Meloxicam side effects: the common, rare, and serious

Meloxicam is a prescription nonsteroidal anti-inflammatory drug (NSAID) used to manage the joint pain associated with certain kinds of arthritis. 

The most common side effects of meloxicam are diarrhea, indigestion, and flu-like symptoms. Headache, dizziness, skin rash, and other gastrointestinal issues such as heartburn, nausea, and gas are also possible side effects (DailyMed, 2019).

All NSAIDs, even the ones that can be purchased without a prescription (like aspirin and ibuprofen) can cause serious side effects, which is why the U.S. Food and Drug Administration (FDA) has issued a black box warning about the serious side effects of meloxicam. A black box warning is the FDA’s most stringent caution attached to drugs that have serious risks. 

One of the most serious potential side effects of meloxicam is an increased risk of gastrointestinal (GI) issues, including bleeding, ulcerations, or perforations (holes) in the stomach or intestine. 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. Get medical help right away if you experience any signs of a stomach ulcer such as bloody or dark stool (tarry stools), vomiting with or without blood, loss of appetite, trouble breathing, or sudden stomach pain that won’t go away (NIH, 2014).

Although meloxicam is commonly prescribed as a tablet, other forms of this prescription drug are not taken orally. Meloxicam does not need to be taken by mouth to cause digestive problems. It does the same when administered as an injection, a form used in hospital settings.

Meloxicam may also increase your risk of bleeding. Meloxicam interferes with normal platelet function, compromising your platelets’ ability to clump together and slowing clotting time. This is of particular concern if you are taking other blood-thinning medications or if you have a history of strokes or falls (Martini, 2014). 

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Meloxicam is approved by the FDA to manage joint pain associated with osteoarthritis, the most common form of arthritis, caused by wear and tear on the joints. It's also used for rheumatoid arthritis (RA), another chronic inflammatory condition, and juvenile RA (affecting children two years of age and older) (FDA, 2012).

While there is currently no cure for these conditions, the pain can be managed with NSAIDs such as meloxicam. Meloxicam may also be used off-label to treat the pain caused by gout flare-ups.

Gout is a painful type of arthritis characterized by sudden pain, redness, and swelling that most commonly affects one joint of the big toe but can appear in any joint in the body. This condition results from a buildup of uric acid in the body, and a range of behavioral factors can trigger flare-ups or attacks in susceptible individuals (Jin, 2012).

Certain foods, like shellfish and red meat, and drugs, like aspirin and certain diuretics (“water pills”), increase the levels of uric acid in the body. The best way to treat gout is by avoiding triggers however meloxicam may be used to help manage gout symptoms and alleviate pain and swelling (Gaffo, 2019).

Meloxicam is available as a generic drug and sold under the brand names Mobic and Vivlodex.

Both the generic and brand-name meloxicam tablets are available in 5 mg, 7.5 mg, 10 mg, and 15 mg dosages. There are multiple forms of this medication. Meloxicam comes as an oral suspension (7.5 mg/5 mL), a disintegrating tablet (7.5 and 15 mg dosages), and an intravenous solution (30 mg/mL). IV-administered meloxicam is only 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.

Many insurance plans cover meloxicam—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, n.d.). 

Certain medications may increase the risk of bleeding if taken with meloxicam. Since meloxicam reduces platelet function, blood thinners (warfarin), antiplatelet agents (aspirin) should not be combined with meloxicam. Drinking alcohol while taking meloxicam also increases your risk of bleeding problems (FDA, 2012).

Combining meloxicam with other NSAIDs (such as naproxen, acetaminophen, or ibuprofen) increases the chance of developing gastrointestinal problems like stomach bleeding or ulcers (DailyMed, 2019).

Meloxicam may decrease the efficacy of other medications. Meloxicam may make drugs that lower high blood pressure (antihypertensive drugs), like ACE inhibitors, angiotensin receptor blockers (ARBs), or beta-blockers less effective (Fournier, 2012). 

Meloxicam may also have this effect on diuretics drugs that reduce fluid retention. Loop diuretics (furosemide) and thiazide diuretics such as hydrochlorothiazide may not work as well if taken with meloxicam (DailyMed, 2019).

Meloxicam may also increase the toxic effect certain medications have on the kidneys. Taking meloxicam with these medications––such as diuretics or cyclosporine––may increase the risk of adverse events such as kidney problems. Combining these drugs may lead to renal impairment or even acute kidney failure (FDA, 2012).

This drug carries a black box warning: meloxicam may increase the risk of heart attacks 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 procedure. Meloxicam can also put you at a greater risk of gastrointestinal bleeding and ulceration or holes (perforations) in the stomach or intestines (FDA, 2012).  

NSAIDs such as meloxicam should also not be taken during the third 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 result in progressive heart problems later on. If you're breastfeeding, tell your healthcare provider before starting treatment with meloxicam (Enzensberger, 2012). 

It is possible to have an allergic reaction to meloxicam. You shouldn’t take this medication if you’re allergic to any of its ingredients. Seek medical attention immediately if you experience any signs of an allergic reaction, including serious skin reactions such as a rash with blisters or hives, shortness of breath, or facial swelling.

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Current version

September 24, 2020

Written by

Linnea Zielinski

Fact checked by

Yael Cooperman, MD

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About the medical reviewer

Yael Cooperman, MD, Ro

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.