Meloxicam is in a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs) and are used to treat pain and/or inflammation. Prostaglandins are chemicals that contribute to inflammation within joints, and it is the inflammation that leads to the common symptoms of pain, tenderness and swelling associated with arthritis. Meloxicam blocks the enzymes that make prostaglandins (cyclooxygenase 1 and 2) and reduces the levels of prostaglandins. As a result, inflammation and its accompanying symptoms are reduced. Meloxicam was approved for use in April 2000.
Meloxicam inhibits cyclooxygenase (COX), the enzyme responsible for converting arachidonic acid into prostaglandin H2—the first step in the synthesis of prostaglandins, which are mediators of inflammation. Meloxicam has been shown, especially at its low therapeutic dose, selectively to inhibit COX-2 over COX-1.
Meloxicam concentrations in synovial fluid range from 40% to 50% of those in plasma. The free fraction in synovial fluid is 2.5 times higher than in plasma, due to the lower albumin content in synovial fluid as compared to plasma. The significance of this penetration is unknown, but it may account for the fact that it performs exceptionally well in treatment of arthritis in animal models.
Meloxicam and other NSAIDs work by inhibiting the action of certain hormones that cause inflammation and pain in the body. These hormones are called prostaglandins. By blocking the effects of prostaglandins, meloxicam is useful at reducing pain, inflammation, and joint swelling associated with different forms of arthritis and other painful conditions.
Meloxicam is used for treating symptoms related to osteoarthritis, rheumatoid arthritis, and juvenile rheumatoid arthritis, among other conditions. By blocking the effects of certain hormones that cause inflammation and pain in the body, the medicine can help alleviate pain, inflammation, and joint swelling. Meloxicam can also be used “off-label” to relieve symptoms of fibromyalgia, gout, and lupus.
Meloxicam is a prescription medication that has been licensed to treat several conditions related to pain, inflammation, swelling, or stiffness.
Specific meloxicam uses include the relief of:
Juvenile rheumatoid arthritis symptoms
Osteoarthritis symptoms
Rheumatoid arthritis symptoms.
Meloxicam is not a cure for the types of arthritis mentioned above, nor does it slow the progression of the disease.
Meloxicam is approved for the treatment of juvenile rheumatoid arthritis in children two years of age and older.
On occasion, your healthcare provider may recommend meloxicam for treating something other than the conditions discussed above. This is called an “off-label” use. Some examples of off-label meloxicam uses include the relief of:
Mild to moderate pain, such as back pain, neck pain, or leg pain
Fibromyalgia symptoms
Gout symptoms
Symptoms of systemic lupus erythematosus (SLE for short or lupus)
Pain or inflammation caused by other conditions.
Meloxicam is also used in the veterinary field, most commonly in dogs, but also sees off-label use in other animals such as cattle, cats and exotics. The U.S. Food and Drug Administration sent a Notice of Violation to the manufacturer for its promotional materials which included promotion of the drug for off-label use. In the U.S. the drug is indicated for management of pain and inflammation associated with osteoarthritis in dogs only. In Europe, where the product has been available since the early 1990s, it is also prescribed and licensed for other anti-inflammatory benefits including relief from both acute and chronic pain in dogs.
Since 2003, the oral (liquid) formulations of meloxicam have been licensed in the U.S for use in dogs only, with the January 2005 product insert specifically warning in bold-face type: “Do not use in cats.” An injectable formulation for use in dogs was approved by the FDA November 2003, with a formulation for cats, for surgical use only, approved in October, 2004.
In the U.S., per the manufacturer's clinical instructions as of July 2010, injectable meloxicam is indicated in operative use with felines as a single, one-time dose only, with specific and repeated warnings not to administer a second dose. In June 2007, a new oral version of meloxicam was licensed in Europe for the long-term relief of pain in cats. As of June 2008, meloxicam is registered for long term use in cats in Australia, New Zealand, and throughout Europe.
A few common side effects of meloxicam include headache, insomnia, swelling, and upper respiratory infections (such as the common cold and flu). Some uncommon meloxicam side effects include high blood pressure, congestive heart failure, and allergic reactions. There are also a number of serious side effects with meloxicam. You should call 911 immediately if, while taking meloxicam, you experience slurred speech, chest pain, or shortness of breath, among other symptoms.
As with any medicine, there are possible side effects with meloxicam (Mobic®). However, not everyone who takes the pain-relief drug will experience side effects. In fact, most people tolerate meloxicam well. When people do develop meloxicam side effects, in many cases they are minor and either require no treatment or can easily be treated by you or your healthcare provider. In clinical trials, up to 10 percent of people stopped taking meloxicam because of side effects.
(The side effects of meloxicam that are discussed below are not a complete list of side effects reported with the drug. Your healthcare provider can discuss a more complete list of side effects with you.)
