Is meloxicam very similar to Celebrex?

Both meloxicam and Celebrex are effective at relieving pain and inflammation, and in general, either one should work well for your pain; however, responses can vary between individuals.

At lower doses, meloxicam is more similar to Celebrex (celecoxib) than it is to other NSAIDs, like ibuprofen or naproxen, because it is relatively selective for the COX-2 enzyme. But at higher doses, even within the prescribed range, meloxicam can inhibit both COX-1 and COX-2 enzymes, which may lead to side effects like stomach ulcers or bleeding. COX-2 selectivity is a dose-related effect.

If you are not having adequate pain relief with the medicine and dose prescribed, contact your healthcare provider for further evaluation.

Key Points

• Meloxicam (brand name: Mobic) and celecoxib (brand name: Celebrex) are both prescription drugs in the group of medicines known as nonsteroidal anti-inflammatory drugs (NSAIDs). They work to reduce prostaglandins in the body, a type of hormone that causes pain and inflammation (swelling).
• Celebrex is classified as a selective COX-2 inhibitor, while meloxicam is relatively selective for cyclooxygenase (COX)-2 at lower doses, but can inhibit COX-1 at higher doses.
• Both are used to treat inflammatory conditions like rheumatoid arthritis, osteoarthritis, Juvenile Rheumatoid Arthritis (JRA) and acute pain, but Celebrex is approved by the FDA for additional indications, like menstrual pain and ankylosing spondylitis, a painful spine condition.
• Both products come as oral medicines. Meloxicam tablet, capsule or liquid is taken once per day, and Celebrex capsule is taken once OR twice a day, based on your medical condition.
• Both meloxicam tablets and celecoxib capsules are available as a generic option which makes them more affordable than their brand name counterparts. In general, meloxicam will usually be less expensive overall, but he oral liquid and capsule may be more pricey. If you prefer, a $4 copay card from the manufacturer of Celebrex may help to lower your costs for the brand product, if you qualify.

NSAIDs are a large group of prescription and over-the-counter (OTC) medications that also contain common medicines like ibuprofen (Advil, Motrin), naproxen (Aleve) and diclofenac (Cataflam, Voltaren). They are commonly used to treat pain and inflammation, headache and fever.

What is the difference between meloxicam and Celebrex?

There are important differences and similarities between these medications, such as how they work (mechanism of action), FDA-approved uses, dosing, potential side effects, drug interactions, and cost.

How do they work?

Both meloxicam and Celebrex are in the group of medicines known as non-steroidal anti-inflammatory drugs (NSAIDs) and inhibit cyclooxygenase (COX) enzymes to lower production of prostaglandins, but there are some differences in how they do this exactly.

• Prostaglandins are hormones found in our body that are associated with pain and inflammation. Blocking (inhibiting) COX enzymes can help lower the production of prostaglandins. In turn, this helps to reduce the inflammation and pain that is often associated with conditions like arthritis or acute pain.
• Meloxicam is a non-selective NSAID and inhibits both COX-1 and COX-2 enzymes at higher doses. However, meloxicam may be relatively more selective for COX-2 at lower doses, similar to nabumetone or etodolac. At lower doses these agents may have a more favorable gastrointestinal and bleeding side effect profile, and are more COX-2 selective, but may lose that protection at higher doses.
• Celebrex (celecoxib) is considered a COX-2 selective NSAID and works primarily via inhibition of COX-2. It is the only COX-2 inhibitor currently available on the U.S. market. COX-2 selective NSAIDs are often chosen by clinicians over nonselective NSAIDs for patients at higher risk of stomach ulcers or bleeding side effects.
• Nonselective COX inhibitors block both COX-1 and COX-2 enzymes and include medications such aspirin, ibuprofen, naproxen and indomethacin.

Higher doses of meloxicam (15 mg once daily) can lead to gastrointestinal and ulcer side effects. Meloxicam has been shown to inhibit COX-2 by a factor of 10 over COX-1, but Celebrex (celcoxib) inhibits COX-2 by a factor of 200- to 300 over COX-1.

