meloxicam
Meloxicam is a prescription non-steroidal anti-inflammatory drug (NSAID) used for different types of arthritis pain. It comes as a capsule, tablet, or liquid that you take by mouth. It's also available as an injection that's given by a healthcare provider in a hospital setting. Common side effects include diarrhea, joint pain, and stomach upset. Like all NSAIDs, meloxicam can raise the risk for stomach bleeds.
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What is Meloxicam?
What is Meloxicam used for?
Pain from osteoarthritis (capsules, tablets, and oral suspension)
Pain from rheumatoid arthritis and juvenile rheumatoid arthritis (JRA) (tablets and oral suspension)
Moderate-to-severe pain (Anjeso injection)
How Meloxicam works
Meloxicam is a non-steroidal anti-inflammatory drug (NSAID). It works by blocking two types of proteins, called cyclooxygenase, or COX, in your body that cause inflammation, pain, and swelling. More specifically, meloxicam blocks COX-2 more than COX-1, which is thought to explain why meloxicam has generally less stomach and kidney side effects compared to other NSAIDs.
Drug Facts
More on Meloxicam essentials
What are the side effects of Meloxicam?
Common Side Effects
- Headache (up to 8%)
- Diarrhea (up to 8%)
- Joint pain (up to 6%)
- Urinary tract infections (up to 6%)
- Flu-like symptoms (up to 6%)
- Upset stomach (up to 5%)
- Swelling (up to 5%)
- Constipation (8%)
- Liver damage (3%)
- Low red blood cells (2%)
Other Side Effects
- Nausea
- Excessive gas
- Dizziness
- Skin rashes
- Accidental injuries
- Falls
- High blood pressure
- Back pain
Serious Side Effects
- Stomach bleeding: feeling faint, vomiting blood, bloody or dark stools, severe stomach pain or discomfort
- Heart attack: chest pain or tightness, pain that radiates up to your shoulder, arm, neck, or jaw
- Stroke: sudden confusion, trouble breathing, weakness in one part of your body or face, slurred speech
- Heart failure: difficulty breathing, swelling, fast heartbeat
- Worsening liver problems or liver failure: swelling of your stomach, yellowing of your skin or the whites of your eyes, confusion, dark or brown urine
- Serious kidney problems: tiredness, dry and itchy skin, low appetite, urinating less than usual, foamy or bloody urine, muscle cramps
- Allergic reactions: hives, rash, blisters, swelling of the lips or tongue, difficulty breathing
- Serious skin reactions: skin reddening, blisters, rash
Source: DailyMed
More on Meloxicam side effects
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Heart failure—shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
- Increase in blood pressure
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Rash, fever, and swollen lymph nodes
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Round red or dark patches on the skin that may itch, burn, and blister
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Headache
- Loss of appetite
- Nausea
- Upset stomach
Pros and cons of Meloxicam
Pros
Only taken once a day
Available as a lower-cost generic
Causes less stomach upset than some other NSAIDs
Works well to treat pain caused by different types of arthritis
Cons
Available only by prescription
Not safe during pregnancy
Might not be the best option if you're 65 years or older, or have kidney, heart, liver, or bleeding problems
Different formulations (e.g., capsules, liquid) might not be able to be substituted for one another
Pharmacist tips for Meloxicam
You can take meloxicam with or without food. However, it's best to take it with food or milk to prevent getting an upset stomach.
Just because you don't feel a difference in your pain level at the start of meloxicam treatment, doesn't mean this medication isn't working. It might take a few weeks before you experience more noticeable pain relief from meloxicam.
Meloxicam can interact with a lot of commonly used medications. For example, meloxicam not only raises your risk for high blood pressure, but it can also cause blood pressure medications to not work as well. Another example is that meloxicam can interact with blood thinners and raise your risk for bleeds. Make sure to tell your provider about all of the medications you're taking before starting meloxicam. Don't start any medications while taking meloxicam without talking to your provider or pharmacist first.
Don't take meloxicam with other NSAIDs, such as ibuprofen (Motrin, Advil) or aspirin without asking your provider first. Doing so puts you at higher risk for stomach bleeds, stroke, and heart attack. NSAIDs are commonly found in over-the-counter pain and cold medications. Talk with your healthcare provider or pharmacist if you're not sure whether you're already taking an NSAID.
Store meloxicam up and away from children and pets so they're less likely to reach and accidentally take the medication. If you think your child accidentally took the medication, call a Poison Control Center right away at 1-800-222-1222.
More tips for the oral solution
Shake meloxicam oral solution gently before using it to make sure you're getting your full dose.
Use a medication dose cup or an oral syringe to measure your dose of meloxicam. Ask your pharmacy to provide you with one if the product doesn't include it in its packaging or if you need extras. Don't use household spoons because they might not be accurate and might cause you to take the wrong dose.
