Author: Nancy Swezey, RN

Meloxicam is a type of nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation. It is available only by prescription. NSAIDs are one of the most broadly used medications.¹ Many NSAIDs are available over the counter (OTC) and are used for various reasons. OTC NSAIDs include:

• Aspirin: Bayer, Excedrin
• Ibuprofen: Advil, Motrin
• Naproxen: Aleve

Meloxicam is sold under the brand name Mobic and comes in 7.5 and 15 mg tablets. It can also be taken transdermally, through a patch, or intravenously (IV).² Meloxicam has a long half-life, meaning that it can take several hours to take full effect. For this reason, it is not commonly used to treat pain that requires immediate relief.²

Instead, it can treat ongoing pain states, both long and short term. Meloxicam is approved by the U.S. Food & Drug Administration (FDA) to treat different types of arthritis in adults and children and musculoskeletal pain conditions, such as low back pain and spinal abnormalities.² Meloxicam is not approved for treating pain in children under 2 years old.

Meloxicam and other NSAIDs are some of the most commonly prescribed types of medications. Meloxicam and other prescription NSAIDs generally come in higher doses than their OTC counterparts. You should not take OTC NSAIDs for more than 10 days without seeing a doctor.

What Meloxicam Does

Meloxicam works by blocking substances in your body that cause inflammation, fever, and pain³ and is prescribed by doctors to treat arthritis pain and inflammation.

Meloxicam treats two types of arthritis: rheumatoid and osteoarthritis. Rheumatoid arthritis is an autoimmune condition that involves inflammation and pain in the joints, while osteoarthritis is related to degeneration.

Many older adults who have joint pain related to arthritis experience osteoarthritis, or sometimes athletes get it from overuse. It is also used for pre- and post-operative pain and to treat fever, headaches, and various other types of pain and inflammation.²

Meloxicam relieves specific symptoms, including:

• Pain
• Sensitivity
• Swelling
• Stiffness
• Fevers

Meloxicam and Addiction

NSAIDs are generally considered safe and have proven to be effective for various conditions without the potential for addiction. In recent years with the opioid epidemic, doctors and other prescribers are looking for alternatives to opioids for pain treatment, and NSAIDs are an option.

Although these types of drugs, such as Meloxicam, don’t come with a high risk of addiction, this is not to say it comes with no risk. Continuous use of meloxicam poses its own risks.

Meloxicam does not get you high, so it is not considered an addictive substance and is often used in place of drugs that are addictive, like opiates, to treat pain.

Many people think of meloxicam and other NSAIDs as benign alternatives to narcotics and other drugs with well-known adverse side effects. However, like any medication, meloxicam overuse can lead to dependence. Furthermore, long-term use of meloxicam and other NSAIDs can be detrimental to your health in multiple ways.

Common Meloxicam Side Effects

As with most drugs, meloxicam use risks are higher if you take it in high doses or over extended periods.

If you have chronic pain from conditions like arthritis, you may be prescribed meloxicam regularly. You wouldn’t be alone in that: about 1 billion people experience some arthritis, and as many as 50% of those chronically use NSAIDs.⁴

It is important that you understand the risks and benefits of meloxicam and the potential hazards it can pose. Furthermore, you need to understand your dosing schedule and take it only as prescribed.

Mild Side Effects

The side effects of meloxicam can be mild to severe. Some of the milder side effects include diarrhea, constipation, gas, and sore throat.³ Usually, these symptoms come and go relatively quickly and pose no long-term threat. When they persist, it is important to let your prescriber know.

Serious Side Effects

It is important for more serious side effects to stop taking meloxicam immediately and let your provider know. These include:

• Fever
• Blisters
• Skin changes: blisters, rash, itchiness, paleness
• Difficulty breathing or swallowing
• Hoarse voice
• Swelling around extremities or in your face and mouth
• Nausea
• Fatigue
• Stomach pain, particularly in the right upper corner
• Yellowing of skin and eyes
• Racing heart
• Back pain
• Difficulty urinating

Who’s at Risk of Meloxicam Side Effects

NSAIDs, as a class, are one of the main causes of medication-related complications and fatalities. This is especially true among older people and those who have existing health problems.¹

You may be at higher risk of meloxicam side effects if you take higher doses, such as a 15 mg tablet versus the 7.5 mg tablet. Many researchers believe its benefits do not outweigh the benefits of the higher dose.⁴

Furthermore, you may be at higher risk of meloxicam side effects if you:

• Take other medications
• Are over 65
• Have any liver or kidney problems

For this reason, the FDA recommends that you take NSAIDs like meloxicam only if necessary and at the lowest effective dose.

