Firocoxib

What it is used for

• Experimentally induced pyrexia (Unapproved/Investigational)
• Contraindicated
• Control of pain and inflammation associated with osteoarthritis
• Control of pain and inflammation associated with osteoarthritis
• Pain and inflammation (osteoarthritis, surgery)

How it is given

Possible side 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)

Cautions & 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
• > **Important Washout Period**: If changing from one NSAID to another, a washout period is required. A 24-hour washout is often recommended between COX-2 selective agents, but 72 hours to 1 week is usually recommended when switching from a non-selective NSAID or aspirin. * Use with caution and enhanced monitoring in patients with pre-existing **renal, hepatic, or cardiovascular dysfunction**. * Use with caution in patients that are **dehydrated, hypovolemic, hypotensive**, or on concomitant diuretic therapy due to increased risk of renal toxicity. * **Geriatric patients** require ongoing monitoring due to naturally reduced renal function. * **Puppy Toxicity**: Doses above the recommended 5 mg/kg in puppies less than 7 months old have been associated with serious adverse reactions, including hepatic fatty changes and death.

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.
• Glucocorticoids (e.g., Prednisolone, Dexamethasone): Synergistic gastrointestinal toxicity leading to severe ulceration or perforation.
• Aminoglycosides (e.g., Gentamicin, Amikacin): Increased risk of nephrotoxicity.
• Platinum-based chemotherapeutics: Potential synergistic efficacy in treating transitional cell carcinomas.
• Glucocorticoids: Increased risk of gastrointestinal ulceration and bleeding.
• Aminoglycosides: Increased risk of nephrotoxicity.

Frequently asked questions