Postoperative pharmacokinetics of meloxicam in horses after surgery for colic syndrome

Salvo, Alessandra Di; Giorgi, Mario; Nannarone, Sara; Lee, H. K; Corsalini, Jacopo; Rocca, Giorgia Della

doi:10.1111/jvp.12461

Cited by 11 publications

(9 citation statements)

References 29 publications

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“…Pharmacokinetic results for the intravenous formulation were similar to those reported previously . Protein binding analysis yielded that meloxicam was highly bound to plasma proteins.…”

Section: Discussionsupporting

confidence: 82%

“…Several formulations are marketed for equids both adults and foals in Europe, Australia, and New Zealand . At this time, pharmacokinetic (PK) studies in healthy and postoperative animals have been only reported for intravenous and oral routes, specifically suspension and tablets (off‐label use) formulations . On the other hand, PK parameters of a granule oral formulation, which is used in equine practice in Europe, Australia, and New Zealand, have not been evaluated.…”

Section: Introductionmentioning

confidence: 99%

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Pharmacokinetics of meloxicam after oral administration of a granule formulation to healthy horses

Mendoza

Serrano-Rodríguez

Pérez-Écija

2019

Veterinary Internal Medicne

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Background Nonsteroidal anti‐inflammatory drugs are administered in horses for several systemic diseases. Selective cyclooxygenase‐2 inhibitors are preferred because of lower risk of adverse effects. Several meloxicam formulations have been tested in horses, but a recently marketed granule oral formulation has not been studied. Objective To characterize the pharmacokinetics of a novel granule meloxicam formulation in fasted and fed horses, and to compare pharmacokinetic features with oral suspension and tablets. Animals Seven healthy adult horses. Methods Meloxicam was administered at 0.6 mg/kg in fasted or fed horses. Blood samples were collected for pharmacokinetic analysis, and vital signs, hematology, and biochemistry variables were monitored for 72 hours. Results No adverse effects were detected. Volume of distribution and clearance after intravenous administration of meloxicam were 0.36 L/kg and 29.12 mL/h/kg, respectively, with a 12.39 hours of terminal half‐life. Protein binding was of 97%. Bioavailability was high for every oral formulation, ranging 70%‐110%, without feed effect. Because of a slower absorption, meloxicam after administration of granules had a longer half‐life (24 and 34 hours, fasted and fed, respectively) and mean residence time (31 and 47 hours), than suspension and tablets (ranging 10‐13 and 13‐15 hours, respectively). In addition, the time above therapeutic concentration was higher for the granule formulation than other formulations. Conclusions and Clinical Importance Granule formulation has different PK parameters compared to other oral formulations, which could enable this formulation to be used for different dosage regimens in order to reach a desired clinical effect or decrease the risk of adverse effects.

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“…Pharmacokinetic results for the intravenous formulation were similar to those reported previously . Protein binding analysis yielded that meloxicam was highly bound to plasma proteins.…”

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Pharmacokinetics of meloxicam after oral administration of a granule formulation to healthy horses

Mendoza

Serrano-Rodríguez

Pérez-Écija

2019

Veterinary Internal Medicne

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“…The clinical trial demonstrated that flunixin provided superior analgesia in the post‐operative period of horses that had undergone surgery to correct strangulating small intestinal lesions even when meloxicam was used twice daily . Pharmacological studies suggest that an increased dosing frequency is unnecessary in the post‐surgical colic and that higher doses used in this study may offset any potential benefits of COX‐2 selectivity. In an experimental model of colic, in which NSAIDs were administered before the ischaemic model of colic was induced, there was no difference in pain score between horses given meloxicam or flunixin in the 24‐h post‐operative period.…”

Section: Resultsmentioning

confidence: 80%

BEVA primary care clinical guidelines: Analgesia

Bowen

Redpath

Dugdale

et al. 2019

Equine Veterinary Journal

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Summary Primary care guidelines provide a reference point to guide clinicians based on a systematic review of the literature, contextualised by expert clinical opinion. These guidelines develop a modification of the GRADE framework for assessment of research evidence (vetGRADE) and applied this to a range of clinical scenarios regarding use of analgesic agents. Key guidelines produced by the panel included recommendations that horses undergoing routine castration should receive intratesticular local anaesthesia irrespective of methods adopted and that horses should receive NSAIDs prior to surgery (overall certainty levels high). Butorphanol and buprenorphine should not be considered appropriate as sole analgesic for such procedures (high certainty). The panel recommend the continuation of analgesia for 3 days following castration (moderate certainty) and conclude that phenylbutazone provided superior analgesia to meloxicam and firocoxib for hoof pain/laminitis (moderate certainty), but that enhanced efficacy has not been demonstrated for joint pain. In horses with colic, flunixin and firocoxib are considered to provide more effective analgesia than meloxicam or phenylbutazone (moderate certainty). Given the risk of adverse events of all classes of analgesic, these agents should be used only under the control of a veterinary surgeon who has fully evaluated a horse and developed a therapeutic, analgesic plan that includes ongoing monitoring for such adverse events such as the development of right dorsal colitis with all classes of NSAID and spontaneous locomotor activity and potentially ileus with opiates. Finally, the panel call for the development of a single properly validated composite pain score for horses to allow accurate comparisons between medications in a robust manner.

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“…The aim of this study by A. Di Salvo and colleagues in Italy and South Korea was to evaluate the pharmacokinetic profile of meloxicam after intravenous administration in horses undergoing laparotomy for colic syndrome .…”

Section: Pharmacokinetics Of Meloxicam After Colic Surgerymentioning

confidence: 99%

Highlights of recent clinically relevant papers

Wright¹

2017

Equine Veterinary Education

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Postoperative pharmacokinetics of meloxicam in horses after surgery for colic syndrome

Cited by 11 publications

References 29 publications

Pharmacokinetics of meloxicam after oral administration of a granule formulation to healthy horses

Pharmacokinetics of meloxicam after oral administration of a granule formulation to healthy horses

BEVA primary care clinical guidelines: Analgesia

Highlights of recent clinically relevant papers

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