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What is meloxicam? | Uses | Dosages | Side effects | Safety info | Alternatives
Living with pain and inflammation from arthritis can be difficult and stressful. However, medications are available. Meloxicam is a prescription drug that is commonly used to help relieve the painful symptoms of arthritis. This article provides an overview of meloxicam including what it is, why it’s prescribed, the usual dosage, possible side effects, and how it compares to other medications used for arthritis.
What is meloxicam?
Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that is often prescribed to treat arthritis. It is an enolic acid that belongs to the oxicam group of NSAIDs.
Like other NSAIDs, meloxicam is a potent cyclooxygenase (COX-1 or COX-2) inhibitor that blocks the formation of prostaglandins. Prostaglandins are chemicals that help facilitate pain and inflammatory pathways. Blocking these chemicals can help treat pain, stiffness, and inflammation of the joints.
Meloxicam is a strong painkiller that must be prescribed by a doctor. It can come as a regular tablet, disintegrating tablet, capsule, or oral suspension liquid. Some popular brand names of meloxicam include Mobic, Vivlodex, Qmiiz ODT, and Comfort Pac-Meloxicam. Boehringer Ingelheim Pharmaceuticals produces brand-name Mobic while various other manufacturers, like Apotex and Lupin Pharmaceuticals, make generic meloxicam.
What is meloxicam used for?
Meloxicam is approved to treat pain and inflammation that results from rheumatoid and osteoarthritis in adults, and juvenile rheumatoid arthritis in children who are at least two years old and weigh at least 60 kilograms. It is sometimes used off-label to treat ankylosing spondylitis, a type of arthritis that affects the spine.
The main symptoms meloxicam treats are pain, stiffness, swelling, and tenderness of the joints. In one study, patients with osteoarthritis in the knee and hip showed significant improvement after 12 weeks of taking meloxicam compared to placebo.
For minor aches and pains, some people take an over-the-counter NSAID like Advil (ibuprofen) or Aleve (naproxen). However, over-the-counter ibuprofen or naproxen may not work as well as other NSAIDs for more severe pain. A healthcare provider may recommend to stop taking the over-the-counter pain reliever and instead take meloxicam, a prescription NSAID that is stronger than ibuprofen.
RELATED: Meloxicam vs. ibuprofen
Meloxicam dosages
For osteoarthritis and rheumatoid arthritis, the standard dosage of meloxicam is 7.5 mg once per day. The maximum daily dosage of meloxicam for osteoarthritis or rheumatoid arthritis in adults is 15 mg per day. For children with juvenile rheumatoid arthritis, the standard dosage is 0.125 mg/kg per day. The maximum dosage of meloxicam in children is 7.5 mg per day.
Meloxicam can take up to two weeks to start working in full effect. Some people may experience improvements in pain, swelling, tenderness, or stiffness within 24 to 72 hours. For other people, it could take a few months to start noticing an improvement in symptoms. The time it takes to experience relief with meloxicam can vary based on the dosage prescribed.
Clinical pharmacist Nonye Uddoh says that “meloxicam treats pain, swelling, and inflammation associated with arthritis. It starts working within 30 minutes, but peaks in efficacy at 4 hours when taken by mouth. Its half-life is 15 to 20 hours, meaning it takes 15 hours to eliminate half of it from your body.”
A missed dose should be taken as soon as remembered. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take double doses of meloxicam.
Meloxicam side effects
As with any medication, there is always the potential for adverse effects. Here is a list of some of the common side effects associated with meloxicam:
Common side effects
- Diarrhea
- Heartburn or indigestion
- Stomach pain
- Constipation
- Gas
- Nausea
- Vomiting
- Dizziness
- Upper respiratory tract infections
- Influenza-like symptoms
Serious side effects
Meloxicam may cause serious side effects including the following:
- Increased risk of heart attack or stroke
- Increased risk of bleeding or ulcers in the stomach, esophagus, or intestines
Like other NSAIDs, meloxicam can cause other serious side effects including:
- New or worsened high blood pressure
- Heart failure
- Liver problems
- Kidney problems
- Low red blood cell count (anemia)
- Allergic reactions
- Skin reactions
Meloxicam carries a black box warning issued by the Food and Drug Administration (FDA) about serious side effects. The most serious side effects of meloxicam include cardiovascular events, such as heart attack or stroke, and gastrointestinal events, such as bleeding or ulcers in the stomach or intestines. These events can be serious and even lead to death.
