Not sure if you should take these two drugs together? Here’s what the experts have to say about it.
Ibuprofen and meloxicam are two medications that are commonly taken to relieve arthritis pain. If you’re contending with pain and stiffness, you might wonder, can they be taken together for better results? In short, that’s definitely not a good idea, but to understand why, it helps to get a window into how these two drugs work.
Similarities Between Meloxicam and Ibuprofen
Both meloxicam and ibuprofen belong to a drug class of painkillers called non-steroidal anti-inflammatory drugs, or NSAIDs, which are the most-commonly prescribed medications for arthritis. In addition to reducing pain, these drugs also relieve inflammation and swelling, curb fevers, and prevent blood clots.
Because they’re both NSAIDS, meloxicam and ibuprofen share similarities in how they work. NSAIDs prevent an enzyme called cyclooxygenase (COX for short) from producing prostaglandins, substances that cause pain by aggravating your nerve endings. COX comes in two forms, COX-1 and COX-2. COX-1 protects the lining of your stomach from the chemicals and acids involved in digestion; it also helps with blood clotting and aids your kidneys. COX-2 activates when your joints become inflamed or suffer injury.
Unlike meloxicam, which primarily blocks COX-1, ibuprofen blocks both COX-1 and COX-2, which means pain relief often comes at the cost of an upset stomach.
Differences Between Meloxicam and Ibuprofen
There are several major differences between the two medications. Ibuprofen (sold under different brand names, including Advil and Motrin) is easily available over the counter, though you can get prescription-strength versions, too. As for meloxicam (sold under various brand names, including Mobic and Vivlodex), you’ll need a doctor’s Rx to purchase.
Meloxicam is approved by the Food and Drug Administration (FDA) to relieve the symptoms of osteoarthritis and rheumatoid arthritis, as well as juvenile rheumatoid arthritis. Ibuprofen also can help relieve the symptoms of arthritis, including pain and swelling, but it’s used much more broadly than meloxicam. Ibuprofen is also commonly reached for to relieve pain caused by sprains, migraines, menstruation, colds and the flu, and sore throat, and may be used to reduce fever as well.
And finally, the timing of the dosage is also different. “Meloxicam is a long-acting drug and taken once a day, with effects that last about 24 hours,” says Ozlem Pala, M.D., a rheumatologist at University of Miami Health System in Florida. “Ibuprofen is short-acting and needs to be taken every six to eight hours.”
Which Is Safer: Meloxicam or Ibuprofen?
Ibuprofen blocks COX-1, the enzyme that protects your stomach from irritation. This means that ibuprofen is more likely to upset your stomach than meloxicam. Meloxicam mostly blocks COX-2 rather than COX-1, particularly at lower doses. “Ibuprofen is more likely to cause gastrointestinal upset compared to meloxicam,” says Dr. Pala. “But in general, the side effect profile is about the same.”
That said, there are other side effects that you should be aware of. “Both medications may be associated with less common but serious side effects, including heart attack, stroke, stomach ulcers, and bleeding,” says Claudia Rondon, Pharm.D., a clinical pharmacist at Lenox Hill Hospital in New York City.
Rondon says that the risk of heart attack and stroke may be higher in those who already have heart disease or risk factors for heart disease. Both drugs also can raise your blood pressure. Similarly, people who have a history of stomach ulcers or bleeding may be more likely to develop them while taking these medications. Older adults also are at higher risk.
For both meloxicam and ibuprofen, major side effects are rare, but they can occur with both medications even when taken on their own. The following is a partial list of possible side effects that can be caused by each. Talk to your doctor right away if you notice any of the following.
Rash, hives, itching, trouble breathing or swallowing, or other signs of allergic reaction
Blood in the urine, vomiting or coughing up blood, or other signs of bleeding
Inability to urinate or a change in how much you urinate, which could indicate kidney problems
A heartbeat that feels abnormal, confusion, weakness, fatigue, and other signs of high potassium.
The signs of heart attack, such as chest pain or discomfort, shortness of breath, feeling weak or faint, pain or discomfort in one or both arms, neck, jaw, back, or shoulders.
Symptoms of stroke, such as weakness on one side of your body, difficulty speaking or thinking, balance and coordination problems, and drooping on one side of your face.
“The safest way to use these medications is to use the lowest effective dose for the shortest time they’re necessary,” says Rondon. “Discuss it with your healthcare provider before taking these medications if you have high blood pressure, heart disease, kidney disease, liver disease, a history of stroke, or history of stomach ulcers or bleeding.”
Is It Safe to Mix Meloxicam With Ibuprofen?
Experts say no, it is not safe to mix meloxicam with ibuprofen. Here are a few reasons why you should avoid this combination.
Side Effects of Taking Meloxicam and Ibuprofen Together
Serious side effects can occur if you take these two drugs at the same time, according to Dr. Pala. The combination of meloxicam and ibuprofen can cause damage to your kidneys, bleeding stomach ulcers, high blood pressure (hypertension), and an increased risk of heart disease.
“Taking ibuprofen and meloxicam together may increase the likelihood of experiencing the side effects of these medications,” Rondon says. She adds that this is also the case with other NSAIDs. In particular, taking two or more NSAIDs together increases the risk of stomach ulcers and bleeding.
How Long After Taking Meloxicam Can I Take Ibuprofen?
Meloxicam is a once-a-day, 24-hour dose, so both Rondon and Dr. Pala say you should not take ibuprofen until a full day has passed since your last dose of meloxicam. Rondon has further advice about taking ibuprofen: “When using over-the-counter ibuprofen to treat pain, do not use it for more than 10 days unless recommended by a healthcare provider.”
Is Meloxicam Stronger Than Ibuprofen?
Meloxicam is stronger than over-the-counter ibuprofen. Prescription-strength ibuprofen, however, also is available, Dr. Pala and Rondon say.
Medications Not to Take With Meloxicam
In addition to avoiding ibuprofen while taking meloxicam, here is a partial list of other drugs you should not take with them without consulting with your doctor:
Other NSAIDs, both prescription or over-the-counter
Medications for high blood pressure
Blood thinners such as Warfarin (coumadin) and Plavix (clopidogrel)
Methotrexate, an immune system suppressant used to treat some types of cancer and some auto-immune diseases, such as rheumatoid arthritis
Amiodarone, a drug used to treat an irregular heartbeat (arrhythmia)
Circling back to the original question: No, you should not take meloxicam and ibuprofen together. Be sure to consult with your doctor before taking each drug, and only take them as directed to ensure minimal side effects and complications.