Meloxicam is a prescription nonsteroidal anti-inflammatory drug (NSAID) primarily used to manage the symptoms of painful, chronic conditions, such as osteoarthritis and rheumatoid arthritis. It works by inhibiting specific enzymes that produce prostaglandins, which are compounds that trigger pain, fever, and inflammation. While effective at reducing stiffness, swelling, and joint pain, meloxicam carries a risk of side effects. Understanding these effects is important for safe medication use.
Common and Expected Adverse Reactions
Gastrointestinal upset is among the most frequently reported issues, including abdominal pain, mild diarrhea, nausea, and indigestion. These symptoms are related to the drug’s mechanism of action, which can irritate the protective lining of the stomach and intestines.
Headaches are a common side effect of meloxicam. Clinical trials show the frequency of headaches ranged from approximately 2.6% to 8.3% of people taking the medication. This reaction is generally considered mild and may be accompanied by other common nervous system effects, such as dizziness.
Meloxicam can also cause the body to retain fluid, which may contribute to a slight increase in blood pressure. Other minor reactions can include a mild skin rash, flu-like symptoms, or general sleepiness. These less severe side effects are often temporary, and they may decrease in intensity as the body adapts to consistent treatment.
Serious Risks and Urgent Warning Signs
While most reactions are mild, meloxicam carries serious risks that require immediate medical attention. These dangers involve damage to the cardiovascular and gastrointestinal systems. Meloxicam can increase the risk of serious cardiovascular thrombotic events, including heart attack and stroke, especially with higher doses or prolonged use. Urgent warning signs include sudden chest pain, shortness of breath, slurred speech, or weakness on one side of the body.
Gastrointestinal toxicity is a major concern, encompassing ulcers, bleeding, and perforation of the stomach or intestines, which can be fatal. These events may occur without prior warning symptoms, but signs of serious bleeding include vomiting material that looks like coffee grounds, or passing black, tarry stools. Additionally, meloxicam can impair kidney function, causing symptoms like a decrease in the frequency or amount of urine produced, unexplained weight gain, or swelling of the lower legs, feet, or hands.
Rarely, the medication can lead to severe allergic or skin reactions, such as Stevens-Johnson syndrome or toxic epidermal necrolysis. These reactions may begin with flu-like symptoms, followed by a painful rash that spreads and causes blistering or peeling of the skin. Any sign of a severe skin reaction, such as a spreading rash or hives, or swelling of the face, tongue, or throat, should be treated as a medical emergency.
Safe Usage Guidelines and Drug Interactions
To minimize adverse effects, meloxicam should be used at the lowest effective dose for the shortest duration necessary. This approach is important for mitigating the risks of gastrointestinal and cardiovascular complications. Patients should avoid taking meloxicam if they are scheduled for or have recently had coronary artery bypass graft (CABG) surgery, as the risk of heart attack and stroke is significantly increased.
Combining meloxicam with blood thinners, such as warfarin, or antiplatelet drugs significantly increases the risk of serious bleeding. The risk of gastrointestinal bleeding is also heightened when meloxicam is taken with certain antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), or with corticosteroid medications.
Using meloxicam alongside other NSAIDs, including over-the-counter ibuprofen or naproxen, is discouraged because it does not increase the benefit but greatly increases the chance of stomach problems. Furthermore, meloxicam can counteract the effects of various blood pressure medications, including angiotensin-converting enzyme (ACE) inhibitors and diuretics. This interaction occurs because the drug promotes fluid retention, reducing the ability of these medications to lower blood pressure or remove excess fluid.