Meloxicam

About Meloxicam

Like that of other NSAIDs, meloxicam’s action is not completely understood but involves blocking the cyclooxygenase (COX-1 and COX-2) enzymes that make prostaglandins, signals behind pain and inflammation. Tablets are labeled for the signs and symptoms of osteoarthritis and rheumatoid arthritis and, in patients weighing at least 60 kg, pauciarticular or polyarticular course juvenile rheumatoid arthritis; the suspension has the same uses, with juvenile arthritis from age 2 at 0.125 mg/kg once a day, up to 7.5 mg. Capsules are labeled only for osteoarthritis pain, and their safety in children is not established. Adults start at 7.5 mg once a day, and some benefit from 15 mg, the maximum; capsules start at 5 mg, up to 10 mg. On hemodialysis the limit is 7.5 mg of tablets or 5 mg of capsules, and use in severe kidney impairment is not recommended.

Its boxed warning says NSAIDs raise the risk of serious heart attacks and strokes, which can be fatal and may begin early in treatment and grow with longer use, and of bleeding, ulcers and perforation of the stomach or intestines, which can be fatal, can occur at any time without warning, and are more likely in older adults and people with past ulcers or bleeding. Meloxicam must not be used in the setting of coronary artery bypass graft (CABG) surgery, by anyone allergic to it, or after asthma, hives or an allergic-type reaction to aspirin or another NSAID. Other warnings cover liver injury, high blood pressure, heart failure and swelling, kidney damage and high potassium, severe allergic and skin reactions including DRESS (a severe reaction that can start with fever, rash or swollen glands), anemia and masked signs of infection. Diarrhea, upper respiratory infections, indigestion and flu-like symptoms are the most common side effects in adults.

NSAIDs used from about 20 weeks of pregnancy can cause rare but serious kidney problems in the unborn baby, leading to low amniotic fluid, and from about 30 weeks can close a fetal blood vessel (the ductus arteriosus) too early; the labels say to limit use between about 20 and 30 weeks to the lowest dose for the shortest time, considering ultrasound checks of the fluid if use goes beyond 48 hours, and to avoid NSAIDs from about 30 weeks. They may also cause reversible infertility in some women. The tablet, capsule and suspension labels each say that form is not interchangeable with other oral meloxicam products, even at the same milligram strength, although the suspension label also allows 5 or 10 mL in place of a 7.5 or 15 mg tablet; changing forms is the prescriber’s decision. Symbravo, approved in January 2025, combines 20 mg of meloxicam with rizatriptan for acute migraine in adults and is a separate product.

Taking Meloxicam

How to take it

Once a day at about the same time, with or without food, at the lowest dose that works for the shortest time your prescriber advises. Shake the suspension gently before each dose.

If you miss a dose

Take it as soon as you remember, unless it is almost time for the next dose; then skip the missed dose and carry on as usual. Do not take a double dose.

Storage

At room temperature in the original, tightly closed container, away from excess heat and moisture (not in the bathroom), out of reach of children.

Interactions to know about

Pain-relieving doses of aspirin and other NSAIDs are not recommended with it, and people on low-dose aspirin are watched more closely for stomach bleeding. Blood thinners, SSRIs and SNRIs add to bleeding risk. It can weaken ACE inhibitors, ARBs, beta blockers and diuretics, can worsen kidney function with ACE inhibitors or ARBs in older, dehydrated or kidney-impaired people, and raises lithium levels and the risk of methotrexate toxicity.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Meloxicam differs from pharmacy to pharmacy

Generic meloxicam tablets have many makers and are taken once a day, so quotes differ by each pharmacy’s fee and markup and by whether meloxicam is on its flat-price generic list.

Capsules have few makers and the suspension has no generic, and because the labels say the forms are not interchangeable, a pharmacist fills only the form written.

Ways to pay less for Meloxicam without insurance

• Ask for generic meloxicam tablets, and ask whether they are on the pharmacy’s flat-price generic list.
• If capsules are prescribed, ask the prescriber whether tablets would suit you; because the forms are not interchangeable, this needs a new prescription.
• If you take it long term, ask for a ninety-day supply once your dose is settled.
• Compare more than one pharmacy, especially for capsules or the suspension.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Meloxicam

1. 1.Is it safe with my heart, kidney or blood pressure conditions?
2. 2.Can I take it with my aspirin, blood thinner, antidepressant or water pill?
3. 3.Which stomach or bleeding symptoms mean I should stop it and get help?
4. 4.Is my prescription for tablets, capsules or the suspension, and can they be swapped?

Related medications