Both COX-1 and COX-2 produce prostaglandins, but these prostaglandins have different effects. Prostaglandins produced by COX-1 work to help protect the lining of the stomach, kidney and activate platelets (to help with blood clotting). Prostaglandins from COX-2 are released after infection or injury and result in inflammation.

NSAIDs that selectively inhibit COX-2, like Celebrex, were developed by researchers to lower the risk of stomach bleeding and ulcers, and other side effects due to COX-1 inhibition, while keeping the pain and inflammation relieving properties of COX-2 inhibitors.

What are meloxicam and Celebrex approved to treat?

Both medicines are approved to treat Rheumatoid arthritis, osteoarthritis and Juvenile Rheumatoid Arthritis (JRA), but Celebrex is approved for a few additional uses.

Celebrex is FDA-approved to treat:

• Osteoarthritis
• Rheumatoid arthritis
• Juvenile Rheumatoid Arthritis (JRA) in children 2 years of age and older, who weigh at least 10 kg (22 lb)
• Ankylosing spondylitis
• Acute (sudden onset pain in adults)
• Primary dysmenorrhea (menstrual or period pain)

Meloxicam is FDA-approved to treat:

• Osteoarthritis
• Rheumatoid arthritis
• Juvenile Rheumatoid Arthritis (JRA) in patients 2 years of age and older, who weigh at least 60 kg (132 lb)

Celebrex is the only COX-2 inhibitor available in the U.S. Other COX-2 inhibitors were removed from the market or never approved by the FDA due to safety concerns like heart attacks, strokes, severe skin reactions, or liver damage.

Your doctor may decide to treat you with either meloxicam or Celebrex for a use that is not FDA-approved, called “off-label” use. Off-label prescribing may be done for uses that are not found in the product labeling. Some doctors may have had good experience using these products in an off-label fashion and it may be an accepted use.

How do the doses compare between meloxicam and Celebrex?

Both meloxicam and Celebrex are taken as oral medications, but meloxicam is only given once per day because it has a longer duration of action in the body.

Celebrex is available as an oral capsule (50 mg, 100 mg, 200 mg, 400 mg). It is usually given as an oral capsule twice a day, but may be used once per day in some indications. If needed, the content of the capsule can be sprinkled on applesauce for children or adult patients who have trouble swallowing.

Meloxicam is available as an oral tablet (7.5 mg, 15 mg), capsule (5 mg, 10 mg) and liquid oral suspension (7.5 mg / 5mL). It is longer-acting than Celebrex and is given only once per day.

When used in children 2 years and older for Juvenile Rheumatoid Arthritis (JRA), dosing is based on weight. You cannot switch between the different formulations of meloxicam at the same dose as they have not been shown to be equivalent. Your doctor would need to write you a new prescription.

Does Celebrex have less side effects than meloxicam?

A significant benefit of Celebrex is that it is associated with less risk of gastrointestinal (stomach, intestine) bleeding compared to non-selective NSAIDs (like ibuprofen or naproxen). At lower doses, meloxicam may be safer for the digestive tract as well, but can lose this effect at higher doses. Celebrex, a COX-2 selective agent, was developed specifically to lower the risk of these side effects.

Meloxicam and Celebrex are both in the large class of drugs known as NSAIDs and share similar side effects such as stomach pain, nausea, diarrhea, heartburn, and gas (flatulence). Other side effects they share include headache, dizziness, edema (fluid retention), rash, sore throat, back pain and flu-like symptoms, among others.

Most people can take NSAIDs on a short-term basis and at recommended doses without problems. But side effects can be difficult to predict in an individual patient and may come without warning, especially at high doses or when used over a long period of time.

In general, to lower the risk for side effects, NSAIDs should only be used exactly as prescribed by your doctor or on the product label (if OTC), at the lowest dose possible for your treatment, and for the shortest amount of time needed.

