Tens of millions of people take oral NSAIDs (nonsteroidal anti-inflammatory drugs) every day. We are talking about celecoxib, diclofenac, ibuprofen, meloxicam and naproxen. Most people realize that such drugs can be irritating to the digestive tract. Indigestion or stomach ulcers are not uncommon. What is less well realized is that these drugs can raise blood pressure. Many doctors and pharmacists may assume that this only occurs in people with existing hypertension. But even people with normal blood pressure can be affected. This reader discovered that meloxicam raised blood pressure way too high!
A Scary Situation!
Q. I was prescribed meloxicam for pain and inflammation. After just one day, my blood pressure went from my typical reading of 120/75 up to 210/131.
I discontinued the prescription immediately. The same thing had happened to my mother when she was prescribed Celebrex.
Anyone prescribed NSAID-type arthritis medicines ought to be very careful. You should self-monitor your blood pressure closely in the first few days, because by the time you get back in to see your provider you could have already had a stroke or heart attack.
A. You describe a well-known but often overlooked adverse drug reaction. Nonsteroidal anti-inflammatory drugs (NSAIDs) can raise blood pressure. This includes OTC pain relievers such as ibuprofen or naproxen as well as prescription medications like celecoxib (Celebrex), diclofenac (Voltaren) and meloxicam (Mobic). Your suggestion to measure blood pressure when taking NSAIDs is really important!
An article in JAMA Internal Medicine (Nov. 22, 2021) noted that people taking antidepressants, NSAIDs, steroids or estrogens are more likely to have uncontrolled hypertension or need extra BP medicines. Here are the conclusions of this study:
“In this nationally representative survey study, 18% of US adults with hypertension reported taking medications that may cause elevated BP. The use of these medications was associated with increased odds of uncontrolled hypertension among individuals not taking antihypertensives and greater use of antihypertensives among both patients with controlled and uncontrolled hypertension.”
This reader is not the only person to discover that meloxicam raised blood pressure.
From Normal to Hypertension on Meloxicam
Q. After diagnosing my arthritis, my doctor prescribed meloxicam. During the three years I took it, my blood pressure went from 120/80 to 190/144. Unfortunately, he wasn’t monitoring it.
When I found I had such high blood pressure, I got off the meloxicam and was put on lisinopril. Six months later, my BP is stable at 130/86. I do want it lower, so the fight is still on. Please monitor your blood pressure while you are on meloxicam.
A. Great advice to anyone taking an NSAID (nonsteroidal anti-inflammatory drug). That includes OTC pain relievers like ibuprofen and naproxen as well as prescription arthritis drugs like celecoxib, diclofenac or meloxicam.
The Black Box Warning with Meloxicam
The FDA mandates the following warning with meloxicam and other NSAIDs.
“NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk.”
Meloxicam Raised Blood Pressure:
The FDA also requires this caution in the official prescribing information:
“NSAIDs, including meloxicam, can lead to onset of new hypertension or worsening of pre-existing hypertension, either of which may contribute to the increased incidence of CV [cardiovascular] events. Patients taking thiazides or loop diuretics may have impaired response to these therapies when taking NSAIDs. NSAIDs, including meloxicam, should be used with caution in patients with hypertension. Blood pressure (BP) should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy.”
We are not sure whether most prescribers share this information with their patients. And we fear that people taking over-the-counter drugs like ibuprofen or naproxen may not take such a warning to heart. After all, OTC drugs are supposed to be safe.
Readers Report Meloxicam Raised Blood Pressure:
Jane has RA (rheumatoid arthritis) and is in pain:
“I took NSAIDS (meloxicam or ibuprofen) for RA pain for a year. These drugs gave me high blood pressure. As soon as I got off these NSAIDs, my blood pressure went back to normal. However, there are so few drugs that doctors will prescribe for pain. I feel abandoned.”
Ralph also developed blood pressure problems with ibuprofen:
“I was suffering from shingles and took a lot of ibuprofen for several months. On a visit to the doctor for the condition, my blood pressure was 179/100.
“I am 73 years old, and have consistently had blood pressure in the range of 120/70 my entire adult life. I researched The People’s Pharmacy website and a man my age reported his sudden rise in blood pressure, saying when he quit taking ibuprofen, his blood pressure quickly dropped to normal.
“I bought a blood pressure cuff so I could test, quit taking Ibuprofen, and my blood pressure was back to normal in two days.”
Judi had a scary encounter with naproxen:
“Last year my surgeon put me on naproxen before it became necessary for him to do neck surgery on me. On day 21 of taking naproxen my blood pressure spiked to 234/180 and I went to the ER. I will never take NSAIDS again.”
Pat also got into trouble with naproxen:
“I haven’t been prescribed meloxicam, but I have been prescribed naproxen for arthritis pain. I have also noticed elevated blood pressure since taking this. So, what does the doctor do? Prescribe a diuretic-type drug to lower blood pressure. I decided to stop NSAIDs altogether, even the OTC type.”
What’s a Person To Do if NSAIDs Raise Blood Pressure?
Most people take NSAIDs because they are in pain. But if such drugs raise blood pressure, they are inappropriate. Taking another medication to treat hypertension brought on by a pain reliever is not the answer.
Anyone caught in this situation may wish to consult our eGuides to Alternatives for Arthritis and Blood Pressure Treatment.
Tough Time of Year:
This is the time of year people start sniffling and sneezing because of colds and influenza. Oral decongestants such as phenylephrine or pseudoephedrine can also raise blood pressure. Here is a link to our article on other medications that can increase blood pressure. You will be surprised that hemorrhoid remedies can also do this!
To learn more about drugs that can make it harder to control hypertension and a variety of strategies to manage it, you might want to consult our eGuide to Blood Pressure Solutions. All our eGuides can be found in the Health eGuides section of this website.