Tulathromycin
Triamilide macrolide
Also known as: Draxxin · Tulathromycine · Tulathromycinum · CP-472295 · CP-547272
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Horses
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Rhodococcus equi infections in foals | 2.5 mg/kg | IM | every 5-7 days | — | 🌎 NA |
- Rhodococcus equi infections in foals: Anecdotally used successfully in milder clinical cases.
Cattle
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Bovine respiratory disease (BRD), bovine foot rot, infectious bovine keratoconjunctivitis (IBK) | 2.5 mg/kg (1.1 mL/100 lb) BW | SC | single dose | — | 🌎 NA |
- Bovine respiratory disease (BRD), bovine foot rot, infectious bovine keratoconjunctivitis (IBK): Inject subcutaneously in the neck. Do not inject more than 10 mL per injection site.
Swine
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Swine respiratory disease (SRD) | 2.5 mg/kg (0.25 mL/22 lb) BW | IM | single dose | — | 🌎 NA |
- Swine respiratory disease (SRD): Inject intramuscularly in the neck. Do not inject more than 2.5 mL per injection site.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Tulathromycin is a semi-synthetic, long-acting macrolide antibiotic of the triamilide subclass. It is primarily utilized in large animal medicine (cattle and swine) for the treatment of respiratory diseases, bovine foot rot, and infectious bovine keratoconjunctivitis (pinkeye).
- Unique Structure: Contains three amine groups (tribasic), which allows for superior penetration into gram-negative pathogens compared to older macrolides.
- Targeted Delivery: It extensively accumulates in host phagocytic cells (macrophages and neutrophils), delivering high concentrations directly to infected lung tissues.
- Convenience: Formulated for single-dose administration due to its exceptionally long tissue half-life (up to 8.75 days in bovine lungs).
Clinical Pearl: While primarily approved for livestock, it is occasionally used off-label in foals for Rhodococcus equi infections and in small ruminants for susceptible respiratory pathogens.
Mechanism of action
Tulathromycin binds to the 50S ribosomal subunit of susceptible bacteria → blocks transpeptidation and translocation processes → inhibits RNA-dependent protein synthesis.
- Generally considered bacteriostatic, but exhibits bactericidal activity against key respiratory pathogens like Mannheimia haemolytica and Pasteurella multocida.
- Its low affinity for bacterial efflux pumps allows it to remain and accumulate within the bacteria.
- Concentrates in host phagocytic cells (macrophages) → migrates to sites of inflammation → releases active drug directly at the infection site, providing targeted therapy.
Safety & warnings
Contraindications
- Prior hypersensitivity to tulathromycin or other macrolides
- Female dairy cattle 20 months of age or older
- Calves to be processed for veal
- Pre-ruminating calves (withdrawal period not established)
Adverse effects
- Transient hypersalivation
- Transient dyspnea (rare)
- Injection site reactions (swelling, pain, discoloration, trim loss at slaughter)
- Anorexia
- Restlessness and excessive vocalization (swine)
Precautions
Withdrawal Times
- Cattle: Must not be slaughtered within 18 days from the last treatment.
- Swine: Must not be slaughtered within 5 days from the last treatment.
Administration Warnings
- Cattle: Administer SC in the neck. Do not inject more than 10 mL per injection site.
- Swine: Administer IM in the neck. Do not inject more than 2.5 mL per injection site.
- Subcutaneous or intramuscular injection can cause a transient local tissue reaction that may result in trim loss at slaughter.
- Reproductive safety in pregnant or lactating animals has not been determined.
Monitoring
- Clinical efficacy (resolution of respiratory signs, lameness, or ocular lesions)
- Injection site for severe reactions
Pharmacokinetics
Absorption
Rapidly and nearly completely absorbed. Bioavailability >90% in cattle (SC) and 88% in swine (IM). Peak plasma concentrations occur within 15 minutes.
Distribution
Very large volume of distribution (11 L/kg in cattle; 13-15 L/kg in swine). Rapidly distributes into body tissues and accumulates heavily in lung tissue.
Metabolism
Eliminated from the body primarily unchanged.
Elimination
Cattle: Primarily via biliary excretion. Swine: Primarily via feces and urine. Lung tissue half-life is extremely long (8.75 days in cattle; 5.9 days in swine).
Overdose
Cattle
Single subcutaneous doses of up to 25 mg/kg caused transient indications of pain at the injection site, including head shaking and pawing at the ground. Injection site swelling, discoloration of subcutaneous tissues, and corresponding histopathologic changes were observed.
Swine
Single IM doses of up to 25 mg/kg caused transient indications of pain at the injection site, restlessness, and excessive vocalization. Brief tremors occurred in one animal receiving 7.5 mg/kg.
Treatment
No systemic treatment for single overdoses should be necessary. Localized treatment at the injection site (e.g., ice pack) to reduce swelling and pain, as well as FDA-approved analgesic medications, can be considered.
Available products
Formulations
- Injectable solution (100 mg/mL)
Veterinary
- Tulathromycin Injection 100 mg/mL in 50, 100, 250, & 500 mL vials (Draxxin)
Regulatory status
No regulatory data for: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store at or below 25°C (77°F). The product is stable at room temperature for up to 36 months.
Client information
Tulathromycin is a long-acting antibiotic used primarily to treat respiratory infections in livestock.
- Single Treatment: Usually requires only one injection due to its long-lasting effects in the lungs.
- Injection Site Reactions: Mild swelling or pain at the injection site is common and usually resolves on its own.
- Strict Withdrawal Times: You must adhere strictly to meat withdrawal times (18 days for cattle, 5 days for swine) before slaughter to prevent drug residues in the food supply.
Important: Do not use this medication in female dairy cows 20 months of age or older, or in calves intended for veal.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.