All NSAIDs contain a Boxed Warning, FDA’s most prominent warning, at the top of the package insert and outlined in the Medication Guide. The NSAID Boxed Warnings states:

• NSAIDs can cause an increased risk of a heart attack or stroke that can lead to death.
• You should not take NSAIDs right before or after a heart surgery called a “coronary artery bypass graft (CABG)
• NSAIDs cause an increased risk of bleeding, ulcers, and tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach and intestines, which can lead to death. These events can occur at any time during use and without warning symptoms.
• Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.

Do not use meloxicam or Celebrex if you have a history of asthma, urticaria (hives) or other allergic-type reactions (including anaphylaxis) after taking aspirin or other NSAIDs.

Use caution if you have a history of liver or kidney disease, high blood pressure, fluid retention or heart failure, are elderly, if you take diuretics, ACE-inhibitors or angiotensin II antagonists medicines.

Serious skin side effects, which can be fatal and can occur without warning, can occur. Discontinue meloxicam or Celebrex at first appearance of rash. Ask your doctor how to recognize these skin reactions. If you have had a previous serious skin reaction with any NSAID, do not take meloxicam or Celebrex.

Common side effects: meloxicam and Celebrex

The most common side effects with NSAIDs include gastrointestinal (stomach) side effects like upset stomach, heartburn, nausea, stomach pain, and diarrhea, and are the main reason many patients stop treatment with NSAIDs.

In arthritis studies looking at the incidence of side effects with Celebrex, results showed the most common side effects (in at least 2% of patients) included:

• Abdominal pain (4.1%)
• Diarrhea (5.6%)
• Stomach upset, heartburn, dyspepsia (8.8%)
• Gas, flatulence (2.2%)
• Nausea (3.5%)
• Back pain (2.8%)
• Peripheral edema, fluid retention (2.1%)
• Dizziness (2%)
• Headache (15.8%)
• Insomnia, trouble sleeping (2.3%)
• Sinusitis (5%)
• Upper respiratory tract infection (8.1%)
• Sore throat (pharyngitis) (2.3%)
• Common cold (rhinitis) (2%)
• Rash (2.2%)

The most common side effects for meloxicam (in at least 5% of patients) include:

• Diarrhea
• Upper respiratory tract infections
• Stomach pain, heartburn (dyspepsia)
• Flu-like symptoms

Serious side effects for both agents can include:

• Increased risk of heart side effects, such as a heart attack, heart failure, stroke and death
• High blood pressure, and may elevate controlled blood pressure
• Severe kidney damage, renal failure
• Sulfonamide allergy (with celecoxib)
• Severe allergic reactions
• Aseptic meningitis
• Vision problems

To view the complete list of warnings, precautions and side effects for meloxicam or Celebrex, review their individual product information, and talk to your healthcare provider to determine if either product might be an option for you.

• Celebrex
• meloxicam

How do costs compare between meloxicam and Celebrex?

Both drugs come in generic formulations which can help to lower pharmacy costs, but meloxicam tends to be less expensive in most cases. For example:

• 30 tablets of 7.5 mg generic meloxicam (usually given once per day) costs about $12, using a freely available coupon at the pharmacy. The oral liquid suspension and oral capsules for meloxicam can be more expensive.
• 60 capsules of generic 100 mg celecoxib (Celebrex), usually given twice a day, costs about $81, using a freely available coupon at the pharmacy.
• For the same strengths and amounts, Brand name Mobic (meloxicam) costs about $300 / 30 tablets and Celebrex costs roughly $568 / 60 capsules.

Your insurance may pay for this medicine after you meet your deductible, which can lower your costs. You still may have a copay that you will have to pay.

If you prefer the brand name product, the manufacturer of Celebrex offers a $4 copay card if you have private or commercial insurance and qualify. You can view the program information here for more information.

Visit the Drugs.com Price Guide to view more cost comparisons, access discount coupons and research manufacturer cost promotions.

This is not all the information you need to know about Celebrex or meloxicam for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.