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Last updated: Dec 01, 2020
5 min read

Meloxicam dosage: what’s the right dose for me?

Disclaimer

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 is a prescription non-steroidal anti-inflammatory drug (NSAID), a type of painkiller used to treat medical conditions characterized by pain and swelling, such as arthritis––pain and swelling in the joints.

While you may be familiar with the dosages of over-the-counter NSAIDs such as naproxen and ibuprofen, this prescription drug is quite different.

Meloxicam is sold as generic meloxicam tablets and under the brand names Mobic and Vivlodex. Meloxicam doses for both generic and brand-name tablets are 5 mg, 7.5 mg, 10 mg, and 15 mg dosages.

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Forms of this medication include meloxicam oral suspension (7.5 mg/5 mL), a disintegrating tablet (7.5 and 15 mg dosages), and an intravenous (IV) solution (30 mg/mL), which is usually used in a hospital setting. 

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.

Many insurance plans cover meloxicam, and a 30-day supply costs between $4 to over $400. The price depends on the strength and whether you purchase brand name or generic pills (GoodRx.com). 

What is meloxicam?

Meloxicam is a prescription NSAID that the U.S. Food and Drug Administration (FDA) approved to treat pain in patients who have osteoarthritis, the most common form of arthritis, typically caused by wear and tear on the joints.

It also is used for rheumatoid arthritis, a chronic inflammatory condition, and juvenile rheumatoid arthritis. None of these conditions can be cured, but the pain associated with joint inflammation can be managed with NSAIDs such as meloxicam (FDA, 2012).

Meloxicam can also be used to treat the pain associated with flare-ups of gout, a painful type of arthritis characterized by sudden pain, redness, and swelling.

This condition most commonly affects one joint of the big toe but can appear in any joint in the body. It results from a buildup of uric acid in the body, and a range of behavioral factors can trigger flare-ups or attacks in people with the condition (Jin, 2012).

Certain drugs, like aspirin and specific diuretics (“water pills”), as well as certain foods, like shellfish and red meat, increase the levels of uric acid in the body. Meloxicam can help manage gout symptoms (Gaffo, 2019; ACR, 2019).

Meloxicam has also been used off-label to treat the pain associated with ankylosing spondylitis, a rare, chronic inflammatory condition of the spine. The small bones of the spine may eventually fuse in individuals with this type of arthritis, limiting back movement. This condition cannot be cured, but the joint and back pain associated with it can be managed with NSAIDs (NIH, 2020).

Meloxicam side effects

The most common side effects of meloxicam are diarrhea, indigestion, and flu-like symptoms. 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 effects on the gastrointestinal system. All NSAIDs inhibit substances called prostaglandins, which play a role in protecting your GI tract.

Taking NSAIDs for long periods of time strips away this protection, leaving the digestive lining vulnerable to damage that can result in the formation of stomach ulcers, perforations in the stomach or intestines, and bleeding. Meloxicam can increase your risk of these serious GI symptoms.

These conditions may occur without warning and may be fatal. Certain people are at higher risk for these adverse effects, including older people and those with a prior history of GI problems. Note that this drug does not need to be taken by mouth to cause digestive problems. It does the same when administered as an injection.

NSAIDs act on different parts of the inflammation pathway to decrease symptoms such as swelling. The use of meloxicam also interferes with normal platelet function, which is important in the formation of blood clots. Meloxicam can slow clotting time and increase your risk of bleeding.

Warnings and when to seek medical attention

There is a black box warning about the serious side effects of meloxicam. A black box warning is the FDA’s most serious advisory on a medication, which comes in the insert for some medications.

Meloxicam may increase the risk of heart attacks and strokes, especially in people with heart disease or other cardiovascular risk factors. This risk may be higher if you use meloxicam long-term. Meloxicam should not be used to treat pain right before or after heart surgery, like a coronary artery bypass graft procedure.

Meloxicam can also put you at a greater risk of gastrointestinal bleeding and ulceration or holes (perforations) in the stomach or intestines. NSAIDs such as meloxicam should also not be taken during the third trimester of pregnancy (FDA, 2012).

These medications may interfere with how the fetus’s heart develops and redirect blood flow in the fetus’s body, which may result in progressive heart problems later on (Enzensberger, 2012). 

If you’re breastfeeding, discuss meloxicam use with a medical professional. It isn’t clear whether or not this medication gets into breastmilk. A healthcare professional can help weigh the benefits of using this medication while nursing. People who are or wish to become pregnant should discuss NSAID use with a healthcare provider.

NSAIDs may affect the embryo’s ability to implant in the uterus, which may mean it’s necessary to discontinue their use in individuals having a hard time getting pregnant. You should seek medical attention immediately if you experience severe abdominal pain, black or bloody stool, dizziness, or loss of consciousness. (Bermas, 2014).

It’s possible to have a severe allergic reaction to meloxicam. 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).

References

  1. 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
  2. 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/
  3. 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/
  4. DailyMed. (2019). Meloxicam tablet. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d5e12448-1ca1-46a4-8de4-e8b94567e5a8
  5. 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/
  6. 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/
  7. Gaffo, A. L. (2019, December 4). Treatment of gout flares. Retrieved Sep. 18, 2020 from https://www.uptodate.com/contents/treatment-of-gout-flares/
  8. GoodRx.com. (n.d.). Meloxicam. Retrieved from https://www.goodrx.com/meloxicam
  9. 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/
  10. 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/
  11. National Institutes of Health (NIH). (2020). Ankylosing spondylitis – Genetics Home Reference. Retrieved from https://medlineplus.gov/genetics/condition/ankylosing-spondylitis/
  12. U.S. 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