美洛昔康
Meloxicam
4-hydroxy-2-methyl-N-(5-methyl-2-thiazolyl)-2H-1,2-benzothiazine-3-carboxamide-1,1-dioxide
別名: Metacam · Meloxidyl · Loxicom · Mobic · Orocam · Rheumocam · Inflacam · Meloxivet · Meloxicamum
由 VetSheet 獸醫團隊審訂更新於 2026年6月3日本內容以實證獸醫文獻為本
經審核的 v13 劑量證據
結構化劑量計算證據Analgesia during gastrointestinal stasis
須由已驗證獸醫確認
- q24h
必須同時考慮的臨床上下文 (2)
- Exclude emergent diagnoses (obstruction, enterotoxemia)
- if renal status stable
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
美洛昔康 (Meloxicam) 是一種廣泛使用的非類固醇消炎止痛藥 (NSAID)，屬於昔康 (oxicam) 類。在獸醫學中，主要用於治療與骨關節炎相關的疼痛和發炎，以及術後疼痛控制。
主要特性包括：
- 鎮痛： 降低疼痛感知。
- 抗發炎： 減少組織發炎。
- 退燒： 降低發燒。
臨床要點： 美洛昔康在小動物臨床中極受歡迎，因為它只需每日給藥一次，且具有適口性極佳的口服懸浮液，可根據病患的確切體重進行精準的劑量調整。
作用機制
Meloxicam exerts its therapeutic effects primarily through the inhibition of cyclooxygenase (COX) enzymes, which are responsible for synthesizing prostaglandins from arachidonic acid.
Arachidonic Acid → COX Enzymes → Prostaglandins & Thromboxanes
- COX-1 (Constitutive): Produces prostaglandins that protect the gastric mucosa, maintain normal renal blood flow, and support platelet function.
- COX-2 (Inducible): Upregulated in response to tissue injury and inflammation, producing pro-inflammatory prostaglandins.
Meloxicam is a COX-2 preferential (or COX-2 selective) NSAID at therapeutic doses. This means it preferentially inhibits the COX-2 enzyme, thereby reducing inflammation and pain, while largely sparing the COX-1 enzyme, which theoretically reduces the risk of gastrointestinal and renal side effects compared to non-selective NSAIDs.
安全性與警告
禁忌症
- 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
- Impaired hepatic, cardiac, or renal function
- Hemorrhagic disorders
- Hypersensitivity to NSAIDs
- Dehydrated, hypovolemic, or hypotensive animals
不良反應
- 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
- Renal impairment
- Hepatic enzyme elevation
注意事項
Important Precautions:
- Hydration Status: Ensure patients are well-hydrated and normotensive prior to administration, especially perioperatively, to mitigate the risk of ischemic renal injury.
- Feline Use: In the United States, meloxicam carries a Black Box Warning for cats regarding repeated oral dosing, which has been associated with acute renal failure and death. However, single-dose injections for post-operative pain are approved, and off-label highly titrated, low-dose chronic use is practiced in other countries under strict monitoring.
- Washout Periods: Implement an appropriate washout period (typically 5-7 days) when transitioning a patient from a corticosteroid or another NSAID to meloxicam.
藥物相互作用
Significantly increases the risk of severe gastrointestinal ulceration and bleeding. Concurrent use is strictly contraindicated.
Additive toxicity; increases risk of GI, renal, and hepatic adverse effects. A washout period is required when switching.
May reduce the efficacy of the ACE inhibitor and increase the risk of renal toxicity.
NSAIDs may reduce the diuretic effect of furosemide.
Increased risk of bleeding complications.
Increased risk of severe gastrointestinal ulceration and bleeding
Increased risk of gastrointestinal and renal toxicity
Potential reduction in hypotensive effect and increased risk of renal toxicity
監測
- 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
- Liver enzymes (ALT, ALP)
- PCV/TP (if GI bleeding suspected)
- Clinical signs of GI upset (vomiting, diarrhea, melena)
藥物動力學
半衰期
吸收
Well absorbed following oral administration. Peak plasma concentrations are typically reached within 2-4 hours in dogs.
分佈
Highly protein-bound (>97%). Penetrates synovial fluid, reaching concentrations approximately 40-50% of those in blood plasma.
代謝
Extensively metabolized in the liver via cytochrome P450 enzymes (oxidation).
排除
Excreted primarily as metabolites in feces (biliary excretion) and urine.
過量
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.
可用產品
劑型
- Oral suspension (0.5 mg/mL, 1.5 mg/mL)
- Injectable solution (5 mg/mL)
- Tablets (1 mg, 2.5 mg, 7.5 mg, 15 mg)
- Transmucosal oral spray
- 0.5 mg/ml oral suspension (cats)
- 1.5 mg/ml oral suspension (dogs)
- 1.0 mg tablet (dogs)
- 2.5 mg tablet (dogs)
- 2 mg/ml injectable solution (cats)
獸醫用
- Metacam 1.5 mg/mL Oral Suspension (Dogs)
- Metacam 0.5 mg/mL Oral Suspension (Cats/Dogs)
- Metacam 5 mg/mL Injectable Solution
- Meloxidyl 1.5 mg/mL Oral Suspension
- Loxicom Oral Suspension
- Orocam Transmucosal Spray
- Inflacam
- Meloxivet
- Rheumocam
人用標示
- Mobic 7.5 mg Tablets
- Mobic 15 mg Tablets
- Generic meloxicam tablets and capsules
各地核准狀態
停藥期: pig meat 5 days · cattle meat 15 days · horse meat 5 days
POM-V status in the UK/EU.
POM-V
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store at controlled room temperature (20-25°C or 68-77°F). Keep oral suspensions tightly closed. Do not freeze.
飼主須知
寵物用藥重要指引：
- 隨餐服用： 請務必將美洛昔康與食物一起餵食，或在進食後立即餵食，以幫助預防腸胃不適。
- 使用正確的滴管： 如果使用液體劑型，請務必使用藥物附帶的專用滴管，以確保給予準確的劑量。
- 注意副作用： 如果您發現以下任何情況，請立即停止給藥並聯繫您的獸醫師：
- 嘔吐或腹瀉
- 黑色、柏油狀或帶血的糞便
- 食慾不振或拒絕進食
- 嗜睡、抑鬱或行為異常
- 飲水量或排尿量增加
嚴重警告： 當您的寵物正在服用美洛昔康時，絕對不要給予人類的止痛藥（如阿斯匹靈、布洛芬/Advil、普拿疼/Acetaminophen）或任何其他獸醫止痛藥。混合使用這些藥物可能會導致致命的胃潰瘍或腎衰竭。
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