Can I use methocarbamol and meloxicam (nonsteroidal anti-inflammatory drug (NSAID)) together?

From the Guidelines

Yes, methocarbamol and meloxicam can generally be taken together as they work differently to manage pain and have no significant drug interactions. Methocarbamol is a muscle relaxant that works on the central nervous system to relieve muscle spasms, while meloxicam is an NSAID that reduces inflammation and pain by blocking certain enzymes in your body. When used together, they can provide complementary pain relief for conditions involving both muscle spasm and inflammation, such as back pain or muscle injuries.

Important Considerations

• Take methocarbamol as prescribed, typically 1500 mg four times daily initially, then reduced to 750 mg every 4 hours as needed.
• Meloxicam is usually taken once daily at 7.5-15 mg.
• Be aware that meloxicam may cause stomach irritation, so take it with food and watch for signs of stomach upset or bleeding, as NSAID use has surpassed Helicobacter pylori as the most commonly identified risk factor among patients with bleeding ulcers, found in 53% of patients in one study 1.
• Stay hydrated while using these medications and avoid alcohol, which can increase side effects like drowsiness and dizziness.
• If you experience unusual side effects or inadequate pain relief, consult your healthcare provider for guidance, especially considering that NSAID use increases the risk for death, with a yearly mortality rate from NSAID use of 16,500 in the United States estimated using the Arthritis, Rheumatism, and Aging Medical Information System database 1.

Key Points to Remember

• The risk of GI complications from NSAID use is significant, with estimates suggesting that NSAID use results in about 100,000 hospitalizations annually in the United States 1.
• The decision to use NSAIDs like meloxicam requires a risk-benefit analysis that weighs the GI vs the CV risk in an individual patient, as recommended by the consensus development conference on the use of nonsteroidal anti-inflammatory agents 1.
• Patients with known CV disease or at high CV risk should be prescribed low-dose ASA, although the benefits of COX-2 selectivity in the presence of aspirin are unclear 1.

From the Research

Methocarbamol and Meloxicam Interaction

• There is limited information available on the specific interaction between methocarbamol and meloxicam 2.
• Methocarbamol is a skeletal muscle relaxant used to treat musculoskeletal conditions, while meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) used to treat rheumatoid arthritis, osteoarthritis, and other conditions 3.
• The use of NSAIDs, such as meloxicam, can increase the risk of gastrointestinal adverse events, including ulceration and bleeding 3, 4.
• Skeletal muscle relaxants, such as methocarbamol, can have adverse effects, including drowsiness, dizziness, and nausea 2.
• There is no direct evidence to suggest a significant interaction between methocarbamol and meloxicam, but patients should be monitored for potential adverse effects when using these medications together 2, 5.

Precautions and Considerations

• Patients should be aware of the potential risks and benefits of using methocarbamol and meloxicam together 6, 4.
• Healthcare providers should monitor patients for signs of gastrointestinal adverse events, such as abdominal pain, bleeding, or ulceration, when using meloxicam 3, 5.
• Patients should also be monitored for signs of adverse effects from methocarbamol, such as drowsiness, dizziness, or nausea 2.
• The use of methocarbamol and meloxicam together should be carefully evaluated, and patients should be informed of the potential risks and benefits of this combination 2, 4.