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www.vetfield.sitew.orgPlumb’sVeterinary DrugHandbookSixth EditionDonald C. Plumb, Pharm.D.distributed byBlackwell Publishing
COPYRIGHT 2008 by Donald C. PlumbAll rights reserved. No part of this book may be reproduced or transmitted in any form or any means,electronic or mechanical, including recording, photocopying, or by any information stor age and retrieval system,without the written permission of the copyright owner.worldwide print distribution by:Blackwell Publishing Professional2121 South State AvenueAmes, Iowa 50014-8300(800) 862-6657www.blackwellpublishing.com/Vet/published byPharmaVet Inc.Stockholm, Wisconsindesign and typesettingPeregrine Graphics ServicesSt. Paul, MinnesotaISBN: 978-0-8138-1097-3Last digit is the print number 9 8 7 6 5 4 3 2 1
For Shirley,Whose efforts, support, and lovemake this reference a reality* * *
Contributors to the Sixth EditionC. A. Tony Buffington, DVM, PhD, DACVNProfessor of Veterinary Clinical SciencesThe Ohio State University Veterinary HospitalColumbus, OHDog and Cat Therapeutic DietsMichelle DuMond, RVTNutrition Support SpecialistThe Ohio State University Veterinary HospitalColumbus, OHDog and Cat Therapeutic DietsAndrea G. Cannon, DVM, DACVDAnimal Dermatology & AllergyRocklin, CA; Modesto, CA; Boise, IDDermatological Agents, TopicalDinah Jordan, PharmD, DICVPMississippi State UniversityMississippi State, MSInsulin, Maropitant, & Mirtazapine MonographsGigi Davidson, DICVPNorth Carolina State UniversityRaleigh, NCOphthalmology Products, TopicalPrinciples of Compounding Ophthalmic ProductsSandra Koch, DVM, MS, DACVDCollege of Veterinary Medicine, University ofMinnesotaSt. Paul, MNDermatological Agents, TopicalCamille DeClementi, VMD, DABTASPCA Animal Poison Control CenterUrbana, ILOverdose and Toxin Exposure DecontaminationGuidelines, ASPCA Animal Poison Control CenterData for Drug MonographsElaine Lust, PharmD, DICVPCreighton UniversityOmaha, NECeftiofur (Free Acid, Sodium and HCl), Danofloxacin,Tulathromycin MonographsTo sign up for e-mail notifi cation ofupdates and errata, or get informationon ordering information for additionalversions, visit Plumb’s Veterinary DrugHandbook’s web site at:www.vetdruginfo.com
Preface to the Sixth EditionIn this edition, Plumb’s Veterinary Drug Handbookcontinues to evolve with the addition of moredrugs, more types of drugs (topical dermatologydrugs), and a new look; however, the basic premiseremains to serve as a single volume reference toassist veterinarians, other health professionals, andanimal caretakers in providing optimal drug therapyfor veterinary patients. The changes to this editioninclude a new design and layout; the addition of75 new drug monographs; updates to the oldermonographs, with a listing for rapid-scanning forpotential drug interactions and overdose informationfor 50 drugs from the ASPCA Animal Poison ControlCenter; and new sections on topical dermatologicagents and products, Principles of CompoundingOphthalmic Products, and Overdose and ToxinExposure Decontamination Guidelines in theappendix.Donald C. PlumbAbout the AuthorDonald C. Plumb, Pharm.D., was formerly Directorof Pharmacy Services and Hospital Director at theUniversity of Minnesota’s Veterinary Medical Center.Now retired from the University of Minnesota,he focuses full-time on providing veterinarydrug information to veterinarians, other healthprofessionals, and animal caretakers.
