Carprofen
Encyclopedia
Carprofen is a non-steroidal anti-inflammatory drug
Non-steroidal anti-inflammatory drug
Nonsteroidal anti-inflammatory drugs, usually abbreviated to NSAIDs or NAIDs, but also referred to as nonsteroidal anti-inflammatory agents/analgesics or nonsteroidal Anti-inflammatory medicines , are drugs with analgesic and antipyretic effects and which have, in higher doses, anti-inflammatory...

 that is used by veterinarian
Veterinarian
A veterinary physician, colloquially called a vet, shortened from veterinarian or veterinary surgeon , is a professional who treats disease, disorder and injury in animals....

s as a supportive treatment for the relief of arthritic
Arthritis
Arthritis is a form of joint disorder that involves inflammation of one or more joints....

 symptoms in geriatric dog
Dog
The domestic dog is a domesticated form of the gray wolf, a member of the Canidae family of the order Carnivora. The term is used for both feral and pet varieties. The dog may have been the first animal to be domesticated, and has been the most widely kept working, hunting, and companion animal in...

s. It is also used for pain relief and to reduce swelling after spay or neuter. It can be used both short term, for joint
Joint
A joint is the location at which two or more bones make contact. They are constructed to allow movement and provide mechanical support, and are classified structurally and functionally.-Classification:...

 pain or post-operative inflammation
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...

, or for day-to-day relief from the pain and inflammation associated with osteoarthritis
Osteoarthritis
Osteoarthritis also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion...

, hip dysplasia, and other forms of joint deterioration .

Carprofen reduces inflammation by inhibiting the production of COX-2
Cyclooxygenase
Cyclooxygenase is an enzyme that is responsible for formation of important biological mediators called prostanoids, including prostaglandins, prostacyclin and thromboxane. Pharmacological inhibition of COX can provide relief from the symptoms of inflammation and pain...

 and other sources of inflammatory prostaglandin
Prostaglandin
A prostaglandin is any member of a group of lipid compounds that are derived enzymatically from fatty acids and have important functions in the animal body. Every prostaglandin contains 20 carbon atoms, including a 5-carbon ring....

s. This is targeted protection, in that it does not interfere with the activity of COX-1.

Administration

Carprofen is available in the USA in 25, 75 and 100 mg tablets (given either with food or straight into the animal's mouth), and in injectable
Injection (medicine)
An injection is an infusion method of putting fluid into the body, usually with a hollow needle and a syringe which is pierced through the skin to a sufficient depth for the material to be forced into the body...

 form. In the UK, it is available in 20, 50 and 100 mg tablets. The usual dosage is 4.4 mg per kilogram (2.0 mg/lb) daily.
In Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...

, Carprofen is marketed as Norocarp or Tergive Injection. Norocarp is available in 20 mg and 50 mg tablets or Norophen in injectable liquid at 5.0% w/v, for cattle
Cattle
Cattle are the most common type of large domesticated ungulates. They are a prominent modern member of the subfamily Bovinae, are the most widespread species of the genus Bos, and are most commonly classified collectively as Bos primigenius...

 and canines
Dog
The domestic dog is a domesticated form of the gray wolf, a member of the Canidae family of the order Carnivora. The term is used for both feral and pet varieties. The dog may have been the first animal to be domesticated, and has been the most widely kept working, hunting, and companion animal in...

. Carprofen is also marketed in many Latin-American (and some Asian and African countries) as Carprodyl in 25 mg and 100 mg tablets for canines
Dog
The domestic dog is a domesticated form of the gray wolf, a member of the Canidae family of the order Carnivora. The term is used for both feral and pet varieties. The dog may have been the first animal to be domesticated, and has been the most widely kept working, hunting, and companion animal in...

 and Carprobay in 20mg and 50mg tablets for dogs.

Carprofen is sometimes divided between morning and evening doses. It is administered two hours before surgery when being used to relieve post-operative pain.

Health issues

Most dogs respond well to carprofen use, but like all non-steroidal anti-inflammatory (NSAID) medications used in humans and animals, it is capable of causing gastrointestinal, liver and kidney problems in some patients.

After introduction there were significant anecdotal reports of sudden animal deaths arising from its use. To date, the FDA has received more than 6,000 adverse reaction reports about the drug (manufactured by Pfizer). As a result, the FDA requested that Pfizer advise consumers in their advertising that death was a possible side effect. Pfizer refused and pulled their advertising, however they have included "death" as a possible side effect on the drug label. Plans call for a "Dear Doctor" letter to be issued to veterinarians and a safety sheet will be attached to pill packages.

