Firocoxib

Dosing by species

Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.

Routes of administration

Contraindications

• Hypersensitivity to firocoxib or other NSAIDs
• Active GI ulcerative conditions (relative contraindication)
• Bleeding disorders or thrombocytopenia (relative contraindication)
• Dogs weighing less than 7 lbs
• Puppies less than 7 months old (US labeling) or less than 10 weeks old (UK labeling)
• Horses less than 1 year old
• Breeding, pregnant, or lactating dogs or horses (safety not established)
• Cats
• Dogs < 10 weeks of age or < 3 kg body weight
• Pregnant or lactating bitches
• Dehydrated, hypovolaemic, or hypotensive patients
• Patients with pre-existing gastrointestinal disease or bleeding
• Patients with blood clotting disorders

Adverse effects

• Dogs: Vomiting, decreased appetite/anorexia, diarrhea, melena, GI ulcers, bloody vomiting, GI perforation
• Dogs: Increases in BUN, creatinine, alkaline phosphatase (ALP), and ALT
• Dogs: Depression/lethargy, ataxia
• Horses: Diarrhea/loose stools, mouth ulcers, facial skin lesions, excitation (rare)
• Gastrointestinal signs (vomiting, diarrhea, inappetence)
• Gastrointestinal ulceration or bleeding
• Renal toxicity (especially during hypotensive states)
• Hepatotoxicity (rare, but liver disease prolongs metabolism)

Drug interactions

• ACE Inhibitors (e.g., enalapril, benazepril) · Some NSAIDs can reduce effects on blood pressure
• Aspirin · May increase the risk of gastrointestinal toxicity (ulceration, bleeding, vomiting, diarrhea)
• Corticosteroids (e.g., prednisone) · May increase the risk of gastrointestinal toxicity (ulceration, bleeding, vomiting, diarrhea)
• Digoxin · NSAIDs may increase serum levels
• Fluconazole · Administration has increased plasma levels of celecoxib in humans and potentially could also affect firocoxib levels in dogs
• Furosemide · NSAIDs may reduce the saluretic and diuretic effects
• Highly Protein Bound Drugs (phenytoin, valproic acid, oral anticoagulants, sulfonamides, etc.) · May displace other highly bound drugs or be displaced by them, potentially increasing serum levels, duration of action, and toxicity
• Methotrexate · Serious toxicity has occurred when NSAIDs have been used concomitantly; use together with extreme caution
• Nephrotoxic Drugs (e.g., aminoglycosides, amphotericin B) · May enhance the risk of nephrotoxicity development
• Other NSAIDs · Increased risk of severe gastrointestinal ulceration and renal toxicity. A 3-5 day wash-out period is required. · major
• Glucocorticoids (e.g., Prednisolone, Dexamethasone) · Synergistic gastrointestinal toxicity leading to severe ulceration or perforation. · major

Monitoring

• Baseline and periodic physical exam including clinical efficacy and adverse effect queries
• Baseline and periodic CBC
• Baseline and periodic liver function tests
• Baseline and periodic renal function tests and electrolytes
• Baseline and periodic urinalysis
• Clinical signs of GI toxicity (vomiting, diarrhea, melena, anorexia)
• Renal parameters (BUN, Creatinine, USG) especially in older dogs or long-term use
• Hepatic enzymes (ALT, ALP, Bilirubin) prior to and during long-term therapy
• Hydration status and blood pressure (especially perioperatively)

Overdose

Limited information is available for acute overdoses in animals. The reported oral LD50 for rats is > 2 grams per kg. * **Management**: Should an overdose occur, contacting an animal poison control center or the manufacturer is highly recommended. * **Treatment**: Use of gut emptying protocols and supportive treatment (IV fluids, oral sucralfate, GI protectants) may be useful in managing the case.