Anti-inflamatory and Analgesics

Ketorolac

By M. Younus, BVSc, MVSc, SKUAST-K

Ketorolac (Derivative of heteroaryl acetic acid)

  • Off label’ or ‘extra-label anti inflammatory NSAID.
  • Rapidly absorbed from intestines in dogs.
  • Provides short term pain relief.
  • Treatment should be limited to 2-5 days

MOA:

  • Ketorolac inhibits both COX-1 and COX-2.
  • COX-1 leads synthesis of those prostaglandins that are important for maintaining a healthy GI tract, renal function, platelet function, and other normal physiologic functions.
  • Cox-2 leads synthesis of those prostaglandins that are important inflammatory mediators.
  • ketorolac also may affect opioid receptors centrally to produce analgesia, but it does not directly bind to opioid receptors.

Effects:

  • The clinical effects are, antipyretic ,anti-inflammatory and analgesic.

Side effects:

  • The side effects are GIT pathology (ulcers and bleeding ) , nephrotoxicity, and increased bleeding time.

Species :

  • Dog, Cat,Goat.

Indication:

  • Pyrexia.
  • Pain and inflammation.
  • Ocular inflammation and pain.

Drug combinations:

  • Ketorolac+ Moxifloxacin for ocular pathology.

Dose:

  • 0.3 to 0.6 mg/kg IV / IM OD/BD X 2-3 days for dog ( post operative treatment)
  • 10mg /Dog (greater than 30kg) PO OD X 2-3 days in nonsurgical orthopedic pain.
  • 0.25 mg/kg IM OD/BD X2-3days in cat (Postsurgical pain).
  • 0.3–0.7 mg/kg IV, IM, SC, PO TID in goat.

Note: To prevent gastrointestinal ulcer in dogs , Misoprostol (2 to 5 μg/kg PO TID) should be used during ketorolac treatment.

Contraindication:

  • Concurrent use of other NSAIDs, corticosteroids, or aspirin.
  • Do not use as preemptive analgesic because of the unpredictability of hypotension under anesthesia and the greater increased risk of renal damage.
  • Don’t use during surgery.
  • Renal impairment.
  • Hypovolemia and hypotension.

Brands:

  • Opthocare – KT 5ml eye drops( Corise Health Care India).

Composition: Each drop contains 0.5 % W/V Moxifloxacin HCl + 0.5%W/V Ketorolac.

  • Moxifloxacin And Ketorolac 5 ml Eye Drops(Vetbiochem India Private Limited).

Composition: Each drop contains 0.5 % W/V Moxifloxacin HCl + 0.5%W/V Ketorolac.

Human brands:

  • Ketlac 2ml injection ( Neonv Lab India).

Composition: Each ml contains 15mg Ketorolac.

  • Ketrol 1ml injection ( Dr Reddys Lab India).

Composition:

  • Each ml contains 30 mg Ketorolac.

Ketoprofen

By M. Younus, BVSc, MVSc, SKUAST-K

Ketoprofen(chiral propionic acid derivative).

  • Approved for horses as a racemic solution but should be avoided in late pregnacy.
  • Oral absorption is rapid and complete in dogs but poor in horses.
  • NSAID of choice for use of short-term for analgesia in cats.

MOA:

  • Ketoprofen Inhibits COX( 1 and 2) thus inhibits synthesis of inflammatory mediators.
  • Ketoprofen has affinity for inflammatory tissues and accumulates there for longer duration and anti-inflammatory effects lasts for up to 24 hrs.

Effects:

  • The clinical effects are, antipyretic ,anti-inflammatory and analgesic

Side effects:

  • Gastric mucosal damage & GI ulceration,
  • Renal crest necrosis, & mild hepatitis in horses.
  • Vomiting and anorexia in dogs.

Species:

  • Horse , Cat, Dog, Cattle and Swine.

Indications:

  • Musculoskeletal pain.
  • Acute and chronic pain.
  • Laminitis and colic in Horse.
  • Endotoxemia.
  • Pyrexia.

Dose:

  • 2 mg/kg IV/IM OD X 5days in horse.
  • 2 mg/kg S/C followed by 1mg/kg PO X 3-5 days in cats.
  • 3 mg/kg IV/IM OD X 3days in cattle.
  • 3 mg/kg IM OD X 3days in swine.
  • 3 mg/kg IM OD in rabbits.
  • 2 mg/kg IM OD-TID in birds.

Contraindication:

  • Renal insufficiency.
  • Hypersensitivity to drug.
  • Use cautiously in hypoprotenemia.

Brands:

  • Profen 100ml vial ( IPPL India).

Composition: Each ml contains 100mg Ketoprofen.

  • Ketoprost 100ml vial( Credence Remedies Pvt. Ltd India).

Composition: Each ml contains 100mg Ketoprofen.

  • Dotprofen 15ml/30ml/100ml vial( Dotcom Pharma India).

Composition: Each ml contains 100mg Ketoprofen.

  • Ketoliv 100ml vial(Liveath India).

Composition: Each ml contains 100mg Ketoprofen.

Meloxicam

By M. Younus, BVSc, MVSc, SKUAST-K

Meloxicam (oxicam family).

  • Non-stereoidal anti-inflammatory drug (NSAID) belonging to the group of enolic acids.
  • FDA approved for single injection use in cats.
  • Oral absorption is good in dogs and calves upto 3 months of age.

MOA:

  • Meloxicam is selective COX- 2 inhibitor, inhibiting the synthesis of prostaglandin E2.

Effects:

  • Anti-inflammatory action.
  • Anti-pyretic and analgesic properties .

Side-effects:

  • Ulcerogenic activity in the gastrointestinal tract.
  • Nephrotoxicity.
  • Disturbances of reproduction, probably due to inhibition of constitutive cyclo-oxygenase.

Species:

  • Ruminants, Dog,Cat, Pig and Horse.

Indication:

  • Inflammation.
  • Pain.
  • Pyrexia
  • Adjunct to antibiotics in bovine respiratory disease.
  • Osteoarthritis.

Dose:

  • 0.2mg/kg P O first day followed by 0.1mg/kg PO on day two and onward for Dogs.
  • 0.02 mg/kg/PO OD for cats.
  • 0.4mg/kg IM/IV OD for swine.
  • 0.5mg/kg IM/IV PO OD for cattle and goat.
  • 0.6mg/kg IM/IV PO OD for horse.
  • 1mg/kg IM/IV PO OD for sheep.

Contraindication:

  • Hypersensitivity to drug.
  • Gastric and intestinal ulcers.

Brands:

  • Melonex 30 ml injection ( Intas India).

Composition: Each ml contains 5mg Meloxicam.

