From the Guidelines
The most effective dosage of Meloxicam is 15 mg once daily, as it provides optimal pain relief and anti-inflammatory effects while maintaining a consistent blood level of the medication throughout the 24-hour period. According to the expert consensus recommendations for the diagnosis and treatment of chronic non-bacterial osteitis (CNO) in adults, published in the Annals of the Rheumatic Diseases in 2025 1, the recommended dosage for Meloxicam is 15 mg/day in one dose. This is supported by the fact that Meloxicam has a relatively long half-life, making once-daily dosing appropriate and effective.
Some key points to consider when prescribing Meloxicam include:
- Starting with the lowest effective dose, which may be 7.5 mg once daily, and increasing to 15 mg if needed
- Taking the medication with food to reduce gastrointestinal side effects
- Being aware of common side effects, such as stomach upset, heartburn, and dizziness
- Consulting with a healthcare provider about appropriate dosing for patients with kidney problems, heart conditions, or a history of gastrointestinal bleeding
It's also important to note that the treatment response should be evaluated at 2-4 weeks after initiation, and treatment can be continued or switched to another NSAID/COXIB if the first did not provide benefit or was not tolerated 1. However, for the specific question of what works best between Meloxicam 7.5 mg BID and 15 mg QPM, the evidence suggests that 15 mg once daily is the more effective dosage.
From the FDA Drug Label
For the relief of the signs and symptoms of osteoarthritis the recommended starting and maintenance oral dose of meloxicam is 7.5 mg once daily. Some patients may receive additional benefit by increasing the dose to 15 mg once daily.
The most effective dosage of Meloxicam is 15 mg once daily, as some patients may receive additional benefit by increasing the dose from 7.5 mg to 15 mg once daily 2.
- 7.5 mg twice a day is not a recommended dosage, and
- 15 mg every evening is equivalent to 15 mg once daily, which is a recommended dosage.
From the Research
Dosage Comparison
The effectiveness of Meloxicam 7.5 mg BID (twice a day) versus 15 mg QPM (every evening) can be evaluated based on several studies:
- A 12-week, double-blind, multiple-dose, placebo-controlled trial 3 found that meloxicam at 7.5 and 15 mg/d was statistically significantly more effective than placebo for all end points, with efficacy evident after 2 weeks of treatment and maintained until the end of the trial.
- A review of clinical trials 4 showed that meloxicam 7.5 mg and 15 mg were significantly more effective than placebo and comparable in efficacy to standard NSAIDs, with a lower incidence of gastrointestinal side effects.
- The recommended dosage of meloxicam is 7.5mg, increased if necessary to a maximum of 15mg daily 5.
Efficacy and Safety
Key points regarding the efficacy and safety of meloxicam include:
- Meloxicam 7.5 and 15 mg/d demonstrated statistically significant efficacy compared to placebo 3.
- Meloxicam had a lower incidence of gastrointestinal adverse events compared to other NSAIDs 4.
- The safety and tolerability profile of meloxicam 15 mg in patients with mild renal impairment was favorable, with no evidence of accumulation of meloxicam 6.
- A long-term study found that meloxicam 15 mg daily was effective and well-tolerated in patients with rheumatoid arthritis, with maintained efficacy over 18 months 7.
Dosage Recommendations
Based on the available evidence:
- The recommended dosage of meloxicam is 7.5mg, increased if necessary to a maximum of 15mg daily 5.
- There is no direct comparison of meloxicam 7.5 mg BID and 15 mg QPM in the provided studies, but the available data suggest that both 7.5 mg and 15 mg daily dosages are effective and well-tolerated 3, 4, 7.