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Question Posted April 23, 2006
Have any of you been using Previcox in your practice, and so what has your experience been?
Carolina Nyarady
Response 1
We have it, and have used it a few times. My overall impression was that it didn't do significantly better than the other NSAIDs we have, and one dog developed diarrhea on it. However, we haven't used it very extensively (I think this is due in part to cost and part to unfamiliarity).
Rachel Davis
Response 2
We are a 5 DVM practice and have been using firocoxib since it became available on the market with good success (a couple cases of diarrhea and unimpressive results as we have seen with the whole NSAID group). Honestly, I am not convinced it is "more effective" then meloxicam or deracoxib. I do really like the ease of dosing firocoxib.
We use meloxicam extensively as a routine pre and post-op NSAID. This of course made my Merial rep very happy when Merial was distributing meloxicam. Now that Boehringer Ingelheim took over the US marketing of it, my Merial rep wants me to replace all of our meloxicam use with firocoxib. The meloxicam seems to be working fine, and we like the injectable option for pre-op patients so I see no reason to change it at this time.
Dennis Chmiel
Response 3
We are a 2 person practice and have used meloxicam since it was introduced by Merial. We use it as a pre-op, along with buprenorphine, and send it home for post op use. Whenever dispensing flavored Nsaids, we add a written label (with bright orange background) that instructs the client to store the meloxicam in a secure cabinet and NOT leave it on a counter where the dog might steal it - also the technician dispensing the drug reviews this command verbally to the client. I've heard of 1 horror story where an individual bought a large quantity of a Cox II inhibitor from a veterinary wholesaler and you guessed it - the dog got to the whole jug - the dog did survive but only after 2 weeks in an ICU. I wonder how much money that individual really saved!
Would someone clue me in on the Rimadyl controversy - I've heard rumors of reactions, but have seen no published articles (maybe I'm reading the wrong journals!). Pfizer sent out an advisory contradicting what they considered unscientific findings. Thanks.
Harry Fritz
Response 4
I've not seen any adverse reaction after rimadyl administration either the injectable form or the oral in adult dogs, even after long term use (see also: Raekallio MR et al. Evaluation of adverse effects of long-term orally administered carprofen in dogs. J Am Vet Med Assoc. 2006 Mar 15;228(6):876-80). There is a report for non fatal hepatocellular toxicosis in dogs
(MacPhail CM, et al. Hepatocellular toxicosis associated with administration of carprofen in 21 dogs. J Am Vet Med Assoc. 1998 Jun 15;212(12):1895-901) but as I've said, although I use a lot of carprofen. I've never seen such a reaction.
George M. Kazakos
Response 5
We just started using Previcox, and, so far, so good. No better/worse than the others.
Regarding Rimadyl, several years ago there was a suggestion (and, there were a few papers) that laborador retreivers were developing liver failure and dying from carprofen. However, given the high percent of old, arthritic labs, out there, it was considered that THAT may have been why. Other breeds do have issues w/ carprofen, as well as the other NSAIDs. We have only had 2 dogs develop severe liver problems w/ Rimadyl; one was an old Golden who was vomiting for 10 days prior to the owner calling us - all clients are warned a minimum of 3 times regarding loss of appetite, v/d, etc and to discontinue the meds; and, it's printed on the label and invoice. This owner was so impressed w/ the improvement in the dog that he didn't stop it. "Molson" was icteric and quite ill when brought in, but, w/ supportive care, recovered. The other was an old Cocker whose owner did discontinue the drug quite quickly, and he recovered. We have had a handful of dogs that we had to stop one or another NSAID due to anorexia, v/d, but, no more frequently than w/ some antibiotics.Both severe reactions were reported to the manufacturer, who reimbursed the owners for some of the workup - very impressive.
Our take on it is that if the drugs are used appropriately, and the owners follow our warnings, that there are usually no more problems than w/ many of the drugs that we use.
Kathy Morris-Stilwell
Response 6
To add another view, I've been practicing in a 4 doctor practice for just less than 2 years and have already had a case of non-fatal hepatotoxicity after administration of Rimadyl to a 3 year old Lab. Thankfully, we require bloodwork before and 3-4 weeks after starting any NSAID long term (and then q6 months.) So, I caught this case only 3 weeks into giving the drug. Interestingly, the dog is doing very well on Deramaxx after a 3 week washout period during which the liver levels returned to normal. I spoke with the makers of Rimadyl and they were quite happy to take my adverse report by phone and even passed it on to the FDA for me.
Cheryl Roth
Response 7
We use Meloxicam mostly in dogs for long term use. We have used Rimadyl and are sing it consistently post surgery. We require pre-op blood work and pre-long term usage blood work and have not had any Rimadyl related incidences. (Yet?) We have had a few (4 ) cases of meloxicam induced ulcerative gastritises after months on the medication.
David J. Kerr
Response 8
We have been using Previcox very frequently since it came out. While it is hard to subjectively say if it is more or less effective than other NSAIDs, it has been very well accepted by clients and by patients. I have had no patients show any side effects thus far, and have had very good feedback from clients that they believe it is effective. Recently I have had one client switch to Previcox from Rimadyl and one from Deramaxx, both of whom were not satisfied by the previous choice, and both of which are very happy with Previcox. It can be substantially more expensive than some of the other choices, depending upon the weight of the dog.
Craig D. Maloney
Response 9
We have had good results with Previxcox in selected patients. We have had severe liver disease in one 10 year old Great Dane after 4 months on the drug with normal labs at start, 2 weeks and 6 weeks.
Ernest Godfrey
Response 10
We use Previcox frequently for osteoarthritis and are as pleased with it as prior NSAIDs (mostly Rimadyl). So far, have not had any GI upset (but haven't used it near as many times). I did have several cases of GI upset with Rimadyl and one Labrador that had hepatotoxicity years ago, but recovered uneventfully. Also using Metacam postop for dogs and cats with good results.
Laura Gaylord