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Previcox


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Summary for the public


What is Previcox?

Previcox contains the active substance firocoxib, which belongs to a class of medicines having antiinflammatory action. Previcox is presented as chewable tablets for dogs (57 mg and 227 mg) and is also authorised as an oral paste for horses (8.2 mg/g).


What is Previcox used for?

Previcox is used for a relief of pain and inflammation associated with osteoarthritis in dogs and for the alleviation of pain and inflammation associated with osteoarthritis and reduction of associated lameness in horses.

The dose, duration of treatment and frequency will depend on the weight and type of animal and condition to be treated. For details, please see the Package Leaflet.


How does Previcox work?

Previcox contains firocoxib, which belongs to a class of medicines called non-steroidal antiinflammatory drugs (NSAIDs) belonging to the Coxib group, which acts by selective inhibition of cyclooxygenase-2 (COX-2). Coxibs display pain relief, anti-inflammatory and antipyretic properties. Firocoxib blocks the enzyme (cyclo-oxygenase) that is involved in the production of prostaglandins. As the prostaglandins are substances that trigger pain, exudation and inflammation, Previcox, therefore, reduces those responses.


How has Previcox been studied?

Previcox has been studied in laboratory animals, as well as in dogs and horses that were treated in various veterinary practices/clinics across Europe (“clinical studies”).

Dog: Previcox chewable tablets for dogs were studied in two large European field studies in dogs for a period of up to 90 days. The results showed an improvement in lameness score in dogs with established osteoarthritis. The product was shown to be comparable to other reference products (carprofen and meloxicam, respectively).

Horse: Two multi-centre studies were conducted (one in the US and one in Europe) to investigate the efficacy, safety and acceptability of firocoxib under field conditions when administered to horses orally once daily for 14 days at a dose of 0.1 mg/kg. The CVMP concluded that Previcox oral paste was as effective as other authorised products (phenylbutazone and vedaprofen) in the alleviation of pain and inflammation associated with osteoarthritis and the reduction of associated lameness in horses.


What benefit has Previcox shown during the studies?

Previcox tablets for dogs improved the scores for the relief of pain and inflammation. Administration of the product in accordance with the recommended dosing schedule for a period of up to 90 days resulted in an improvement in lameness score in dogs with established osteoarthritis.

Previcox oral paste administered once daily for 14 days at a dose of 0.1 mg/kg improved clinical scores for lameness and soft tissue injuries in horses and also helped alleviate pain and inflammation associated with osteoarthritis in horses.


What are the side-effects of Previcox?

The side effects of Previcox are typical for those seen with other medicines in this product class (NSAIDs) such as oral lesions (tissue damage) in the mouth of horses, soft faeces/diarrhoea or lethargy. These reactions are generally of a transitory nature and are reversible when the treatment is stopped. Previcox must not be administered with corticosteroids or other NSAIDs. Care should also be taken when used with molecules displaying action on renal flow e.g. diuretics.


What are the precautions for the person who gives the medicine or comes into contact with the animal?

Wash hands after use of the product.
Return halved tablets to the blister and keep out of the reach of children.
Women of child-bearing age should avoid contact with, or wear disposable gloves, when administering the product. In case of accidental ingestion, seek medical advice immediately and show the package leaflet or the label to the physician.


What is the time to allow before a horse can be slaughtered and the meat used for human consumption (withdrawal period)?

After the last day of treatment with Previcox, horses should not be slaughtered for 26 days (when treated with the oral paste). The use of Previcox is not permitted in mares producing milk for human consumption.


Why has Previcox been approved?

The Committee for Medicinal Products for Veterinary Use (CVMP) concluded that the benefits of Previcox exceed the risks for the treatment of relief of pain and inflammation in both dogs and horses and recommended that Previcox be given a marketing authorisation. The benefit-risk balance may be found in module 6 of this EPAR.


Other information about Previcox

The European Commission granted the initial marketing authorisation valid throughout the European Union, for Previcox to Merial on 13 September 2004. The extension application for the oral paste in horses was subsequently approved in February 2007. Information on the prescription status of this product may be found on the label/outer package.