Notes and CautionsDosages and Extra-Label Use of MedicationsDosages for the various species for the drugs listed in thisreference come from a variety of sources and are referenced totheir source in the appendix. While a sincere effort has been madeto assure that the dosages and information in cluded in this bookare accurate and reflect the original source’s information, errorscan occur; it is recommended that the reader refer to the originalreference or the approved labeling information of the product foraddi tional information and verification of all dosages.Except for labeled dosages for veterinary-approvedproducts (for a given species and indication,) dosages listedin this reference should be considered “extra-label” and arenot necessarily endorsed by the manufacturer, the Food andDrug Administration (FDA) or this author. Veterinarians areresponsible as per the Animal Medical Drug Use Clarification Act(AMDUCA) for the appropriate use of medications. The AnimalMedicinal Drug Use Clarification Act of 1994 (AMDUCA) allowsveterinarians to prescribe extralabel uses of certain approvedanimal drugs and approved human drugs for animals undercertain conditions. Extralabel (or extra-label) use refers to theuse of an approved drug in a manner that is not in accordancewith the approved label directions. The key constraints ofAMDUCA are that any extralabel use must be by or on the orderof a veterinarian within the context of a veterinarian-clientpatient relationship, must not result in violative residues in foodproducing animals, and the use must be in conformance with theimplementing regulations published at 21 CFR Part 530. A list ofdrugs specifically prohibited from extra-label use appears in theCode of Federal Regulations. For additional information go to theFDA-Center for Veterinary Medicine Website at: http://www.fda.gov/cvm/Abbreviations: OTC & RxIn addition to the abbreviations used in writing prescriptions(e.g., tid, q8h, etc.—see the abbreviation list in the appendix), theterms OTC or Rx are found in parentheses after a listed dosageform. If Rx, the drug is considered to be a prescription or legendproduct, and requires a prescription. OTC denotes that the item isavailable “over-the-counter” and does not require a prescriptionfor purchase.Trade and Proprietary NamesThe notation used to signify trade names or proprietary names isan italicized, capitalized name followed by a (e.g., Amoxi-Tabs ).This notation may not accurately represent the drug’s officialregistered copyright, trademark, or licensed status (e.g., , etc.)Drug InteractionsDrug interaction identification and evaluation is in its infancyin veterinary medicine, as relatively little specific informationis known on the subject for the variety of species treated. Whiledrug interactions can be clinically significant and potentially lifethreatening in veterinary patients, most of the interactions listedin the monographs are derived from human medicine (whichis only slightly more informed than veterinary medicine on thistopic) and are often included primarily to serve as cautions tothe prescriber to be alert for unforeseen outcomes, or to enhancemonitoring associated with the drug therapy. Additionally, itis likely there are potentially many other clinically significantinteractions between drugs that are not listed; prescribers arereminded that the risk for adverse drug interactions occurringincreases with the number of different drugs given to anindividual patient.DisclaimerThe author/publisher/distributor assume no responsibilityfor and make no warranty with respect to results that may beobtained from the uses, procedures, or dosages listed, and donot necessarily endorse such uses, procedures, or dosages. Theauthor/publisher shall not be liable to any person whatsoever forany dam ages, or equivalencies, or by reason of any misstatementor error, negligent or otherwise obtained in this work. Should thepur chaser not wish to be bound by the above, he/she may returnthe reference to the distributor for a full refund.
