Meloxicam and sleep: Why you may feel tired

In this article:

• Does meloxicam make you sleep?
• Why does meloxicam make you sleepy?
• Common meloxicam side effects
• Meloxicam alternatives
• How to combat meloxicam fatigue

In this article

• Does meloxicam make you sleep?
• Why does meloxicam make you sleepy?
• Common meloxicam side effects
• Meloxicam alternatives
• How to combat meloxicam fatigue

Meloxicam is a prescription generic nonsteroidal anti-inflammatory drug (NSAID) that helps manage pain and inflammation. It’s approved by the Food and Drug Administration (FDA) to treat osteoarthritis (OA), rheumatoid arthritis (RA), and juvenile rheumatoid arthritis (JRA). For many people, meloxicam is an important part of their treatment plan, but like any medication, meloxicam comes with side effects. Some may wonder whether it can make them feel tired or sleepy. In this article, we’ll break down how meloxicam works, whether it can cause sleepiness, and practical steps you can take to avoid drowsiness and use the medication safely.  

Does meloxicam make you sleep?

Yes, some people report feeling sleepy or fatigued, but it’s not one of the drug’s most common side effects. Drowsiness and somnolence are listed on the drug label as side effects that occurred in fewer than 2% of clinical trial participants. 

Michael Genovese, MD, a physician and chief medical adviser at AscendantNY in New York City, says, “Fatigue or sleepiness can also occur as a side effect or indirectly due to drug-induced insomnia or potential liver issues, but are not common symptoms and they should be reported to your doctor, especially if they are severe or come with signs of medication overdose.”

NSAIDs, in general, have been associated with central nervous system (CNS) effects, such as confusion, sleepiness, and dizziness. In addition, insomnia is a side effect that’s been reported in more than 2% of patients taking the medication. 

For most people, side effects are mild, but they can become more noticeable if you take doses that are higher than normal, have certain health conditions, or are combining meloxicam with another drug that causes the side effect in question. 

If meloxicam consistently makes you feel tired or sleepy, check in with your healthcare provider. They can determine whether the medication is the cause and whether an adjustment or alternative might help. For example, if you’re prescribed meloxicam 15 mg tablets, they may lower your dose to 7.5 mg tablets. 

Why does meloxicam make you sleepy?

Research doesn’t offer a clear answer as to why meloxicam makes some people feel sleepy, but there are some possible reasons based on how it works. Meloxicam works by inhibiting cyclooxygenase-2 (COX-2), an enzyme involved in inflammation and pain signaling. Although it mainly acts outside the brain, NSAIDs like meloxicam can still cross the blood-brain barrier and affect the central nervous system. This can result in side effects such as fatigue, slowed thinking, confusion, or drowsiness. 

“The anti-inflammatory effect reduces prostaglandins, which help regulate pain perception,” says Eve Elizabeth Pennie, MD, a physician, epidemiologist, and Medical Expert at Drugwatch. “Mild dizziness or changes in blood pressure can also be felt as fatigue,” she adds.

CNS depressant effects are reversible and more often reported in situations of overdosing on the drug. According to the drug’s prescribing information, severe outcomes like high blood pressure, kidney failure, slowed breathing (respiratory depression), and coma have occurred, but these are considered rare side effects.

There’s still more to study on how NSAIDs like meloxicam affect sleep and energy. “Once pain or inflammation improves, many people also experience a rebound-type fatigue,” Dr. Pennie says. In addition, one small clinical study found that NSAIDs may disrupt normal sleep cycles, which could contribute to feeling tired the next day.

Common meloxicam side effects 

More common side effects of meloxicam in adults include:

• Headache 
• Indigestion
• Diarrhea 
• Nausea 
• Dizziness
• Upper respiratory tract infections 
• Fluid retention or swelling 
• Abdominal or stomach pain
• Rash

Gastrointestinal (GI) symptoms such as stomach pain, diarrhea, indigestion, flatulence (gas), and nausea were the most commonly reported side effects of people taking meloxicam in 12-week clinical trials. People taking higher doses of meloxicam (22.5 mg or more) are at higher risk of serious side effects. According to the drug label, people should not take more than 15 mg of meloxicam a day.  

Although meloxicam can be taken with or without food, the Arthritis Foundation and some healthcare professionals recommend taking it with food or an antacid to avoid the GI side effects common to NSAIDs.

Meloxicam alternatives

If you experience side effects from meloxicam, your healthcare provider may recommend another option. The best alternative to meloxicam depends on your diagnosis, other health conditions, and how you’ve responded to medications in the past. The following are some options you may be offered.

Other NSAIDs

There are over-the-counter (OTC) and prescription NSAIDs that are similar to meloxicam and may be recommended for osteoarthritis, rheumatoid arthritis, and juvenile rheumatoid arthritis. Examples of OTC NSAIDs include Advil (ibuprofen) and Aleve (naproxen), while examples of prescription NSAIDs include Celebrex (celecoxib), Voltaren (diclofenac), and Relafen (nabumetone). 

These drugs work in similar ways to meloxicam, but since they’re NSAIDs, they all share a potential risk of CNS side effects such as drowsiness, dizziness, and confusion. However, these effects aren’t common, and most people don’t experience severe sleepiness when taking NSAIDs unless there’s an overdose.

Diclofenac is available as a topical gel and may be less likely to cause sleepiness since it acts on the local area. 

Non-NSAID medications

There are also pain-relief options that aren’t NSAIDs. Acetaminophen is typically used for pain relief, but it doesn’t treat inflammation the same way that NSAIDs do. However, it’s not reported to cause sleepiness when taken at recommended doses. 

Some prescription options can also work without causing drowsiness. Topical lidocaine, such as patches or gels, may help with localized pain and usually doesn’t cause drowsiness, but it doesn’t treat inflammation the same way meloxicam does.

NSAID Prices & Pain Management Resources

A healthcare provider may also consider corticosteroid drugs such as prednisone for symptom flare-ups. These come in oral or injectable forms and don’t typically cause drowsiness. However, corticosteroids do come with a different set of side effects to consider. 

Non-drug options

Other options that may be used as add-on therapy include:

• Physical therapy
• Exercise
• Weight management
• Heat or cold therapy
• Joint braces during activity

Because every option comes with its own benefits and drawbacks, it’s worthwhile to discuss your options with your healthcare provider before you start or stop treatments on your own. 

How to combat meloxicam fatigue

If you’re taking meloxicam and feeling tired, there are practical ways to manage the symptom so it doesn’t interfere with your day. “To manage these symptoms of sleepiness, I recommend that patients discuss taking their single daily dose at bedtime with their doctor, ensure good sleep hygiene, and avoid driving until they understand how the drug affects them,” Dr. Genovese says. 

“Patients may want to drink plenty of fluids and avoid consuming alcohol or any other sedating substance,” Dr. Pennie adds. If you have fatigue that persists or worsens, bring it to your healthcare provider’s attention so they can look into the potential causes, rule out drug interactions, and adjust your medication plan to keep your treatment both safe and effective.

Bottom line

Sleepiness is a rare but possible side effect of taking meloxicam. While meloxicam works by reducing inflammation and pain, some people may experience CNS side effects such as drowsiness, tiredness, or confusion, especially at higher doses or when taken with other drugs that cause sedation. However, insomnia or trouble sleeping is more common than drowsiness.

For those who experience drowsiness with meloxicam, taking it at night or checking for drug interactions with a healthcare provider may help reduce daytime sleepiness. If drowsiness is severe or persistent, you should reach out to your healthcare provider anyway. They can recommend adjustments or alternatives to meloxicam that would be best for you.