Authorisation details
Name: Previcox
EMEA Product number: EMEA/V/C/000082
Active substance: firocoxib
INN or common name: Firocoxib
Species: HorsesDogs
ATCvet Code: QM01AH90
Marketing Authorisation Holder: Merial
Revision: 15
Date of issue of Market Authorisation valid throughout the European Union: 13/09/2004
Contact address:
Merial
29 avenue Tony Garnier
69007 Lyon
France




Product Characteristics

ANNEX I

SUMMARY OF PRODUCT CHARACTERISTICS


1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Previcox 57 mg chewable tablets for dogs
Previcox 227 mg chewable tablets for dogs
2.
QUALITATIVE AND QUANTITATIVE COMPOSITION
Each tablet contains:
Active substance:
Firocoxib 57 mg
Firocoxib
227 mg
Excipients:
Iron oxides (E172)
Caramel (E150d)
For a full list of excipients, see section 6.1.
3.
PHARMACEUTICAL FORM
Chewable tablets.
Tan-brown, round, convex, engraved scored tablets.
4.
CLINICAL PARTICULARS
4.1 Target species
Dogs
4.2 Indications for use, specifying the target species
For the relief of pain and inflammation associated with osteoarthritis in dogs.
For the relief of post-operative pain and inflammation associated with soft-tissue and orthopaedic
surgery in dogs.
4.3 Contraindications
Do not use in pregnant or lactating bitches.
Do not use in animals less than 10 weeks of age or less than 3 kg body weight.
Do not use in animals suffering from gastrointestinal bleeding, blood dyscrasia or haemorrhagic
disorders.
Do not use concomitantly with corticosteroids or other NSAIDs.
4.4 Special warnings
None.
4.5 Special precautions for use
Special precautions for use in animals
The recommended dose, as indicated in the dosing table, should not be exceeded.
2
Use in very young animals, or animals with suspected or confirmed impairment of renal, cardiac or
hepatic function may involve additional risk. If such use cannot be avoided, those dogs require careful
veterinary monitoring.
Avoid use in any dehydrated, hypovolaemic or hypotensive animals, as there is a potential risk of
increased renal toxicity. Concurrent administration of potentially nephrotoxic drugs should be
avoided.
Use this product under strict veterinary monitoring where there is a risk of gastrointestinal bleeding, or
if the animal previously displayed intolerance to NSAIDs. Renal and/or hepatic disorders have been
reported in very rare cases in dogs administered the recommended treatment dose. It is possible that a
proportion of such cases had sub-clinical renal or hepatic disease prior to the commencement of
therapy. Therefore, appropriate laboratory testing to establish baseline renal or hepatic biochemistry
parameters is recommended prior to and periodically during administration.
The treatment should be discontinued if any of these signs are observed: repeated diarrhoea, vomiting,
faecal occult blood, sudden weight loss, anorexia, lethargy, degradation of renal or hepatic
biochemistry parameters.
Special precautions to be taken by the person administering the veterinary medicinal product to
animals
Wash hands after use of the product.
In case of accidental ingestion, seek medical advice immediately and show the package leaflet or the
label to the physician.
Return halved tablets to the blister and keep out of the reach of children.
4.6 Adverse reactions (frequency and seriousness)*
Emesis and diarrhoea have occasionally been reported. These reactions are generally of a transitory
nature and are reversible when the treatment is stopped. Renal and/or hepatic disorders have been
reported in very rare cases in dogs administered the recommended treatment dose. Rarely, nervous
system disorders have been reported in treated dogs
If adverse reactions like vomiting, repeated diarrhoea, faecal occult blood, sudden weight loss,
anorexia, lethargy, degradation of renal or hepatic biochemistry parameters occur, use of the product
should be stopped and the advice of a veterinarian should be sought. As with other NSAIDs, serious
adverse effects can occur and, in very rare cases, may be fatal.
* The frequency of possible adverse effects is defined using the following convention:
Rare (affects 1 to 10 animals in 10,000)
Very rare (affects less than 1 animal in 10,000)
4.7 Use during pregnancy, lactation or lay
Do not use in pregnant or lactating bitches.
Laboratory studies in rabbits have shown evidence of maternotoxic and foetotoxic effects at dose rates
approximating the recommended treatment dose for the dog.
4.8 Interaction with other medicinal products and other forms of interaction
Pre-treatment with other anti-inflammatory substances may result in additional or increased adverse
effects and accordingly a treatment-free period with such drugs should be observed for at least 24
hours before the commencement of treatment with Previcox. The treatment-free period, however,
should take into account the pharmacokinetic properties of the products used previously.
3
Previcox must not be administered in conjunction with other NSAIDs or glucocorticosteroids.
Gastrointestinal tract ulceration may be exacerbated by corticosteroids in animals given non-steroidal
anti-inflammatory drugs.
Concomitant treatment with molecules displaying action on renal flow, e.g. diuretics or Angiotensin
Converting Enzyme (ACE) inhibitors, should be subject to clinical monitoring. Concurrent
administration of potentially nephrotoxic drugs should be avoided as there might be an increased risk
of renal toxicity. As anaesthetic drugs may affect renal perfusion, t he use of parenteral fluid therapy
during surgery should be considered to decrease potential renal complications when using NSAIDs
peri-operatively.
Concurrent use of other active substances that have a high degree of protein binding may compete
with firocoxib for binding and thus lead to toxic effects.
4.9 Amounts to be administered and administration route
Oral use.
Osteoarthritis:
Administer 5 mg per kg bodyweight once daily as presented in the table below.
Tablets can be administered with or without food.
Duration of treatment will be dependent on the response observed. As field studies were limited to 90
days, longer-term treatment should be considered carefully and regular monitoring undertaken by the
veterinarian.
Relief of post-operative pain
Administer 5 mg per kg bodyweight once daily as presented in the table below for up to 3 days as
needed, starting approximately 2 hours prior to surgery.
Following orthopaedic surgery and depending on the response observed, treatment using the same
daily dosing schedule may be continued after the first 3 days, upon judgement of the attending
veterinarian.
Body weight (kg)
Number of chewable tablets by size
mg/kg range
57 mg
227 mg
3 – 5.5
0.5
5.2 – 9.5
5.6 – 10
1
5.7 – 10.2
10.1 – 15
1.5
5.7 – 8.5
15.1 – 22
0.5
5.2 – 7.5
22.1 – 45
1
5.0 – 10.3
45.1 – 68
1.5
5.0 – 7.5
68.1 – 90
2
5.0 – 6.7
4.10 Overdose (symptoms, emergency procedures, antidotes), if necessary
In dogs ten weeks of age at the start of treatment at dose rates equal or greater to 25 mg/kg/day (5
times the recommended dose) for three months, the following signs of toxicity were observed:
bodyweight loss, poor appetite, changes in the liver (accumulation of lipid), brain (vacuolisation),
duodenum (ulcers) and death. At dose rates equal or greater to 15 mg/kg/day (3 times the
recommended dose) for six months, similar clinical signs were observed, albeit that the severity and
frequency were less and duodenal ulcers were absent.
In those target animal safety studies, clinical signs of toxicity were reversible in some dogs following
cessation of therapy.
4
 
