A new option for treating arthritic joint pain and inflammation in horses will soon be available. This summer, the Food and Drug Administration (FDA) approved a tablet form of the COX-2 selective firocoxib, sold under the name Equioxx. The tablets are expected to be available by prescription only through veterinarians by early October.
COX-2 selectives are nonsteroidal anti-inflammatory drugs (NSAIDs) that block enzymes that lead to inflammation while sparing others that support normal body functions. This selective action reduces the risk of certain side effects associated with other NSAIDs, such as gastric ulcers and compromised kidney function. Equioxx was the first---and remains the only---COX-2 selective available for horses. The paste form was approved in 2005 and the injectable in 2010.
Equioxx tablets, which contain 57 milligrams of firocoxib, are formulated as a chewable administered once a day to horses weighing 800 to 1,300 pounds and appear to be extremely palatable, says Hoyt Cheramie, DVM, senior manager of large animals veterinary services with Merial. “Many horses will eat one directly out of your hand, but consumption of the entire dose should be confirmed.” Cheramie says he expects the tablet to be less expensive per dose than the paste formulation of Equioxx. (On average, the cost for the paste ranges from $5.25 to $10.35 per dose.)
The option of prescribing Equioxx in tablet form will allow veterinarians to better tailor treatment to a horse’s particular situation, says Cheramie. “Veterinarians might continue to use the injectable form in a hospital setting, if a horse isn’t eating or already has a catheter in place,” he says. “The paste will still be helpful for giving horses very specific doses; you can adjust it to within 50-pound increments, which can be very beneficial to someone who needs to stay within allowable levels for competition.” Equioxx is the only NSAID approved for 14-day consecutive use by the American Quarter Horse Association and the United States Equestrian Federation.
This article first appeared in EQUUS issue #469, October 2016.