ContentsAntivenin (Latrodectus Mactans) Black Widow Spider 66Apomorphine HCl 67Apramycin Sulfate 69systemic MonographsAcarbose 1Acemannan 2Acepromazine Maleate 3Acetaminophen 6Acetazolamide 7Acetic Acid 9Acetohydroxamic Acid 9Acetylcysteine 10Acitretin 12Acyclovir 14Aglepristone 15Albendazole 17Albuterol Sulfate 19Alendronate Sodium 21Alfentanil HCl 22Allopurinol 24Alprazolam 26Altrenogest 27Aluminum Hydroxide 29Amantadine HCl 30Amikacin Sulfate 32Aminocaproic Acid 35Aminopentamide Hydrogen Sulfate 36Aminophylline/Theophylline 37Amiodarone HCl 40Amitriptyline HCl 42Amlodipine Besylate 44Ammonium Chloride 46Ammonium Molybdate 47Ammonium Tetrathiomolybdate 47Amoxicillin 48Amoxicillin/Clavulanate Potassium 51Amphotericin B Desoxycholate 53Amphotericin B Lipid-Based 53Ampicillin 57Ampicillin Sodium/Sulbactam Sodium 60Amprolium Hydrochloride 62Antivenin (Crotalidae) Polyvalent (Equine Origin) 63Antivenin (Crotalidae) Polyvalent Immune Fab (OvineOrigin) 63Antivenin (Micrurus Fulvias) Eastern and TexasCoral Snake 65Ascorbic Acid 70Asparaginase 71Aspirin 73Atenolol 77Atipamezole HCl 79Atovaquone 80Atracurium Besylate 81Atropine Sulfate 83Auranofin 86Azaperone 87Azathioprine 88Azithromycin 91Aztreonam 92Baclofen 94Barbiturate Pharmacology 95Benazepril HCl 96Betamethasone 97Bethanechol Chloride 99Bisacodyl 101Bismuth Subsalicylate 102Bleomycin Sulfate 104Boldenone Undecylenate 106Bromide, Potassium 107Bromide, Sodium 107Bromocriptine Mesylate 109Budesonide 110Buprenorphine HCl 112Buspirone HCl 114Busulfan 115Butorphanol Tartrate 116Cabergoline 120Calcitonin Salmon 121Calcitriol 122Calcium Acetate 124Calcium Salts 125Captopril 129Carbenicillin Indanyl Sodium 130Carbimazole 132Carboplatin 133Carnitine 135Carprofen 136Carvedilol 139Caspofungin Acetate 140
Cefaclor 141Codeine 225Cefadroxil 143Colchicine 227Cefazolin Sodium 144Corticotropin (ACTH) 229Cefepime HCl 147Cosyntropin 230Cefixime 148Cromolyn Sodium 232Cefoperazone Sodium 149Cyanocobalamin (Vitamin B-12) 233Cefotaxime Sodium 151Cyclophosphamide 234Cefotetan Disodium 153Cyclosporine 237Cefoxitin Sodium 154Cyproheptadine HCl 240Cefpodoxime Proxetil 156Cytarabine 241Ceftazidime 157Dacarbazine (DTIC) 243Ceftiofur Crystalline Free Acid 159Dactinomycin 245Ceftiofur HCl 161Dalteparin Sodium 246Ceftiofur Sodium 164Danazol 248Ceftriaxone Sodium 166Danofloxacin Mesylate 249Cefuroxime 168Dantrolene Sodium 250Cephalexin 170Dapsone 252Cephapirin 172Darbepoetin Alfa 254Cetirizine HCl 173Decoquinate 255Charcoal, Activated 174Deferoxamine Mesylate 256Chlorambucil 176Deracoxib 257Chloramphenicol 178Deslorelin Acetate 259Chlordiazepoxide Clidinium Br 181Desmopressin Acetate 260Chlorothiazide 183Desoxycorticosterone Pivalate 262Chlorpheniramine Maleate 185Detomidine HCl 263Chlorpromazine HCl 186Dexamethasone 265Chlorpropamide 188Dexmedetomidine 270Chlortetracycline 190Dexpanthenol 271Chorionic Gonadotropin (HCG) 191Dexrazoxane 272Chromium 193Dextran-70 273Cimetidine 194Diazepam 275Ciprofloxacin 197Diazoxide, Oral 278Cisapride 199Dichlorphenamide 280Cisplatin 200Dichlorvos 281Citrate Salts 202Diclazuril 282Clarithromycin 204Diclofenac Sodium 283Clemastine Fumarate 206Dicloxacillin 284Clenbuterol HCl 207Diethylcarbamazine Citrate 286Clindamycin 209Diethylstilbestrol 287Clofazimine 212Difloxacin HCl 289Clomipramine HCl 213Digoxin 291Clonazepam 215Dihydrotachysterol 294Clonidine 217Diltiazem HCl 296Clopidogrel Bisulfate 218Diminazene Aceturate 298Cloprostenol Sodium 219Dimenhydrinate 299Clorazepate Dipotassium 221Dimercaprol 301Clorsulon 223Dimethyl Sulfoxide 303Cloxacillin 224Dinoprost Tromethamine 305
