you’re nursing, talk to a healthcare professional before using meloxicam. While we aren’t sure how much meloxicam reaches breast milk, your healthcare provider can help you weigh the risks and benefits of using this medication while breastfeeding (FDA, 2012). If you are pregnant, it’s important to know that you should not take this medication or any NSAIDs (like ibuprofen or naproxen) after the second trimester of pregnancy.
These medications may interfere with the development of the fetus’s heart and redirect blood flow in its body, which may result in progressive heart problems later on (Bloor, 2013; Enzensberger, 2012). Research has also shown that NSAIDs like meloxicam may make it harder for the embryo to implant (Bermas, 2014). If you take meloxicam regularly, consult with a healthcare professional if you have been trying to conceive or plan to start trying.
Meloxicam drug interactions
Certain medications may increase the risk of bleeding if taken with meloxicam. Blood thinners (like warfarin) and antiplatelet agents (like 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 naproxen increases the chance of developing gastrointestinal problems, like bleeding or stomach ulcers.
Meloxicam may affect how well blood pressure medications work. Drugs that lower blood pressure (antihypertensive drugs), like ACE inhibitors, angiotensin receptor blockers (ARBs), or beta-blockers may be less effective if taken with meloxicam (Fournier, 2012; Johnson, 1994).
Meloxicam may have this effect on other medications such as diuretics (aka “water pills”), drugs that reduce fluid retention. Loop diuretics such as furosemide and thiazide diuretics such as hydrochlorothiazide (HCTZ) may not work as well if taken with meloxicam. These medications may also worsen kidney function if taken together, potentially causing kidney failure (DailyMed, 2019).
Meloxicam forms and brand names
Meloxicam is available as a generic drug and sold under the brand names Mobic and Vivlodex. 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. IV meloxicam is used in a hospital setting.
Most people usually 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 dose as usual. Don’t take a double dose. Meloxicam tablets should be stored at room temperature and out of the reach of children.
A 30-day supply of meloxicam costs between $4 to over $400, and many insurance plans cover this prescription drug (GoodRx.com). The price depends on the strength and whether you purchase brand name or generic pills.
- American College of Rheumatology (ACR) (2019). Gout. Retrieved on 16 September 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 16 September 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/
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- 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., MD, MsPH. (2019, December 4). Treatment of gout flares. Retrieved September 18, 2020, from https://www.uptodate.com/contents/treatment-of-gout-flares/
- GoodRx.com (n.d.). Meloxicam. Retrieved 16 September 2020 from https://www.goodrx.com/meloxicam
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- 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/
- Kulik, A., Bykov, K., Choudhry, N. K., & Bateman, B. T. (2015). Non-steroidal anti-inflammatory drug administration after coronary artery bypass surgery: Utilization persists despite the boxed warning. Pharmacoepidemiology and Drug Safety, 24(6), 647-653. doi:10.1002/pds.3788. Retrieved from https://scholar.harvard.edu/files/nkc/files/2015_nsaids_after_cabg_pds.pdf
- 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/
- 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/
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- 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