  • Melonex 10ml oral suspension ( Intas India).

Composition: Each ml contains 1.5mg Meloxicam.

  • Melonex 1000mg Meloxicam Bolus( Intas India).

Composition:

  • Zobid- M 15ml/ 30ml/100ml Injection Zydus Cadila India).

Composition: Each ml contains 5mg Meloxicam.

Nimesulide

By M. Younus, BVSc, MVSc, SKUAST-K

Nimesulide ( NSAID).

  • Belongs to sulphonamide group.
  • Extra label use in Horse.
  • Commonly used in Dog to reduce osteoarthritis associated pain.

MOA:

  • Nimesulide is a COX2-specific NSAID and Inhibits PG synthesis at inflammation site.It also inhibits neutrophil oxidative response and platelet activating factor.
  • Systemic and local application of nimesulide may reduce adhesion formation.

Effects:

  • Anti-inflammatory.
  • Anti-pyretic.
  • Analgesic.

Side Effects:

  • Large dose of may cause painful condition in dogs and cats.
  • In a few cases,it may cause mild gastritis in dogs.
  • Abortion may occur pregnant animals.
  • Large dose of Nimesulide may cause gastric irritation and toxicity symptoms in liver and Kidney.
  • Rarely, it causes acute renal failure in new borne and young calves, in puppies and Kitten.

Species:

  • Ruminants, Dog and Horse.

Indication:

  • Pain, fever and inflammation.
  • Osteoarthritis in dogs.

Drug combinations:

  • Nimesulide + Paracetamol to increase anti-pyretic ,anti- inflammatory and analgesic activity.

Dosage:

  • 3 mg/kg IM OD for Cattle, Sheep & Goat.
  • 2 mg/kg IM OD for Dog.
  • 1mg/kg PO or 1.5mg/kg IV OD/ BD for Horse.

Contraindication:

  • Pregnancy.
  • Liver and kidney dysfunction.
  • Hypotensive animals.

Brands:

  • Nimovet 50ml Injection ( Indian immunological ).

Composition:

Each ml contains 100mg Nimesulide.

  • Nimosid P 30ml/100ml Injection (Zenley Animal Health India).

Composition:

Each ml contains 100mg Nimesulide and 150mg Paracetamol.

Robenacoxib

By M. Younus, BVSc, MVSc, SKUAST-K

Robenacoxib ( NSAID).

  • Approved for Dogs and Cats.
  • Belongs to coxib series of anti-inflammatory drugs.
  • Novel pain killer in pets especially in cats.
  • Safety of margin for Robenacoxib is good as compared to NSAIDS which are generally toxic to cats.

MOA:

  • Robenacoxib is more Cox-2 inhibitor and less Cox-1inhibitor, inhibiting synthesis of those prostaglandins which are responsible for Inflammation.
  • Robenacoxib accumulates in inflammatory exudate and less in blood and other healthy organs so makes it more safe compared to other NSAIDS.

Effects:

  • Anti-inflammatory effect.
  • Analgesics effect.

Side effects:

  • Mild :
  • Soft stools.
  • Vomiting.
  • Severe:
  • Kidney damage.
  • GIT ulceration.
  • Bleeding.

Species:

  • Dog and Cat.

Indication:

  • Pain after orthopaedic or soft tissue surgery.
  • Acute or chronic inflammatory pain.
  • Musculoskeletal pain and inflammation.
  • Chronic osteoarthritis.

Dose:

  • 1-2mg/kg PO/SC x 3 days.
  • Donot exceed treatment beyond 3days.
  • Following protocol may be followed:

Dogs:

  • 5mg/ 2.5-5kg bwt.
  • 10mg/5-10kg bwt.
  • 20mg/10-20kg bwt.
  • 40mg/ 20-40kg bwt.
  • 80mg/ 40-80kg bwt

Cats:

  • 6mg/2.5-6kg bwt.
  • 12mg/6-12kg bwt.
  • Donot use in pets having less than 2.5kg bwt.
  • Give either without food or with a small amount of food

Contraindication:

  • Concurrent use of Corticosteroid should be avoided. This is true with other NSAIDS.
  • Concurrent use with other drugs that cause damage to kidney.
  • Stomach ulceration.
  • Cardiac problems.
  • Renal insufficiency.
  • Hepatic insufficiency.
  • Coagulation problems.

Brands:

  • Onsior 5mg/6mg/10mg/20mg/40mg tab( Elanco USA) offered by GNH India.
  • Onsior 20ml inj vial ( Elanco USA)offered by GNH India. Each ml contains 20mg
  • Robenacoxib oral solution ( SVP USA).

Tolfenamic acid

By M. Younus, BVSc, MVSc, SKUAST-K

Tolfenamic acid (N-(2-methyl-3-chlorphenyl)-anthranilic acid)

  • Nonsteroidal anti-inflammatory agent.

MOA:

  • Tolfenamic acid inhibits the biosynthesis of prostaglandins by inhibition of COX-1 and COX-2 pathways.
  • It also presents inhibitory actions on the prostaglandin receptors.

Effects:

  • Anti-inflammatory action.

Side effects:

  • GIT disturbances.

Species:

  • Cattle.
  • Sheep and Goat.
  • Cat and Dog.
  • Pig.

Indication:

  • Inflammatory pain.
  • Respiratory tract inflammation in cattle.
  • Mastitis and Metritis.

Dose:

  • 2mg/ kg IM 48hrly in cattle Sheep Goat and Pig.
  • 4mg / kg 48hrly in Cat and Dog.

Contraindication:

  • Concurrent use of other NSAIDS.
  • GIT bleeding.
  • Liver and kidney diseases.

Brands:

  • Maxxtol 30ml inj vial( Intas India).

Composition: Each ml contains 40mgTolfenamic acid.

  • Tolfine 8% 30ml/ 100ml inj vial( Vetquinol India)

Composition: Each ml contains 80 mg Tolfenamic acid.

  • Tosafe 30ml inj vial( Safcon Life Sciences India).

Composition: Each ml contains 40 mg Tolfenamic acid.

Tepoxalin

By M. Younus, BVSc, MVSc, SKUAST-K

Tepoxalin( NSAID).

  • Approved for use in dogs.

MOA:

  • Tepoxalin inhibits both COX iso-enzymes and 5-lipoxygenase (5-LOX).
  • This results in reduced formation of PGs, TX and leukotrienes (LTs).

Effects:

  • Anti inflammatory action and analgesic property.

Side effects:

  • Vomiting.
  • Anorexia.
  • Diarrhea.

Species:

  • Dog

Dose:

  • 10-20mg /Kg PO OD .
  • Maintenance dose 10mg /Kg PO OD.