In dogs seven months of age at the start of treatment at dose rates greater than or equal to
25 mg/kg/day (5 times the recommended dose) for six months, gastrointestinal adverse effects, i.e.
vomiting were observed.
Overdose studies were not conducted in animals over 14 months of age.
If clinical signs of overdosing are observed, discontinue treatment.
4.11 Withdrawalperiod(s)
Not applicable.
5.
PHARMACOLOGICAL PROPERTIES
Pharmacotherapeutic group: Anti-inflammatory and anti-rheumatic products, non-steroids.
ATCvet code: QM01AH90
5.1 Pharmacodynamic properties
Firocoxib is a non-steroidal anti-inflammatory drug (NSAID) belonging to the Coxib group, which
acts by selective inhibition of cyclooxygenase-2 (COX-2) – mediated prostaglandin synthesis.
Cyclooxygenase is responsible for generation of prostaglandins. COX-2 is the isoform of the enzyme
that has been shown to be induced by pro-inflammatory stimuli and has been postulated to be
primarily responsible for the synthesis of prostanoid mediators of pain, inflammation, and fever.
Coxibs therefore display analgesic, anti-inflammatory and antipyretic properties. COX-2 is also
thought to be involved in ovulation, implantation and closure of the ductus arteriosus, and central
nervous system functions (fever induction, pain perception and cognitive function). In in-vitro canine
whole blood assays, firocoxib exhibits approximately 380-fold selectivity for COX-2 over COX-1.
The concentration of firocoxib required to inhibit 50% of the COX-2 enzyme (i.e., the IC 50 ) is
0.16 (± 0.05) µM, whereas the IC 50 for COX-1 is 56 (± 7) µM.
5.2 Pharmacokinetic particulars
Following oral administration in dogs at the recommended dose of 5 mg per kg of bodyweight,
firocoxib is rapidly absorbed and the time to maximal concentration (T max ) is 1.25 (± 0.85) hours. The
peak concentration (C max ) is 0.52 (± 0.22) g/ml (equivalent to approximately 1.5 µM), area under the
curve (AUC 0-24) is 4.63 (1.91) µg xhr/ml, and oral bioavailability is 36.9 (20.4) percent. The
elimination half-life (t ½ ) is 7.59 (± 1.53) hours. Firocoxib is approximately 96% bound to plasma
proteins. Following multiple oral administrations, the steady state is reached by the third daily dose.
Firocoxib is metabolised predominantly by dealkylation and glucuronidation in the liver. Elimination
is principally in the bile and gastrointestinal tract.
6.
PHARMACEUTICAL PARTICULARS
6.1 List of excipients
Lactose Monohydrate
Microcrystalline Cellulose
Chartor Hickory Smoke Flavour
Hydroxypropyl Cellulose
Croscarmellose Sodium
Magnesium Stearate
Caramel E150d
Silica, colloidal anhydrous
Iron Oxides
5
6.2 Incompatibilities
Not applicable.
6.3 Shelf life
Shelf life of the veterinary medicinal product as packaged for sale: 3 years
Half tablets should be returned to the original market container and may be stored for up to 7 days
6.4 Special precautions for storage
Do not store above 30°C.
Store in the original package.
6.5 Nature and composition of immediate packaging
Previcox tablets are supplied in carton boxes containing blisters (transparent PVC /aluminium foil and
paper backing).
The chewable tablets are available in the following pack sizes:
57 mg: 1 carton box containing one blister of 10 tablets
1 carton box containing three blisters of 10 tablets each
1 carton box containing eighteen blisters of 10 tablets each
227 mg: 1 carton box containing one blister of 10 tablets
1
carton
box
containing
three
blisters
of
10
tablets
each
1 carton box containing eighteen blisters of 10 tablets each
Not all pack sizes may be marketed.
6.6 Special precautions for the disposal of unused veterinary medicinal product or waste
materials derived from the use of such products
Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal
products should be disposed of in accordance with local requirements.
7.
MARKETING AUTHORISATION HOLDER
MERIAL
29 avenue Tony Garnier
FR-69007 Lyon
France.
8.
MARKETING AUTHORISATION NUMBER(S)
EU/2/04/045/001-6
9.
DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION
13/09/2004
6
10 DATE OF REVISION OF THE TEXT
01/2010
Detailed information on this veterinary medicinal product is available on the website of the European
Medicines Agency (EMA) http://www.ema.europa.eu
PROHIBITION OF SALE, SUPPLY AND/OR USE
Not applicable.
7
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Previcox 8.2 mg/g oral paste for horses.
2.
QUALITATIVE AND QUANTITATIVE COMPOSITION
Each syringe contains 7.32 g of paste and delivers:
Firocoxib 8.2 mg/g
For a full list of excipients, see section 6.1.
3.
PHARMACEUTICAL FORM
Oral paste.
White to off-white paste.
4.
CLINICAL PARTICULARS
4.1 Target species
Horses.
4.2 Indications for use specifying the target species
Alleviation of pain and inflammation associated with osteoarthritis and reduction of associated