Pfizer acknowledges a problem with some dog owners, especially the consumer group which mounted a campaign dubbed BARKS, for Be Aware of Rimadyl's Known Side-effects (including loss of appetite, wobbling, vomiting, seizures and severe liver malfunction). The drug company is reported to be contacting pet owners who have told their stories on the Internet, and is offering to pay medical and diagnostic expenses for some dogs who may have been harmed by carprofen.

General symptoms to watch for include:
  • Loss of appetite
  • Vomiting
  • Diarrhea
  • Increase in thirst
  • Increase in urination
  • Fatigue and/or Lethargy
  • Loss of coordination
  • Seizures


Other symptoms which can indicate a problem, and which are worth raising with a vet include excessive drinking or urination, blood or dark tar-like material in urine
Urine
Urine is a typically sterile liquid by-product of the body that is secreted by the kidneys through a process called urination and excreted through the urethra. Cellular metabolism generates numerous by-products, many rich in nitrogen, that require elimination from the bloodstream...

 or stools, jaundice
Jaundice
Jaundice is a yellowish pigmentation of the skin, the conjunctival membranes over the sclerae , and other mucous membranes caused by hyperbilirubinemia . This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluid...

 (yellowing of eyes), unusual lethargy and so on.

Other side effects of Rimadyl include:
  • Black, tarry stools or flecks of blood in the vomit
  • Drowsiness
  • Staggering, stumbling, weakness or partial paralysis
    Paralysis
    Paralysis is loss of muscle function for one or more muscles. Paralysis can be accompanied by a loss of feeling in the affected area if there is sensory damage as well as motor. A study conducted by the Christopher & Dana Reeve Foundation, suggests that about 1 in 50 people have been diagnosed...

    , full paralysis, dizziness
    Dizziness
    Dizziness refers to an impairment in spatial perception and stability. The term is somewhat imprecise. It can be used to mean vertigo, presyncope, disequilibrium, or a non-specific feeling such as giddiness or foolishness....

    , loss of balance.
  • Change in urination
    Urination
    Urination, also known as micturition, voiding, peeing, weeing, pissing, and more rarely, emiction, is the ejection of urine from the urinary bladder through the urethra to the outside of the body. In healthy humans the process of urination is under voluntary control...

     habits (frequency, color, or smell)
  • Change in skin
    Skin
    -Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...

     (redness, scabs, or scratching)
  • Change in behavior (such as decreased or increased activity level, seizure
    Seizure
    An epileptic seizure, occasionally referred to as a fit, is defined as a transient symptom of "abnormal excessive or synchronous neuronal activity in the brain". The outward effect can be as dramatic as a wild thrashing movement or as mild as a brief loss of awareness...

     or aggression).


Excess use of Rimadyl can lead to gastritis
Gastritis
Gastritis is an inflammation of the lining of the stomach, and has many possible causes. The main acute causes are excessive alcohol consumption or prolonged use of nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen. Sometimes gastritis develops after major surgery, traumatic...

 and ulcer formation. It is also believed that in some breeds of dogs it may induce kidney
Kidney
The kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid–base balance, and...

 and liver
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...

 damage.

Carprofen should not be administered to animals that are also being given steroids (one of the primary risks of this combination being that it can cause ulcers in the stomach). In dogs, it is recommended that the dog be taken off carprofen for three full days before ingesting a steroid (such as prednisolone
Prednisolone
Prednisolone is the active metabolite of prednisone, which is also used as a drug.-Uses:Prednisolone is a corticosteroid drug with predominant glucocorticoid and low mineralocorticoid activity, making it useful for the treatment of a wide range of inflammatory and auto-immune conditions such as...

).

According to the official Rimadyl website, the drug should not be given at the same time with other types of medications such as other NSAIDs (aspirin
Aspirin
Aspirin , also known as acetylsalicylic acid , is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication. It was discovered by Arthur Eichengrun, a chemist with the German company Bayer...

, etodolac
Etodolac
Etodolac: Etodolac belongs to a class of drugs called nonsteroidal anti-inflammatory drugs . Other members of this class include aspirin, ibuprofen , naproxen , indomethacin , nabumetone and numerous others. These drugs are used for the management of mild to moderate pain, fever, and inflammation...

