Meloxicam是COX-2較優勢選擇性抑制作用的非固醇類抗發炎劑，用於緩解關節炎症狀及當作止痛劑。已知 >1%的病患口服meloxicam後會有暈眩、耳鳴副作用，0.1-1%的病患會有嗜睡副作用。依據衛生署藥品分類，Meloxicam屬於醫師處方藥。本案例為一40歲健康男性病患因自我醫療以綠茶飲品送服meloxicam來緩解頭痛而誘發急性暈眩無法站立，隨即由同事扶助，送到本院急診室處理，並安排住院接受進一步治療。住院期間除給予藥物症狀治療外，也進行腦幹聽覺誘發電位檢查（BAEP）、頸椎（C-spine）及核磁共振攝影（MRI）檢查結果均正常。相關症狀顯著的改善後，病患於6天後出院，出院診斷為急性暈眩。經回顧meloxicam與綠茶飲品之間的藥物食物交互作用的文獻，認為綠茶飲品中最可能與meloxicam產生不良交互作用的成分是咖啡因。雖然有待進一步評估，但本案例顯示meloxicam併服綠茶飲品可能導致急性暈眩。據此提醒病人服藥時，以白開水送服較佳，同時建立民眾對自我醫療的正確觀念，以預防類似事件發生。
 

Meloxicam, a COX-2 selective inhibitor of nonsteroidal anti-inflammatory drug, is commonly used to relieve the symptoms of arthritis and as a pain killer. There were more than 1% of patients could happen to have the side effects of dizziness and tinnitus, and 0.1-1% would encounter the problem of somnolence. In Taiwan, meloxicam was categorized as the prescription drug, which should be prescribed by physicians. A 40-year-old health male happened to have an acute vertigo episode after taking meloxicam with the green tea beverage. At that moment, the patient was unable to stand up by himself and was referred to ER by his friend. Then, he was admitted to inpatient department for further treatment. During his hospitalization, he was treated with medications for his symptoms and was further evaluated through of the examinations of Brain Stem Auditory Evoked Potential (BAEP), and MRI for C-spine. There were no positive results. Six days later, he was discharged from the hospital with the diagnosis of acute vertigo. Upon the literature review, it is suspected that the episode might be associated with the interaction between the caffeine (i.e., in the green tea beverage) and meloxicam. Although further assessment might be needed, this case report could illuminate the potential mechanism about the occurrence of acute vertigo due to the concurrent use of meloxicam and green tea. Accordingly, it would be very important to remind the patients about taking medicine with water and perform self-care education for the patients to prevent further unexpected events.