How long does it take for meloxicam to start working?

In this article:

• How long does it take for meloxicam to work?
• Onset of action
• Contraindications
• Bottom line

In this article

• How long does it take for meloxicam to work?
• Onset of action
• Contraindications
• Bottom line

Meloxicam is a prescription drug originally branded under the name Mobic. As a nonsteroidal anti-inflammatory drug (NSAID), it is prescribed for moderate to severe pain experienced from disorders such as osteoarthritis, rheumatoid arthritis, or juvenile rheumatoid arthritis. It may also be used in ankylosing spondylitis. Meloxicam is unique from other over-the-counter NSAID options in that it follows a different metabolic pathway that is less harmful to the gastrointestinal system. This is important when there is a need for longer-term use of an NSAID, as there can be many arthritic and chronic inflammatory conditions. There is a delayed onset of action with meloxicam, and how quickly it works will depend on the dosage type your provider chooses. Generally speaking, meloxicam can take a few days to weeks to reach its full potential.

RELATED: What is Meloxicam: Uses, Warnings & Interactions 

How long does it take for meloxicam to work? 

The onset of pain relief with meloxicam is dependent on the dosage type. Injectable meloxicam has been shown to work faster, with some patients reporting signs of pain relief within a few hours up to the first day. It may be several days for some. Taking the oral tablet form may take two weeks before you notice significant relief from pain and inflammation. With the oral form, you have to take the drug consistently for at least five days to reach a point where there is a consistent amount of drug in your bloodstream to provide relief.

Clinical trials looked at patient-identified pain intensity scores. Patients who received injectable meloxicam for post-operative pain measured the pain on a scale from 0 to 10, with 10 being the most intense pain. There was a statistically significant difference in pain scale rating in the first 48 hours, with the reported pain level being 3 or less on average after 48 hours in one of the trials. Meloxicam is expected to provide pain relief by decreasing the inflammatory response in the body. The increase of inflammatory markers in the body leads to swelling of tissues and pain. Consistent use of meloxicam is expected to relieve that process.

What can affect how long it takes meloxicam to work?

The administration route is the primary factor affecting meloxicam’s onset of action. Intravenous injections can provide meaningful pain relief within two to three hours of the dose, while the oral dosage forms may take several days to provide meaningful pain relief. 

Oral meloxicam can be taken without regard to meals. However, it has been shown that taking meloxicam immediately following a high-fat meal can increase the peak blood concentration, but overall absorption remains the same. There are no known factors that speed up or increase total absorption with oral dosage.

Other factors are suspected to affect absorption, though it is difficult to quantify the impact:

• Renal Impairment: Total plasma concentrations of oral meloxicam in patients with renal disease or insufficiency have been shown to be lower than in patients with normal kidney function. There are no notable differences between IV administration and IV administration.
• Age: Younger children aged 6 years or under were shown to have lower exposure to meloxicam than older children. There is thought to be a link to body weight.
• Gender: Females may have a lower absorption of oral meloxicam. IV meloxicam was not significantly affected by gender.

What is the standard meloxicam dosage?

Meloxicam is a type of NSAID that specifically inhibits cyclooxygenase-2 (COX-2). Traditional first-generation NSAID pain relievers are not generally intended for long-term use. This is primarily due to serious side effects of long-term use, such as gastrointestinal irritation, stomach pain, bleeding, and ulceration. These drugs include aspirin, Advil or Motrin (ibuprofen), and Aleve (naproxen). COX-2 inhibitors avoid the pathway that leads to gastrointestinal irritation and damage, making them safer for longer-term use. 

Only two COX-2 inhibitor analgesics are currently on the market: meloxicam and celecoxib (brand name Celebrex). While COX-2 inhibitors are preferred for long-term use, some common side effects remain. Side effects of meloxicam include abdominal pain, headache, back pain, nausea, and constipation. 

The appropriate dose of meloxicam is determined primarily by the intended reason for use, age, and dosage form. There are multiple oral dosage forms (tablets, capsules, oral liquid suspension, and orally disintegrating tablets), and use approved by the U.S. Food and Drug Administration (FDA) may vary by the form. The dosages below represent common dose ranges for the most common uses of meloxicam.

Osteoarthritis (Adult)

• Tablets, oral suspension, orally disintegrating tablets (ODT): 7.5 mg to 15 mg by mouth once daily
• Capsules: 5 mg to 10 mg by mouth daily

Rheumatoid arthritis (Adult)

• Tablets, oral suspension, ODT: 7.5 mg to 15 mg by mouth once daily

Juvenile rheumatoid arthritis (Children 2 to 17 years old)

• Oral suspension: 0.125 mg/ kg/ dose (up to 7.5 mg) by mouth daily
• ODT: 7.5 mg by mouth daily

Moderate to severe pain

• IV: 30 mg IV once daily
• Oral formulations are not recommended for acute pain

RELATED: Meloxicam dosage, forms, and strengths

Who should avoid taking meloxicam?

You should not take meloxicam if you have a history of hypersensitivity or allergic reaction to meloxicam or any other NSAID drug. This reaction includes hives, swelling of the tongue, or skin rash. Meloxicam is not recommended for children under the age of 2 as safety and efficacy have not been established. Meloxicam is contraindicated in patients undergoing coronary artery bypass graft surgery (CABG) as it has been linked to occurrences of stroke and myocardial infarction.

In some cases, patients can take meloxicam but should be cautious. Meloxicam can worsen high blood pressure (hypertension) and exacerbate congestive heart failure. Meloxicam in patients with heart disease can cause an increased risk of cardiovascular thromboembolism, heart attack (acute myocardial infarction), or stroke. These can be fatal.

While meloxicam was designed to be less harmful to the gastrointestinal tract than traditional NSAIDs, it is best to avoid it and all NSAIDS in patients with a history of GI bleeding, GI perforation, or ulcers. Patients with liver disease and kidney problems should also be cautious about taking meloxicam. 

Meloxicam can worsen anemia in those with pre-existing anemia. Meloxicam should be avoided in pregnancy, especially in the third trimester. There is not enough data to recommend meloxicam being used while breastfeeding.

Meloxicam should not be taken if you are on certain other types of medications. Before taking meloxicam, speak to your pharmacist or healthcare professional for medical advice if you are taking any of the following types of products, as there may be significant drug interactions:

• Blood thinners such as aspirin, Coumadin (warfarin), or heparin
• Other NSAID drugs such as aspirin, ibuprofen, naproxen, piroxicam, diclofenac
• Corticosteroids such as prednisone
• Lithium (lithium levels must be monitored and may need to be adjusted down)
• Methotrexate and cyclosporine
• Diuretics
• Certain supplements

Always inform your healthcare provider of all medical conditions and medications you take, including prescription and over-the-counter drugs.

RELATED: Meloxicam Alternatives

The bottom line

Meloxicam is best administered intravenously if a patient needs quick-onset relief from acute pain. Oral meloxicam takes longer to absorb and can be affected by several factors. It must be taken consistently for best results. Oral meloxicam is ideal for chronic arthritis, while IV meloxicam is best for moderate to severe acute pain.