Diphenhydramine HCl 308Flavoxate HCl 388Diphenoxylate HCl Atropine Sulfate 310Florfenicol 389Dirlotapide 312Fluconazole 391Disopyramide Phosphate 314Flucytosine 393Dobutamine HCl 316Fludrocortisone Acetate 394Docusate 317Flumazenil 396Dolasetron Mesylate 319Flumethasone 397Domperidone 320Flunixin Meglumine 400Dopamine HCl 321Fluorouracil 402Doramectin 323Fluoxetine 404Doxapram HCl 325Fluticasone Propionate 405Doxepin HCl 327Fluvoxamine Maleate 407Doxorubicin HCl 328Folic Acid 409Doxycycline 331Fomepizole 410Edetate Calcium Disodium 334Furazolidone 411Edrophonium Chloride 336Furosemide 413Emodepside Praziquantel 337Gabapentin 415Enalapril 338Gemcitabine HCl 417Enoxaparin Sodium 340Gemfibrozil 418Enrofloxacin 342Gentamicin Sulfate 419Ephedrine Sulfate 345Glimepiride 423Epinephrine 347Glipizide 424Epoetin Alfa/Erythropoietin 349Glucagon 425Eprinomectin 351Glucocorticoid Agents, General Information 427Epsiprantel 352Glucosamine/Chondroitin Sulfate 429Ergocalciferol 352Glutamine 431Ertapenem Sodium 354Glyburide 432Erythromycin 355Glycerin, Oral 433Esmolol HCl 358Glycopyrrolate 434Estradiol Cypionate 360Gold Salts, Injectable 436Ethacrynic Acid 362Gonadorelin 438Ethambutol HCl 363Granisetron HCl 440Ethanol 365Griseofulvin 441Etidronate Disodium 366Guaifenesin 443Etodolac 367Halothane 445Etomidate 369Hemoglobin Glutamer-200 (Bovine) 446Euthanasia Agents with Pentobarbital 370Heparin 448Famciclovir 371Hetastarch 451Famotidine 372Hyaluronate Sodium 452Fatty Acids, Essential/Omega 374Hydralazine HCl 453Felbamate 375Hydrochlorothiazide 455Fenbendazole 376Hydrocodone Bitartrate 458Fentanyl 379Hydrocortisone 459Fentanyl Citrate, Injectable 379Hydrogen Peroxide 3% (Oral) 462Ferrous Sulfate 382Hydromorphone 464Filgrastim 384Hydroxyurea 466Finasteride 385Hydroxyzine 467Firocoxib 386Hyoscyamine Sulfate 469
Ibafloxacin 470Magnesium/Aluminum Antacids 551Ifosfamide 471Magnesium (Parenteral) 553Imidocarb Dipropinate 473Mannitol 555Imipenem-Cilastatin Sodium 474Marbofloxacin 557Imipramine 476Maropitant Citrate 558Inamrinone Lactate 478Mechlorethamine HCl 560Insulin 479Meclizine HCl 561Interferon Alfa, Human Recombinant 484Medetomidine HCl 562Interferon Omega, Feline 486Medium Chain Triglycerides 564Iodide, Sodium 487Medroxyprogesterone Acetate 565Iodide, Potassium 487Megestrol Acetate 567Ipecac Syrup 488Meglumine Antimoniate 570Ipodate Sodium 490Melarsomine 571Ipratropium Bromide 491Melatonin 572Irbesartan 492Meloxicam 574Iron Dextran 493Melphalan 575Isoflupredone Acetate 494Meperidine HCl 577Isoflurane 496Mercaptopurine 579Isoniazid (INH) 497Meropenem 581Isoproterenol HCl 499Metformin HCl 582Isosorbide Dinitrate 500Methadone HCl 584Isosorbide Mononitrate 500Methazolamide 585Isotretinoin 502Methenamine Mandelate 587Isoxsuprine HCl 504Methimazole 588Itraconazole 505Methionine 589Ivermectin 508Methocarbamol 591Kaolin/Pectin 512Methohexital Sodium 592Ketamine HCl 513Methotrexate 594Ketoconazole 517Methoxyflurane 596Ketoprofen 521Methylene Blue 597Ketorolac Tromethamine 523Methylphenidate 599Lactulose 524Methylprednisolone 600Leflunomide 526Methyltestosterone 604Leucovorin Calcium 527Metoclopramide HCl 606Leuprolide 528Metoprolol 608Levamisole 529Metronidazole 610Levetiracetam 532Mexiletine HCl 613Levothyroxine Sodium 534Mibolerone 614Lidocaine HCl 536Midazolam HCl 616Lincomycin HCl 539Milbemycin Oxime 618Liothyronine Sodium 541Mineral Oil 620Lisinopril 542Minocycline HCl 621Lomustine 544Mirtazapine 623Loperamide HCl 545Misoprostol 625Lorazepam 547Mitotane 627Lufenuron 548Mitoxantrone HCl 629Lysine 550Morantel Tartrate 631Magnesium Hydroxide 551Morphine Sulfate 632
