From the Guidelines
Meloxicam is not considered safe during pregnancy and should be avoided, especially outside of the second trimester. As a nonsteroidal anti-inflammatory drug (NSAID), meloxicam can cause serious complications for both the mother and developing baby. According to the study published in Nature Reviews Neurology 1, NSAIDs can be used only during the second trimester, emphasizing the need for caution with their use during pregnancy. In the first and second trimesters, NSAIDs like meloxicam may increase the risk of miscarriage and birth defects. During the third trimester, these medications can cause premature closure of the ductus arteriosus (a blood vessel in the fetus), potentially leading to pulmonary hypertension in the newborn. They can also delay labor, increase bleeding risk, and cause kidney problems in the developing fetus. Some key points to consider when evaluating the safety of meloxicam during pregnancy include:
- The potential for fetal harm, particularly during the first and third trimesters
- The increased risk of miscarriage and birth defects associated with NSAID use during the first and second trimesters
- The potential for premature closure of the ductus arteriosus and pulmonary hypertension in the newborn during the third trimester If pain management is needed during pregnancy, acetaminophen (Tylenol) is generally considered a safer alternative for short-term use, as recommended by the study 1. However, any medication during pregnancy should only be taken under direct medical supervision. Always consult with your obstetrician or healthcare provider before taking any medication during pregnancy, as they can recommend the safest options based on your specific situation and medical needs.
From the Research
Safety of Meloxicam During Pregnancy
- Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that may pose risks to the fetus during pregnancy 2, 3, 4.
- The use of NSAIDs, including meloxicam, is considered reasonably safe in the second trimester, but may be associated with fetal risks such as renal injury, oligohydramnios, and constriction of the ductus arteriosus 2.
- In the third trimester, NSAIDs are usually avoided due to significant fetal risks, including premature closure of the ductus arteriosus and impairment of fetal kidney function 3, 4.
- The safety of meloxicam during pregnancy has not been specifically studied, but the general consensus is that NSAIDs should be used with caution and only when the maternal benefits outweigh the potential fetal risks 5, 4, 6.
Trimester-Specific Considerations
- First trimester: NSAIDs, including meloxicam, may increase the risk of miscarriage and malformations 4.
- Second trimester: Meloxicam may be used for a short period, but its use is associated with fetal risks such as cryptorchism 2.
- Third trimester: Meloxicam is usually avoided due to significant fetal risks, including premature closure of the ductus arteriosus and impairment of fetal kidney function 3, 4.
General Recommendations
- NSAIDs, including meloxicam, should be used at the lowest effective dose and for the shortest duration possible during pregnancy 4, 6.
- Alternative pain management options, such as paracetamol, ibuprofen, and non-pharmacological interventions, should be considered before using meloxicam during pregnancy 3, 6.