Indication:

  • Osteoarthritis.

Contraindication:

  • Hypersensitivity.

Availability:

  • Available as
  • Zubrin 50/100/200mg tab Schering-Plough Animal Health Corp USA). Each tab contains 50 mg/100mg/200mg tepoxalin.

Asprin

By M. Younus, BVSc, MVSc, SKUAST-K

Asprin (Acetylsalicylic acid)

  • Approved by FDA for use in dogs.

MOA:

  • Aspirin inhibits cyclooxygenase thereby reduces production of prostaglandins.

Effects:

  • Anti-inflammatory effect.

Side effects:

  • GIT problems like ulceration and bleeding.
  • Nausea or diarrhea.
  • Reduced blood supply to the kidney, possibly leading to kidney failure.
  • Reduced ability to clot blood.

Species:

  • Dogs.

Indication:

  • Osteoarthritis.
  • Musculoskeletal inflammation.
  • Pain and fever.
  • Excessive blood clotting.

Dose :

  • 10-40mg/kg PO BD.

Contraindication:

  • Aspirin allergy
  • Ulcers.
  • Cancer.
  • Bleeding disorders.
  • Asthma.
  • Kidney dysfunction or disease.
  • Liver damage.
  • Low blood protein.

Brands:

Available as human brands in India.

  • Asa 50 tab ( German Remidies India).

Composition: Each tab contains 50mg Acetylsalicylic.

  • Ascad 150 tab ( Microlabs India).

Composition: Each tab contains 150mg Acetylsalicylic.

  • Aspent 60 tab(Solus India).

Composition: Each tab contains 60mg Acetylsalicylic.

  • Cotaspirin 100 tab( Natco India).

Composition: Each tab contains 100mg Acetylsalicylic.

  • Disprin 150 tab ( Aristo India).

Composition: Each tab contains 150mg Acetylsalicylic.

  • Ecosprin75 tab( USV India).

Composition: Each tab contains 75mg Acetylsalicylic.

  • Ecosprin 150 tab ( Intas India).

Composition: Each tab contains 150mg Acetylsalicylic.

Carprofen

By M. Younus, BVSc, MVSc, SKUAST-K

Carprofen ( propionic acid NSAID).

  • Approved for Dogs.

MOA:

  • Carprofen inhibits the activity of the enzymes cyclo-oxygenase (COX) I and II. Hence there is decreased formation of precursors of prostaglandins and thromboxane.
  • The specificity to COX I and COX II varies from species to species.

Effects:

  • The inhibition to the formation of prostaglandins, by prostaglandin synthase results in pain relief, anti-inflammationory and antipyretic effect.

Side effects:

  • GIT ulceration and bleeding.
  • Lethargy.
  • Death in few cases ( most adverse effect).
  • Vomiting.
  • Seizures.
  • Loss of coordination.
  • Paralysis.
  • Bloody urine / stools.
  • Liver dysfunction.

Species:

  • Cattle, Horse, Dog, Cat and Rabbit.

Indication:

  • Muscle and skeletal pain.
  • Osteoarthritis.
  • Post operative pain.
  • Mastitis in Cow.
  • Inflammation associated with bovine respiratory disease.

Dose:

  • 2 – 4mg/kg IV/ IM OD in cats.
  • 2.2mg/kg IM BD in dogs.
  • 0.7mg/kg IV or IM OD in horses and cows.
  • IV is preferred route in Horses as IM injection causes muscle damage.
  • Empirical dose rate for Rabbits.

Contraindication:

  • Simultaneous use of other NSAIDS/ Steroids.
  • Gastric ulceration and bleeding.
  • Bleeding disorders such as Von Willebrand’s disease.
  • Should be used under supervision in case of liver and kidney diseases.

Brands:

  • Carodyl 100 tab (Sava vet India).

Composition: Each tab contains 100 mg Carprofen.

  • Carodyl 20ml Inj vial (Sava vet India).

Composition: Each ml contains 50mg Carprofen.

  • Ultrafix 50 tab ( Corise India).

Composition: Each tab contains 50mg Carprofen.

  • Carpade 30ml inj vial ( Carus laboratories India).

Composition: Each ml contains 50mg Carpofen.

Deracoxib

By M. Younus, BVSc, MVSc, SKUAST-K

Deracoxib ( Coxib NSAID Pyrazole class).

  • Approved for Dogs.

MOA:

  • Deracoxib selectively inhibits COX-2, but at higher doses, it also inhibits COX-1.
  • This leads to the inhibition of inflammatory prostaglandins at lower doses and the inhibition of prostaglandins responsible for healthy gut, kidney, and platelet function at higher doses.

Effects:

  • The result is reduced inflammation and pain relief at lower doses.

Side effects:

  • Adverse effect on GIT, renal and platelet function.

Species:

  • Dog.

Indication:

  • Osteoarthritis and inflammation.
  • Post orthopedic and dental surgeries.

Dose:

  • Administer 1-2mg/kg orally once daily with food for pain and inflammation.
  • Administer 3-4mg/kg orally once daily with food for post-operative pain, for a maximum duration of 7 days.

Contraindication:

  • Anorexia.
  • Hypovolemia.
  • Renal insufficiency.
  • Bloody stools.
  • Allergy to sulpha drugs.

Brands:

  • Deracox 25mg tab( Cuckos India).

Compositon: Each tab contains 25mg Deracoxib.

Firocoxib

By M. Younus, BVSc, MVSc, SKUAST-K

Firocoxib (NSAID)

  • Approved for oral use in dog and horse.

MOA:

  • Firoxocib is a cyclooxygenase inhibitor.
  • Selectively inhibits cyclooxygenase-2 (COX-2).
  • Sparingly inhibits cyclooxygenase-1 (COX-1).
  • COX-2 is responsible for production of inflammatory mediators.
  • COX-1 is responsible for the production of prostaglandins for the maintenance of physiological functions, including gastric cytoprotection, renal homeostasis, and normal platelet function.

Effects:

  • Anti-inflammatory and analgesic action.

Side effects:

  • Gastric irritation.
  • Erosions and ulceration of mucous membrane and skin.

Species:

  • Dog and Horse.

Dose:

  • 5 mg/kg PO OD as needed in dog.
  • 0.1 mg/kg PO OD X14 days or 0.09 mg/kg IV OD X 5 days in

horse.

Indication:

  • Osteoarthritis and postoperative pain in dog.
  • Osteoarthritis in horse.

Contraindication:

  • Dog less than 7 months of age.
  • concurrent use of other NSAIDS and glucocorticoid .
  • Patients on diuretics
  • Other nephrotoxic drugs
  • Hypersensitivity to Drug or other NSAIDS.

