Ibuprofen or Meloxicam. What’s Better?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for the treatment of acute pain and chronic inflammatory and degenerative joint diseases. However, there can be a downfall to long-term use of NSAIDS – they can increase the occurrence of upper gastrointestinal (GI) complications such as ulcers and bleeding. There are some NSAIDS, known as “partially selective NSAIDS,” that are known to result in fewer GI effects while still having the same effectiveness.   

While ibuprofen (Advil) is considered a typical NSAID, meloxicam (Mobic) is considered a partially selective NSAID. So which one is better? Let’s look.

Which is better for pain?

To sum it up, meloxicam is associated with similar pain reduction effects relative to nonselective NSAIDs, like ibuprofen, in short-term studies on arthritis and soft tissue pain.

Winner = neither. It’s a draw for pain.

What about gastrointestinal (GI bleeding)?

Surprisingly, meloxicam is associated with a higher risk of bleeding compared to ibuprofen. One thing to remember though – with ibuprofen the higher the dose the higher the risk of GI bleed (200 mg less risk, 600 mg more risk). Moral of the story?

Winner = ibuprofen. Meloxicam has not been conclusively demonstrated to offer an advantage over nonselective NSAIDs with regard to adverse events on the gut.

What about the heart?

Long-term use of NSAIDS, like Ibuprofen, carry a slightly increased risk of stroke and heart disease. Meloxicam has not been shown to be associated with increased risk of heart attack. At high doses or in persons with diagnosed coronary heart disease ibuprofen, but not Meloxicam, has been suggested to increase the risk of heart attack.

Winner = meloxicam

What about the kidneys?

Kidney problems in folks taking ibuprofen are rare, but they are known to happen. Two measures of kidney function, serum creatinine, and creatinine clearance have been found to be significantly increased in patients treated with ibuprofen as compared to meloxicam. This is important. meloxicam may be safer on the kidneys due to fewer effects on the blood flow to the kidneys.

Winner = meloxicam.

What about the liver?

Neither meloxicam or ibuprofen have harmful effects on the liver compared to placebo.

Winner = both

What about cost?

Since both meloxicam and ibuprofen are generic, the cost is not a problem for either.

Winner = both

Which is more convenient? 

Meloxicam is taken once daily at a dose of 7.5 mg or 15 mg, whereas ibuprofen 200 mg tablets are taken every six to eight hours. However, ibuprofen is available over the counter whereas meloxicam is a prescription medication only.

Winner = ibuprofen.

Dr. O

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