lameness in horses .
4.3 Contraindications
Do not use in animals suffering from gastrointestinal disorders and haemorrhage, impaired hepatic,
cardiac or renal function and bleeding disorders.
Do not use in breeding, pregnant or lactating animals.
Do not use concomitantly with corticosteroids or other NSAIDs.
4.4 Special warnings
None.
4.5 Special precautions for use
Special precautions for use in animals
Do not use in animals less than 10 weeks. If side effects occur, treatment should be discontinued and
the advice of a veterinarian should be sought. Avoid use in any dehydrated, hypovolaemic or
hypotensive animal, as there may be potential risk of increased renal toxicity. Concurrent
administration of potentially nephrotoxic drugs should be avoided.
The recommended treatment dose and duration should not be exceeded.
8
Special precautions to be taken by the person administering the veterinary medicinal product to
animals
In case of accidental ingestion, seek medical advice immediately and show the package leaflet or the
label to the physician.
Avoid contact with eyes and skin. If it occurs, rinse affected area immediately with water.
Wash hands after use of the product.
Women of child-bearing age should avoid contact with, or wear disposable gloves, when
administering the product.
4.6 Adverse reactions (frequency and seriousness)
Lesions (erosion/ulceration) of the oral mucosa and of the skin around the mouth may occasionally be
observed in treated animals. Typically, these lesions are mild and resolve without treatment, but oral
lesions may be associated with salivation and labial and tongue oedema.
4.7 Use during pregnancy, lactation or lay
No data is available in horses. However, studies with laboratory animals have shown embryo-
foetotoxicity, malformations, delayed parturition and decreased pup survival. Therefore, do not use in
breeding, pregnant or lactating animals.
4.8 Interaction with other medicinal products and other forms of interaction
Other NSAIDs, diuretic and substances with high protein binding may compete for binding and lead to
toxic effects. Do not use concomitantly with corticosteroids or other NSAIDs.
Pre-treatment with other anti-inflammatory substances may result in additional or increased adverse
effects and a treatment-free period with such products should therefore be observed. The treatment-
free period should take into account the pharmacological properties of the products used previously.
Concomitant treatment with molecules displaying action on renal flow (e.g. diuretics) should be
subject to clinical monitoring. Concurrent administration of potentially nephrotoxic drugs should be
avoided as there might be an increased risk of renal toxicity.
4.9 Amounts to be administered and administration route
Oral use.
Administer 0.1 mg firocoxib per kg bodyweight, once daily. Duration of treatment will be dependent
on the response observed, but should not exceed 14 days .
To administer Previcox at the dose of 0.1 mg firocoxib/kg, set the syringe plunger to the appropriate
dose division for the horse’s weight. Each full dose division on the syringe plunger delivers sufficient
firocoxib to treat 100 kg body weight. The contents of one syringe will treat horses weighing up to
600 kg. To ensure correct dosage, bodyweight should be determined as accurately as possible to avoid
overdosing.
To deliver firocoxib at the appropriate dosage, unlock the knurled ring on the syringe plunger by
rotating it ¼ turn and slide it along the plunger shaft to the appropriate dose division for the horse’s
weight. Rotate the plunger ring ¼ turn to lock it in place and ensure it is locked.
Make sure the horse’s mouth contains no feed. Remove the cover from the tip of the syringe. Insert the
syringe tip into the horse’s mouth at the interdental space and deposit the paste on the base of the
tongue.
9
4.10 Overdose (symptoms, emergency procedures, antidotes), if necessary
Lesions (erosion/ulceration) of the oral mucosa and of the skin around the mouth may occasionally be
observed in treated animals when administered the recommended treatment dose. Typically, these
lesions are mild and resolve without treatment, but oral lesions may be associated with salivation and
labial and tongue oedema. The incidence of oral/skin lesions increases with increasing dose.
At high dosages and prolonged treatment (3 times the recommended dose for 42 consecutive days and
2.5 times the recommended dose for 92 consecutive days administered once daily) mild to moderate
renal lesions were observed. If clinical signs occur, treatment should be discontinued and symptomatic
treatment initiated.
4.11 Withdrawalperiod
Meat and offal: 26 days
Do not use in mares producing milk for human consumption.
5.
PHARMACOLOGICAL PROPERTIES
