メロキシカム

動物種別の用量

投与経路

禁忌

• Patients with known hypersensitivity to meloxicam or other NSAIDs
• Active gastrointestinal ulceration or bleeding
• Pre-existing renal, hepatic, or cardiovascular dysfunction
• Hypovolemic, dehydrated, or hypotensive patients (increased risk of renal toxicity)
• Concurrent use of other NSAIDs or corticosteroids
• Bleeding disorders
• Gastrointestinal ulceration or bleeding
• Impaired hepatic, cardiac, or renal function
• Hemorrhagic disorders
• Hypersensitivity to NSAIDs
• Concurrent use of corticosteroids or other NSAIDs
• Dehydrated, hypovolemic, or hypotensive animals

有害事象

• Gastrointestinal upset (vomiting, diarrhea, inappetence)
• Gastrointestinal ulceration or bleeding (melena, hematemesis)
• Renal toxicity (elevated BUN/Creatinine, acute kidney injury)
• Hepatic toxicity (elevated ALT/AST, rare but possible)
• Lethargy or depression
• Vomiting
• Diarrhea
• Inappetence
• Gastrointestinal ulceration
• Renal impairment
• Hepatic enzyme elevation

薬物相互作用

• Corticosteroids (e.g., Prednisone, Dexamethasone) · Significantly increases the risk of severe gastrointestinal ulceration and bleeding. Concurrent use is strictly contraindicated.
• Other NSAIDs (e.g., Carprofen, Deracoxib) · Additive toxicity; increases risk of GI, renal, and hepatic adverse effects. A washout period is required when switching.
• ACE Inhibitors (e.g., Enalapril, Benazepril) · May reduce the efficacy of the ACE inhibitor and increase the risk of renal toxicity.
• Furosemide · NSAIDs may reduce the diuretic effect of furosemide. · moderate
• Anticoagulants (e.g., Heparin, Warfarin) · Increased risk of bleeding complications.
• Corticosteroids · Increased risk of severe gastrointestinal ulceration and bleeding · major
• Other NSAIDs · Increased risk of gastrointestinal and renal toxicity · major
• ACE Inhibitors · Potential reduction in hypotensive effect and increased risk of renal toxicity · moderate

モニタリング

• Baseline blood work (CBC, Chemistry panel) prior to initiating chronic therapy
• Renal values (BUN, Creatinine, SDMA, USG)
• Hepatic enzymes (ALT, AST, ALP)
• Clinical signs of GI toxicity (vomiting, diarrhea, melena, anorexia)
• Hydration status
• BUN
• Creatinine
• SDMA
• Liver enzymes (ALT, ALP)
• PCV/TP (if GI bleeding suspected)
• Clinical signs of GI upset (vomiting, diarrhea, melena)

過量投与

**Overdose Management:** Overdosage of meloxicam increases the risk of severe gastrointestinal ulceration, acute renal failure, and hepatic toxicity. * **Recent Ingestion (< 2 hours):** Induce emesis (if no contraindications) followed by the administration of activated charcoal to prevent further absorption. * **Gastrointestinal Protection:** Initiate GI protectants such as sucralfate, H2-receptor antagonists (e.g., famotidine), or proton pump inhibitors (e.g., omeprazole). * **Renal Protection:** Administer intravenous fluid therapy (e.g., Lactated Ringer's or 0.9% NaCl) at diuresis rates for 48-72 hours to support renal perfusion and flush the kidneys. * **Monitoring:** Monitor baseline and daily renal panel (BUN, Creatinine, Phosphorus), PCV/TP, and liver enzymes.