More on Meloxicam tips
Frequently asked questions about Meloxicam
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What are the risks and warnings for Meloxicam?
Meloxicam can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Stomach bleeding
Risk factors: Older adults | History of stomach bleeding or bleeding problems | Liver problems | Taking other medications that raise your risk of bleeds | Drinking alcohol | Smoking | Taking meloxicam for a long time
Taking meloxicam raises your risk for stomach ulcers (sores) and bleeds, which can happen any time during treatment. In some cases, stomach bleeding can be life threatening. Your risk might be higher if you have any of the risk factors above. Certain medications can raise your risk for stomach bleeds, such as aspirin, other oral NSAIDs, oral corticosteroids, certain antidepressants, and blood thinners (anticoagulants). Discuss all of your conditions and medications with your provider before starting meloxicam so they can talk with you about your risk for stomach bleeding. If you're vomiting blood, have bloody or dark stools, feel faint, or have severe stomach pain that doesn't go away while taking meloxicam, get medical attention right away.
Heart attack and stroke
Risk factors: History of heart problems | Taking high doses of meloxicam | Taking meloxicam for a long time | History of, or planned, heart surgery
Meloxicam can raise your risk of having blood clots, heart attack, and stroke. If you have heart problems, talk to your healthcare provider before starting this medication. To lower your risk, take this medication at the lowest dose and for the shortest time possible. Don't take meloxicam if you had, or will have, heart surgery. Call 911 if you experience chest pain, shortness of breath, weakness on one side of your body, or trouble speaking or walking.
High blood pressure and heart failure
Risk factors: History of heart problems
Meloxicam can raise your blood pressure or put you at risk for heart failure. This is because it can cause your body to hold onto extra fluid. Let your provider know if you have a history of heart problems, or are taking blood pressure medications, before starting meloxicam so they can help make sure it's safe for you. While taking meloxicam, monitor your blood pressure and let your provider know if you notice any changes. If you experience chest pain with physical activity, swelling, fainting, trouble breathing, headache, or irregular heartbeat while taking meloxicam, contact your provider.
Liver problems
Risk factors: History of liver problems
Rarely, meloxicam can cause serious liver problems that can lead to liver failure. If you notice swelling of your stomach, stomach pain, yellowing of your skin or the whites of your eyes, stool changes (black, tarry, or bloody stools), nausea, vomiting, confusion, or dark or brown urine, get medical help right away. These can be signs of liver damage.
Kidney damage and high potassium levels
Risk factors: Kidney or liver problems | Heart failure | Taking certain high blood pressure medications, such as water pills, ACE inhibitors, or ARBs | Older adults | Loss of body fluid through conditions such as severe vomiting, bleeding, or diarrhea | Using meloxicam for a long time
Meloxicam can damage your kidneys by slowing down blood flow to the kidneys. The risk is higher if you're taking certain blood pressure medications (like ACE inhibitors, ARBs, or water pills), or have certain conditions (like kidney or liver problems and heart failure). Kidney damage is usually reversible once you stop taking meloxicam. This medication isn't recommended if you have very severe kidney problems, so discuss the risks and benefits of taking it with your provider. Let your provider know if you notice a change in how often you urinate after starting meloxicam as this can be a sign of kidney damage.
In addition, kidney damage from meloxicam can also lead to high potassium levels. Sometimes, this medication can cause high potassium levels even in people with normal kidneys. If you experience signs of high potassium levels, such as nausea, muscle weakness, or tingling sensations in your muscles, tell your healthcare provider right away because it might be dangerous.
Severe allergic reactions
Risk factors: Aspirin allergy | NSAID allergy
Severe allergic reactions to meloxicam are possible. These can include life-threatening reactions like anaphylaxis (closing of the throat). Before starting meloxicam, let your provider know if you have an allergy to aspirin or other NSAIDs. If you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after using meloxicam, seek medical attention right away.
Rarely, meloxicam can cause serious skin reactions. Stop using meloxicam and get medical attention right away if you notice skin changes such as rash, blisters, skin reddening, or skin peeling.
Severe asthma attack
Risk factors: Asthma and stuffy nose with or without nasal polyps | Allergic reaction to aspirin or other NSAIDs
Meloxicam can cause your airways to tighten, which might lead to severe asthma attacks. Be careful using this medication if you have asthma. People who've experienced asthma attacks triggered by aspirin (Aspir-Low) or other NSAIDs in the past should avoid meloxicam. Get medical help right away if your throat tightens and you can't breathe.
Harm to unborn babies
Meloxicam can cause harm to your unborn baby or complications during delivery if taken during the second half of pregnancy. If you're pregnant or thinking of becoming pregnant, talk to your provider about the risk and benefits of meloxicam before using this medication.