Moxidectin 635Pentosan Polysulfate Sodium 712Mycobacterial Cell Wall Fraction Immunomodulator 637Pentoxifylline 714Mycophenolate Mofetil 639Pergolide Mesylate 715Naloxone HCl 641Phenobarbital 717Naltrexone HCl 642Phenoxybenzamine HCl 720Nandrolone Decanoate 643Phenylbutazone 722Naproxen 645Phenylephrine HCl 724Narcotic (Opiate) Agonist Analgesics, Pharmacology of 647Phenylpropanolamine HCl 726N-Butylscopolammonium Bromide 647Phenytoin Sodium 727Neomycin Sulfate 648Pheromones 730Neostigmine 651Phosphate, Parenteral 731Niacinamide 652Physostigmine Salicylate 733Nitazoxanide 653Phytonadione 734Nitenpyram 655Pimobendan 736Nitrofurantoin 656Piperacillin Sodium 738Nitroglycerin 658Piperacillin Sodium Tazobactam 739Nitroprusside Sodium 659Piperazine 741Nizatidine 661Pirlimycin HCl 743Novobiocin Sodium 662Piroxicam 744Nystatin 664Polysulfated Glycosaminoglycan 746Octreotide Acetate 665Ponazuril 747Olsalazine Sodium 666Potassium 748Omeprazole 667Pralidoxime Chloride 750Ondansetron 669Praziquantel 751Orbifloxacin 670Prazosin HCl 754Oseltamivir Phosphate 671Prednisolone 755Oxacillin Sodium 673Prednisone 755Oxazepam 675Primaquine Phosphate 762Oxfendazole 676Primidone 764Oxibendazole 677Probenecid 766Oxybutynin Chloride 678Procainamide HCl 767Oxymorphone HCl 679Procarbazine HCl 770Oxytetracycline 682Prochlorperazine 771Oxytocin 685Promethazine HCl 773Pamidronate Disodium 688Propantheline Bromide 775Pancrelipase 689Propionibacterium Acnes Injection 777Pancuronium Bromide 690Propofol 778Pantoprazole 692Propranolol HCl 780Parapox Ovis Virus Immunomodulator 693Protamine Sulfate 783Paregoric 694Pseudoephedrine HCl 784Paromomycin Sulfate 695Psyllium Hydrophilic Mucilloid 785Paroxetine HCl 696Pyrantel Pamoate 786Penicillamine 698Pyridostigmine Bromide 788Penicillins, General Information 699Pyridoxine HCl (Vitamin B-6) 790Penicillin G 701Pyrilamine Maleate 791Penicillin V Potassium 705Pyrimethamine 792Pentazocine 707Pyrimethamine Sulfadiazine 794Pentobarbital Sodium 709Quinacrine HCl 796
Quinidine 797Thioguanine 870Ramipril 800Thiopental Sodium 872Ranitidine HCl 801Thiotepa 874Rifampin 803Thyrotropin 875Romifidine HCl 805Tiamulin 876Ronidazole 807Ticarcillin Disodium 877S-Adenosyl-Methionine (SAMe) 809Ticarcillin Disodium Clavulanate Potassium 880Saline/Hyperosmotic Laxatives 810Tiletamine HCl/Zolazepam HCl 882Selamectin 812Tilmicosin 884Selegiline HCl 814Tiludronate Disodium 885Sertraline HCl 815Tiludronic Acid 885Sevelamer HCl 817Tinidazole 887Sevoflurane 818Tiopronin 888Sildenafil Citrate 820Tobramycin Sulfate 889Silymarin; Milk Thistle 821Tocainide HCl 892Sodium Bicarbonate 822Tolazoline HCl 893Sodium Polystyrene Sulfonate 825Tolfenamic Acid 895Sodium Stibogluconate; Sodium Antimony Gluconate 826Toltrazuril 896Sodium Sulfate 827Topiramate 897Sodium Thiosulfate 827Torsemide 898Somatotropin 828Tramadol HCl 900Sotalol HCl 829Triamcinolone Acetonide 901Spectinomycin HCl 831Triamterene 905Spinosad 1015Trientine HCl 906Spironolactone 832Trilostane 907Stanozolol 834Trimeprazine Tartrate With Prednisolone 909Staphylococcal Phage Lysate 836Tripelennamine HCl 910Streptokinase 837Tulathromycin 911Streptozocin 838Tylosin 913Succimer 839Ursodiol 915Succinylcholine Chloride 841Valproic Acid 916Sucralfate 843Vanadium 918Sufentanil Citrate 844Vancomycin HCl 919Sulfachlorpyridazine Sodium 846Vasopressin 920Sulfadiazine/Trimethoprim 847Vecuronium Bromide 922Sulfamethoxazole/Trimethoprim 847Verapamil HCl 923Sulfadimethoxine 851Vinblastine Sulfate 925Sulfadimethoxine/Ormetoprim 853Vincristine Sulfate 927Sulfasalazine 854Vitamin E/Selenium 929Taurine 856Voriconazole 931Tepoxalin 857Warfarin Sodium 933Terbinafine HCl 858Xylazine HCl 935Terbutaline Sulfate 859Yohimbine HCl 938Testosterone 861Zafirlukast 939Tetracycline HCl 863Zidovudine (AZT) 940Theophylline 37Zinc 942Thiabendazole 867Zonisamide 943Thiamine HCl 869
