Meloxicam
Meloxicam is a non-steroidal anti-inflammatory drug. Its label indicates it for relief of the signs and symptoms of osteoarthritis and of rheumatoid arthritis, and it carries the boxed warning that applies across the NSAID class.
Key points
- The label indicates meloxicam tablets for relief of the signs and symptoms of osteoarthritis.
- It is separately indicated for relief of the signs and symptoms of rheumatoid arthritis.
- The boxed warning states that NSAIDs cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal.
- That risk may occur early in treatment and may increase with duration of use.
How it works
Meloxicam belongs to the NSAID class, reducing inflammation and pain through inhibition of prostaglandin synthesis. The class membership is the practical point rather than an aside, because the boxed warning is written against NSAIDs as a group, which is why switching to a different anti-inflammatory does not by itself avoid it.
Safety specific to meloxicam
Cardiovascular thrombotic events. The boxed warning states that NSAIDs cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. Two phrases in it are easy to skim and worth reading twice: the risk may occur early in treatment, which removes the assumption that short courses are automatically safe, and it may increase with duration of use, which is the reason for the shortest effective course.
Bypass surgery. Meloxicam is contraindicated in the setting of coronary artery bypass graft surgery.
Gastrointestinal events. The same boxed warning covers serious gastrointestinal bleeding, ulceration and perforation. The wider class position, and what it means in practice for anyone taking an anti-inflammatory long term, is set out in our guide to anti-inflammatory painkiller safety.
When to seek urgent care
Chest pain, breathlessness, weakness on one side or difficulty speaking are the cardiovascular events the boxed warning describes. Black or tarry stools, vomiting blood or material resembling coffee grounds, or severe persistent stomach pain are the gastrointestinal ones. All warrant emergency assessment rather than waiting.
Further reading
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