Pharmacotherapeutic group: Anti-inflammatory and anti-rheumatic products, non-steroids, ATC vet
code: QM01AH90.
5.1 Pharmacodynamic properties
Firocoxib is a non-steroidal anti-inflammatory drug (NSAID) belonging to the Coxib group, which
acts by selective inhibition of cyclooxygenase-2 (COX-2)-mediated prostaglandin synthesis.
Cyclooxygenase is responsible for generation of prostaglandins. COX-2 is the isoform of the enzyme
that has been shown to be induced by pro-inflammatory stimuli and has been postulated to be
primarily responsible for the synthesis of prostanoid mediators of pain, inflammation, and fever.
Coxibs therefore display analgesic, anti-inflammatory, and antipyretic properties. COX-2 is also
thought to be involved in ovulation, implantation and closure of the ductus arteriosus, and central
nervous system functions (fever induction, pain perception, and cognitive function). “In “ in vitro
equine whole blood assays, firocoxib exhibits 222 to 643 fold selectivity for COX-2 over COX-1. The
concentration of firocoxib required to inhibit 50% of the COX-2 enzyme (i.e., the IC50) is 0.0369 to
0.12 μM, whereas the IC50 for COX-1 is 20.14 to 33.1 μM .
5.2 Pharmacokinetic particulars
Following oral administration in horses at the recommended dose of 0.1 mg per kg of bodyweight,
firocoxib is rapidly absorbed, and the time to maximal concentration (T max ) is 3.9 (± 4.4) hours. The
peak concentration (C max ) is 0.075 (± 0.033) µg/ml (equivalent to approximately 0.223 µM), area
under the curve (AUC 0-24 ) is 0.96 (± 0.26) µg x hr/ml, and oral bioavailability is 79 (± 31) percent.
The elimination half-life (t ½ ) after a single dose is 29.6 (± 7.5) hours and 50.6 hours after 14 days of
dosing. Firocoxib is approximately 97% bound to plasma proteins. Following multiple oral
administrations, the steady state is reached by approximately the eighth daily dose. Firocoxib is
metabolised predominantly by dealkylation and glucuronidation in the liver. Elimination is principally
in the excreta (primarily the urine), with some biliary excretion also observed.
6.
PHARMACEUTICAL PARTICULARS
6.1 List of excipients
Titanium dioxide (E 171)
Glycerol triacetate
10
Silica, colloidal anhydrous
Magnesium carbonate, heavy
Macrogol 300
6.2 Incompatibilities
Not applicable.
6.3 Shelf life
Shelf life of the veterinary medicinal product as packaged for sale: 3 years
Shelf life after first opening the syringe: 3 months
6.4 Special precautions for storage
Replace cap after use.
This medicinal product does not require any special storage conditions.
6.5 Nature and composition of immediate packaging
Pre-filled oral syringes made of polypropylene, with a polyethylene cap, a rubber rod tip, and a
polypropylene plunger rod.
Each syringe contains a net weight of 7.32 g of oral paste and is labelled in 100 kg dosing increments.
Each syringe is packaged in an individual carton box.
6.6 Special precautions for the disposal of unused veterinary medicinal products or waste
materials derived from the use of such products
Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal
products should be disposed of in accordance with local requirements.
7.
MARKETING AUTHORISATION HOLDER
MERIAL
29 avenue Tony Garnier
FR-69007 Lyon
France.
8. MARKETING AUTHORISATION NUMBER
EU/2/04/045/007
9. DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION
13/09/2004
10. DATE OF REVISION OF THE TEXT
10/04/2008
11
PROHIBITION OF SALE, SUPPLY AND/OR USE
Not applicable.
Detailed information on this veterinary medicinal product is available on the website of the European
Medicines Agency (EMA) http://www.ema.europa.eu/
12
ANNEX II
A.
MANUFACTURING AUTHORISATION HOLDER(S) RESPONSIBLE FOR
BATCH RELEASE
B.
CONDITIONS OR RESTRICTIONS OF THE MARKETING
AUTHORISATION REGARDING SUPPLY OR USE
C.
CONDITIONS OR RESTRICTIONS OF THE MARKETING
AUTHORISATION WITH REGARD TO SAFE AND EFFECTIVE USE
D.
STATEMENT OF THE MRLs
13
A. MANUFACTURING AUTHORISATION HOLDER(S) RESPONSIBLE FOR BATCH
RELEASE
Name and address of the manufacturer responsible for batch release
Merial S.A.S.
4 Chemin de Calquet
31300 Toulouse
France
B. CONDITIONS OR RESTRICTIONS OF THE MARKETING AUTHORISATION
REGARDING SUPPLY OR USE
To be supplied only on veterinary prescription.
C. CONDITIONS OR RESTRICTIONS OF THE MARKETING AUTHORISATION WITH
REGARD TO THE SAFE AND EFFECTIVE USE OF THE PRODUCT
Not applicable
D. STATEMENT OF THE MRLs
In accordance with Council Regulation (EEC) No 2377/90, as amended and in accordance with Article
34.4b of Regulation (EC) No 726/2004 of 31 March 2004.
Firocoxib is included in Annex I of Council Regulation (EEC) No 2377/90 in accordance with the
following table:
Pharmacologically
active substance(s)
Marker
residue
Animal
species
MRLs
Target
tissues
Other provisions
Firocoxib
Firocoxib
Equidae 10 μg/kg
15 μg/kg
60 μg/kg
10 μg/kg
Muscle
Fat
Liver
Kidney
14
 
