The most obvious difference between meloxicam and ibuprofen is that meloxicam is prescription-only, while ibuprofen is available over-the-counter (although certain types and strengths of ibuprofen are also prescription-only). Ibuprofen was the first NSAID to be made available over-the-counter because it is usually well-tolerated. Both meloxicam and ibuprofen are NSAIDs, so the way in which they work is fundamentally the same. However, there are differences in their chemical make-ups; the suffix -oxicam refers to NSAIDs that are ‘enolic acids’ while -profen refers to ‘arylpropionic acids’. It means there are differences regarding aspects such as usage, dosing, longevity, and side effects. Uses
Both can be used to treat osteoarthritis and rheumatoid arthritis. Meloxicam is also used to treat juvenile idiopathic arthritis in children 2 years of age or older, while ibuprofen is used to treat fever, headache, migraine, and mild to moderate aches and pains. Longevity
Meloxicam is longer-lasting than ibuprofen, so is usually taken once per day whereas ibuprofen is usually taken every six to eight hours. Risk of Gastrointestinal Complications
Meloxicam may present a higher risk of gastrointestinal complications than low-level doses of ibuprofen. The risk of complications with ibuprofen increases at stronger doses. Risk of Cardiovascular Complications
While many studies have shown a link between NSAIDs and an increased risk of cardiovascular complication – hence the FDA's black box warning – there is no conclusive evidence whether meloxicam or ibuprofen presents a greater risk than the other. However, it is widely agreed that the risk increases at higher doses, with long-term use, and in people with a history of cardiovascular disease. Other differences exist between meloxicam and ibuprofen. Meloxicam, for example, inhibits the COX-2 enzyme to a greater extent to the COX-1 enzyme, while ibuprofen inhibits them equally (it should be noted that some other NSAIDs are more COX-2 selective than meloxicam). Ultimately, the decision to use meloxicam or ibuprofen (or a different NSAID) is based on your individual therapeutic requirements and your risk profile. If you have any concerns about either meloxicam or ibuprofen, you should speak to your doctor or pharmacist.