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What is meloxicam?

Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase, an enzyme important for making prostaglandins, which are the mediators of pain and inflammation in the body. While some NSAIDs can be purchased over the counter, meloxicam is only available with a prescription.

What does meloxicam treat?

Meloxicam reduces inflammation and pain. It's approved by the US Food and Drug Administration (FDA) for treating the following conditions:¹

  • Osteoarthritis

  • Rheumatoid arthritis

  • Juvenile idiopathic arthritis in children two years and older

How do you take meloxicam?

Meloxicam is available as a standard tablet, an orally disintegrating tablet, a capsule, and an injectable solution. Your doctor will determine the appropriate form and dose for you based on several factors, including:

  • Your age

  • The condition you're treating

  • Other medical conditions you have

  • The form of meloxicam you take

Typically, doctors prescribe the lowest dose and increase the amount as needed, eventually settling on the lowest amount that effectively manages the condition being treated. 

Forms and strengths

Meloxicam is available in the following forms and strengths:²

Oral tablet

  • Available in 7.5mg and 15mg strengths

  • May be taken with or without food

  • Should be taken around the same time each day

Orally disintegrating tablet

  • Available in 7.5mg and 15mg strengths

  • Placed on the tongue where it dissolves

  • May be followed with a glass of water once it dissolves

Capsule

  • Available in 5mg and 10mg strengths

  • May be taken with or without food

  • Should be taken around the same time each day

  • Should not be taken at the same dose as the other oral forms

Injectable solution

  • Available in single-dose vials with a strength of 30mg/mL

  • Administered only in a healthcare setting

For osteoarthritis

People with osteoarthritis may take meloxicam in any of the oral forms. 

Those prescribed meloxicam tablets will take 7.5–15mg daily, and 15mg is the maximum daily dose.

Those taking the capsules will start with 5mg per day, and their doctor may increase their dose to a maximum of 10mg daily.

For rheumatoid arthritis

People with rheumatoid arthritis may take meloxicam in one of the two tablet forms.

Whether they take the drug in the standard tablet or orally disintegrating tablet form, patients will take 7.5–15mg of meloxicam daily. The maximum daily dose is 15mg.

For juvenile idiopathic arthritis

Children with juvenile idiopathic arthritis who weigh at least 60kg may take tablets or capsules up to a maximum daily dose of 7.5mg. Their doctor will calculate the appropriate amount based on the child’s weight. 

The injectable form of meloxicam is reserved for treating moderate-to-severe pain and is administered intravenously by a qualified professional in a healthcare setting. It may be used alone or alongside non-NSAID analgesics.³

Seeing results

It may take up to two weeks to see the full results of taking meloxicam. However, some people may see improvements in pain, swelling, soreness, and stiffness within a few days. 

Warnings and potential side effects of meloxicam

Meloxicam has boxed warnings. Like other non-steroidal anti-inflammatory drugs, meloxicam increases the risk of severe gastrointestinal events, including bleeding, ulceration, and perforation, which may come on without warning and sometimes be fatal.¹

Meloxicam also increases the risk of potentially fatal cardiovascular events, including blood clots, heart attack, and stroke. The risk may increase the longer the patient takes the medication.

This drug is contraindicated for the treatment of pain associated with coronary artery bypass graft (CABG) surgery.

Meloxicam is associated with side effects, some of which are severe. The following lists of potential side effects are not exhaustive. If you notice anything unusual while taking meloxicam, consult your doctor.⁴

The most common side effects associated with meloxicam include:

  • Sore throat

  • Gas, indigestion, nausea

  • Headache

  • Diarrhea

  • Constipation

Mild side effects typically resolve within a few days to weeks. If you experience persistent adverse effects, speak with your doctor.

Less common side effects that may be severe and require urgent medical attention include:

  • Fever

  • Itching or blistering skin

  • Rash or hives

  • Swelling around the eyes, mouth, abdomen, legs, ankles, or feet

  • Difficulty breathing or shortness of breath

  • Difficulty swallowing

  • Hoarseness

  • Ringing in the ears, hearing loss

  • Fast heartbeat

  • Unexplained weight gain

  • Nausea, vomiting

  • Excessive fatigue

  • Yellowing of the skin or eyes

  • Back pain

  • Difficulty urinating or urine that’s cloudy, discolored, or contains blood

While these less common side effects may not seem severe, they may signal the presence of a serious underlying condition, such as any of the following:¹

Cardiovascular events and conditions

NSAIDs increase the risk of potentially fatal cardiovascular events, including heart attack, stroke, and conditions such as hypertension and congestive heart failure. There is also an increased risk of blood clots when given in higher doses. Patients with risk factors or known cardiovascular disease have a higher risk of these events.²

Gastrointestinal adverse events

Meloxicam can trigger gastrointestinal problems, including inflammation, bleeding, ulceration, and perforation, which may be fatal. People with a history of ulcers or gastrointestinal bleeding have a more than ten-fold increased risk of recurrence.