ANNEX III
LABELLING AND PACKAGE LEAFLET
15
A. LABELLING
16
PARTICULARS TO APPEAR ON THE OUTER PACKAGE
Carton Box labelling
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Previcox 57 mg chewable tablets for dogs
2.
STATEMENT OF ACTIVE AND OTHER SUBSTANCES
Firocoxib 57 mg
3.
PHARMACEUTICAL FORM
Chewable tablet
4.
PACKAGE SIZE
10 tablets
30 tablets
180 tablets
5.
TARGET SPECIES
Dogs
6.
INDICATION(S)
Pain and inflammation associated with osteoarthritis.
Peri-operative pain management.
7.
METHOD AND ROUTE(S) OF ADMINISTRATION
Oral use.
Administer 5 mg per kg bodyweight once daily.
8.
WITHDRAWAL PERIOD
Not applicable
9.
SPECIAL WARNING(S), IF NECESSARY
Read the package leaflet before use.
17
 
10. EXPIRY DATE
EXP {month/year}
Half tablets should be returned to the original market container and may be stored for up to 7 days
11. SPECIAL STORAGE CONDITIONS
Do not store above 30°C.
12. SPECIAL PRECAUTIONS FOR THE DISPOSAL OF UNUSED PRODUCTS OR
WASTE MATERIALS, IF ANY
Read the package leaflet before use.
13. THE WORDS “FOR ANIMAL TREATMENT ONLY” AND CONDITIONS OR
RESTRICTIONS REGARDING SUPPLY AND USE, if applicable
For animal treatment only - to be supplied only on veterinary prescription.
14. THE WORDS “KEEP OUT OF THE REACH AND SIGHT OF CHILDREN”
Keep out of the reach and sight of children.
15. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER
MERIAL, 29 avenue Tony Garnier, FR-69007 Lyon, France
16. MARKETING AUTHORISATION NUMBER(S)
EU/2/04/045/001 10 tablets
EU/2/04/045/002 30 tablets
EU/2/04/045/005 180 tablets
17. MANUFACTURER’S BATCH NUMBER
Lot
18
 