Brands:

  • Alfiroxx 57/227 chewable tab( Alivira Animal Health India).

Composition: Each tab contains 57mg Firocoxib/ 227 mg Firocoxib.

  • Firotail 57/227 chewable tab( Vivaldis India).

Composition: Each tab contains 57mg Firocoxib/ 227 mg Firocoxib.

Foreign brands:

  • Equioxx Oral past (Merial LLC, Duluth Brazil) available in packs of 20 individually-boxed syringes and packs of 72 individually wrapped syringes.

Composition: Each syringe contains 6.93 grams of Equioxx paste, sufficient to treat a 1250 lb. horse.

  • Previcox chewable tablets ((Merial LLC, Duluth Brazil) for dogs.

Composition: Each tab contains 57mg Firocoxib/ 227 mg Firocoxib.

Phenylbutazone

By M. Younus, BVSc, MVSc, SKUAST-K

Phenylbutazone ( pyrazolone derivative).

  • One of the most commonly administered NSAIDs because of its low cost, ease of administration, and relatively few adverse effects.
  • First choice as Anti-inflammatory drug in horses.

MOA:

  • Phenylbutazone Inhibits COX-1 and COX-2 enzymes.
  • COX-1 regulates prostaglandins involved in normal cellular processes.
  • COX-2 regulates prostaglandins that are thought to be primarily responsible for inflammatory responses.
  • Phenylbutazone as COX-2–inhibiting medication reduces inflammation.
  • Inhibition of prostaglandin synthesis also accounts for their analgesic, antipyretic, and platelet-inhibitory actions.

Effects:

  • Anti-inflammatory and analgesic action.
  • Antipyretic action.

Side effects:

  • Adverse GI effects, including oral, esophageal, gastric, cecal, and right dorsal colonic ulcerations, and accompanying protein-losing enteropathy, hypoproteinemia, leukopenia, and anemia.
  • Renal papillary necrosis (renal medullary crest necrosis) results from inhibition of prostaglandins that maintain renal blood flow.
  • Ulcerative cystitis associated with prolonged phenylbutazone administration.
  • Negative effect on bone healing in horses.
  • Extravascular administration results in severe tissue necrosis.
  • Significantly suppresses total T4 and free T4 concentrations in horses for 10 day.

Species:

  • Horse and Cattle. Some times for managing chronic pain like due to osteoarthritis in Dogs.

Indication:

  • Lameness.
  • Laminitis.
  • Osteoarthritis.
  • Myositis.
  • Pyrexia.

Drug combinations:

  • Phenylbutazone+ Sodium salicylate potentiate antipyretic and anti-inflammatory effect.

Dose:

  • 4.4 mg/kg IV BD on the first day of therapy followed by a decreased dose and increased dosing interval for subsequent therapy.

Contraindication:

  • Phenylbutazone has a narrow safety margin, especially in foals and ponies and dehydrated horses.
  • Phenylbutazone is prohibited from use in female dairy cattle younger than 20 months of age.
  • Masks the Lameness in horses so should not be in such horses who are to be examined for soundness.
  • GIT ulcers.
  • Renal disease.

Brands:

  • Artiject 100ml inj vial ( SSS Vet Science).

Composition: Each ml contains 200mg phenylbutazone.

  • Udil-S 30ml/100ml inj vial ( Morvel India).

Composition: Each ml contains 200mg phenylbutazone.

  • Artizone 30ml/100ml inj vial ( Zoetis India)

Composition: Each ml contains 200mg phenylbutazone.

Flunixin

By M. Younus, BVSc, MVSc, SKUAST-K

Flunixin (NSAID)

  • Approved drug for Horse and Cattle.
  • Quickly absorbed into the blood stream.
  • Pain relief and fever reduction usually starts within one to two hours.

MOA:

  • Flunixin is cyclooxygenase inhibitor ,inhibiting the body’s production of inflammatory mediators like prostaglandins and other chemicals that stimulate the body’s inflammatory response.

Effects:

  • The net effect is potent analgesic, antipyretic, and anti-inflammatory.

Side effects:

  • Stomach and colon ulceration.
  • Vomiting and diarrhea.

Species:

  • Horse , Cattle, Camel, Sheep and Goat.

Dose:

  • 1.1mg/kg IV in horse colic.
  • 0.25 mg/kg with antibiotics for sepsis in horse.
  • 1.0-2.2mg /kg IV /IM in cow mastitis.
  • 1.1-2.2mg/kg IM/IV in camel sheep and goat.
  • 1 – 2 mg/ kg b S/C or slow I/V in pig. 3-5 days treatment as per the condition.

Indication:

  • Short-term treatment of moderate pain and inflammation.
  • Treat of abdominal pain in horse.
  • To decrease signs of sepsis in horse.
  • Anti-inflammatory of the eye including corneal ulcers, uveitis, conjunctivitis.
  • To decrease clinical signs associated with coliform mastitis in cattle.
  • For treatment of diarrhea in dairy calf.
  • With antibiotics, for treatment of BRD in cattle.
  • For use before Ai to increase pregnancy rate in cattle.
  • For pyrexia associated with SRD in pig.

Contra indication:

  • Avoid use with other anti-inflammatory drugs such as corticosteroids or other NSAIDs.
  • Use cautiously with aminoglycoside antibiotics and oral blood thinners, such as warfarin.
  • Gastrointestinal ulcers.
  • Liver and Kidney disease.
  • Do not use in bulls intended for breeding.
  • Avoid use during PG phase of oestrous cycle as it delays onset of oestrous.

Brands:

  • Megludyne ( Virbac India) 20ml/ 100ml vial.

Composition: Each ml contains 50mg Flunixin.

  • Flunim 20ml inj vial(Zenley Animal Health India).

Composition: Each ml contains 50mg Flunixin.

  • Flumeg 20 ml ( Gee Vet India).

Composition: Each ml contains 50mg Flunixin.

  • Unizif 20 ml inj vial( Intas India).

Composition: Each ml contains 50mg Flunixin.

Pregabalin

By M. Younus, BVSc, MVSc, SKUAST-K

Pregabalin( 3-isobutyl derivative of gamma-amino butyric acid).

  • Analgesics and anticonvulsant.

MOA:

  • Pregabalin inhibits the alpha2-delta (α2δ) subunit of the N-type voltage-dependent calcium channel on neurons.
  • Reduction of calcium influx resulting in reduced release of neurotransmitters, specifically excitatory amino acids, from presynaptic neurons.