Common Side Effects of Meloxicam
Meloxicam has been studied extensively in clinical trials, with thousands of people worldwide having been evaluated. In these studies, side effects are always documented and compared to those that occur in a similar group of people not taking the medicine. Based on these studies, the most common side effects of meloxicam that occurred more often in those taking meloxicam included:
Heartburn or indigestion (dyspepsia) -- up to 9.5 percent
Upper respiratory infections, including the common cold and flu -- up to 8.3 percent
Diarrhea -- up to 7.8 percent
Nausea -- up to 7.2 percent
Urinary tract infections (UTI) -- up to 6.9 percent
Joint pain -- up to 5.3 percent
Abdominal pain (or stomach pain) -- up to 4.7 percent
Swelling -- up to 4.5 percent
Anemia -- up to 4.1 percent
Headache -- up to 3.6 percent
Insomnia -- up to 3.6 percent
Gas -- up to 3.0 percent.
Other side effects occurring in more than 1 percent of people, and thought to be related to meloxicam, included but were not limited to:
Dizziness
Sore throat (pharyngitis)
Unexplained rash
Itching
Vomiting
Back pain.
As with any drug, there is the potential for serious side effects with meloxicam. The U.S. Food and Drug Administration (FDA) warns that people using NSAIDs, including meloxicam, may have a higher risk of having a heart attack or stroke than those people who do not take NSAIDs. This warning does not apply to those who take aspirin. This risk may be higher in people who have been taking NSAIDs for a long time. These events can occur without any warning and can lead to loss of life. Get emergency medical help by calling 911 as soon as possible if you experience any of the following symptoms:
Chest pain
Shortness of breath
Weakness on one part of your body
Slurred speech.
Other possible serious side effects with meloxicam include but are not limited to:
Allergic reactions such as swelling of the face or body, blisters, unexplained skin rash, wheezing, or difficultly breathing
Stomach or intestinal problems, including bleeding, ulcers, or a hole (known as a perforation)
Liver damage, which can cause nausea, fatigue, yellowing of the skin or whites or the eyes, and excessive tiredness
Kidney problems, including kidney failure
Fluid retention or unexplained weight gain
Congestive heart failure
The sensation that the pill is stuck in your throat.
Because meloxicam can increase the risk of major or life-threatening bleeding, contact your doctor immediately if you notice any unusual bleeding or have any of the following symptoms:
Bloody nose
Black, tarry stools
Blood in the urine or stools
Vomiting blood
Red or purple spots on the skin.
You must not use meloxicam during pregnancy or if you are trying to become pregnant due to possible harm to the unborn baby and interference with normal labor/delivery.
Tell your doctor before using meloxicam if you are breast-feeding. It is not known whether using meloxicam during breastfeeding is dangerous. There are no data on the excretion of meloxicam into human milk; however, meloxicam was excreted in the milk of lactating rats at concentrations higher than those in plasma. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the nursing mother.
During clinical studies, there were also some side effects that occurred rarely in people taking meloxicam. These side effects occurred in less than 2 percent of people. It is difficult to tell whether these side effects were actually caused by the medication itself or something else. These possible meloxicam side effects include but are not limited to:
High blood pressure (hypertension)
Congestive heart failure
Fainting
Allergic reactions
An increase in liver enzymes
Dry mouth
An ulcer in the stomach or intestines (peptic ulcer)
Pancreatitis
Anxiety
Depression
Appetite increase
Weight changes
Swelling
Hair loss (alopecia)
Asthma.
It is possible that you may experience some of the meloxicam side effects explained above or none at all. Unfortunately, there is no way for your healthcare provider to know beforehand if you will have side effects from a medicine that you have never tried. Therefore, make sure to let your healthcare provider know if you develop any side effects or simply something that “just does not seem right.” While it may not be a side effect of meloxicam, your healthcare provider will be able to diagnose and treat the problem.
Do not use meloxicam just before or after heart bypass surgery (coronary artery bypass graft, or CABG).
This medicine may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term.
This medicine may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking meloxicam, especially in older adults.
You should not use this medication if you are allergic to meloxicam, or if you have a history of allergic reaction to aspirin or other NSAIDs.
To make sure you can safely take meloxicam, tell your doctor if you have any of these other conditions:
a history of heart attack, stroke, or blood clot;
heart disease, congestive heart failure, high blood pressure;
a history of stomach ulcers or bleeding;
liver or kidney disease,
a seizure disorder such as epilepsy;
asthma;
polyps in your nose; or
if you smoke.
Review by Anonymous: User Rating: 9.0
meloxicam for Osteoarthritis: I have arthritis in my left leg due to an injury. I am on Neurontin for the nerve pain and was originally prescribed piroxicam for the associated arthritis pain. It made me terribly ill, couldn't keep anything down, and we switched to meloxicam. The side effects vanished and the pain relief was wonderful. This medication helps get me through my days.
