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Meloxicam Side Effects: What Are They?

People who suffer from rheumatoid arthritis and osteoarthritis deal with daily, chronic pain that can have a serious impact on their quality of life. Rheumatoid arthritis affects more than 1.3 million Americans, including both adults and children, and about one percent of the population worldwide. Osteoarthritis is the most common joint disorder in the United States, affecting approximately ten percent of men and thirteen percent of women aged 60 and older, and is the most common cause of total hip and total knee replacements in the United States. Meloxicam is a medication available for daily management of rheumatoid arthritis in adults and children and osteoarthritis in adults, but it is not without side effects.  There’s a lot to know about meloxicam, including its benefits, risks, uses, and costs, before asking your doctor about the medication.

What Is Meloxicam?

Meloxicam is a high-dosage non-steroidal anti-inflammatory drug (NSAID) that is categorized with medicines like aspirin, ibuprofen, and naproxen. NSAIDs work by decreasing levels of prostaglandins, which are substances in your body that cause inflammation. They are typically used to decrease swelling, inflammation, fever, and pain. Unlike medications like aspirin, ibuprofen, and naproxen, meloxicam is a prescription drug and is not available without a prescription due to its strength and potential for serious side effects. Meloxicam is available in an oral suspension, oral tablets, and oral capsules. Meloxicam is also sold under the brand names Mobic, Vivlodex, and Meloxicam Comfort Pac that have all been approved by the Food and Drug Administration, or FDA.

What Is Meloxicam Used to Treat?

In general, meloxicam is used to reduce inflammation and swelling and provide pain relief. Specifically, meloxicam is used to treat pain and inflammation caused by rheumatoid arthritis and osteoarthritis in adults and juvenile rheumatoid arthritis in children. A brief explanation of the conditions treated with meloxicam and their associated symptoms can be found below.
 

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disorder that causes your body to mistakenly attack itself, damaging the joints, skin, eyes, lungs, heart, and blood vessels. Rheumatoid arthritis causes painful swelling in the lining of the joints that can ultimately result in bone erosion and joint deformity. This same inflammation can also cause damage to other parts of the body. Although treatment options for rheumatoid arthritis have improved dramatically in recent years, severe forms of the condition can be physically disabling. Symptoms of rheumatoid arthritis include:

  • Joint stiffness that is worse in the mornings or following periods of inactivity
  • Tender, warm, swollen joints
  • Fatigue, fever, and loss of appetite

In its early stages, rheumatoid arthritis begins by affecting smaller joints, including those in the fingers, hands, toes, and feet. Over time, the disease may begin to impact the larger joints, including wrists, knees, ankles, elbows, hips, and shoulders. About 40 percent of rheumatoid arthritis patients experience signs and symptoms in other parts of the body as well, including the skin, eyes, lungs, heart, kidneys, salivary glands, nerve tissue, bone marrow, and blood vessels.
 

Osteoarthritis
Osteoarthritis is different from rheumatoid arthritis in several ways. First, osteoarthritis is not an autoimmune disorder; it is caused by the wearing down overtime of the protective cartilage that protects the ends of the bones. Osteoarthritis is often called a “wear and tear” disease because it is more likely to affected older people, obese individuals, those with joint injuries, and people with other conditions that place increased stress on the joints.  While osteoarthritis is most commonly experienced in the hands, knees, hips, and spine, it can affect and cause damage to any joint. Damage caused by osteoarthritis cannot be reversed, but the pain caused by the condition can be managed and the progression of the disease can be slowed with a combination of lifestyle changes and some treatments. Symptoms of osteoarthritis include:

  • Pain in affected joints during or after movement
  • Stiffness upon waking or after periods of inactivity
  • Tenderness in affected joints
  • Reduced flexibility in affected joints
  • Grating, popping, or crackling sensation in affected joints
  • Bone spurs forming around affected joints
  • Swelling caused by soft tissue inflammation around the affected joint 

How Does Meloxicam Treat Pain?

