Introduction

Meloxicam is a type of medicine known as a non-steroidal anti-inflammatory drug (NSAID). It’s commonly used to ease pain and reduce inflammation, particularly in conditions like osteoarthritis and rheumatoid arthritis. For UK patients and healthcare professionals alike, understanding how meloxicam works, its safety, and how it stacks up against other NSAIDs—such as naproxen, ibuprofen, and celecoxib—is crucial. In this article, we’ll explore meloxicam’s mode of action, appropriate dosages, potential side effects, and how it compares with similar medications to help you make informed decisions about its use.

Understanding Meloxicam: How It Works, What It’s For, and Available Forms

Meloxicam works by blocking an enzyme called cyclo-oxygenase-2 (COX-2), which plays a key role in causing inflammation and pain. Importantly, meloxicam targets COX-2 more than COX-1, an enzyme whose inhibition often leads to stomach, kidney, and other unwanted side effects. As noted in studies, “Meloxicam has greater in vitro and in vivo inhibitory action against the inducible isoform of cyclo-oxygenase (COX-2)… than against the constitutive form…(COX-1), inhibition of which is associated with gastric, renal and other adverse effects.” This selective action means meloxicam can effectively relieve inflammation while potentially being gentler on your stomach.

In the UK, meloxicam is mostly available as oral tablets—commonly 7.5 mg and 15 mg strengths—with the 15 mg dose usually reserved for those needing stronger relief. Injectable versions exist but are less frequently used. Official guidelines from the British National Formulary (BNF) approve meloxicam for treating osteoarthritis and rheumatoid arthritis in adults. Interestingly, meloxicam is also prescribed in veterinary medicine for dogs, receiving careful dosing to keep it safe and effective.

Meloxicam Dosage: What You Need to Know

For adults, treatment usually starts at 7.5 mg once daily. If symptoms require, this may be increased to 15 mg per day. The BNF advises against exceeding 15 mg daily, as higher doses don’t improve results and increase side effect risks. So, if you’ve wondered, “Can I take 30 mg of meloxicam?” the answer is firmly no—it’s not a licensed dose and could be risky.

Meloxicam can be taken over a long period, but regular check-ups with your GP or specialist are vital to make sure it remains the right choice for you and to minimise any side effects. Always stick to the prescribed amount and never exceed the recommended dose without medical advice.

How Does Meloxicam Compare with Other NSAIDs?

When weighing meloxicam against popular NSAIDs like naproxen, ibuprofen, and celecoxib, several factors stand out. Clinical studies have shown that “Meloxicam was at least as effective as piroxicam and naproxen in patients with rheumatoid arthritis, and diclofenac and piroxicam in patients with osteoarthritis.”

Thanks to its selectivity for COX-2, meloxicam often causes less stomach irritation than non-selective NSAIDs such as naproxen and ibuprofen. One study found that “Meloxicam 7.5 or 15 mg caused less gastrointestinal mucosal damage on endoscopy than piroxicam 20 mg, with a significant difference between meloxicam 7.5 mg and piroxicam.” In addition, meloxicam generally has better overall tolerability: “Meloxicam was at least as well tolerated as piroxicam, diclofenac or naproxen overall but had improved gastrointestinal tolerability compared with these agents.”

Doctors choose the best NSAID based on your health, risks, and how you’ve tolerated medicines before. In the UK, NHS and BNF recommendations support personalised treatment plans to optimise effectiveness and minimise harm.

Potential Risks and When to Seek Medical Help

Like all medications, meloxicam can cause side effects. The most common issues include tummy upset, headaches, and dizziness. However, some patients ask, “What are the worst side effects of meloxicam?” These can, rarely, include serious problems such as stomach ulcers, gastrointestinal bleeding, heart-related issues, and very unusual blood or skin conditions.

A particularly rare but serious adverse effect is immune-mediated thrombocytopenia—a dangerous drop in platelets that help blood clot. Research highlights that “Thrombocytopenia has been documented as a rare adverse effect of some nonsteroidal anti-inflammatory drugs (NSAIDs) including diclofenac, naproxen, and ibuprofen. However, only one previously documented case of meloxicam-associated thrombocytopenia has been reported in the literature.” This condition “can be life threatening if it is not identified and treated promptly.” If you notice bruising, black stools, or unusual bleeding while taking meloxicam, it’s essential to inform your doctor right away. Experts recommend “a thorough medication history… with a focus on those drugs that have been recently initiated” to diagnose such issues quickly.

It’s also important to understand that while meloxicam is generally well tolerated, it carries a risk of serious stomach complications at commonly prescribed doses. As noted in clinical reports, “Despite this better tolerance profile, compared with less selective NSAIDs, it is worth knowing that it can cause serious digestive complications when dosages of 15 mg daily are administered.” Prompt attention to symptoms such as severe abdominal pain, vomiting blood, or black, tarry stools is crucial.

Certain groups should take extra care with meloxicam, including older adults, those with kidney or liver problems, heart disease, or during pregnancy. Regular monitoring and discussions with your healthcare team will help keep you safe.

Conclusion: Finding the Right Balance for UK Patients

Meloxicam remains a valuable and effective option for managing pain and inflammation, especially in long-term conditions like arthritis. Its selective action offers relief with, in many cases, a gentler effect on the stomach compared to some older NSAIDs. UK patients benefit most when treatment is individualised, weighing the benefits against the potential risks under the guidance of healthcare professionals.

Always take meloxicam exactly as prescribed and report any unusual symptoms promptly. For reliable and up-to-date advice, visit respected UK resources such as the NHS website or consult the British National Formulary.

References

• Ranieri, M., Bradley, E. F., & Simon, A. B. (2013). Meloxicam-Induced Thrombocytopenia. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 34(2). https://doi.org/10.1002/phar.1372
• Noble, S., & Balfour, J. A. (1996). Meloxicam. Drugs, 51(3), 424-430. https://doi.org/10.2165/00003495-199651030-00007
• del Val, A. (1998). Meloxicam. Reactions Weekly, 723, 9-10. https://doi.org/10.2165/00128415-199807230-00031