Review by suzrhodes: User Rating: 8.0
meloxicam for Osteoarthritis: ... After consulting my pharmacist, I tried the meloxicam (15 mg) and it works better than Celebrex for me - inflammation is my major problem, and I'm pleased. Also, Meloxicam is much cheaper. IMPORTANT - Take with meals to avoid stomach problems.
Review by caligirlnindy: User Rating: 10
meloxicam for Inflammatory Conditions: I was prescribed Meloxicam for inflammation, stiffness and pain in my knee. I took one pill before I went to bed. I woke up with virtually no pain or stiffness. I sit in front of a computer all day and would be have to get up every 30 minutes just to stretch my leg. I saw a difference the very first day. It is my [helping] drug.
Review by Anonymous: User Rating: 1.0
meloxicam for Osteoarthritis: Did nothing for me.
Review by Anonymous: User Rating: 1.0
meloxicam for Tendonitis: After 12 days of use there was no change in my pain.
Review by Anonymous:
meloxicam for Inflammatory Conditions: My experience is that it works beautifully for inflammatory conditions relevant to sciatica problems including pain reduction using 1 tablet per day but the pain returns in approximately 2 days if you stop taking it.
Review by Anonymous: User Rating: 9.0
meloxicam for Inflammatory Conditions: This is very helpful in treating my chronic inflammation. I can't move on rainy days without it! No side effects noticed. After finding out I had virtually no Vitamin D in my system and correcting that, I was able to reduce my dose from 15 mg to 7.5mg.
Review by Deedsy: User Rating: 8.0
meloxicam for Osteoarthritis: I have Osteoarthritis in my hands, elbows, knees, neck/spine and hips. It didn't really reduce the pain in my knees or hips but it really cuts the pain in my hands, and especially at the base of both thumbs to the wrist area. I take 7.5mg twice a day. I didn't realize how much it helped my hands until I ran out and couldn't get to the pharmacy right away to pick up my refill. My hands and thumbs ached pretty bad and it hurt just holding something in either hand. The only relief I could get was by using a moist-heat heating pad and that only helps as I'm using it, and it aches worse at the base of my thumbs down to the outside of both wrists. Peroxicam tore up my stomach. Meloxicam hasn't, it works great with no ill effects.
Review by Anonymous: User Rating: 10
meloxicam for Fibromyalgia: THREE years ago I start with fibro pain all over my body and could not move at all. I tried Celebrex and gave me a bad skin rash and did not take the pain away. ... a [helping] drug for me. I changed my life.
Review by Chip W: User Rating: 9.0
meloxicam for Osteoarthritis: Arthritis in my back (L4-L5) causing extreme pain in my right hip for an hour or two after getting up in the morning. I'd had 3 steroid injections in my back which relieved the pain for 3 - 6 months. I was ready for another injection but instead tried meloxicam. It's now 3 months later. Most of the time there's no pain; occasional pain is quite tolerable. No noticeable side effects so far.
Review by Anonymous:
meloxicam for Inflammatory Conditions: Gave me the hives on the first day but my pain did feel better
Review by Anonymous: User Rating: 10
meloxicam for Rheumatoid Arthritis: Helped clear up over all joint pain.
Review by Anonymous: User Rating: 8.0
meloxicam for Fibromyalgia: I have fibromyalgia. Meloxicam together with Naproxen, the only medicines that gave me considerable relief; although as expected, it is still not enough for fibromyalgia in particular. However, it is surprisingly good for a NSAID.
Review by ...: User Rating: 10
Works great if you have an impacted molar. Buys you a little time until you can make it to a dentist.
Review by Anonymous: User Rating: 5.0
meloxicam for Inflammatory Conditions: Went to urgent care with chest pain, diagnosed with Costochronditis. Meloxicam 15mg once daily helped with pain, but only for about 8 hours. Splitting the dose led to less effective pain relief. Hasn't seemed to resolve Costochondritis. Went to ER, referred to chest specialist.
Review by debcat53: User Rating: 2.0
meloxicam for Osteoarthritis: This medication was very helpful in relieving the pain in my knees, due to osteoarthritis. Unfortunately, I developed serious stomach problems. I am no longer taking this helpful medicine. Too risky with the stomach problems.
Review by Anonymous: User Rating: 9.0
meloxicam for Inflammatory Conditions: knee and back pain: I have been using meloxicam for about 2 weeks and I can see very much improvement of the pain in my knee and also back. I feel so much more active. I exercise almost every day for 45 minutes to an hour and this is so much easier now. I am 76.
Review by Anonymous: User Rating: 10
meloxicam for Fibromyalgia: I'm not so sure my condition was fibromyalgia, but it probably was. I was in excruciating pain in my muscles and tendon-joints, for weeks, ibuprofen and aspirin or paracetamol did absolutely nothing. Codeine helped, but I am allergic to it. I was put on meloxicam by my doctor, and within a day the pain faded, now I take two 7.5mg tablets a day and I am absolutely pain free, not even a minor ache anywhere. Meloxicam is a wonder drug for ache's and pains, both minor and severe.