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Meloxicam Dosing Question (Hypothetical)


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I've wondered about this for a while but the latest threat brought it back to mind. Why is it so dangerous to (potentially) slightly overdose the dog using the human brand.

 

I'm asking, because I mentioned to my BIL who works for a pharmaceutical company that I usually ask doctors to start me on the smallest possible dose of anything possible, because I seem to need less medication than average and he pointed to my fairly low weight. But that doesn't seem to be a standard consideration for human doctors and they don't do it unless I ask.

 

Are vets more careful on the whole than human doctors?

Are dogs more sensitive than people?

Are some drugs just a bigger deal--Meloxicam, benadryl, etc.?

Is it because dog weights obviously vary more than people weights so the issue of weight is thought about more?

Something else I haven't thought of?

 

Anyway, curious to hear from any vet/vet tech/medical types/experienced people who want to chime in.

Beth, Petey (8 September 2018- ), and Faith (22 March 2019). Godspeed Patrick (28 April 1999 - 5 August 2012), Murphy (23 June 2004 - 27 July 2013), Leo (1 May 2009 - 27 January 2020), and Henry (10 August 2010 - 7 August 2020), you were loved more than you can know.

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Need to be careful with the NSAIDs because they have the potential for adverse side effects. They are great drugs, and we need them to reduce inflammation. But they are one thing that you really don't want to overdose.

Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

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My understanding is that meloxicam has a lower safety margin than some of the other NSAIDs used for dogs. While technically a COX-2 inhibitor it does still have a higher potential for GI upset & damage than say carprofen Rimadyl. I believe this is why the veterinary version of meloxicam is a liquid so the dose can be more closely tailored to the individual dog.

 

The human dose of meloxicam is much too high for safe use in dogs IMHO. You need the smalled human pill, 7.5mg. Even then you may need to give just 1/3 pill for a Greyhound sized dog. The pills are quite small & some can be difficult to break evenly. You may not be giving the dog an even dose each time. That makes the human meloxicam pills more difficult & as a result more risky when used for dogs.

 

All that said, I do use it for my dogs 50 lbs & up. They get either 1/4 to 1/3 pill, usually just 1/4 if that is effective. The ones I've gotten recently are easier to break & 1/4 seems to effective for my 60 lb girl with some arthritis pain. While I don't think I would want to use it on a continuous long term basis, it is proving to be safe & effective on an as needed basis.

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I think there are a couple different issues here. One being drug specific, and the other being more general in terms of drug dosing.

I'm not very familiar with medication dosing in people, but I get the impression that many meds are used at the same or similar doses in people, regardless of the size of the person. This is probably because the variation in size in humans is relatively small, and the safety margin of most drugs allow this to be done fairly safely.

In vet med, there's such a huge range in size even within the dog species, that we have to tailor drug doses to each individual patient. Sometimes this is done by a very precise calculation, but often it has to be rounded based on the sizes that tablets and capsules come in. Many products are divided into weight ranges, such as the heartworm prevention and flea control medications.

Each medication has a particular therapeutic range (the dose that needs to be given for the drug to be effective) as well as a margin of safety. Safety is determined through research studies where dogs are given the medication at higher doses than the therapeutic range to see if and what side effects occur. Some medications are safe even when given at 20+ times the therapeutic dose. Others start to show side effects at only 2 or 3 times the therapeutic dose. This information is often accessible on drug labels, and some of the data is pretty scary when you actually look at the studies.

NSAIDs are meds that tend to have a fairly low margin of safety, and some dogs are more sensitive to others. So the safety studies only give you a general idea. For example, the 10 dogs in the official FDA study may not have developed problems until 2-3X the standard dose was given, but certain individual dogs may not be able to tolerate even 1.5 times the label dose (and you get the occasional case that has side effects even when the approved label dose is given).

With any medication that has the potential for life-threatening side effects, I think we need to be very careful about dosing and try to use the lowest effective dose, especially if it's going to be a long term treatment. I hope this answered some of your questions? I think this is an interesting topic. :)

Jennifer &

Willow (Wilma Waggle), Wiki (Wiki Hard Ten), Carter (Let's Get It On),

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It did, thank you for taking the time to answer so throughly. :)

 

I'm curious on the other side too, why most human doctors seem to pay virtually no attention to weight (even when a person might weigh 1/2 to 3x the average weight in a clinical trial) but that's a question for someone else. I know there is begining to be a discussion of this issue with birth control efficacy, but I haven't really seen it elsewhere.

Beth, Petey (8 September 2018- ), and Faith (22 March 2019). Godspeed Patrick (28 April 1999 - 5 August 2012), Murphy (23 June 2004 - 27 July 2013), Leo (1 May 2009 - 27 January 2020), and Henry (10 August 2010 - 7 August 2020), you were loved more than you can know.

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Actually there was a piece on the NBC evening news last night about how many women are becoming addicted to prescription opiates because doctors have them take a "normal" dose, which is usually made for men's sizes. This is really overdosing for a small woman, and can cause death in some cases.

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