Meloxicam dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 100ml of 7.5mg/5ml | 3 bottles | $146.46 | $48.82 |
Typical dosing for Meloxicam
Different dosage forms (e.g., tablet, capsules, liquid) of meloxicam might not be interchangeable with each other. This means they may not be equal to each other on a milligram-by-milligram basis. Discuss with your provider if you want to switch between different types of meloxicam.
In addition, your dose might differ if you have kidney problems.
Pain from osteoarthritis: The typical starting dose is 5 mg by mouth once daily. The maximum dose is 10 mg per day.
Meloxicam tablets and suspension:
For meloxicam suspension, each 5 mL of liquid contains 7.5 mg of meloxicam.
Pain from rheumatoid arthritis and osteoarthritis: The typical dose is 7.5 mg to 15 mg by mouth once daily. The maximum dose is 15 mg per day.
Pain from juvenile rheumatoid arthritis (children weighing 60 kg or more): The typical dose is 7.5 mg by mouth once daily. The maximum dose is 7.5 mg daily.
Pain from juvenile rheumatoid arthritis (children weighing 60 kg or less): Your child's provider will determine your child's dose based on their body weight. The typical dose is 0.125 mg/kg of your child's body weight by mouth once daily. The maximum dose is 7.5 mg daily.
Moderate-to-severe pain: The typical dose is 30 mg injected into the veins (IV) over 15 seconds once daily by a healthcare provider.
More on Meloxicam dosage forms
How much does Meloxicam cost?
Meloxicam contraindications
History of asthma, hives, or other allergic reactions after taking aspirin or another NSAID
Use of meloxicam after coronary artery bypass graft surgery (CABG)
What are alternatives to Meloxicam?
Pain from osteoarthritis (capsules, tablets, and oral suspension)
Pain from rheumatoid arthritis and juvenile rheumatoid arthritis (JRA) (tablets and oral suspension)
Moderate-to-severe pain (Anjeso injection)
Ankylosing spondylitis (AS) (arthritis of the spine)
Polyarticular juvenile idiopathic arthritis (arthritis in children)
Tendonitis and bursitis
Pain
Pain from osteoarthritis of the knees - topical solutions and 1% gel
Pain from osteoarthritis of small joints, such as hands and wrists - 1% gel only
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References
Best studies we foundAmerican Kidney Fund. (n.d.). High potassium (hyperkalemia): Causes, prevention and treatment.
Arthritis Foundation. (n.d.). Juvenile idiopathic arthritis (JIA).
Baudax Bio, Inc. (2023). ANJESO- meloxicam injection [package insert]. DailyMed.
Centers for Disease Control and Prevention (2023). Facts about gastroschisis.
Centers for Disease Control and Prevention. (2020). Spoons are for soup, milliliters are for medicine.
Drugs and Lactation Database (LactMed). (2020). Meloxicam. National Institute of Child Health and Human Development.
Emerald Therapeutics, LLC. (2022). MELOXICAM suspension [package insert]. DailyMed.
Furst, D. E. (1997). Meloxicam: Selective COX-2 inhibition in clinical practice. Seminars in Arthritis and Rheumatism.
Lupin Pharmaceuticals, Inc. (2022). MELOXICAM capsule [package insert]. DailyMed.
Montford, J. R., et al. (2017). How dangerous is hyperkalemia? Journal of the American Society of Nephrology: JASN.
Sousa, A. G. P., et al. (2016). Hyporeninemic hypoaldosteronism and diabetes mellitus: Pathophysiology assumptions, clinical aspects and implications for management. World Journal of Diabetes.
U.S. Food and Drug Administration. (2016). FDA drug safety communication: FDA warns of rare but serious skin reactions with the pain reliever/fever reducer acetaminophen.
U.S. Food and Drug Administration. (2020). Nonsteroidal anti-inflammatory drugs (NSAIDs): drug safety communication - Avoid use of NSAIDs in pregnancy at 20 weeks or later.
U.S. Food and Drug Administration. (2022). FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later because they can result in low amniotic fluid.
Wojtulewski, J. A., et al. (1996). A six-month double-blind trial to compare the efficacy and safety of meloxicam 7.5 mg daily and naproxen 750 mg daily in patients with rheumatoid arthritis. British Journal of Rheumatology.
Wongrakpanich, S., et al. (2018). A comprehensive review of non-steroidal anti-inflammatory drug use in the elderly. Aging and Disease.
Yocum, D., et al. (2000). Safety and Efficacy of Meloxicam in the Treatment of Osteoarthritis. Archives of Internal Medicine.
Zydus Pharmaceuticals USA Inc. (2022). MELOXICAM tablet [package insert]. DailyMed.
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