Liver problems

NSAIDs, including meloxicam, can affect liver function and cause increased enzyme levels. Rarely, NSAID use may lead to fatal liver necrosis and failure.

Kidney conditions

Long-term NSAID use is associated with various kidney conditions, including renal papillary necrosis, renal insufficiency, and renal failure.

Skin reactions

Meloxicam may trigger exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis. For some people, the skin reactions triggered by NSAIDs are fatal. 

Who should not take meloxicam?

The drug is typically well-tolerated, but meloxicam is contraindicated for certain groups of people. Specifically:

  • People with known hypersensitivity to meloxicam

  • Those who have experienced asthma or any type of allergic reaction after taking aspirin or other NSAIDs

  • People seeking relief for pain related to CABG surgery

Additionally, patients with any of the following conditions should proceed with caution and be closely monitored while taking meloxicam:²

  • Risk factors for cardiovascular disease, known cardiovascular conditions, or a recent heart attack

  • A history of peptic ulcer disease or gastrointestinal bleeding, especially those with risk factors, including those:

    • Also taking steroids, aspirin, anticoagulants, or selective serotonin-receptor inhibitors

    • Who smoke cigarettes or drink alcohol

    • With advanced liver disease

    • Who are older in age or have other serious health conditions

  • Moderate to severe kidney disease or kidney failure

  • Severe liver disease

  • Severe high blood pressure

  • Older age and multiple medical concerns

Long-term use of meloxicam

To minimize side effects, you should take meloxicam at the lowest effective dose for the shortest time necessary. Because long-term use is associated with a greater risk of severe side effects, your doctor may recommend a short course of meloxicam followed by non-NSAID treatments for long-term symptom relief.

Missed doses

If you forget to take a dose of meloxicam, take it when you remember, unless it’s nearly time for your next dose, then skip the missed dose and resume your usual schedule. 

Never double your dose to make up for a missed one.

Overdoses

A meloxicam overdose is rarely fatal but can lead to severe complications.¹

Signs of a meloxicam overdose may include:

  • Nausea

  • Vomiting

  • Stomach pain

  • Lethargy and drowsiness

  • Gastrointestinal bleeding

  • High blood pressure

  • Acute kidney injury

  • Respiratory depression

  • Coma

If you've taken too much of this medication, call the National Poison Control helpline and seek emergency medical care.⁵

What to discuss with your doctor before starting meloxicam

You’ll need to meet with your doctor to acquire a prescription for meloxicam. At your appointment, you should discuss the following topics:

  • Any allergies or intolerances you have (especially to any of the medication’s active or inactive ingredients)

  • All medications, supplements, vitamins, or herbs you take (regularly or occasionally)

  • Other health conditions you have, including asthma, bleeding problems, and heart, liver, or kidney conditions

  • If you smoke cigarettes or drink alcohol

  • Contraceptive use and current or planned pregnancies

  • Recent or upcoming surgeries, especially heart bypass surgery

Stopping meloxicam

Your doctor can guide you in stopping meloxicam safely. You may want to discuss alternative treatment options in case your symptoms return when you discontinue the drug.

Meloxicam in pregnancy and breastfeeding

Pregnancy

Meloxicam is designated a pregnancy category C (up to 30 weeks) to category D (30 weeks and beyond) drug, according to the US FDA.¹

There are no adequate studies with patients taking meloxicam during pregnancy, but animal research has demonstrated a risk to the fetus. Your doctor will discuss the benefits and the risks of continuing to take the drug during your pregnancy.