Like other NSAIDS, meloxicam works to treat pain by decreasing inflammation. NSAIDs reduce the production of prostaglandins, which are substances in the body that cause inflammation, pain, and fever. Prostaglandins have plenty of helpful jobs, too; they protect the stomach lining and intestines from stomach acid, aid in blood clotting by activating blood platelets and help the kidneys function normally.  Prostaglandins are produced by two types of enzymes: COX-1 and COX-2. While both enzymes create prostaglandins that produce inflammation, pain, and fever, only COX-1 produces the beneficial prostaglandins that protect the stomach and intestinal lining and promote blood clotting. Some NSAIDs, called non-selective NSAIDs, work by blocking both COX-1 and COX-2, which also stops the prostaglandins from protecting the stomach and intestinal lining. Others, called partially selective NSAIDs, only block COX-2, which helps to prevent some gastrointestinal side effects. Meloxicam is a partially selective NSAID that only operates on COX-2. 

How Much Does Meloxicam Cost?

Meloxicam is available as an oral tablet, oral solution, and oral capsule. The medication is covered by many commercial and Medicare drug insurance plans, and pharmacy discount plans can offer savings as well. Manufacturers coupons and patient assistance programs may be available for the brand name version of the drug through the manufacturer’s website. 
Approximate Costs of Mobic and Meloxicam
 
Mobic
Meloxicam
 
Per Unit
30 Units
Per Unit
30 Units
7.5 mg oral tablet
$5.87
$176.09
$0.54
$16.18
15 mg oral tablet
$14.37
$431.10
$0.55
$16.47

What Are the Benefits of Using Meloxicam?

Meloxicam is less risky for people with heart conditions than NSAIDs like ibuprofen, which have been shown to increase the risk of a heart attack when used long-term. Meloxicam is safer on the kidneys than NSAIDs like ibuprofen due to fewer effects on blood flow to the kidney. Another benefit of meloxicam is that it is not a narcotic and not an opioid, which reduces the likelihood of abuse and addiction and makes it a viable treatment option for people with a history of drug and alcohol abuse and addiction. Because it is available in a variety of forms from a number of manufacturers, meloxicam is also affordable and covered by most insurance plans. The medication comes in many different forms, allowing doctors to help patients treat their pain most efficiently. No matter the form, be sure to store your medication at room temperature. 

How Do I Know What Dose of Meloxicam I Should Take?

Meloxicam is generally prescribed at an initial dose of 7.5 mg taken once per day for adults suffering from rheumatoid arthritis or osteoarthritis. After establishing how the medication affects the patient, the dose may be increased to a maximum maintenance dose of 15 mg taken once per day. However, the lowest effective dose should be used in order to minimize side effects. Children ages two and older who are being treated for juvenile rheumatoid arthritis will be treated at a maximum dose of 7.5 mg taken once per day. Be sure to speak with your health care professional about the correct dosage, including what to do about a missed dose and any questions about the drug information. 

How Do I Use Meloxicam to Treat Pain Associated with Rheumatoid Arthritis and Osteoarthritis?

Meloxicam may be taken with or without food but should be taken exactly as prescribed. The medication should not be taken in larger doses than recommended or for longer than recommended. Children’s weight should be monitored while taking meloxicam and the doctor should be notified if changes in weight occur because the dose of meloxicam prescribed to children is determined by the child’s weight. Meloxicam should not be taken with alcohol because it can increase the risk of stomach bleeding. If you drink alcohol regularly or have a drinking problem, talk to your doctor before taking meloxicam.

What Side Effects Are Associated with Meloxicam?

Meloxicam has similar side effects to other drugs in its class, but some may be more pronounced because meloxicam is considered a high-dose NSAID. Common side effects of meloxicam include:

  • Upset stomach and abdominal pain
  • Nausea
  • Dizziness
  • Diarrhea
  • Anemia
  • Edema
  • Constipation
  • Gas and bloating
  • Weight gain 

If your side effects are persistent or become worse, seek medical advice from your doctor or seek immediate medical attention if serious. Unlikely, but potentially serious side effects associated with meloxicam include:
Allergic reactions like skin rash and skin reactions like itching, hives, blistering, or swelling of the face, lips, or tongue
Blood clots, as indicated by:

