Concurrent Use of Mobic (Meloxicam) with Methotrexate

Safety Considerations

The British College of Dermatology suggests that NSAIDs, including meloxicam, can reduce renal elimination of methotrexate, potentially increasing methotrexate blood levels and toxicity 1

The American Academy of Dermatology recommends more frequent monitoring of liver function tests (LFTs) and complete blood count (CBC) when using meloxicam with methotrexate 1, 2
The American College of Rheumatology suggests standard monitoring for methotrexate includes CBC, LFTs, and renal function tests within the first 1-2 months of usage, and continued monitoring every 3-4 months thereafter 3
When adding meloxicam, the British College of Dermatology considers more frequent monitoring initially (every 2-4 weeks for the first few months) 1, 3

The American College of Rheumatology strongly recommends folic acid supplementation with methotrexate to reduce adverse effects 2, 3
The American Academy of Dermatology suggests folic acid should be taken daily except on the day methotrexate is administered 2
The British College of Dermatology recommends maintaining adequate hydration to improve renal elimination of methotrexate 1

The British College of Dermatology and the American College of Rheumatology suggest watching for signs of increased methotrexate toxicity, including mouth sores or ulcers 1, unusual bruising or bleeding 3, and yellowing of skin or eyes 2

The British College of Dermatology recommends avoiding this combination in patients with pre-existing renal impairment 1
The British College of Dermatology suggests dose adjustments may be necessary in elderly patients or those with mild renal impairment 1