Carprofen Explained

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Verifiedrevid:460020416
Iupac Name:(RS)-2-(6-Chloro-9H-carbazol-2-yl)propanoic acid
Width:280
Chirality:Racemic mixture
Legal Us Comment:Veterinary use only
Routes Of Administration:Oral, injection
Protein Bound:High (99%)
Elimination Half-Life:Approximately 8 h (range 4.5–9.8 h) in dogs
Iuphar Ligand:7141
Cas Number:53716-49-7
Atcvet:yes
Atc Prefix:M01
Atc Suffix:AE91
Pubchem:2581
Drugbank:DB00821
Chemspiderid:2483
Unii:FFL0D546HO
Kegg:D03410
Chebi:364453
Chembl:1316
C:15
H:12
Cl:1
N:1
O:2
Smiles:CC(C1=CC=C2C(NC3=CC=C(C=C32)Cl)=C1)C(O)=O
Stdinchi:1S/C15H12ClNO2/c1-8(15(18)19)9-2-4-11-12-7-10(16)3-5-13(12)17-14(11)6-9/h2-8,17H,1H3,(H,18,19)
Stdinchikey:PUXBGTOOZJQSKH-UHFFFAOYSA-N

Carprofen is a nonsteroidal anti-inflammatory drug (NSAID) of the carbazole and propionic acid class that was previously for use in humans and animals but is now only available to veterinarians for prescribing as a supportive treatment for various conditions in animals.[1] Carprofen reduces inflammation by inhibition of COX-1 and COX-2; its specificity for COX-2 varies from species to species.[1] Marketed under many brand names worldwide,[2] carprofen is used as a treatment for inflammation and pain, including joint pain and postoperative pain.[1]

Human use

Carprofen was used in humans for almost ten years, starting in 1988, for the same conditions as in dogs; namely, joint pain and inflammation. Side effects tended to be mild, usually consisting of nausea or gastrointestinal pain and diarrhoea. It was available by prescription in 150 mg to 600 mg doses.[3] Dosages over 250 mg were reserved for pain caused by severe trauma, such as postoperative inflammation; 150 mg doses were commonly used to relieve arthritis pain, while 200 mg doses were commonly prescribed for severe arthritis or inflammatory pain. The drug was taken orally.

Pfizer voluntarily removed the medication from the market for human use on commercial grounds.[3]

Veterinary medicine

Canine use

Carprofen is one of eleven nonsteroidal anti-inflammatory drugs approved for use in dogs.[4] It aids in the relief of inflammation, pain, and fever. Carprofen can be administered in pill, chewable tablet, or injection form.[5]

Carprofen can be used for long-term pain management of such conditions as osteoarthritis, which is common in canine patients, or after surgical procedures for relief of acute pain and inflammation.[5] [6]

In patients suffering from pain, carprofen has been shown to improve energy, activity level, comfort, and general well-being.[6]

Adverse effects

Most dogs respond well to carprofen use, but like all NSAIDs, it can cause gastrointestinal, liver, and kidney problems.[7]

In 1999, the Food and Drug Administration (FDA) received more than six thousand anecdotal reports of sudden animal death after usage of Pfizer's Rimadyl brand of carprofen. In response, the FDA requested that Pfizer advise consumers in their advertising that death is a possible side effect;[8] Pfizer refused and pulled their advertising, later including death as a possible side effect on the drug label.[9]

Adverse effects can include:

Effects of overdose include gastritis and ulcer formation.[13]

In healthy dogs given carprofen, no perioperative adverse effects on the cardiovascular system have been reported at recommended dosages.[14] [15] Perioperative administration of carprofen to cats did not affect postoperative respiratory rate nor heart rate.[16]

Carprofen should not be administered concurrently with steroids, as this can cause ulcers in the stomach. Dogs should be taken off carprofen for three full days before ingesting a steroid (such as prednisolone). Carprofen should not be given at the same time with other types of medications, such as other NSAIDs (aspirin, etodolac, deracoxib, meloxicam, tepoxalin), or steroids such as dexamethasone, triamcinolone, cortisone, or prednisone.

Carprofen must be used with caution within the supervision of a veterinarian in dogs with liver or kidney disease, dehydration, bleeding deficits, or other health problems. It 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.[17] It has not been established whether carprofen can be safely used in pregnant dogs, dogs used for breeding purposes, or in lactating dogs.