PARTICULARS TO APPEAR ON THE OUTER PACKAGE
Carton Box labelling
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Previcox 227 mg chewable tablets for dogs
2.
STATEMENT OF ACTIVE AND OTHER SUBSTANCES
Firocoxib 227 mg
3.
PHARMACEUTICAL FORM
Chewable tablet
4.
PACKAGE SIZE
10 tablets
30 tablets
180 tablets
5.
TARGET SPECIES
Dogs
6.
INDICATION(S)
Pain and inflammation associated with osteoarthritis.
Peri-operative pain management.
7.
METHOD AND ROUTE(S) OF ADMINISTRATION
Oral use.
Administer 5 mg per kg bodyweight once daily.
8.
WITHDRAWAL PERIOD
Not applicable
9.
SPECIAL WARNING(S), IF NECESSARY
Read the package leaflet before use.
19
 
10. EXPIRY DATE
EXP {month/year}
Half tablets should be returned to the original market container and may be stored for up to 7 days
11. SPECIAL STORAGE CONDITIONS
Do not store above 30°C.
12. SPECIAL PRECAUTIONS FOR THE DISPOSAL OF UNUSED PRODUCTS OR
WASTE MATERIALS, IF ANY
Read the package leaflet before use.
13. THE WORDS “FOR ANIMAL TREATMENT ONLY” AND CONDITIONS OR
RESTRICTIONS REGARDING SUPPLY AND USE, if applicable
For animal treatment only - to be supplied only on veterinary prescription.
14. THE WORDS “KEEP OUT OF THE REACH AND SIGHT OF CHILDREN”
Keep out of the reach and sight of children.
15. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER
MERIAL, 29 avenue Tony Garnier, FR-69007 Lyon, France
16. MARKETING AUTHORISATION NUMBER(S)
EU/2/04/045/003 10 tablets
EU/2/04/045/004 30 tablets
EU/2/04/045/006 180 tablets
17. MANUFACTURER’S BATCH NUMBER
Lot
20
 
MINIMUM PARTICULARS TO APPEAR ON BLISTERS OR STRIPS
{NATURE/TYPE}
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Previcox 57 mg chewable tablets
Firocoxib
2.
NAME OF THE MARKETING AUTHORISATION HOLDER
MERIAL
3.
EXPIRY DATE
EXP {month/year}
4.
BATCH NUMBER
Lot
21/33
 
MINIMUM PARTICULARS TO APPEAR ON BLISTERS OR STRIPS
{NATURE/TYPE}
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Previcox 227 mg chewable tablets
Firocoxib
2.
NAME OF THE MARKETING AUTHORISATION HOLDER
MERIAL
3.
EXPIRY DATE
EXP {month/year}
4.
BATCH NUMBER
Lot
22
 
PARTICULARS TO APPEAR ON THE OUTER PACKAGE
Carton box labelling
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Previcox 8.2 mg/g oral paste for horses.
2.
STATEMENT OF ACTIVE AND OTHER SUBSTANCES
Firocoxib 8.2 mg/g
3.
PHARMACEUTICAL FORM
Oral paste.
4.
PACKAGE SIZE
1 syringe.
5.
TARGET SPECIES
Horses.
6.
INDICATION(S)
Alleviation of pain and inflammation associated with osteoarthritis and reduction of associated
lameness in horses .
7.
METHOD AND ROUTE(S) OF ADMINISTRATION
Oral use.
8.
WITHDRAWAL PERIOD
Withdrawal period: Meat and offal: 26 days.
Do not use in mares producing milk for human consumption.
9.
SPECIAL WARNING(S), IF NECESSARY
Read the package leaflet before use.
23
 