appendixOphthalmic Products, Topical 945Ketorolac 956Routes of Administration For Ophthalmic Drugs 945Suprofen 957Diagnostic Agents 946Nepafenac 957Steroidal Anti-inflammatory Agents 957Fluorescein Sodium 946Prednisolone Acetate 957Lissamine Green 946Dexamethasone 957Phenol Red Thread 947Loteprednol Etabonate 957Proparacaine 947Rose Bengal 947Corticosteroids, Topical 957Ophthalmic Analgesics 959Schirmer Tear Test 947Morphine Sulfate 959Tetracaine 948Nalbuphine 959Glaucoma, Topical Agents 948Parasmpathomimetics (Miotics) 949Antimicrobial Ophthalmic Therapy 959Antibiotics, Single & Combination Agents 959Pilocarpine 949Chloramphenicol 960Demecarium 949Ciprofloxacin 960Echothiophate Iodide 949Gatifloxacin 960Sympathomimetics 950Levofloxacin 960Apraclonidine 950Moxifloxacin 960Brimonidine 950Norfloxacin 960Beta-Adrenergic Antagonists 950Ofloxacin 960Betaxolol 950Gentamicin 961Carteolol 951Tobramycin 961Levobunolol 951Sulfacetamide 961Metipranolol 951Tetracycline 961Timolol 951Oxytetracycline 961Carbonic Anhydrase Inhibitors 952Brinzolamide 952Dorzolamide 952Antibiotic Combinations 962Antibiotic and Corticosteroid Combinations 962Antifungals 963Prostaglandins 952Amphotericin B 963Latanaprost 952Povidone Iodine 963Bimatoprost 952Natamycin 964Travoprost 952Miconazole 964Miscellaneous Agents for Treatment of Glaucoma 953Epinephrine 953Mydriatic-Cycloplegic Vasoconstrictors 953Cyclopentolate 953Silver Sulfadiazine 964Itraconazole 965Voriconazole 965Antivirals 966Phenylephrine 953Trifluridine 966Atropine 954Idoxuridine 967Tropicamide 954Interferon Alpha 967Anti-inflammatory/Analgesic Ophthalmic Agents 955Mast Cell Stabilizers, Antihistamines, Decongestants 955Acyclovir 967Valacyclovir 967Cromolyn Sodium 955Famciclovir 967Lodoxamine 955Ganciclovir 967Olopatadine 955Cidofovir 967Non-Steroidal Antiinflammatory Agents 955Penciclovir 967Bromfenac 955Keratoconjunctivitis Sicca 968Diclofenac 956Cyclosporine 968Flurbiprofen 956Tacrolimus 969
Artificial Tear Products/Ocular Lubricants 969Ophthalmic Irrigants 969Topical Hyperosmotic Agents 970Antifungal Agents 994Clotrimazole 994Enilconazole 994Polysulfonated glycosaminoglycan 970Ketoconazole 995Hypertonic Sodium Chloride 970Lime Sulfur 995Viscoelastic Substances 970Hyaluronic Acid 971Cytotoxic Ophthalmic Agents 971Cisplatin beads 9715-Fluorouracil 971Mitomycin-C 971Sympathomimetics 972Hydroxyamphetamine 972Cocaine 972Miconazole 996Nystatin 997Selenium Sulfide 998Terbinafine HCl 999Keratolytic Agents 1000Salicylic Acid 1000Sulfur, Precipitated 1001Coal Tar 1002Antiseborrheic Products 1003Anticollagenase Agent 972Phytosphingosine 1003Acetylcysteine 972Immunomodulators, Topical 1003Edetate Disodium 972Imiquimod 1003Principles of Compounding Ophthalmic Products 973Tacrolimus 1004Dermatological Agents, Topical 976Pimecrolimus 1004Non-Corticosteroid Antipruritics 976Aluminum Acetate Solution 976Diphenhydramine HCl 977Retinoids 1005Tretinoin 1005Antiparasitic Agents, Topical 1006Pramoxine HCl 977Amitraz 1006Colloidal Oatmeal 978Crotamiton 1007Phenol/Menthol/Camphor 979Fipronil (S)-Methoprene 1008Lidocaine 979Imidacloprid 1009Lidocaine/Prilocaine (EMLA Cream) 979Imidacloprid with Permethrin 1009Antiinflammatory Agents 980Corticosteroids 980Imidacloprid with Moxidectin 1009Metaflumizone 1010Hydrocortisone 980(s)-Methoprene Combinations 1010Triamcinolone Acetonide 982Pyriproxyfen & Pyriproxyfen Combinations 1011Betamethasone 983Permethrin 1012Isoflupredone Acetate 984Pyrethrins and Pyrethrin Combinations 1013Antiinfectives, Topical 985Antibacterial Agents 985Spinosad 1015OTIC Preparations 1016Gentamicin Sulfate 985Ear Cleaners/Flushes/Antiseptic/Disinfectants 1016Bacitracin and Bacitracin Combinations 986Corticosteroid/Antiinflammatory 1017Benzoyl Peroxide 987Antimicrobial (Antibacterial) 1018Clindamycin 988Antimicrobial (Antifungal) 1018Mupirocin 988Corticosteroid Antimicrobial 1018Nitrofurazone 989Antiparasitic Preparations 1019Silver Sulfadiazine (SSD) 990Antiseptics 990Small Animal Therapeutic Diets 1020Therapeutic Diets for Dogs 1021Chlorhexidine 990Modified Fiber Diets for Dogs 1021Ethyl Lactate 992Novel Protein Diets for Dogs 1021Povidone Iodine 992Nutrient Dense Diets for Dogs 1024Triclosan 993Reduced Fat Diets for Dogs 1026Reduced Sodium Diets for Dogs 1028
