Meloxicam vs. Indomethacin
See how Meloxicam and Indomethacin compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Meloxicam is taken once a day, while indomethacin usually needs two to four doses a day, with the dose adjusted weekly.
Both drugs carry the same FDA boxed warnings for heart attack, stroke, and stomach bleeding, and neither is approved for use around bypass surgery.
Indomethacin is FDA-approved for gout flares and bursitis that meloxicam does not cover, while only meloxicam is approved for juvenile rheumatoid arthritis.
Meloxicam vs. Indomethacin Drug Summary
Meloxicam
Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that acts with some preference for the COX-2 enzyme at typical doses. It is FDA-approved to relieve pain and swelling from osteoarthritis, rheumatoid arthritis, and juvenile rheumatoid arthritis in children 2 and older. It comes in tablet, dissolving tablet, capsule, liquid, and IV forms, and only needs to be taken once a day.
Indomethacin
Indomethacin is a nonselective NSAID that has been used for decades to relieve pain and swelling from osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, gout flares, and bursitis or tendinitis. It is taken as a capsule two to four times a day, with the dose adjusted weekly based on how well it is working. A separate IV form is also used for a heart condition in premature infants.
Meloxicam vs. Indomethacin Side Effects
Meloxicam
Indomethacin
Meloxicam vs. Indomethacin Dosage
Meloxicam
Indomethacin
| STAGE | DOSE | WHEN |
| Starting dose | 7.5 mg once daily | At the start |
| Maximum dose | 0.125 mg/kg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg 2-3 times daily | At the start |
| Maximum dose | Up to 200 mg/day divided | If needed |
| Dose changes | 2 increases | As tolerated |
Meloxicam
| STAGE | DOSE | WHEN |
| Starting dose | 7.5 mg once daily | At the start |
| Maximum dose | 0.125 mg/kg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Indomethacin
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg 2-3 times daily | At the start |
| Maximum dose | Up to 200 mg/day divided | If needed |
| Dose changes | 2 increases | As tolerated |
Meloxicam vs. Indomethacin Indications
Meloxicam
Meloxicam is FDA-approved to relieve pain and stiffness from osteoarthritis and rheumatoid arthritis in adults, plus juvenile rheumatoid arthritis in children 2 and older. It is not approved for use around bypass graft surgery. Some doctors also prescribe it off-label for ankylosing spondylitis or general musculoskeletal pain.
Osteoarthritis in adults
Rheumatoid arthritis in adults
Juvenile rheumatoid arthritis (ages 2+)
Off-label: ankylosing spondylitis
Off-label: general musculoskeletal pain
Indomethacin
Indomethacin is FDA-approved for moderate to severe osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute gouty arthritis, and painful bursitis or tendinitis. It is not approved for use around bypass graft surgery and is generally avoided in children 14 and younger. Off-label, doctors sometimes use it for certain headache disorders or preterm labor.
Osteoarthritis (moderate to severe)
Rheumatoid arthritis (moderate to severe)
Ankylosing spondylitis
Acute gouty arthritis
Bursitis or tendinitis
Meloxicam vs. Indomethacin Pros and Cons
Meloxicam
Meloxicam's once-daily dosing and COX-2 preference make it a common first NSAID choice for chronic joint pain. Like all NSAIDs, it still carries boxed warnings for cardiovascular and gastrointestinal risks. Insurance coverage and pricing can vary widely by plan and pharmacy.
Pros
Only needs to be taken once a day
Preferential COX-2 activity may be gentler on the stomach at typical doses
Only one of the two approved for juvenile rheumatoid arthritis in kids 2 and up
Comes in tablet, dissolving tablet, capsule, liquid, and IV forms
Cons
Not approved for gout flares or bursitis and tendinitis
Ankylosing spondylitis use is off-label rather than FDA-approved
Fixed once-daily dosing is harder to adjust quickly during a sudden flare
Indomethacin
Indomethacin's flexible, frequently adjusted dosing and long track record make it useful for gout flares and acute inflammatory pain that need fast control. It shares the same class-wide boxed warnings as meloxicam. Its multiple daily doses can be harder for some patients to stick with.
Pros
FDA-approved for acute gout flares and bursitis or tendinitis
On-label approval for ankylosing spondylitis
Dose can be adjusted week to week for faster symptom control
Decades of clinical use across many inflammatory conditions
Cons
Requires two to four doses a day instead of one
Nonselective COX inhibition may carry a higher GI irritation risk
Generally avoided in children 14 and younger
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