Meloxicam Drug Interactions

by on June 13, 2012

Meloxicam is a medication that helps to relieve the symptoms of joint pain, stiffness and swelling that occur in rheumatoid arthritis and osteoarthritis.  It does this by limiting a process called inflammation.

Drug interactions occur when a patient takes two or more drugs which affect each other’s functioning. This can have two main effects on the patient: either one or both of the drugs may stop working properly, meaning that the patient is left without proper treatment, or one or both drugs end up working too much and the patient suffers multiple side-effects. These side-effects can sometimes have serious negative consequences. In some cases as a result of these interactions your doctor may have to take you off one of your medications, change you to another medication, or adjust the doses of your medications to limit these negative effects resulting from the drug interactions.

Significant Meloxicam Interactions

The most serious result of drug interactions with meloxicam is increased risk of bleeding of the stomach or gut. You should make your physician aware if you take any of the following medications with meloxicam, and follow their advice.

ACE inhibitors- the effects of these blood-pressure-lowering drugs may be reduced when taken with meloxicam. Some examples of common ACE inhibitors include:

  • Enalapril
  • Lisinopril
  • Ramipril

Anticoagulants- this group of medications work by thinning the blood of those at risk from blood clotting disorders, but if prescribed with meloxicam can result in bleeding from the stomach and gut.

  • Acenocoumarol
  • Dabigatran etexilate
  • Phenindione
  • Warfarin
  • Plavix

Antidepressants –if taken with meloxicam, certain antidepressants, particularly the SSRI class, can increase the risk of stomach and gut bleeding.

  • Citalopram
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Fluvoxamine Maleate
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • Venlafaxine (Effexor)

Immunosuppressants- these medications inhibit the negative effects of over-activity of the immune system. If certain immunosupressants are taken with meloxicam, there may be an increased risk of kidney damage if ciclosporin is used, or enhanced side-effects if methotrexate is consumed. Methotrexate and meloxicam may be prescribed together in rheumatoid arthritis, but the dosages must be carefully prescribed by the physician.

  • Ciclosporin
  • Methotrexate

NSAIDs- meloxicam is an NSAID, and these medications work by inhibiting pain pathways in the body. Using other medications of the same type increases the risk of side effects.  There are many medications in this group, so some of the most common are included below.

  • Aspirin
  • Diclofenac
  • Ibuprofen
  • Indometacin
  • Mefanamic acid
  • Naproxen (Aleve)

Quinolones- this group of antibiotics taken with meloxicam may result in convulsions.

  • Ciprofloxacin (Cipro)
  • Levofloxacin
  • Moxifloxacin
  • Nalidixic acid
  • Norfloxacin
  • Ofloxacin

Sulphonylureas- taking meloxicam with these anti-diabetic medications increases their side effects.

  • Glibenclamide
  • Gliclazide
  • Glimeperide
  • Glipizide
  • Tolbutamide

Miscellaneous- certain individual drugs can also interact negatively with meloxicam.

  • Erlotinib- this anti-cancer drug interacts with meloxicam and causes an increased risk of bleeding of the stomach and gut.
  • Ketorolac- a post-eye surgery medication, interactions with this medication increases its side effects and also the risk of bleeding of the stomach and gut. 
  • Lithium- taken as a mood stabiliser, the side effects and toxicity of this medication are increased by interaction with meloxicam.