Meloxicam interactions: What you need to know

Meloxicam is a popular pain-killer medication among American households, and it is very likely that you have taken it or found it in your home at least on one occasion. Also known under the brand name Mobic, Meloxicam is part of the nonsteroidal anti-inflammatory drug (NSAID) family. Unlike other over-the-counter (OTC) NSAIDs, such as ibuprofen, it can only be obtained through a physician´s prescription. The medical indications of Meloxicam include many inflammatory conditions, such as osteoarthritis and rheumatoid arthritis.

While Meloxicam is a powerful and common drug to manage the pain and swelling associated with inflammation, it can have potential interactions with other medications. Meloxicam interactions can be serious and warrant the attention of both patients and professional healthcare providers.

Table Of Contents:

• Meloxicam Overview
• Meloxicam Adverse Effects
• Meloxicam Drug Interactions: What To Avoid?
• Other Common Meloxicam Drug Interactions
• Meloxicam Interactions: Foods and Drinks to Avoid
• When to Seek a Doctor
• Meloxicam Interactions − Bottom Line
• People Also Ask

Meloxicam Overview

Meloxicam is often commercialized under the brand name MOBIC, is a powerful NSAID that has been approved by the U.S. Food and Drug Administration (FDA) to treat inflammatory conditions in adults such as:

• Acute Pain
• Acute Flares of Gout
• Osteoarthritis
• Rheumatoid Arthritis

It is also used to treat juvenile idiopathic arthritis in the pediatric population.

Meloxicam can be taken as capsules, tablets, or oral suspension. Any of these forms ensures effective oral absorption. Meloxicam should generally be taken with food to reduce the risk of unwanted gastrointestinal side effects; taking it with a full glass of water may also help to reduce irritation to the esophagus or stomach.

Meloxicam Adverse Effects

While meloxicam is a pretty potent and effective painkiller, several adverse effects can come with the use of this medication that you should be aware of for your safety.

Some of the most common and important adverse effects of Meloxicam include:

• Nausea
• Vomiting
• Diarrhea
• Indigestion
• Abdominal pain
• Headache
• Dizziness
• Upper respiratory tract infections
• Gastrointestinal complications: Gastric ulcers, Gastrointestinal bleeding, Perforation of the stomach or intestines
• Renal issues: Impaired kidney function, increased blood urea nitrogen (BUN), increased serum creatinine
• Cardiovascular issues: Hypertension (high blood pressure), edema (swelling), increased risk of heart attack, increased risk of stroke
• Allergic reactions: Anaphylaxis, rash and itching

Although gastrointestinal, renal, and cardiovascular complications are not that common, they are serious side effects that have been fairly described, and both physicians and patients should be aware when dealing with meloxicam.

Meloxicam Drug Interactions: What To Avoid?

Meloxicam has 389 documented interactions with other drugs. Although most of them may be extremely rare and not relevant, you should be aware of several well-described interactions with other common medications. When combined with Mobic, certain drugs can reduce the effectiveness of your treatment or lead to serious side effects that pose a significant risk to your health.

The following list contains some important medications that you should avoid or use with caution while consuming meloxicam:

Other NSAIDs

The most important drug interaction of Meloxicam is perhaps the one it has with other NSAIDs. Most of the time, people are not aware that most painkillers are part of the same family, the NSAIDs. Not realizing this may result in people with severe pain to start taking 2 or 3 different NSAIDs together, which in turn may have harmful consequences.

Meloxicam and other NSAIDs, like ibuprofen and naproxen, increase the risk of gastrointestinal bleeding, stomach ulcers, or even bowel perforation. This is mainly because NSAIDs inhibit the protective prostaglandins in the stomach lining. Therefore, concurrent use of Meloxicam with other NSAIDs significantly increases the risk of developing severe and life-threatening gastrointestinal complications.

Corticosteroids (e.g., prednisone)

Similar to what happens with NSAIDs, corticosteroids like prednisone are known to irritate the stomach, which can result in the development of gastrointestinal ulcers and bleeding. Therefore, you should avoid combining these medications as it may increase the likelihood of these adverse effects. Furthermore, concomitant use of these medications can synergistically negatively impact renal function.

Blood Pressure Medications (E.g., ACE inhibitors, angiotensin receptor blockers, or beta-blockers)

If you suffer from hypertension, you may be under medical treatment with ACE inhibitors such as lisinopril, angiotensin receptor blockers (ARBs) such as losartan, or beta-blockers such as metoprolol. However, you should be aware that meloxicam can interact with these drugs and reduce their effectiveness. Meloxicam induces sodium and water retention, which directly counteracts the blood pressure-lowering effects of your blood pressure mediations.

Moreover, meloxicam can reduce renal blood flow, which is opposed to the mechanism of action of ACE inhibitors and ARBs, thus making them ineffective and increasing the risk of kidney damage. This is particularly true for people with renal comorbidities or the elderly.

Diuretics (E.g., furosemide, hydrochlorothiazide)

Diuretics, also known as water pills, are used to stop fluid retention by eliminating excess water through urine, which may lower blood pressure. Like blood pressure medications, Meloxicam can lead to sodium and water retention, which may result in ineffective diuretics in removing excess water and reducing blood pressure. Additionally, due to Meloxicam’s potentially harmful effect on renal blood flow, concomitant use with diuretics can further exacerbate the impact and lead to renal damage.

