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.

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.

When does Meloxicam start working?

Time passed since treatment started:

• 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.

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.

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.

Bottle of oral suspension

• 100ml of 7.5mg/5ml

Capsule

• 5mg
• 10mg

Tablet

• 7.5mg
• 15mg

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.

Meloxicam capsules:

• 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.

Anjeso (meloxicam) injection:

• Moderate-to-severe pain: The typical dose is 30 mg injected into the veins (IV) over 15 seconds once daily by a healthcare provider.

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Meloxicam will not be safe for you to take.

• History of asthma, hives, or other allergic reactions after taking aspirin or another NSAID
• Use of meloxicam after coronary artery bypass graft surgery (CABG)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Meloxicam capsules, tablets, and oral solution:

• 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%)

Meloxicam (Anjeso) injection:

• 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

Contact your healthcare provider immediately if you experience any of the following.

• 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

When do Meloxicam possible side effects begin and end?

Time passed since treatment started:

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 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
• 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 to your care team if they continue or are bothersome):

• Diarrhea
• Nausea
• Upset stomach