Meloxicam vs Ibuprofen for Fever Reduction
Meloxicam is not recommended as a fever-lowering agent and does not have equivalent antipyretic power to ibuprofen. While both are NSAIDs, ibuprofen is specifically validated and recommended for fever control, whereas meloxicam is designed as a once-daily anti-inflammatory agent for chronic conditions like arthritis, not for acute fever management 1.
Why Ibuprofen is Preferred for Fever
Multiple randomized, double-blind, placebo-controlled studies demonstrate that ibuprofen significantly reduces fever and provides pain relief in both children and adults with acute febrile illnesses 1.
The Infectious Diseases Society of America specifically recommends ibuprofen (along with acetaminophen) as an analgesic/antipyretic agent for fever control 1.
Ibuprofen has a rapid onset of action with maximal antiplatelet and antipyretic effects occurring within minutes of administration 1.
Why Meloxicam is Not Appropriate for Fever
Meloxicam has a 20-hour half-life and is designed for once-daily dosing in chronic inflammatory conditions, making it unsuitable for acute fever management where rapid onset and offset are needed 2, 3.
Meloxicam is a preferentially selective COX-2 inhibitor developed specifically for long-term treatment of osteoarthritis and rheumatoid arthritis, not for acute symptomatic relief 4, 2, 5.
No clinical trials or guidelines support the use of meloxicam as an antipyretic agent - all published studies focus on its efficacy in chronic arthritis conditions over weeks to months 4, 5, 6.
Pharmacologic Differences
Ibuprofen has a short half-life (2-6 hours) allowing for flexible dosing and rapid symptom control, whereas meloxicam's 20-hour half-life means it takes days to reach steady-state and cannot be titrated quickly 1, 2.
Meloxicam's selective COX-2 inhibition profile was designed to reduce gastrointestinal side effects in chronic use, not to optimize antipyretic efficacy 4, 2, 3.
Safety Considerations
Aspirin should be avoided in children for fever control due to Reye syndrome risk, but ibuprofen is safe and effective 1.
Both meloxicam and ibuprofen carry cardiovascular risks with chronic use, but ibuprofen's short-term use for fever poses minimal risk 7, 8.
Meloxicam belongs to the oxicam class of NSAIDs, which has been associated with higher risk of severe cutaneous adverse reactions (Stevens-Johnson syndrome/toxic epidermal necrolysis) compared to other NSAID classes including ibuprofen 1, 9.
Clinical Bottom Line
For fever reduction, use ibuprofen or acetaminophen as first-line agents 1. Meloxicam should never be used for acute fever management - it is a chronic anti-inflammatory medication with no established role or evidence base for antipyretic therapy. The pharmacokinetic profile, clinical trial data, and guideline recommendations all support ibuprofen (or acetaminophen) as the appropriate choice for fever control.