Ibuprofen is easily one of the most common medications in the US. Meloxicam might not be as popular, but it’s still reportedly the most prescribed NSAID.

Is one inherently better than the other?

Read on for an in-depth meloxicam vs. ibuprofen comparison.

Meloxicam vs. Ibuprofen: At a Glance

Before we dig deep, let’s check out this quick comparison:

  Meloxicam Ibuprofen
Trade Names Mobic Advil, Genpril, Motrin
Classification COX-2 selective NSAID Non-selective NSAID
CSA Schedule Not a controlled substance Not a controlled substance
Market Status Prescription Over-the-counter
Formulations Oral, injection Oral, topical
Onset of Action Relatively slow (orally) Relatively fast (orally)
Dose Frequency Once daily Every 4–6 hours
Absorption Rate Unaffected by food Slowed down by food
Common Uses Osteoarthritis, rheumatoid arthritis Headaches, muscle aches, menstrual pain, common cold
Gastrointestinal Risk Low Very low
Cardiovascular Risk Moderate Moderate

Meloxicam vs. Ibuprofen: In-Depth Comparison

Check out how the two drugs compare to each other:

Mechanism of Action

Both meloxicam and ibuprofen belong to a class of pain killers called nonsteroidal anti-inflammatory drugs or NSAIDs. So, they work in more or less the same way.

There’s a type of enzyme in our bodies called cyclooxygenase (COX for short). This enzyme releases hormone-like substances called prostaglandins when it’s triggered. These prostaglandins, in turn, activate the inflammatory response, creating the sensation of pain.

NSAIDs work by blocking the COX enzymes, but not all drugs in this class are created equal. Not all COX enzymes are the same, either. There are two relevant types: COX-1 and COX-2.

COX-2 is the one responsible for the pain response.

COX-1, on the other hand, protects our stomach and intestinal linings from the digestive juices. It’s also involved in maintaining normal blood platelet function. Blocking this enzyme leads to a range of undesirable effects, including stomach ulcers.

Now, if you refer to the quick comparison table, you’ll see that ibuprofen is a non-selective NSAID. This essentially means it inhibits both COX enzymes.

Meloxicam, however, has a bit of a selective action on COX-2. In theory, this should translate to fewer unwanted effects. But we’ll take a closer look at how both drugs compare in terms of side effects in a moment.

Indications and Availability

Ibuprofen is FDA-approved for short-term relief of several types of pain. It can be used for headaches, muscle aches, toothaches, menstrual cramps, back pain, and even minor arthritis.

It’s also readily available over-the-counter (OTC). Meloxicam isn’t as easy to get since it’s a prescription medication in the US. Your physician might prescribe meloxicam if you’re diagnosed with osteoarthritis or rheumatoid arthritis.

Effectiveness

When taken orally, both drugs can be highly effective for moderate pain management. Even for operation-related pain, some studies show that there’s no statistically significant difference in efficacy.

There’s evidence that both NSAIDs work well for molar extraction cases as well.

Onset of Action and Standard Dose

It can take 4–10 hours for a tablet or capsule of meloxicam to reach peak blood levels. And for chronic cases, patients might need several days to feel better. But since it’s a relatively slow but long-acting painkiller, meloxicam is only taken once daily.

In comparison, ibuprofen is rapid-acting. Its effects typically kick in within 20–30 minutes, with the peak pain relief around 1–2 hours after the dose. Of course, you’ll need to take it more often to maintain its effect throughout the day.

In any case, it’s recommended to take the lowest possible dose of any NSAID to limit the side effects. You’ll have to consult your healthcare provider to find what the “lowest possible dose” means in your case.

Side Effects

While NSAIDs are generally well-tolerated, some of the potential side effects are:

  • Nausea
  • Heartburn
  • Diarrhea
  • Drowsiness

However, the most feared side effects are the gastrointestinal disturbances and the increased risk of cardiovascular disease. Let’s take a closer look at how meloxicam and ibuprofen fare in these two aspects.

Gastrointestinal Disturbances

The blockage of COX-1 can lead to stomach upset, ulcers, and gastrointestinal bleeding. And we’ve already discussed how ibuprofen is a non-selective COX inhibitor. This might lead some to believe it’s more likely to cause gastrointestinal issues compared to meloxicam.

Yet, studies show that the opposite is true. Ibuprofen and celecoxib carry a lower risk than meloxicam and diclofenac.

Note that taking an NSAID like ibuprofen with meals can reduce the side effects compared to taking it on an empty stomach. The downside here is that food can also slow down the absorption.

Meloxicam’s absorption, on the other hand, isn’t affected by food.