Meloxicam Overdose

In addition to its side effects, it is possible to overdose on meloxicam and other NSAIDs. Overdose symptoms include:³

• Drowsiness
• Vomiting
• Bloody stools
• Bloody, dark vomit
• Slurred speech
• Chest pain

After taking meloxicam, if you or someone you are with has trouble breathing, seizures, or cannot be woken up, emergency services should be called immediately.

Meloxicam and Other Medications

Important considerations for taking meloxicam include what other medications and supplements you take, as well as your health history. For example, many people take aspirin, another NSAID, at low doses to prevent heart attacks.

If you take aspirin and meloxicam together, you have a much higher risk of developing ulcers than taking them alone.⁴ Other medications that may change the effect of meloxicam include:^3,4

• ACE inhibitors
• Lithium
• Medications for depression
• Steroids
• Other NSAIDs
• Diuretics

Health conditions that may increase the risk of adverse side effects from meloxicam include:⁵

• Diabetes
• Heart disease
• Older age
• Liver or kidney problems
• High blood pressure
• History of ulcers or GI problems
• Conditions that require high doses of NSAIDs

Meloxicam and Gastrointestinal Side Effects

Perhaps the most well-known adverse effects of meloxicam and other NSAIDs are gastrointestinal (GI) problems, such as bleeding, ulcers, and holes in your stomach or intestines.

GI effects of NSAIDs are common and serious and raise valid concerns among providers and consumers. Some studies show that meloxicam has a lower risk for GI side effects than other NSAIDs, which is one reason prescribers choose it.

You are more likely to experience these side effects if you have had stomach or intestinal issues in the past, if you take steroids, drink alcohol, or smoke cigarettes.^1,6 Very often, meloxicam is prescribed with a proton-pump inhibitor (PPI) such as Nexium or Prilosec to prevent these complications.¹

Meloxicam and Heart and Lung Disease

Meloxicam and other NSAIDs also put you at risk for stroke, heart attack, and cardiovascular disease. Because of how frequently aspirin is prescribed to prevent heart disease, many people don’t recognize this risk. But NSAIDs other than aspirin can lead to heart disease and heart disease-related death, particularly in people who have already had heart problems.

Similarly, if you have asthma, you can have worsened symptoms from meloxicam and other NSAIDs.⁶ If you have heart and breathing problems, your prescribers may choose alternatives to meloxicam.

Kidney and Liver Problems from Meloxicam

Another risk of meloxicam use is damage to your kidneys. Meloxicam and other NSAIDs can cause:

• Kidney injury,
• Long-term kidney disease
• Imbalance in your electrolytes
• Inflammation of your kidneys
• Acidic imbalances
• Fluid retention
• High blood pressure

Kidney complications from NSAIDs are usually related to high doses or long-term use.⁶ If not treated, meloxicam overuse can lead to kidney failure.

Less common than GI, cardiovascular, and kidney problems from meloxicam use—but just as serious—are liver problems. It is often related to toxicity from meloxicam intake.⁶ If you have existing liver or kidney disease, your doctor will likely prescribe you alternative medications or lower doses of meloxicam.

Safety with Meloxicam and other NSAIDs

The 2016 Global Burden of Disease data revealed a broad increase in musculoskeletal function issues, and with that, an increase in NSAID usage.⁶ Increased use comes with an increased responsibility of prescribers and consumers to understand the risks and benefits of taking NSAIDs. It is for this reason that the FDA has issued a health advisory related to NSAID use.

Meloxicam warnings from the FDA include advising people to minimize their intake to minimize their risk.⁶

Before taking meloxicam, or even any OTC NSAID, make sure you review your health status and other medications with your doctor to determine if it’s safe for you. If you or someone you know is dependent or overusing meloxicam, contact a rehab specialist at 800-934-1582(Who Answers?) .

References

1. Gwee, K. A., Goh, V., Lima, G., & Setia, S. (2018). Coprescribing proton-pump inhibitors with nonsteroidal anti-inflammatory drugs: risks versus benefits. Journal of pain research, 11, 361–374. https://doi.org/10.2147/JPR.S156938
2. Bekker, A., Kloepping, C., & Collingwood, S. (2018). Meloxicam in the management of post-operative pain: Narrative review. Journal of anaesthesiology, clinical pharmacology, 34(4), 450–457.
3. Medline Plus. (2020, April 15). Meloxicam: Medlineplus drug information. Retrieved February 28, 2021.
4. Fleischmann, R., Iqbal, I., & Slobodin, G. (2002). Meloxicam. Expert opinion on pharmacotherapy, 3(10), 1501-1512.
5. Davis, A., & Robson, J. (2016). The dangers of NSAIDs: look both ways. The British journal of general practice: the journal of the Royal College of General Practitioners, 66(645), 172–173.
6. Bindu, S., Mazumder, S., & Bandyopadhyay, U. (2020). Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective. Biochemical pharmacology, 180, 114147.