, deracoxib
Deracoxib
Deracoxib is a non-steroidal anti-inflammatory drug of the coxib class, used in veterinary medicine to treat osteoarthritis in dogs. It is sold in tablets, which have added beefy flavor to increase palatability...

, meloxicam
Meloxicam
Meloxicam is a nonsteroidal anti-inflammatory drug with analgesic and fever reducer effects. It is a derivative of oxicam, closely related to piroxicam, and falls in the enolic acid group of NSAIDs...

, tepoxalin
Tepoxalin
Tepoxalin is a nonsteroidal anti-inflammatory drug approved for veterinary use in the United States and the European Union. It is primarily used to reduce inflammation and relief of pain caused by musculoskeletal disorders such as hip dysplasia and arthritis.It is generally marketed under the...

) or steroids such as dexamethasone
Dexamethasone
Dexamethasone is a potent synthetic member of the glucocorticoid class of steroid drugs. It acts as an anti-inflammatory and immunosuppressant...

, triamcinolone
Triamcinolone
Triamcinolone is a long-acting synthetic corticosteroid given orally, by injection, inhalation, or as a topical ointment or cream....

, cortisone
Cortisone
Cortisone is a steroid hormone. It is one of the main hormones released by the adrenal gland in response to stress. In chemical structure, it is a corticosteroid closely related to corticosterone. It is used to treat a variety of ailments and can be administered intravenously, orally,...

 or prednisone
Prednisone
Prednisone is a synthetic corticosteroid drug that is particularly effective as an immunosuppressant drug. It is used to treat certain inflammatory diseases and some types of cancer, but has significant adverse effects...

. However, dog owners whose pets have been administered Rimadyl and have experienced side effects are highly recommended to contact a veterinarian as soon as they appear and to stop the therapy.

Also, Rimadyl must be used with caution and within the closely monitoring of a veterinarian in dogs with liver or kidney disease, dehydration
Dehydration
In physiology and medicine, dehydration is defined as the excessive loss of body fluid. It is literally the removal of water from an object; however, in physiological terms, it entails a deficiency of fluid within an organism...

, bleeding deficits, or other health problems. Rimadyl is not recommended for use in dogs with bleeding disorders (such as Von Willebrand's disease), as safety has not been established in dogs with these disorders. Also, it has been not yet established if Rimadyl can be safely used in pregnant dogs, dogs used for breeding purposes or in lactating female dogs.

Several laboratory studies and clinical trials have been conducted to establish the safety of using Rimadyl. Clinical studies were conducted in nearly 300 dogs, coming from different breeds. These dogs have been treated with Rimadyl at the recommended dose for 2 weeks. According to these studies, the drug was clinically well tolerated and dogs treated with Rimadyl did not have a greater incidence of adverse reactions when compared to the placebo-treated animals.

There are a number of factors that might however contribute to the high incidence of adverse drug experience reports received for Rimadyl by the Center for Veterinary Medicine in the late 1990s. These include:
  • The type of drug;
  • Wide use;
  • Duration of use. While the side effects from Rimadyl are known to occur within a short period of time after administration, it is believed that long-term use may actually result in a higher risk for adverse reactions;
  • Senior dog use. Older dogs are generally more prone to side effects caused by carprofen.

Human usage

Carprofen is no longer marketed for human usage, after being withdrawn on commercial grounds.

Rimadyl was removed from the market for use in humans once less expensive options were developed. This medicine was prescribed to treat the same conditions for which it is used with dogs, viz., joint pain and inflammation. The drug was accepted well by the human body and the side effects tended to be mild, usually consisting of nausea or gastro-intestinal pain and diarrhea.

This drug was used in humans for almost 10 years, starting in 1988 until it was voluntarily pulled from the market by Pfizer when Advil
Advil
Advil is a brand of ibuprofen, a nonsteroidal anti-inflammatory drug . Advil is manufactured by Pfizer and has been on the market since 1984.-History:...

 began successfully competing.

For human use, Rimadyl was available only by prescription
Prescription drug
A prescription medication is a licensed medicine that is regulated by legislation to require a medical prescription before it can be obtained. The term is used to distinguish it from over-the-counter drugs which can be obtained without a prescription...

in 150 to 600 mg doses. Dosage over 250 mg was intended only for relieving pain after severe trauma, such as post-surgery inflammation. 150 mg doses were commonly used to relieve the pain of arthritis, while 200 mg doses were commonly prescribed in cases of severe arthritis or severe inflammation pain. The drug was taken orally.

The current version of Rimadyl is prohibited for use by humans.

External links

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