Cardiovascular Events

Some researchers report that the risk of heart attacks or strokes varies between NSAIDs. However, the FDA clarifies that this information isn’t enough for us to say which NSAIDs are definitely less risky than the others.

Interaction With Alcohol

Whether you take ibuprofen or meloxicam, it’s best to avoid mixing your drugs with alcohol.

It’s likely not going to be as immediately harmful as, say, a mixture of opioid painkillers and alcohol. However, it does put you at a higher risk of stomach irritation and gastrointestinal bleeding.

Drug Interactions

Both drugs can interact with a number of prescription and OTC medications. Consult your physician before taking either pain reliever if you’re on any of the following:

  • Blood thinners (like warfarin, aspirin, and enoxaparin)
  • Medications for high blood pressure
  • Other NSAIDs (like celecoxib, diclofenac, and ketoprofen)
  • Mood stabilizers (like lithium)

Forms and Combinations

Ibuprofen is sold as tablets, capsules, oral suspensions, and even topical gels for targeted pain relief.

You can also find ibuprofen mixed with other painkillers in the same formulation. For instance, it’s combined with acetaminophen (the active ingredient in Tylenol) in tablet form and sold under the brand name Combogesic. The additive effect works well for managing acute pain.

While meloxicam and acetaminophen can be taken together safely, you’ll have to get each active ingredient separately (i.e., buy both Mobic and Tylenol). Of course, you still have to follow strict dosage instructions provided by your healthcare provider for each drug.

You can find meloxicam in other combinations. For instance, Symbravo contains the NSAID with rizatriptan and is used for managing migraine attacks. Meanwhile, Zynrelef injections contain meloxicam and the anesthetic bupivacaine.

Contraindications

Both drugs are considered generally safe, but there are some contraindications.

Meloxicam, for instance, shouldn’t be used to manage post-operative pain for patients undergoing coronary artery bypass grafts. Ibuprofen is also not recommended before or after heart surgery.

Naturally, people who have a history of allergic reactions towards NSAIDs should avoid both drugs.

Overdose Risk

Most cases of toxicity from NSAIDs are unintentional and involve young children. Ibuprofen overdoses also tend to be more common than those of meloxicam, which makes sense when you consider that meloxicam (a prescription drug) isn’t as widely available in the first place.

If you believe someone has taken too much of either drug, seek immediate medical attention or call New Jersey’s Poison Control Center.

The symptoms to watch out for are:

  • Worsening and lasting stomach pain
  • Drowsiness and fainting
  • Vomiting blood
  • Redness or swelling

Possibility of Abuse and Misuse

Neither drug is considered a controlled substance by the DEA. They’re not associated with physical dependence and addiction in and of themselves. That said, there’s still potential for misuse, especially among over-the-counter NSAIDs like ibuprofen.

For instance, one study showed that over 15% take too many painkiller pills. Some people abuse ibuprofen in combination with narcotics like codeine as well.

Why You Should Avoid Mixing Ibuprofen and Meloxicam

You shouldn’t take meloxicam with ibuprofen. There isn’t much benefit in doing so. On the contrary, the combination increases your risk for serious side effects.

Speak with your healthcare provider if you’re on one of these drugs and feel like you’re not getting enough pain relief. They might alter your dose, add a safe analgesic combination, or change the treatment plan altogether.

How Meloxicam and Ibuprofen Compare to Other Painkillers

Now that we’ve covered meloxicam and ibuprofen in-depth, we can take a quick look at common NSAIDs, along with their doses and gastrointestinal (GI) risks.

NSAID Trade Name Selectivity Dose Frequency GI Risk
Meloxicam Mobic COX-2 selective Once daily Low
Ibuprofen Advil Non-selective Every 4–6 hours Very low
Celecoxib Celebrex COX-2 selective 1–2 times per day Very low
Etoricoxib Arcoxia COX-2 selective Once daily Low
Diclofenac Voltaren COX-2 preferential 2–3 times per day Low
Ketorolac Toradol Non-selective Every 4–6 hours High
Naproxen Aleve Non-selective 2 times per day Moderate
Piroxicam Feldene Non-selective Once daily High

The Bottom Line

To wrap up, both meloxicam and ibuprofen are anti-inflammatory drugs.

Some would say that meloxicam is a more convenient medication because of its once-a-day dose. However, it’s not without its side effects. You also need a prescription for it, unlike ibuprofen.

Just keep in mind that just because ibuprofen is easy to get doesn’t mean you can use it whenever. If your pain doesn’t resolve within a few days, it’s time to stop and ask a doctor for help.

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