Effects:

  • Blocking channels has minimal impact on normal neurons but can inhibit simulated neurons responsible for seizures and certain types of pain.
  • Inhibition of release of neurotransmitters like glutamate, norepinephrine, dopamine , serotonin and substance p results in reduction of pain perception.

Side effects:

  • Lethargy
  • Dizziness.
  • Dryness of mouth.
  • Nausea and Vomiting.
  • Constipation.
  • Anxiety.
  • Weight gain.

Drug combination:

  • Pregabalin+ Phenobarbital.
  • Pregabalin+ Potassium bromide.

These combinations reduce seizure frequency in refractory patients.

Dose:

  • 3-4 mg/kg PO QID.

Species:

  • Dog and Cat.

Indication:

  • Neuropathic pain that does not respond to NSAIDs or opiates.
  • Seizures.

Contraindication:

  • Use cautiously in renal insufficiency.

Brands:

Available as Human brands:

  • Gabanext 75mg tab( AHPL India).

Composition: Each tab contains 75 mg pregabalin.

  • Neugabid-SR 75mg tab( Emenox Health Care India).

Composition: Each tab contains 75 mg pregabalin.

  • Nova-SR 75mg tab( Cilpa India).

Composition: Each tab contains 75 mg pregabalin.

  • Precarise 75mg tab ( Carise India).

Composition: Each tab contains 75 mg pregabalin.

  • Pregabin 75mg tab( Molekule India Pvt Ltd India).

Composition: Each tab contains 75 mg pregabalin.

Gabapentin

By M. Younus, BVSc, MVSc, SKUAST-K

Gabapentin( Gamma amino acid)

  • Structurally related to GABA.
  • Good oral absorption.
  • Eliminatd through kidney.

MOA:

  • Gabapentin inhibits the alpha2-delta (α2δ) subunit of the N-type voltage-dependent calcium channel on neurons.
  • Reduction of calcium influx resulting in reduced release of neurotransmitters, specifically excitatory amino acids e.g., substance P, glutamate, norepinephrine, from presynaptic neurons.

Effects:

  • Blocking channels has minimal impact on normal neurons but can inhibit simulated neurons responsible for seizures and certain types of pain.
  • Inhibition of release of neurotransmitters like glutamate, norepinephrine, dopamine , serotonin and substance p results in reduction of pain perception.

Side effects:

  • Lethargy
  • Dizziness.
  • sedation.
  • Ataxia.
  • Abruptly stopping the drug leads to withdrawal-induced seizures.

Species:

  • Dog and Cat.

Indication:

  • Neuropathic pain that does not respond to NSAIDs or opiates.
  • Seizures.

Dose:

For pain relief:

  • 5-10 mg/kg PO TID in dogs.
  • 1.25–10 mg/kg PO OD in cats.

For ancillary therapy of refractory seizures:

  • 10–30 mg/kg PO BD/TID in dogs.
  • 5–10 mg/kg PO BD/TID in cats.
  • Begin with a lower dose and gradually increase.

Contraindication:

  • Use cautiously in renal insufficiency.
  • Avoid commercially available human oral solution containing Xylitol( Hypoglycemic and hepatotoxic).

Brands:

  • Vetina Gabapentin 300mg tab(Vetina Healthcare India).

Composition: Each tab contains Gabapentin 300 mg.

Colchicine

By M. Younus, BVSc, MVSc, SKUAST-K

Colchicine (an alkaloid )

  • Anti-inflammatory agent.
  • Narrow margin of safety.
  • As extra label drug used in shar pei dogs to control fever and joint swelling.

MOA:

  • Colchicine inhibits a key stage of cellular mitosis (microtubule polymerization).
  • It also blocks the hepatic synthesis and secretion of serum amyloid.
  • It also decreases fibroblast proliferation and fibrogenesis.

Effects:

  • Anti-inflammatory.
  • Antifibrotic.

Side effects:

  • Hemorrhagic diarrhea, Bone marrow Suppression Peripheral neuropathies.

Species:

  • Dogs.

Dose:

  • 0.01 to 0.3 mg/kg/ PO OD.

Indication:

  • Familial renal amyloidosis in Shar-Pei dogs. This inherited inflammatory disease and is also called familial Shar-Pei fever (FSF)
  • Colchicine use should be limited to those canine patients with noninflammatory fibrotic hepatopathies.

Contraindication:

  • Colchicine should not be used in animals with advanced kidney disease, cardiac dysfunction, or gastrointestinal disease.
  • Colchicine should be used with caution in older animals and/or debilitated animals.
  • Colchicine inhibits mitosis and is considered teratogenic. and should be used with caution in pregnant animals.
  • Colchicine should not be used with chloramphenicol, and anti-neoplastics. macrolide antibiotics, antifungals, cholesterol lowering medications (statins), cyclosporine, digoxin, and diltiazem.

Brands:

Available as Human brands:

  • Goutnil 0.5mg Tab (Inga Laboratories Pvt. Ltd India).

Composition: Each tab contains 0.5mg Colchicine.

  • Zycolchin 0.5mg Tab (Zydus Cadila Healthcare India).

Composition: Each tab contains 0.5mg Colchicine.

  • Coljoy 5mg tab Zydus Cadila Healthcare India).

Composition: Each tab contains 5mg Colchicine.

  • Colchiheal 0.5mg tab ( Healing Pharma India).

Composition: Each tab contains 0.5mg Colchicine.

Tramadol

By M. Younus, BVSc, MVSc, SKUAST-K

Tramadol ( 4-phenyl-piperidine analogue of codeine)

  • Centrally acting analgesic.
  • Extra label drug for dogs.

MOA:

  • Tramadol binds to the mu opioid receptor thereby modulates the descending pain pathways within the central nervous system.
  • Also inhibits norepinephrine and serotonin reuptake in the central nervous system.

Effects:

  • Analgesia.

Side effects:

  • Gastrointestinal disturbance like decreased appetite, vomiting, diarrhea, or constipation in dogs.
  • Nervous signs like tremors seizure and incoordination .

Species:

  • Dogs

Indication:

  • Tramadol is used to treat pain caused by surgery and chronic conditions such as cancer or joint pain.

Dose:

  • 1 -2 mg /kg PO BD.

Contraindication:

  • Opioid sensitivity.
  • Pre-existing seizure disorders.
  • Renal impairment.
  • Hepatic dysfunction.
  • Debilitated patients.
  • Geriatric patients.

Brands:

  • Ultrafix-T 50mg tab ( Corise health care India).

Composition: Each tab contains 50mg Tramadol hydrochloride.

  • Pet paltra 60 ml oral solution( OriHeal Life Sciences India)

Composition:

Each 5 ml contains 100 mgTramadol Hydrochloride

Betamethasone

By M. Younus, BVSc, MVSc, SKUAST-K

Betamethasone( glucocorticoid).