Several laboratory studies and clinical trials have been conducted to establish the safety of using carprofen. Clinical studies were conducted in nearly 300 dogs of different breeds. The dogs were treated with Rimadyl at the recommended dose for two weeks. According to these studies, the drug was clinically well tolerated, and the treated dogs did not have a greater incidence of adverse reactions when compared to the control group.[18]

A number of factors may contribute to the high incidence of adverse reports received for carprofen by the Center for Veterinary Medicine in the late 1990s. These include:

Equine use

Carprofen may be administered intravenously to horses.[20] A single dose has been shown to reduce prostaglandin E2 production and inflammatory exudate for up to 15 hours,[21] although there was less effect on eicosanoid production when compared to the effects produced by NSAIDs such as phenylbutazone or flunixin.[22] Prostaglandin E2 and inflammatory exudate are also reduced and leukotriene B4 is inhibited. Carprofen can also be given orally, but intramuscular use may produce muscle damage.[23]

Other animal use

Carprofen is used as an analgesic for mouse surgical procedures.[24] Carprofen may also be used on adult fish.[25]

Brands and dosage forms for veterinary use

It is marketed under many brand names including: Acticarp, Artriofin, Austiofen, Bomazeal, Canidryl, Carporal, Carprieve, Carprocow, Carprodolor, Carprodyl, Carprofelican, Carprofen, Carprofène, Carprofeno, Carprofenum, Carprogesic, Carprosol, Carprotab, Carprox, Comforion, Dolagis, Dolocarp, Dolox, Eurofen, Kelaprofen, Librevia, Norocarp, Norodyl, Novocox, Ostifen, Prolet, Quellin, Reproval, Rimadyl, Rimifin, Rofeniflex, Rovera, Rycarfa, Scanodyl, Tergive, Vetprofen, and Xelcor.[2]

Veterinary dosage forms include 25 mg, 75 mg, and 100 mg tablets, and 50 mg per mL injectable form.[1] [26] and more recent a 50 mg Caplet called Carprox for senior dogs aged 10 years+.