  • Changes in vision
  • Chest pain or back pain
  • Severe, sudden headache
  • Pain, swelling or warmth in the arm or leg
  • Trouble speaking
  • Sudden numbness or weakness in the face, arm, or leg
  • Liver damage, as indicated by:
  • Dark urine that is yellow or brown
  • Flu-like symptoms such as sore throat 
  • Light-colored stools
  • Loss of appetite
  • Nausea
  • Right upper stomach pain
  • Weakness, exhaustion, and tiredness
  • Yellowing of the eyes or skin

Internal or external bleeding, as indicated by:

  • Bloody or black, tarry stools
  • Red or dark brown urination
  • Spitting up blood or brown material
  • Red spots on the skin or other unusual bruising
  • Unusual bleeding from the eye, gums, or nose
  • Stroke, as evidenced by:
  • Changes in vision
  • Confusion
  • Trouble speaking or understanding
  • Severe headaches
  • Sudden numbness or weakness of the face, arm, or leg
  • Trouble walking
  • Trouble breathing
  • Dizziness
  • Loss of balance or coordination

Is Meloxicam Considered Safe for Pregnant or Breastfeeding Women?

The current recommendation for meloxicam use in pregnant women is that it should be avoided in early pregnancy if possible and should definitely not be taken if you are 30 or more weeks pregnant. If you have taken even a single dose of meloxicam after the 29th week of pregnancy, you should contact your doctor immediately. The use of meloxicam past the 29th week of pregnancy can cause a blood vessel called the ductus arteriosus, which is responsible for delivering nutrients and oxygen from the mother to the baby, to close prematurely.  The use of meloxicam past the 29th week of pregnancy is also linked to persistent pulmonary hypertension in newborns, which is when a newborn baby’s lungs do not adapt to breathing outside the womb. Finally, meloxicam can also result in oligohydramnios, or reduced fluid around the baby. 
It is presently unknown whether meloxicam passes into breast milk. Talk to your doctor prior to taking meloxicam if you are nursing or planning to nurse.

What Drug Interactions Do I Need to Be Aware of?

Meloxicam should not be used in patients taking any other NSAIDs, including aspirin, due to the combined effects of the medications. Meloxicam increases the risk of bleeding, especially stomach bleeding, so it should not be taken with other drugs that cause bleeding, including antiplatelet drugs and blood thinners. Other medications known to interact with meloxicam include:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Selective serotonin and norepinephrine reuptake inhibitors (SSNRIs)
  • Corticosteroids
  • Pemetrexed
  • Cyclosporine
  • Methotrexate
  • Warfarin
  • Lithium
  • Blood pressure medications including angiotensin receptor blockers (ARBs), angiotensin-converting enzyme (ACE) inhibitors, beta-blockers
  • Diuretics

Who Should Not Take Meloxicam?

Prior to prescribing meloxicam, your doctor should be aware of your complete medical history including over-the-counter medication you're taking. Individuals with heart failure or kidney disease should not take meloxicam. People who have a history of the following conditions should talk to their physicians about their medical history before taking meloxicam:

  • Systemic mastocytosis
  • Anemia
  • Increased risk of bleeding due to a clotting disorder
  • Increased risk of bleeding
  • Alcoholism
  • High blood pressure
  • Heart attack
  • Chronic heart failure
  • Stroke
  • Blood clot
  • Stomach or intestinal ulcer
  • Bleeding of the stomach or intestines
  • Visible water retention
  • Abnormal liver function
  • Pregnancy
  • Gastrointestinal rupture
  • Tobacco smoking
  • Increased cardiovascular event risk
  • Aspirin exacerbated respiratory disease

How Do I Know If Meloxicam Is Right for Me?

Meloxicam is a helpful tool for patients looking to manage chronic pain associated with rheumatoid arthritis in adults and children and osteoarthritis in adults. Because meloxicam is not a narcotic pain medication, it carries a lower risk of dependence than opioid drugs used to treat pain. Therefore, meloxicam is an excellent pain management option for people who have a history of addiction and want to avoid the use of opioids and controlled substances or those who are looking for non-habit forming pain medication for any number of reasons. Meloxicam should not be used by people with renal impairment or a history of heart problems, although meloxicam is safer for people with these conditions than some other NSAIDs, such as ibuprofen.

Published April 30th, 2020 by Bridget Reed
Fact Checked by Chris Riley

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