  • Primary use is intra-articular administration in horses.

MOA:

  • Betamethasone binds to specific intracellular glucocorticoid receptors and subsequently binds to DNA to modify gene expression.
  • Certain anti-inflammatory proteins are produced while the synthesis of certain inflammatory mediators are inhibited.

Effects:

  • Overall reduction in chronic inflammation and autoimmune reactions.

Side effects:

  • Laminitis.
  • Chances of septic arthritis after intra-articular injection.
  • Reactive synovitis after intra-articular injection.
  • Hyperadrenocorticism. retard growth in young animals.
  • In dogs short term use can cause polydipsia (PD), polyphagia (PP), and polyuria (PU) . Long-term use can cause:
  • Dull and dry hair coat.
  • Weight gain and panting,
  • Digestive disorders.
  • Worsening of diabetes mellitus.
  • Muscle wasting, and behavioral changes (eg, depression, lethargy, aggression).
  • Immune suppression.

Species:

  • Horse , Dog and Cattle.

Indication:

  • In horses, intra-articular injection for relief from pain and inflamed joints.
  • Premature labour in pregnant dogs.
  • Inflammatory ailments that present with itching, swelling and other symptoms of skin conditions in a range of species.

Dose:

  • 9mg /per joint under aseptic condition in horses. Repeat after 4weeks.
  • 10-20mg total dose IM/ IV in cattle.
  • Anti-inflammatory effect: 0.2 mg/kg PO OD/BD in dogs.
  • Immunosuppressive effects: 0.2–0.5 mg/kg PO OD/BD in dogs.

Contraindication:

  • Acute or chronic bacterial infections unless therapeutic doses of an effective antimicrobial agent are used.
  • Systemic fungal infections.
  • High blood pressure.
  • Chronic heart failure.
  • Stomach ulcer.

Brands:

  • Beta- X 10ml inj vial ( Novitech India). Composition: Each ml contains 4mg Betamethasone Sodium Phosphate.
  • Betadot 5ml inj vial( Dotcom Pharma India). Composition: Each ml contains 4mg Betamethasone Sodium Phosphate.
  • Betazone- vet 5ml inj vial ( Gosoka pharmaceuticals India). Composition: Each ml contains 4mg Betamethasone Sodium Phosphate.

Dexamethasone

By M. Younus, BVSc, MVSc, SKUAST-K

Dexamethasone ( synthetic adrenal steroid).

  • Glucocorticoid commonly used in veterinary medicine.
  • Synthetic analogue of prednisolone.

MOA:

  • Dexamethasone binds steroid ligands of glucocorticoid specific receptor in the cells and form hormone complex. This hormone complex is then translocated to nucleus where it binds specific DNA site to alter expression.
  • The new expression is transcribed to mRNa for synthesis of new proteins including lipocortin, a protein known to inhibit PLA2a and thereby block the synthesis of prostaglandins, leukotrienes, and PAF.
  • Dexamethasone also inhibits COX-1, COX-2, interleukins, adhesion molecules and collagenase.
  • Dexamethasone also Inhibits uptake of glucose by peripheral tissues and mammary glands.

Effects:

  • Anti-inflammatory action.
  • Membrane stabilisation.
  • Enhancement of protein and fat metabolism.

Side effects:

  • Hyperglycaemia.
  • Drop in Milk production in cattle.
  • Abortion in late gestation.
  • Immune suppression.
  • Osteoclastic activities..
  • Osteoporosis when used for long period.

Species:

  • Cat,Dog , Horse Cattle and Pig.

Indication:

  • Allergic inflammation.
  • Anaphylactic shock.
  • Heaves.
  • Immune suppression.
  • Induction of parturition.
  • Septic shock.
  • Endotoxemia.
  • Ketosis.

Dose:

  • 0.1mg/kg IM/IV in horse, cattle and pig.
  • 0.28-2.2mg/kg PO/IM in dog and cat.

Contraindication:

  • Pregnancy.
  • Diabetes.
  • Pituitary pars intermedia dysfunction in horses.
  • Osteoporosis.
  • Gut ulcers.

Brands:

  • Dexona-vet 5ml inj vial( Zydus India).

Composition: Each ml contains 4.4mg Dexametason sodium phosphate.

  • Dexamethasone5 -100ml inj vial ( Vetoquinol India).

Composition: Each ml contains 5mg Dexametason sodium phosphate.

  • Dexacin 2- 100ml inj vial ( IPPL India).

Composition: Each ml contains 2mg Dexametason phosphate.

Triamcinolone

By M. Younus, BVSc, MVSc, SKUAST-K

Triamcinolone ( Flourinated Prednisolone).

  • Glucocorticoid used to treat inflammatory and allergic conditions.

MOA:

  • Triamcinolone inhibit phospholipase A2 on cell membranes, preventing the breakdown of lysosomal membranes of leukocytes.
  • The formation of arachidonic acid is prevented, and there is decrease in expression of cyclooxygenase and lipoxygenase.
  • Thus the synthesis of prostaglandins and leukotrienes are inhibited.
  • Triamcinolone also inhibits nuclear factor kappa-B, which decreases the production of pro-inflammatory signals such as interleukin-6, interleukin-8, and monocyte chemoattractant protein-1.

Effects:

  • Anti-inflammatory, Antiallergic

Side effects:

  • Immune suppression.
  • Osteoporosis in long use.

Species:

  • Cat, Dog and Horse.

Indication:

  • Inflammation and related disorders in cat dog and horses.
  • Allergic and dermatologic disorders in dogs and cats
  • Acute arthritis horses dogs and cats.

Dose:

  • 0.05 mg to 0.1 mg /pound IM/ SC single injection.
  • 0.01 mg to 0.02/pound IM/ SC single injection.
  • Intra-articular and intrasynovial:
  • 1 mg to 3 mg triamcinolone acetonide for cats and dogs
  • 6 mg to 18 mg for horses.
  • Repeat after 3-4 days.

Contraindication:

  • Viral infections except for emergency therapy.
  • Tuberculosis.
  • Chronic nephritis, or cushingoid syndrome.
  • Existence of congestive heart failure.
  • Diabetes and osteoporosis .

Brands:

  • Vetlog 5ml inj vial ( Zydus India).

Composition: Each ml contains 6mg Triamcinolone.

Prednisolone

By M. Younus, BVSc, MVSc, SKUAST-K

Prednisolone ( Synthetic Glucocorticoid).

  • Wide range of action.
  • Approved for use in Animals.