Notes and References

  1. Web site: Rimadyl (carprofen) prescribing information leaflet. www2.ZoetisUS.com. Zoetis Inc.. 5 February 2022.
  2. Web site: International brand names for Carprofen. www.Drugs.com. Drugs.com. 4 October 2017.
  3. Web site: Committee for Veterinary Medicinal Products: Carprofen. www.EMA.Europa.eu. European Agency for the Evaluation of Medicinal Products. 2009.
  4. Web site: Animal Drugs @ FDA - NSAID labels. AnimalDrugsAtFDA.FDA.gov. US FDA. 16 November 2021.
  5. Web site: Burke A . 10 November 2016. Rimadyl for Dogs – uses, side effects & alternatives. www.AKC.org. American Kennel Club. 16 November 2021.
  6. Web site: Rimadyl. www.ZoetisPetCare.com. 16 November 2021.
  7. Reimer ME, Johnston SA, Leib MS, Duncan RB, Reimer DC, Marini M, Gimbert K . The gastroduodenal effects of buffered aspirin, carprofen, and etodolac in healthy dogs . Journal of Veterinary Internal Medicine . 13 . 5 . 472–477 . September 1999 . 10499732 . 10.1111/j.1939-1676.1999.tb01465.x . free .
  8. Web site: Update on Rimadyl. www.FDA.gov. FDA's Center for Veterinary Medicine. 1 December 1999. 16 December 2019. dead. https://web.archive.org/web/20140908220655/http://www.fda.gov/AnimalVeterinary/NewsEvents/CVMUpdates/ucm129408.htm. 8 September 2014.
  9. Luna SP, Basílio AC, Steagall PV, Machado LP, Moutinho FQ, Takahira RK, Brandão CV . Evaluation of adverse effects of long-term oral administration of carprofen, etodolac, flunixin meglumine, ketoprofen, and meloxicam in dogs . American Journal of Veterinary Research . 68 . 3 . 258–264 . March 2007 . 17331014 . 10.2460/ajvr.68.3.258 . free .
  10. Web site: A review of signs of a potentially life-threatening reaction to Rimadyl. www.srdogs.com. 20 May 2010.
  11. Web site: Dog owner information about Rimadyl (carprofen). www.Rimadyl.com. Pfizer. 20 May 2010. 15 July 2011. https://web.archive.org/web/20110715184915/https://www.rimadyl.com/display.aspx?drug=RC&species=CN&sec=610. dead.
  12. News: Carprofen For Dogs: Dosage, Side Effects, And Alternatives . en . Relievet . 2022-07-21.
  13. Web site: Generic dog Rimadyl online. RimadylOnline.com. dead. https://web.archive.org/web/20110715184803/http://rimadylonline.com/. 15 July 2011. 15 July 2011.
  14. Boström IM, Nyman GC, Lord PE, Häggström J, Jones BE, Bohlin HP . Effects of carprofen on renal function and results of serum biochemical and hematologic analyses in anesthetized dogs that had low blood pressure during anesthesia . American Journal of Veterinary Research . 63 . 5 . 712–721 . May 2002 . 12013473 . 10.2460/ajvr.2002.63.712 . free .
  15. Frendin JH, Boström IM, Kampa N, Eksell P, Häggström JU, Nyman GC . Effects of carprofen on renal function during medetomidine-propofol-isoflurane anesthesia in dogs . American Journal of Veterinary Research . 67 . 12 . 1967–1973 . December 2006 . 17144795 . 10.2460/ajvr.67.12.1967 . free .
  16. Höglund OV, Dyall B, Gräsman V, Edner A, Olsson U, Höglund K . Effect of non-steroidal anti-inflammatory drugs on postoperative respiratory and heart rate in cats subjected to ovariohysterectomy . Journal of Feline Medicine and Surgery . 20 . 10 . 980–984 . October 2018 . 29165006 . 10.1177/1098612X17742290 . 30649716 . 11129237 .
  17. Web site: Rimadyl (Carprofen). www.VetDepot.com. Vet Depot. dead. https://web.archive.org/web/20100523014832/http://www.vetdepot.com/Rimadyl-Carprofen-25mg-60-Caplets.html. 23 May 2010. 20 May 2010.
  18. Web site: 2007. Rimadyl [package insert]]. www.Rimadyl.com. New York. Pfizer Animal Health. 13 August 2014.
  19. Web site: Get the facts about pain relievers for pets. www.FDA.gov. Center for Veterinary Medicine. 3 November 2020.
  20. McIlwraith CW, Frisbie DD, Kawcak CE. 2001. Nonsteroidal Anti-Inflammatory Drugs. Proc. AAEP. 47. 182–187.
  21. Lees P, McKellar Q, May SA, Ludwig B . Pharmacodynamics and pharmacokinetics of carprofen in the horse . Equine Veterinary Journal . 26 . 3 . 203–208 . May 1994 . 8542839 . 10.1111/j.2042-3306.1994.tb04370.x .
  22. Lees P, Ewins CP, Taylor JB, Sedgwick AD . Serum thromboxane in the horse and its inhibition by aspirin, phenylbutazone and flunixin . The British Veterinary Journal . 143 . 5 . 462–476 . 1987 . 3119142 . 10.1016/0007-1935(87)90024-8 .
  23. McKellar QA, Bogan JA, von Fellenberg RL, Ludwig B, Cawley GD . Pharmacokinetic, biochemical and tolerance studies on carprofen in the horse . Equine Veterinary Journal . 23 . 4 . 280–284 . July 1991 . 1915228 . 10.1111/j.2042-3306.1991.tb03718.x .
  24. Adamson . Trinka . 2010. Assessment of Carprofen and Buprenorphine on Recovery of Mice after Surgical Removal of the Mammary Fat Pad . J Am Assoc Lab Anim Sci. 49 . 5 . 610–616 . 20858363 . 2949431 .
  25. Uney . Kamil . Pharmacokinetics and Bioavailability of Carprofen in Rainbow Trout (Oncorhynchus mykiss) Broodstock . Pharmaceutics. 2021 . 13 . 7 . 990 . 10.3390/pharmaceutics13070990 . free . 34208822 . 8309133 .
  26. Web site: Carprofen (Veterinary – Systemic). The United States Pharmacopeial Convention. 2007.