【缺藥訊息】 公告日期：2024/7/17。 缺藥品項：Mobic 錠劑 15 mg 缺藥原因：廠商停產 替代藥品：院內有同類替代品 配套措施：停產品項將保留慢箋用罄關檔停用，請改以院內同類品項替代。 【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，不建議老年人長期使用。 GFR <30 mL/min 以下之慢性腎臟疾病病人，建議勿處方本品 (NSAID)。

Osteoarthritis: Relief of the signs and symptoms of osteoarthritis (OA); management of OA pain.
Rheumatoid arthritis : Relief of signs and symptoms of rheumatoid arthritis (RA); relief of the signs and symptoms of pauciarticular or polyarticular course juvenile RA in patients ?2 years of age (suspension) and in patients weighing ?60 kg (ODT, tablet).

Analgesic, Nonsteroidal Anti-inflammatory Drug (NSAID)

Distribution:
1. Children 2 to 6 years : Apparent Vd: 0.19 L/kg
2. Children and Adolescents 7 to 16 years : Apparent Vd: 0.13 L/kg
3. Adults:Vdss~10 L.
Protein binding: ~99%, primarily to albumin
Metabolism: Hepatic via CYP2C9 and CYP3A4 (minor); forms 4 metabolites (inactive).
Half-life elimination:
1. Children 2 to 6 years : 13.4 hours
2. Children and Adolescents 7 to 16 years : 12.7 hours
3. Adults: Oral: ~15 to 22 hours
Time to peak:
1. Children and Adolescents 2 to 16 years: Initial: 1 to 3 hours; secondary: 6 to 12 hours
2.Adults: Initial: 4 to 5 hours (tablet); Secondary: 12 to 14 hours (tablet)
Excretion: Urine (predominantly as inactive metabolites; <1% unchanged drug); feces (predominantly as inactive metabolites; 1.6% as unchanged drug).
Clearance:
1. Children 2 to 6 years: 0.17 mL/minute/kg.
2. Children and Adolescents 7 to 16 years : 0.12 mL/minute/kg .
3. Adults: 7 to 9 mL/minute.

1. Hypersensitivity to meloxicam or any component of the formulation
2. History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other nonsteroidal antiinflammatory drugs
3. Use in the setting of coronary artery bypass graft surgery
4. Phenylketonuria

Use of NSAIDs can be considered for the treatment of mild rheumatoid arthritis flares in pregnant women; however, use should be minimized or avoided early and late in pregnancy

It is not known if meloxicam is present in breast milk.

Common:
Dyspepsia,diarrhea, nausea, urinary tract infection
US Boxed Warning:
1. NSAIDs cause an increased risk of serious (and potentially fatal) adverse cardiovascular thrombotic events, including myocardial infarction (MI) and stroke. Risk may occur early during treatment and may increase with duration of use.
2. NSAIDs cause an increased risk of serious GI inflammation, ulceration, bleeding, and perforation (may be fatal); elderly patients and patients with history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events. These events may occur at any time during therapy and without warning.

Osteoarthritis, rheumatoid arthritis:
Initial 7.5 mg once daily; some patients may receive additional benefit from increasing dose to 15 mg once daily; maximum dose: 15 mg/day

Children ≥2 years and Adolescents:
1. Usual dose: 0.125 mg/kg once daily
2. Maximum daily dose: 7.5 mg/day; higher doses (up to 0.375 mg/kg/day or 15 mg/day) have not demonstrated additional benefit in clinical trials

CrCl ≥20 mL/minute: No dosage adjustment necessary
CrCl <20 mL/minute: There are no dosage adjustments provided in the manufacturer's labeling; use is not recommended

1. Mild to moderate impairment (Child-Pugh class A or B): No dosage adjustment necessary.
2. Severe impairment (Child-Pugh class C): There are no dosage adjustments provided in the manufacturer's labeling; use with caution.