Antiplatelet agents (E.g., aspirin, clopidogrel)

Antiplatelet agents such as Aspirin or Clopidogrel interfere with platelet aggregation, your body’s first protection against bleeding. Meloxicam can also mildly affect platelet function. When these two drugs are used concomitantly, they can significantly increase the risk of bleeding, either through the gastrointestinal system or other parts of the body. Physicians should closely monitor patients on this combination for signs of bleeding, such as easy bruising, prolonged bleeding from minor cuts, or occult bleeding on the feces.

Blood thinners (e.g., warfarin)

Blood thinners such as warfarin inhibit crucial points of the coagulation cascade, which may be useful in people who suffer from clotting disorders. However, the use of these medications carries a bleeding risk, which can be further potentiated by the effect that Meloxicam has on platelet function. Therefore, concurrent use of Meloxicam and blood thinners should be avoided or at least closely monitored to manage the increased bleeding risk adequately.

Antidepressants (e.g., fluoxetine, sertraline)

Antidepressant medications such as fluoxetine and sertraline can have a mild effect on platelet function. When these medications are combined with Meloxicam, their effect synergistically increases the bleeding risk that results from platelet dysfunction. Avoiding the usage of these medications together, closely monitoring the patient, or dose adjustments should be considered to reduce the bleeding risks of patients suffering from both pain and depressive symptoms.

Other Common Meloxicam Drug Interactions

Lithium

Lithium is commonly prescribed for the treatment of Bipolar syndrome. Meloxicam can reduce the renal clearance of Lithium and result in toxicity. Patients should be monitored closely for symptoms like:

• Nausea
• Vomiting
• Diarrhea
• Tremors
• Confusion

Methotrexate

Taking Meloxicam and Methotrexate together can increase the risk of gastrointestinal bleeding and kidney damage. Close monitoring by a professional healthcare provider is essential to reduce these risks and adjust dosages accordingly.

Cyclosporine

Cyclosporine can also alter renal function, which may result in kidney damage. When used in combination with meloxicam, there is a significantly increased risk of renal impairment. Therefore, kidney function must be monitored closely while a patient is taking these two medications.

Meloxicam Interactions: Foods and Drinks to Avoid

Certain drinks like alcohol and coffee can increase the likelihood of stomach ulcers and gastrointestinal bleeding when taken with Meloxicam. Therefore, the consumption of these drinks should be reduced or avoided. On the other hand, Grapefruit juice can interfere with meloxicam metabolism and increase blood concentration, so healthcare providers recommend against its consumption while on treatment with meloxicam.

Foods or supplements containing Omega-3 fatty Acids, garlic, and ginger can have mild blood-thinning properties. Therefore, an interaction with Meloxicam is possible, and you should consult your physician before consuming these substances during your treatment.

When to Seek a Doctor

You should contact your doctor if you experience any of the following while treated with Meloxicam:

• Signs of Gastrointestinal Bleeding: Black stools, bloody vomit, severe stomach pain.
• Unusual bruising or bleeding: Prolonged bleeding from cuts, frequent nosebleeds.
• Signs of kidney dysfunction: reduced urine production, leg swelling, fatigue.
• Cardiovascular Symptoms: chest pain, shortness of breath, sudden weakness, slurred speech.
• Allergic reactions: rash, itching, severe swelling, difficulty breathing.

Meloxicam Interactions − Bottom Line

Meloxicam can interact with various medications, such as other NSAIDs, corticosteroids, blood thinners, and even some antidepressants. These interactions may increase the risk of experiencing gastrointestinal, bleeding, and kidney issues. It is essential to consult your healthcare provider about all medications and supplements you are taking to ensure meloxicam’s safe and effective use.

People Also Ask

Can you take gabapentin and meloxicam together?

Many people who suffer from chronic pain often wonder if it is safe to take gabapentin and meloxicam together. The short answer is yes. Gabapentin and Meloxicam can be taken together, as they treat different types of pain and do not have direct interactions. However, you should always consult your healthcare provider to ensure the safe use of these medications.

Is it safe to take Meloxicam and Tylenol (Acetaminophen) together?

Yes, it is safe to take Meloxicam and Tylenol together, as they have different mechanisms of action. However, you should consult your healthcare provider before combining medications and obtain medical advice based on your health needs.

What supplements cannot be taken with Meloxicam?

Avoid taking meloxicam with supplements that have blood-thinning properties, such as omega-3 fatty acids (fish oil), garlic, and ginkgo biloba, as they can increase the risk of bleeding.

Page Sources

1. UpToDate: Meloxicam: Drug information
2. GoodRx Health: 7 Meloxicam Interactions You Should Know About
3. Mayo Clinic: Meloxicam (Oral Route)
4. Drugs.com: Meloxicam Interactions
5. Ro: Meloxicam interactions: what you shouldn't mix with this drug
6. Single care: Meloxicam interactions to avoid
7. National Library of Medicine: Meloxicam: a reappraisal of pharmacokinetics, efficacy and safety