From the Guidelines
Several once-daily alternatives to meloxicam include celecoxib (Celebrex), naproxen (Naprosyn), piroxicam (Feldene), and nabumetone (Relafen). According to the most recent evidence from 1, these medications are listed as preferentially or highly selective COX-2 inhibitors or have a long half-life, allowing for once-daily dosing.
Key Considerations
- Celecoxib is a COX-2 selective NSAID that can be taken at 100-200mg once daily and may have a lower risk of gastrointestinal side effects compared to traditional NSAIDs 1.
- Naproxen can be taken as a 500mg dose twice daily or as a 750-1000mg extended-release formulation once daily, however, the study does not specify the extended-release formulation 1.
- Piroxicam has a long half-life allowing for 20mg once-daily dosing 1.
- Nabumetone is dosed at 1000-2000mg once daily, typically at bedtime 1.
Important Factors to Consider When Switching
When switching from meloxicam, consider that these alternatives may have different side effect profiles - celecoxib may have fewer GI effects but potentially more cardiovascular concerns, while traditional NSAIDs like naproxen may have more GI issues but potentially fewer cardiovascular risks. All should be taken with food to minimize stomach irritation, and patients with kidney disease, heart disease, or a history of GI bleeding should use these medications with caution and under medical supervision.
From the FDA Drug Label
NSAID medicines that need a prescription Generic Name Trade Name Celecoxib Celebrex® Diclofenac Cataflam®, Voltaren®, ArthrotecTM (combined with misoprostol) ... Meloxicam Mobic® Naproxen Naprosyn®, Anaprox®, Anaprox® DS, EC-Naproxyn®, Naprelan®, Naprapac® (copackaged with lansoprazole)
Alternatives to meloxicam that are once daily:
- Celecoxib (Celebrex®): The dosage is once daily 2.
- Naproxen (Naprosyn®, Anaprox®, Anaprox® DS, EC-Naproxyn®, Naprelan®): Some formulations of naproxen are once daily 3.
- Diclofenac: Not all formulations are once daily, check the specific formulation 4.
From the Research
Alternatives to Meloxicam
Alternatives to meloxicam that are once daily include:
- Celecoxib, a cyclo-oxygenase (COX)-2 selective inhibitor, which is approved for the relief of the signs and symptoms of osteoarthritis (OA), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) 5, 6, 7, 8
Dosage and Administration
Celecoxib can be administered once or twice daily, with a recommended dosage of 200 or 400 mg/day for the symptomatic treatment of OA, RA, and AS 6, 7
Efficacy and Safety
Celecoxib has been shown to be effective in reducing the signs and symptoms of OA, RA, and AS, with a lower incidence of upper gastrointestinal ulceration and complications compared to nonselective NSAIDs 5, 6, 7, 8
Comparison to Meloxicam
Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that is also used to manage OA, RA, and AS, but it is typically administered in a single oral dose of 7.5mg, increased if necessary to a maximum of 15mg daily 9