Reduced Protein/Phosphorus Diets for Dogs 1029Hematology: Canine, Feline, Bovine, Equine 1057Reduced Energy Diets for Dogs 1030Coagulation: Canine, Feline, Bovine, Equine 1058Restricted Mineral Diets for Dogs 1032Urinalysis: Canine, Feline 1058Geriatric Diets for Dogs 1032Cerebral Spinal Fluid: Canine, Feline 1058Dental Diets for Dogs 1034Ferret: Male Albino 1059Other Therapeutic Diets for Dogs 1034Rabbit: Female New Zealand White 1059Therapeutic Diets for Cats 1035Avian: Macaws 1059Modified Fiber Diets for Cats 1035Avian: Parrots, African Grey 1059Novel Protein Diets for Cats 1036Hematology: Sheep, Goats, Swine 1060Nutrient Dense Diets for Cats 1037Chemistry: Sheep, Goats, Swine 1060Reduced Fat Diets for Cats 1038Restricted Mineral Diets for Cats 1040Phone Numbers and Websites 1061Reduced Energy Diets for Cats 1041Food and Drug Administration Center for Veterinary Medicine(FDA-CVM) 1061Reduced Phosphorus/Protein for Cats 1043U.S. Department of Agriculture (USDA) 1061Reduced Sodium for Cats 1044U.S. Environmental Protection Agency (EPA) 1061Geriatric Diets for Cats 1045Food Animal Residue Avoidance Databank (FARAD) 1061Other Therapeutic and Hairball Diets for Cats 1046Drug Enforcement Administration (DEA) 1061Overdose and Toxin Exposure Decontamination Guidelines 1047Animal Poison Centers 1061ARCI UCGFS Classifications 1049Animal Blood Banks 1061Chemotherapy Protocols for Treatment of Neoplastic DiseasesIn Small Animals 1050Veterinary Pharmaceutical Manufacturers & Suppliers 1062Canine Lymphoma Protocols 1050References 1066Prednisone Chlorambucil Protocol 1050COP (Cyclophosphamide-Vincristine-Prednisone) Protocol 1050Legally Importing Drugs for Compassionate Use into the USA 1065Systemic Drugs Sorted by Therapeutic Class or Major Indication1099Doxorubicin Protocol 1050Antihistamines 1099Wisconsin-Madison Protocol—Short 1051Central Nervous System Drugs 1099VELCAP-S Protocol 1051Euthanasia Agents 1099Other Canine Protocols 1051Cardiovascular Agents 1099Canine Sarcoma & Carcinoma Treatment Protocol “AC” 1051Respiratory Drugs 1100Canine Osteogenic Sarcoma Adjuvant Protocol 1051Renal And Urinary Tract Agents 1100Mast Cell Tumor Protocol 1052Gastrointestinal Agents 1100Feline Lymphoma Protocols 1052Hormones/Endocrine/Reproductive Agents 1100COPLA Protocol 1052Anti-Infective Drugs 1101COP Protocol 1052Blood Modifying Agents 1102COAP Protocol 1052Fluid & Electrolyte Modifiers 1102Ferret Lymphoma Protocols 1052Ferret LSA Protocol 1052Antineoplastics 1102Immunomodulators 1102Conversion Tables for Weight in Kilograms to Body Surface Area(m2) 1052Antidotes 1102Tables of Parenteral Fluids 1053Dermatologic Agents (Systemic) 1103Abbreviations Used In Prescription Writing 1054Vitamins And Minerals/Nutrients 1103Solubility Definitions 1055Cholinergic Muscle Stimulants 1103Conversion: Weights; Temperature; Liquids 1055Systemic Acidifiers 1103Milliequivalents & Molecular Weights 1055Systemic Alkalinizers 1103“Normal” Vital Signs 1055Unclassified 1103Estrus and Gestation Periods for Dogs & Cats 1056Conversion of Conventional Chemistry Units to SI Units 1056Reference Laboratory Ranges 1057Chemistry: Canine, Feline, Bovine, Equine 1057Bone/Joint Agents 1102Index 1104