Risk factors for cardiovascular events while using meloxicam include high blood pressure, heart disease, and a recent heart attack or stroke. Risk factors for gastrointestinal bleeding include older age, smoking, alcohol use, liver disease, bleeding problems, and a history of stomach ulcers. Long-term use of meloxicam may also increase the risk of serious side effects.
Seek immediate medical attention if you experience severe chest pain, coughing up blood or vomit that looks like coffee grounds, or black, bloody, or tarry stools. You should stop taking meloxicam and call your doctor immediately if you experience any of these side effects.
Allergic reactions
Meloxicam may also cause allergic reactions that can be life-threatening. An allergic reaction could cause shortness of breath, hives, or swelling of the lips, tongue, and face. If you believe you are having an allergic reaction, seek medical help immediately.
This list of side effects is not comprehensive. Ask a healthcare professional for more details regarding the possible side effects of meloxicam.
Meloxicam safety information
Restrictions
Meloxicam should not be taken in people who have a known allergy to meloxicam or those who have experienced asthma, itching, or other allergic-type reactions after taking aspirin or an NSAID. Meloxicam should be avoided right before or after a heart procedure called coronary artery bypass graft (CABG).
Meloxicam should only be taken as prescribed. A healthcare provider normally prescribes the lowest dose that is effective enough to relieve symptoms. It should only be used for the shortest time necessary to relieve symptoms.
Interactions
Meloxicam may need to be avoided with the following drugs due to possible drug interactions:
- Anticoagulants, such as warfarin
- Antiplatelet agents, such as aspirin
- Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine
- Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine
- Blood pressure medications, such as ACE inhibitors, ARBs, beta-blockers, and diuretics
- Lithium
- Methotrexate
- Cyclosporine
- Pemetrexed
- Other NSAIDs
Some medications can increase the risk of ulcers and bleeding when taken with NSAIDs like meloxicam. Anticoagulants, antiplatelet agents, and certain antidepressants, such as SSRIs and SNRIs, should be used with caution or avoided if you are also taking meloxicam.
Meloxicam, like other NSAIDs, can increase blood pressure. Therefore, certain blood pressure medications like ACE inhibitors, ARBs, beta-blockers, and diuretics may be less effective when taken with meloxicam. Your doctor may recommend monitoring your blood pressure if you are taking a blood pressure medication and meloxicam.
If you are taking lithium, methotrexate, cyclosporine, or pemetrexed, you may be at an increased risk of toxicity from any of these drugs if you are also taking meloxicam. Symptoms of drug toxicity may need to be monitored when taking these drugs with meloxicam.
Tell your doctor about all of the medications you take, including prescription drugs, over-the-counter medications, and herbal products. Your doctor may take these other medications into account when determining whether or not meloxicam is right for you.
Pregnancy
If you are pregnant, planning to become pregnant, or breastfeeding, you should avoid taking meloxicam. It’s possible that meloxicam could cause infertility or negatively affect an unborn baby. Whether or not meloxicam transfers to babies through breast milk is unclear. Consult with a healthcare provider before taking meloxicam or any other pain reliever while pregnant or breastfeeding.
Are there alternatives to meloxicam?
There are several alternatives to meloxicam. Any medication that’s classified as an NSAID will work similarly to meloxicam. Some over-the-counter medications, like Aleve or Tylenol, may be recommended first before trying a prescription NSAID. Consult with a medical professional to determine which medication is best for treating your arthritis pain.