The FDA has issued a warning to avoid using NSAIDs from 20 weeks of pregnancy until delivery due to the possibility of kidney problems in the fetus that could result in low amniotic fluid levels. Previous recommendations had been to stop taking NSAIDs starting at 30 weeks to prevent premature closure of the fetal ductus arteriosus, which remains a serious cardiovascular concern.⁶

Breastfeeding

It’s unknown if significant amounts of meloxicam pass through breast milk in humans or what effect it might have on babies. Speak with your doctor about benefits and risks, potential alternative treatments, and whether you should stop or continue taking meloxicam while nursing.⁷

Interactions with other drugs

Meloxicam interacts with other medications. Some interactions may boost a drug’s effects, while others hinder them. Speak with your doctor before you start taking any new medications. Among the drugs that are known to interact with meloxicam are the following:¹

  • Cholestyramine, which may accelerate the clearing of meloxicam from the body

  • Lithium, which may be present in higher blood concentrations in people taking meloxicam concurrently

  • Methotrexate, which may clear from the body more slowly when taken with meloxicam

  • Cyclosporine, which may be more likely to cause kidney toxicity in people taking meloxicam

  • Drugs that can increase the risk of bleeding, such as aspirin, warfarin, selective serotonin reuptake inhibitors, and serotonin-norepinephrine reuptake inhibitors

  • Medications for high blood pressure, such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and beta-blockers

  • Diuretics (can also be used for blood pressure), including loop diuretics (furosemide, bumetanide) and thiazide diuretics (hydrochlorothiazide)

  • Other NSAIDs, such as ibuprofen (Motrin, Advil), naproxen (Aleve), and diclofenac (Voltaren), may increase the risk of gastrointestinal toxicity

  • Steroid medications, such as prednisone, may increase the risk of gastrointestinal bleeding

Can I drink alcohol while taking meloxicam?

Drinking alcohol while taking meloxicam increases the risk of gastrointestinal bleeding, particularly if you have other risk factors. It is important to discuss with your doctor whether or not it is safe to drink alcohol while taking this medication or any of the drugs it interacts with, such as other NSAIDs.

Allergy information

Meloxicam may also cause allergic reactions that may be severe. The following signs may indicate an allergic reaction:

  • Shortness of breath

  • Hives, itching, peeling skin rash

  • Swelling of the mouth, tongue, throat, and face

  • Vomiting

  • Loss of consciousness

Drug allergies can be life-threatening. If you suspect you’re having an allergic reaction to meloxicam, seek emergency medical care.

Drug approval history

2000: The US FDA approves meloxicam (Mobic) tablets⁸

2004: The US FDA approves meloxicam (Mobic) oral suspension⁹

2015: The US FDA approves meloxicam capsules (Vivlodex)¹⁰

2015: Mobic oral suspension is discontinued (a business-related decision not linked to product safety or efficacy)¹¹

2018: The US FDA approves the orally disintegrating tablet form of meloxicam (QMIIZ ODT)¹²

2020: The US FDA approves the injectable form of meloxicam (Anjeso)¹³

Tips and advice for taking meloxicam

The following tips can help you maximize the effectiveness of meloxicam while potentially reducing the risk of severe side effects:

  • Don’t combine meloxicam with other NSAIDs unless advised by your doctor

  • Let your prescriber know if you start taking any new medications while you are taking meloxicam to avoid drug interactions and serious adverse effects

  • Avoid smoking cigarettes and drinking alcohol while taking meloxicam, as these may increase the risk of gastrointestinal bleeding

  • Taking meloxicam with food may reduce stomach upset

  • Wait at least ten minutes before laying down after taking meloxicam

  • Store your medication at 59–86°F (15–30°C) in a tightly closed container, and keep it out of the reach of children¹

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Disclaimer

Here at HealthMatch, we’ve done our best to ensure that the information provided in this article is helpful, up to date, and, most importantly, accurate.

However, we can’t replace the one-to-one advice of a qualified medical practitioner or outline all of the possible risks associated with this particular drug and your circumstances.

It is therefore important for you to note that the information contained in this article does not constitute professional medical or healthcare advice, diagnosis or recommendation of treatment and is not intended to, nor should be used to, replace professional medical advice. This article may not always be up to date and is not exhaustive of all of the risks and considerations relevant to this particular drug. In no circumstances should this article be relied upon without independent consideration and confirmation by a qualified medical practitioner.

Your doctor will be able to explain all possible uses, dosages, precautions, interactions with other drugs, and other potential adverse effects, and you should always talk to them about any kind of medication you are taking, thinking about taking or wanting to stop taking.

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