Adverse EffectsAdverse effects re ported in cats include flatulence, soft stools anddiar rhea; in dogs, diarrhea and weight loss. Ad verse effects are morelikely at higher doses.While acarbose alone does not cause hypo glycemia, it may contribute to it by reducing the rate and amount of glucose absorbedwhen the patient is receiving other hypoglycemic agents (insulin,oral hypoglycemics).Acarbose(ay-kar-bose) Precose Oral AntidiabeticPrescriber HighlightsAntihyperglycemic agent that reduces the rate & amountof glucose absorbed from the gut after a meal; may beuse ful for mild reductions in blood glucose in dogs or catsTTContraindications: Underweight animals, known hypersensitivity, diabetic ketoacidosis, inflammatory bowel disease, colonic ulceration, partial intestinal obstruction orpredis position to obstruction, chronic intestinal diseasewith marked disorders of digestion or absorption & whenexcessive gas formation would be detrimentalTTDose–dependent diarrhea & flatulence are the adverseeffects most likely to be notedTTGive with meals (preferably right before)TTExpense may be an issueTTReproductive/Nursing SafetySafety in pregnancy has not been established; weigh any potentialrisks versus benefits in preg nant animals. In humans, the FDA categorizes this drug as category B for use during pregnancy (Animalstudies have not yet demonstrated risk to the fetus, but there are noadequate studies in pregnant women; or animal studies have shownan adverse effect, but adequate studies in pregnant women have notdemonstrated a risk to the fetus in the first trimester of pregnancy, andthere is no evidence of risk in later trimesters.)Overdosage/Acute ToxicityAcute overdosages are likely to cause only diarrhea and flatulence.No treatment should be necessary. Should acute hypoglycemiaoccur secondary to other antihy po glycemics, parenteral glucoseshould be admin istered. If treating orally, use glucose (do not usesucrose).Uses/IndicationsMay be useful for mild reduc tions in blood glucose concentrations(250 – 350 mg/dl range) in dogs and cats with non-insulin-dependent diabetes mellitus and as adjunctive treat ment of insulin dependent diabetes mellitus.Drug InteractionsThe following drug interactions have either been reported or aretheoretical in humans or animals receiving acarbose and may be ofsignificance in veterinary patients:!!Charcoal: Intestinal adsorbents may reduce the efficacy of acarbose!!Digoxin: Acarbose may reduce digoxin blood concentrations!!Hyperglycemic agents (corticosteroids, thiazides, estrogens, phe nothiazines, thyroid hormones, and calcium chan nel blockers): Maynegate the effects of acarbose!!Pancreatin, Pancrelipase, or Amylase: Exogenous enzyme formulations may reduce the efficacy of acarbosePharmacology/ActionsAcarbose competitively inhibits pancreatic alpha-amylase andalpha-glucosidases found in the small intestine. This delays thediges tion of complex carbohydrates and disaccharides to glucoseand other monosaccharides. Glucose is absorbed lower in the GItract in lesser amounts than is normal thereby reducing insulin re quirements during the postprandial hyperglycemic phase. Acarbosehas no effect on lactase.Laboratory Considerations!!Increased serum aminotransferase levels have been noted in somehumans taking high dosages for a long periodPharmacokineticsIn dogs about 4% of an oral dose is absorbed; in humans only about2% of an oral dose is absorbed from the gut which is then ex cretedby the kidneys. Practically all remaining drug in the gut is metabolized in the GI tract by intestinal bacteria. Patients with severe renal dys function attain serum levels approximately 5 times those ofnormal subjects.Doses!!Dogs:a) For dogs poorly controlled with insulin and dietary therapywhen another reason for the poor control cannot be identified: Initially 12.5 – 25 mg total dose per dog PO with eachmeal. Give only at the time of feeding. May increase doseafter two wee
Plumb’s Veterinary Drug Handbook. continues to evolve with the addition of more drugs, more types of drugs (topical dermatology drugs), and a new look; however, the basic premise remains to serve as a single volume reference