- Aleve (naproxen): Aleve is long-lasting and treats mild to moderate pain, inflammation, and fever. It’s available over the counter or with a prescription, and it is usually taken twice daily.
- Zorvolex (diclofenac): Zorvolex is approved to treat acute pain and pain from osteoarthritis. It is usually prescribed to be taken three times daily for pain and is comparable to meloxicam and other NSAIDs, like ibuprofen. See diclofenac vs. ibuprofen to learn more about diclofenac and how it compares to ibuprofen.
- Celebrex (celecoxib): Celebrex is approved to treat pain and inflammation from arthritis. It is also approved to treat menstrual cramps (primary dysmenorrhea). Celebrex is usually taken once or twice per day. Check out meloxicam vs. Celebrex for more information on the differences between meloxicam and Celebrex.
- Feldene (piroxicam): Feldene can help with joint stiffness, pain, and swelling caused by rheumatoid arthritis and osteoarthritis. It is usually prescribed to be taken once daily.
- Lodine (etodolac): Lodine is approved to treat acute pain, as well as pain from rheumatoid arthritis and osteoarthritis. Like other NSAIDs, it may take a couple of weeks to experience maximum relief. Lodine has been discontinued as a brand in the United States and is currently prescribed as the generic version, etodolac.
- Relafen (nabumetone): Relafen is approved to treat pain and inflammation caused by rheumatoid arthritis and osteoarthritis. It is typically taken once or twice per day. Relafen has been discontinued as a brand in the United States and is currently prescribed as the generic version, nabumetone.
- Tylenol Extra Strength (acetaminophen): Tylenol is an over-the-counter drug that helps relieve pain and reduce fevers. It is not an anti-inflammatory drug that helps reduce swelling and inflammation like NSAIDs. Tylenol may be less effective than NSAIDs for inflammatory conditions like arthritis. However, it may be safer and recommended for people with high blood pressure, stomach problems, and other conditions.
- Prednisone: Prednisone is a prescription medication used to treat a variety of conditions, such as allergic disorders, asthma, psoriasis, lupus, and arthritis. Prednisone is part of a group of drugs called corticosteroids, and it works by decreasing the activity of the immune system to reduce swelling and inflammation. It is often prescribed to treat rheumatoid arthritis flares.
Natural remedies for arthritis
Some natural and home remedies may help with arthritis symptoms and act as an alternative to meloxicam. Certain herbal supplements have anti-inflammatory effects, and natural treatments like massage therapy, acupuncture, or chiropractic adjustments may help relieve pain. Here’s a list of some of the most popular natural and home remedies that people use to treat the stiffness, pain, aching, and swelling from arthritis:
- Anti-inflammatory diet. Foods that contain omega-3 fatty acids, vitamin D, and antioxidants may help lower inflammation. An anti-inflammatory diet includes foods like fish, walnuts, flaxseed, kale, and fresh fruits and vegetables.
- Staying active. Regular exercise can help strengthen the muscles that surround the joints, which gives them more support. Exercise may also help improve flexibility and overall energy. Stretching, walking, strength training, biking, and swimming are all activities that someone with arthritis could benefit from.
- Ginger and turmeric. Even though herbal supplements like ginger and turmeric aren’t FDA-approved to treat arthritis, many people with arthritis still use them and benefit from their anti-inflammatory effects. Ginger is a natural spice that has been used for thousands of years for its anti-inflammatory effects in the body. Turmeric is a powerful anti-inflammatory agent that contains the main active ingredient curcumin, which may help with joint inflammation and swelling.
- Boswellia. Also known as Indian frankincense, boswellia is known for its anti-inflammatory properties. It can be taken orally or applied topically as part of an essential oil. While it may help relieve symptoms of arthritis, more research is needed to determine the overall effects of boswellia on health.
- Chiropractic care. Chiropractic adjustments may help relieve pain that comes from having osteoarthritis. Treatment can vary on a case-by-case basis, but most chiropractic manipulations are done on the neck, back, and spine. Many chiropractic offices offer massage therapy, which may also help relieve pain.
