woman with knee and joint pain

Nonsteroidal Anti-inflammatory Drugs (NSAIDs) are among the most popular drugs in the pharmacy. Millions of people swallow ibuprofen (Advil, Motrin IB, etc) and naproxen (Aleve) that they buy without a prescription. Doctors also prescribe NSAIDs in large quantities. Some of their favorites include: celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), indomethacin (Indocin) and meloxicam (Mobic).
Despite their popularity, such drugs have the potential to do a significant amount of harm. Here are just some of the questions that we have received about meloxicam (Mobic) in particular.

“I am on high blood pressure medication and was prescribed meloxicam for a painful back sprain/strain from yard work. Within three days I was in the ER with extremely eleveated high blood pressure. Be careful if you take these types of drugs.

“My doctor prescribed meloxicam (Mobic) for a rotator cuff injury. My blood pressure was normal the day that I saw him. Not long after I realized I was experiencing headaches. I happened to see my rheumatologist a week later and was told my blood pressure was high. I stopped taking the Mobic a day later. I am hoping my BP will return to normal.”

“Is generic Mobic included in the category of NSAIDS possibly causing heart problems?”

High Blood Pressure

A little appreciated complication of meloxicam (as well as most other NSAIDs) is hypertension. For some, there may be only a little increase in blood pressure. For others, like Dee or I.H., the increase can be significant. Such drugs can cause fluid retention, which may in part account for the increase in blood pressure. This may be because such drugs can alter kidney function. But there may also be other cardiovascular risks.

Repeat Heart Attacks

Danish researchers identified nearly 100,000 patients over the age of 30 who had experienced a first-time heart attack sometime between 1997 and 2009. They were followed for up to 5 years after their initial heart attacks (Circulation, online, Sept 10, 2012). The scientists were especially interested in the post-heart attack use of nonsteroidal anti-inflammatory drugs.

Heart attack survivors who took an NSAID-type pain reliever were at a substantially higher risk of having another heart attack or dying than those patients who did not take such drugs. In their first year following a heart attack, about one-fifth of the NSAID users died, compared to 12 percent of those not taking an NSAID-type pain reliever. Over the five years of the study, NSAID users were about twice as likely to die as non-users. They were also at increased risk for another heart attack. The investigators concluded:

“It would seem prudent to limit NSAID use among patients with cardiovascular disease and to get the message out to clinicians taking care of these patients that NSAIDs are potentially harmful, even 5 years after MI [myocardial infarction or heart attack].”

When most health care providers think about side effects associated with NSAIDs they think GI toxicity. Here is an example of such a problem:

“I have had arthritis for over a decade. I am on methotrexate, folic acid, and meloxicam. Just recently (2 months ago) I started to have problems with my stomach: nausea. I thought it was some kind of bug but I was not sick, sick.

“I just recently had my 3rd major attack, and ended up in the emergency room. After 5 hours of tests, the diagnosis was inflammation of my esophagus. I have come to the to the conclusion that it is the medications that are making me sick.”

NSAIDs can cause inflammation of the digestive tract. Symptoms may include nausea and bad heartburn. The distress can become unbearable and put people (like CLC) in the emergency department. Life threatening bleeding or perforated ulcers can result.

NSAID Side Effects

  • Heartburn, indigestion, abdominal pain, nausea, vomiting, constipation
, diarrhea
  • Headache, dizziness, drowsiness, disorientation
  • Skin rash, sensitivity to sunlight, itching (potentially serious, so notify the MD!)
  • Fluid retention, edema, high blood pressure
  • Heart failure
, heart attack, stroke
  • Ringing in ears, hearing changes
  • Visual disturbances
  • Ulcers, bleeding ulcers, perforated ulcers
  • Liver damage, kidney damage
  • Blood disorders, anemia
  • Worsening asthma symptoms

Other Ways to Relieve Pain

“I have burning in my legs. I do not have restless leg syndrome… but the burning is more noticeable at night. I do exercise and do stretches. I take meloxicam for knee pain but that has not helped. Rubs do nothing. Any other suggestions?” Lorrie

We offer dozens of non-drug options in our book, Best Choices From The People’s Pharmacy. Herbs such as boswellia, spices such as cayenne or turmeric, supplements such as fish oil or vitamin D and foods such as grape juice with Certo, honey and vinegar, pineapple juice and tart cherries have all provided relief for some people with joint pain.

Incorporating anti-inflammatory foods into tasty recipes is another approach to managing pain relief while limiting side effects. In our book Recipes & Remedies From The People’s Pharmacy, we offer instructions for remedies like cherry spritzer (p. 62), curcumin milk (p. 60), ginger pickle (p. 50), pineapple-cherry cocktail (p. 65), virgin raisins (p. 64) or anti-inflammatory curcumin scramble (p. 103). Adding fish to the diet in dishes such as favorite fish platter (p. 106), fish tacos with radish & lime (p. 120) horseradish-crusted salmon with cranberry catsup (p. 127), pescado al cilantro (p. 137) salmon with fava bean & spring pea mash (p. 141) or spicy fresh tuna salad (p. 143) puts anti-inflammatory power into everyday meals, and adds heart benefits rather than risks.

