Pharmacokinetics of potassium bromide in adult horses

Abstract

and clinical relevance Loading doses of 120 mg/kg daily over 5 d and maintenance doses of approximately 90 mg/kg of KBr administered once daily resulted in serum bromide concentrations consistent with therapeutic efficacy for the management of seizures in other species. The clinical efficacy of this agent as an anticonvulsant medication and/or calmative in horses warrants further investigation.

Disposition of levetiracetam in healthy adult horses

“…While pharmacokinetic data are available for gabapentin and pregabalin in horses, poor oral bioavailability, significant sedation, and colic signs will likely limit the use of these new AED drugs in the horse (Mullen, Schwark, & Divers, ; Terry et al., ). Therefore, treatment for seizure disorders in horses remains limited to conventional first‐line AEDs such as phenobarbital and potassium bromide (Raidal & Edwards, ; Reimer & Sweeney, ).…”

Differential Diagnosis and Management of Horses with Seizures or Alterations in Consciousness

“…21,30 Bromide (sodium or potassium) is another anticonvulsant drug which can be used in the horse. 13,31 Potassium bromide is the oldest anticonvulsant drug and was first used in 1857 to treat seizures in people. Potassium bromide has experienced a resurgence of its use in the management of canine epilepsy, and more recently in horses that were refractory to phenobarbital (e.g., inadequate control of seizures despite adequate to high serum phenobarbital levels).…”

“…Hence, potassium bromide should not be the sole agent used to treat ongoing seizures. 31,32 Potassium bromide (initial dose of 25-40 mg/kg/ day PO) should be administered in combination with phenobarbital. The suggested therapeutic concentration, based on a study in dogs, is 1-3 mg/ml when used as a monotherapy and 1-2 mg/ml when used in combination with phenobarbital.…”

“…33 When used as monotherapy in horses, a loading dose of 120 mg/kg daily over 5 days followed by a maintenance dose of 40 mg/kg/day was associated with a serum concentration of 1 mg/ml, which is within the therapeutic window reported in other species. 31 Toxic effects have been reported in dogs with serum concentration above 2.7 mg/ml. 34,31 Bromide toxicosis (bromism), which can occur in people with chronic oral administration, appears to be rare in horses.…”

“…31 Toxic effects have been reported in dogs with serum concentration above 2.7 mg/ml. 34,31 Bromide toxicosis (bromism), which can occur in people with chronic oral administration, appears to be rare in horses. One study reported bromide toxicity in horses fed hay that contained bromide ion residue from accidental treatment with methyl bromide.…”