MOA:

  • Prednisolone enters into the cytoplasm of the cell and binds to glucocorticoid receptors forming glucocorticoid receptors complex.
  • The glucocorticoid receptor complex then enter into the nucleus of the cell and binds to specefic glucocorticoid binding sites on DNA known as glucocorticoid response elements (GREs).This leads to gene expression or inhibition.
  • Complex binding to positive GREs leads to synthesis of anti-inflammatory proteins while binding to negative GREs blocks the transcription of inflammatory genes.

Effects:

  • Anti-inflammatory effect.
  • Immunosuppression.

Side effects:

  • Abortion in pregnant animals.
  • Decrease in milk production.
  • Itching.
  • Facial swelling.
  • Increased drinking, increased urination, and increased appetite.
  • Osteoporesis on prolonged use.
  • Fluid retention.
  • Immune suppression.

Species:

  • Horse ,Ruminants, Dog, Cat and Pig.

Indication:

  • Inflammation.
  • immunosuppression.
  • Pruritis.
  • Recurrent airway obstruction in horses.
  • Addison’s disease.
  • Neoplasia like lymphoid malignancies, mast cell tumors, and brain tumors in dogs and cats.
  • Ketosis.
  • As adjunct to Mastitis treatment.
  • As an ingredient in a number of intramammary antibiotic preparations. The usual dose corresponds to 10 mg prednisolone per infected quarter O.D for a aximum of 3 treatments.
  • Rheumatoid arthritis in cattle, horses , dogs and Cats.

Drug combinations:

  • Prednisone + azathioprine.
  • Prednisolone+ Chlorambucil.
  • Prednisolone+ Antibiotic.

Dose:

  • 50- 200mg / cow IM X 3-5 days.
  • 25-50mg / calf IM x 3-5 days.
  • 5-15mg / dog or cat IM.
  • 0.5-1.0 mg/kg PO in dog.
  • 1-2 mg/kg PO in cat.
  • Oral prednisolone is also used for alleviation of chronic cancer pain @ 0.25 to 1.0 mg/kg in dogs, and 0.5 to 1.0 mg/kg in cats.
  • The cat with immune-mediated arthritis should be given 2 to 4 mg/kg daily in two divided doses x 2 weeks followed by gradual tapering over a further 6 to 8 weeks.
  • 0.25-1mg /kg PO/IM/ IV in horses.

Contraindication:

  • Pregnant animals.
  • Immune compromised animals.
  • Animals allergic to drug.
  • As Single therapy in Inflammation associated with infections.
  • Hyperglycemia.

Brands:

  • Prednisolone acetate 10ml inj ( MSD India).

Composition: Each ml contains 10mg prednisolone.

  • Prednisolone Acetate B Vet C 10ml inj( Zuche Pharmaceuticals India).

Composition: Each ml contains 10mg prednisolone.

  • Prednisolone acetate 10ml inj ( Vetoquinol India).

Composition: Each ml contains 10mg prednisolone.

  • Pridmix 10ml inj (SSS Vet Science).

Composition: Each ml contains 10mg prednisolone.

  • Predinex 10 ml inj (Redwin HealthCare India).

Composition: Each ml contains 10mg prednisolone.

  • Prednis 5mg tab ( Lloyd ) offered by Malladi Drugs And Pharmaceuticals India.

Composition: Each tab contains 5mg Prednisolone.

Hydromorphone

By M. Younus, BVSc, MVSc, SKUAST-K

Hydromorphone ( Hydrogenated ketone of Morphine).

  • Extra label opioid drug.

MOA:

One Side:

  • Hydromorphone activates mu-opioid receptors which then couple with the membrane-associated G protein inhibiting formation of cAMP.
  • Phosphorylation of calcium channels is reduced.
  • voltage-gated calcium channel close and potassium channels open leading to hyperpolarization of the neurons and blockade of substance P release.

Effects:

  • Excitatory neurotransmitters are not released (especially in the dorsal horn of the spinal cord).
  • Activated mu-opioid receptors also inhibit postsynaptic response (especially in the dorsal root ganglion) to excitatory neurotransmitters
  • The net effect is decrease in nociceptive transmission.

Other Side:

  • Hydromorphone like other opioids activate glial cells.
  • The activated glial cells dysregulate opioid so reverse antinociceptive effect of the drug.
  • Also, resistance develops wherein there is cascade of events that force calcium channels to remain open despite the presence of opioid.

Effects:

Resumption of pain transmission.

Overall effect:

Perception of pain is balancing act between the activity of the opioids and the activity of glia.

Species:

  • Dog.

Indication:

  • As sedative, analgesic and preanesthetic agent in dog.

Dose:

  • 0.05-0.2 mg/kg IV/IM/ SC repeat after 2-4 hrs.
  • Reversal: naloxone 0.02-0.04 mg/kg IV/IM.

Contraindication:

  • Dog with TBI(Traumatic Brain Injury), brain tumour or fragile eye(s).
  • Pre-existing heart disease, lung disease, kidney disease, or low thyroid function.
  • Dog on MAO/SSRI /TCA/ Anticholinergic medicines.

Brands:

Available as Human brands.

  • Dilaudid 1mg/ml or 2mg/ml or 4mg/ ml ampule of 1ml (Purdue Pharma USA)
  • Dilaudid-HP 50 ml vial( Purdue Pharma USA).
  • Dilaudid-HP 10mg /ml ampule of 1ml or 10mg / ml ampule of 5ml. ( Purdue Pharma USA).

Composition: Each ml contains 10 mg Hydromorphone.

Oxymorphone

By M. Younus, BVSc, MVSc, SKUAST-K

Oxymorphone( 3-O-demethylation metabolite of oxycodone).

  • Potent opioid with three to five times higher μ opioid receptor affinity than morphine.
  • Approved for dogs.

MOA:

  • Oxymorphone binds with the opioid mu-receptor.
  • These mu-binding sites are discretely distributed in CNS. Oxymorphone also binds to and inhibits GABA inhibitory interneurons via mu-receptors.
  • These interneurons normally inhibit the descending pain inhibition pathway.

Effects:

  • Analgesia.
  • Sedation.

Side effects:

  • Dry Mouth.
  • Itching.
  • Excessive sweating.
  • Vomiting.
  • Red eyes.
  • Anxiety.

Species:

  • Dog.

Indication:

  • Short-term analgesia.
  • For sedation.
  • As an adjunct to anesthesia.

Drug combinations:

  • Oxymorphone + diazepam, are drawn into separate syringes and injected IV to induce heavy sedation in an old dog or one with a reduced requirement for anaesthetic agents.

Dose:

  • 0.05 mg/kg IV, IM, SC, every 3–4 hours.