You can find all our books and guides in The People’s Pharmacy Store. And please reconsider routine use of NSAIDs like ibuprofen, meloxicam, naproxen and diclofenac. Such drugs may ease pain a bit, but the list of side effects is scary. People who have had heart attacks are not the only ones at risk for serious, even life-threatening complications.

We would love to hear your story about the pros and cons of NSAIDs. Have they worked without problems? Have you experienced side effects? Have you tried non-drug approaches for pain relief such as acupuncture or one of the herbs we mention above?

Share your experience below and thanks.

Join Over 90,000 Subscribers at The People's Pharmacy

Each week we send two free email newsletters with breaking health news, prescription drug information, home remedies and a preview of our award-winning radio show. Join our mailing list and get the information you need to make confident choices about your health.

  1. Kris
    Temecula, Ca.

    I’ve only taken Meloxicam once and it’s done nothing that the 200mg I took before seeing the Dr. did. I just called the pharmacist to ask how long I should wait before just going back to regular ibuprofen. He really didn’t seem to want me to stop taking the Meloxicam even though I told him it had done nothing for me. He said it could take up to 2 weeks, seriously??? I have a muscle stain in my low back that I’d really not have to wait 2 weeks for relief from. I’m going to stop the Meloxicam and go back to Advil.

  2. susan

    Decreased joint pain and stiffness noticeably within 3 days. No stomach problems but was careful to eat something as directed.
    Then about 3 weeks into taking, ankles with pitting edema and at about 4 weeks, my well controlled high blood pressure on just 2.5 mg Vasorec went to 160/105. Have doubled Vasorec for now and stopped Mobic. Will look into other means for pain and stiffness. Thank you for this forum.

  3. eile

    I am a 57 year old active cardio exerciser, weight lifter and I run about 15 miles per week. I have taken Mobic off and on for 5 years and have no side effects. I usually take it for a week and then skip at least a month or more until pain comes back-usually inflammation in my lower back or other areas. I was wondering if my exercising would increase the chance of heart attack or stroke(since that is the worst side effect). And is it only a risk when i take it or for the weeks in between?

  4. Fireman

    After a forth arthroscopic procedure on a grade 4 shoulder my Ortho doc prescribed Mobic 15 mg, once a day for pain and to assist with physical therapy. Within 2-3 days my shoulder pain significantly subsided and I honestly felt the magic bullet had been discovered. I did notice some mild extremity (ankle) swelling but thought little of it, the shoulder felt so good, a little swelling was a minor inconvenience. After 21 days of 15 mg per day, I woke up, severe shortness of breath and extreme swelling in both ankles.

    I immediately got in contact with my cardiologist who did a complete exam, EKG, Echogram, and ultrasound of lower extremities…he also advised me to contact my Ortho doc immediately regarding the Mobic. I contacted the Ortho Doc who advised to cease the Mobic immediately and diligently follow the cardiologists medical plan. I ceased taking the Mobic, and within 48 hours my ankle swelling returned to a normal size, and had dropped 14 lbs… all within 48 hours. The shoulder pain has again returned to significantly restrictive with secondary set backs to physical therapy. I now experience extreme fatigue, headaches, etc. I will be following up with both docs in the near future, however for what it is worth…this particular medication, thou extremely effective, carries extreme side effects in certain patients. Use with caution……

    • Tony

      I totally agree with you, not the right medication for some people, I won’t take it anymore, I’d rather deal with my neck and back pain. I couldn’t figure out what medication was causing my weight issue and headaches. Hearing someone else experience the same effects has been very helpful. Thanks for sharing.

  5. Monica
    North Carolina

    I have been on and off meloxicam for almost 2 years now. I have noticed when I suddenly stop taking it, I seem highly irritable and I mean over the top like “I want to bite somebody’s head off” irritable. Is that a normal side effect? Would it be better to slowly ween myself off a regular daily dose? I take it for the bursitis in my shoulder which flares around my work load as a catering director. I thought by stopping it when I’m not in pain was a good thing but if I have to become an evil, crazy “stay away from that girl” kind of person, perhaps I shouldn’t deviate from daily ritual…. any thoughts and/or comments would be welcome.

  6. Pat

    I was on Meloxicam for more years then I can remember. Horrible headaches, huge digestive problems, painful leg pains, raised blood pressure, hair loss, swelling, hearing issues, itching, limited use in my arms , this list just goes on and on. The pain I was in was so bad that at age 60 I decided to stop all mammograms, pap tests etc as I felt what I was living with was hard enough and I would not be able to handle fighting cancer should I get it. This naturally happy, very active ole gal was giving up. It has been several months since I stopped Meloxicam, my improvements are remarkable. At this time I do not take anything for pain, not to say I do not have pain. Right now good old arthritis pain just isn’t as bad as being on Meloxicam.

What Do You Think?

We invite you to share your thoughts with others, but remember that our comment section is a public forum. Please do not use your full first and last name if you want to keep details of your medical history anonymous. A first name and last initial or a pseudonym is acceptable. Advice from other commenters on this website is not a substitute for medical attention. Do not stop any medicine without checking with the prescriber. Stopping medication suddenly could result in serious harm. We expect comments to be civil in tone and language. By commenting, you agree to abide by our commenting policy and website terms & conditions. Comments that do not follow these policies will not be posted.