Contraindication:

  • Severe hepatic impairment.
  • Use cautiously in renal impairment.

Brands:

Available as: Human brands:

  • Numorphan 1ml inj ampule(Endo Pharmaceuticals USA). Each ml contains 1mg Oxymorphone.
  • Numorphan 10 ml inj vial (Endo Pharmaceuticals USA). Each ml contains 1.5 mg Oxymorphone.

Morphine

By M. Younus, BVSc, MVSc, SKUAST-K

Morphine ( Alkaloid of Opium and is phenanthrene derivative).

  • Extra label opioid drug.

MOA:

One Side:

  • Morphine activates mu-opioid receptors.
  • Activated opioid receptor couple with the membrane-associated G protein; this leads to decreased intracellular formation of cAMP. So there is less phosphorylation of calcium channels, leading to closing off the voltage-gated calcium channel and opening of potassium channels enhancing potassium influx.
  • This causes hyperpolarization of the neurons and blockade of substance P release.
  • So there is inhibition of presynaptic release of excitatory neurotransmitters (especially in the dorsal horn of the spinal cord).
  • Activated mu-opioid receptors also inhibit postsynaptic response (especially in the dorsal root ganglion) to excitatory neurotransmitters .
  • The net effect is decrease in nociceptive transmission.

Other Side:

  • MorphIne like other opioids activate glial cells.The activated glial cells dysregulate opioid so reverse antinociceptive effect the drug.
  • Also, resistance develops wherein there is cascade of events that force calcium channels to remain open despite the presence of opioid.
  • Therefore, perception of pain is balancing act between the activity of the opioids and the activity of glia.

Effects:

  • Alleviates pain.

Side effects:

  • Nausea, vomiting and constipation/ diarrhea.
  • Dizziness and drowsiness,
  • Rash,itching and increased sweat.
  • Abdominal pain, indigestion, dry mouth, decreased appetite and dehydration.
  • Difficulty in breathing.
  • Irregular heartbeats, high/low blood pressure and orthostatic hypotension.

Species:

  • Dog and Cat.

Indication:

  • As sedative, analgesic and preanesthetic agents.

Dose:

Morphine:

  • 0.1mg-2mg/kg IV/IM/ SC in dog.
  • 0.2mg-0.5mg/kg IV/IM/ SC in cat.
  • Duration: 4-6hrs.

Contraindication:

  • Dog with TBI, brain tumor or fragile eye(s).
  • Pre-existing heart disease, lung disease, kidney disease, or low thyroid function.
  • Animals on MAO/SSRI /TCA/ Anticholinergic medicines.

Brands:

Available as human brands.

  • Morphine sulphate 1ml Injection( Haftkin India).

Composition:1ml contains 10mg Morphine.

  • Morphitroy 1ml Injection( Troikaa India).

Composition: 1 ml contains 15mg Morphine.Vermor1ml Injection( Verve India).

  • Vermor 1ml Injection( Verve India).

Composition:1 ml contains 10mg Morphine.

Buprenorphine

By M. Younus, BVSc, MVSc, SKUAST-K

Buprenorphine (Opioid).

  • Approved for cats and dogs.
  • 30 times more potent than morphine.

MOA:

  • Buprenorphine is a partial agonist of μ-opioid receptors.
  • These receptors are located throughout the CNS in areas involved in sensory and motor function.
  • Agonistic binding alters the transmission of pain messages via C and A-delta fibres.

Effects:

  • Analgesia.

Side effects

  • Respiratory depression and gastrointestinal tract (GIT) stasis.

Drug combinations:

  • Buprenorphine+Carprofen provides effective postoperative analgesia.

Species:

  • Dog and Cat.

Dose:

  • 0.01 to 0.02 mg/kg IV/ IM BD to QID.
  • 10-20mcg /kg transmucosal .

Indication:

  • Management of both acute and chronic pain.
  • Management of post operative pain.

Contraindication:

  • Buprenorphine should be avoided in renal disease, hypothyroidism, and Addison’s disease.
  • Buprenorphine should be avoided in hepatic disease.
  • Concurrent use of MAO inhibitors.

Availability:

  • Simbadol 10ml inj vial ( Zoetis USA).

Composition: Each ml contains 1.8mg buprenorphine.

  • Bupredyne 10ml inj vial ( Jurox Australia).

Composition: Each ml contains 0.3mg buprenorphine.

Human brands:

  • Tidigesic 2ml inj ( Sun India).

Composition: Each ml contains 0.2mg buprenorphine.

  • Norphin 2ml inj ( Unichem India).

Composition: Each ml contains 0.3mg buprenorphine.

  • Buprigesic2ml inj ( Neon Labs India).

Composition: Each ml contains 0.3mg buprenorphine.

Grapiprant (Piprant class). orally bioavailable antagonist of the prostaglandin E receptor subtype 4 (EP4), Poseses potential analgesic, immunomodulating and antineoplastic activities.Grapiprant has been approved by the FDA’s Center for Veterinary Medicine and was categorized as a non-cyclooxygenase inhibiting non-steroidal anti-inflammatory drug (NSAID).The serum concentration of grapiprant is increased when used in conjunction with other drugs such as acetaminophen, albendazole, and alitretinoinMOA: Grapiprant binds and blocks the prostaglandin EP4 receptor. This way inhibits the binding of prostaglandin E2 (PGE2) with EP4 receptors. Thus prostaglandin E2 pro-inflammatory action is inhibited. The inhibition of PGE2-EP4 binding also prevents proliferation in tumor cells in which the PGE2-EP4 signaling pathway is over-activated. In addition, EP4 receptor inhibition modulates the immune system by preventing both interleukin-23 (IL-23) production and the IL-23-mediated expansion of Th17 cells. As EP4 is expressed by peripheral sensory neurons, blockade of EP4-mediated signaling may induce an analgesic effect. EP4, a prostanoid receptor subtype, is a G protein-coupled receptor that is expressed in certain types of cancers; it promotes tumor cell proliferation and invasion.Effects: This analgesic and anti-inflammatory effects in osteoarthritis in dogs. Side-effects: mild diarrhea, appetite loss, and vomiting. It is theorised that it might lead to reduced tear production due to it being a sulfa-based medication,Species:Dog.Indication:Grapiprant is indicated for the control of pain and inflammation associated with osteoarthritis in dogsDose: 2 mg/kg a day.Contraindication:allergic to it.are younger than 9 months old.weigh less than 8 pounds.are breeding, pregnant, or nursing.have severe heart disease.are currently taking other NSAIDs or corticosteroids.Brands:Grapitail 100mg ( 100

mg Grapiprant) tab ( Vivaldis India).