10. EXPIRY DATE
EXP {month/year}
Once broached, use within 3 months.
11. SPECIAL STORAGE CONDITIONS
This medicinal product does not require any special storage conditions. Replace cap after use.
12. SPECIFIC PRECAUTIONS FOR THE DISPOSAL OF UNUSED PRODUCT OR
WASTE MATERIALS , IF ANY
Read the package leaflet before use.
13. THE WORDS “FOR ANIMAL TREATMENT ONLY” AND CONDITIONS OR
RESTRICTIONS REGARDING SUPPLY AND USE, if applicable
For animal treatment only. To be supplied only on veterinary prescription.
14. THE WORDS “KEEP OUT OF THE REACH AND SIGHT OF CHILDREN”
Keep out of the reach and sight of children.
15. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER
MERIAL, 29 avenue Tony Garnier, FR-69007 Lyon, France.
16. MARKETING AUTHORISATION NUMBER(S)
EU/2/04/045/007
17. MANUFACTURER’S BATCH NUMBER
Lot {number}
24
 
MINIMUM PARTICULARS TO APPEAR ON SMALL IMMEDIATE PACKAGING UNITS
Syringe labelling
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Previcox 8.2 mg/g oral paste for horses
2.
QUANTITY OF THE ACTIVE SUBSTANCE(S)
Firocoxib 8.2 mg/g
3.
CONTENTS BY WEIGHT, BY VOLUME OR NUMBER OF DOSES
7.32 g of oral paste
4.
ROUTE(S) OF ADMINISTRATION
Oral use.
5.
WITHDRAWAL PERIOD
Withdrawal period: Meat and offal: 26 days.
Do not use in mares producing milk for human consumption.
6.
BATCH NUMBER
Lot {number}
7.
EXPIRY DATE
EXP {month/year}
Once broached, use within 3 months.
8.
THE WORDS “FOR ANIMAL TREATMENT ONLY”
For animal treatment only.
25
 
B. PACKAGE LEAFLET
26
PACKAGE LEAFLET
Previcox 57 mg chewable tablets for dogs
Previcox 227 mg chewable tablets for dogs
1.
NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER AND OF
THE MANUFACTURING AUTHORISATION HOLDER RESPONSIBLE FOR BATCH
RELEASE, IF DIFFERENT
Marketing authorisation holder :
MERIAL, 29 avenue Tony Garnier, FR-69007 Lyon, France
Manufacturer for the batch release :
MERIAL, 4 Chemin du Calquet, FR-31300 Toulouse, France
2.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Previcox 57 mg chewable tablets for dogs
Previcox 227 mg chewable tablets for dogs
3.
STATEMENT OF THE ACTIVE SUBSTANCE(S) AND OTHER INGREDIENT(S)
Each tablet contains:
Firocoxib 57 mg
Firocoxib 227 mg
Iron oxides (E172)
Caramel (E150d)
4.
INDICATION(S)
For the relief of pain and inflammation associated with osteoarthritis in dogs.
For the relief of post-operative pain and inflammation associated with soft-tissue and orthopaedic
surgery in dogs.
5.
CONTRAINDICATIONS
Do not use in pregnant or lactating bitches.
Laboratory studies in rabbits have shown evidence of maternotoxic and foetotoxic effects at dose rates
approximating the recommended treatment dose for the dog.
Do not use in animals less than 10 weeks of age or less than 3 kg bodyweight.
Do not use in animals suffering from gastrointestinal bleeding, blood dyscrasia or haemorrhagic
disorders.
Do not use concomitantly with corticosteroids or other non-steroidal anti-inflammatory drugs
(NSAID).
6.
ADVERSE REACTIONS*
Emesis and diarrhoea have occasionally been reported. These reactions are generally of a transitory
nature and are reversible when the treatment is stopped. Renal and/or hepatic disorders have been
reported in very rare cases in dogs administered the recommended treatment dose . Rarely, nervous
system disorders have been reported in treated dogs
27
If adverse reactions like vomiting, repeated diarrhoea, faecal occult blood, sudden weight loss,
anorexia, lethargy, degradation of renal or hepatic biochemistry parameters occur, use of the product
should be stopped and the advice of a veterinarian should be sought. As with other NSAIDs, serious
adverse effects can occur and, in very rare cases, may be fatal.
If you notice any serious effects or other effects not mentioned in this leaflet, please inform your
veterinary surgeon.
* The frequency of possible adverse effects is defined using the following convention:
Rare (affects 1 to 10 animals in 10,000)
Very rare (affects less than 1 animal in 10,000)
7.
TARGET SPECIES
Dogs.
8.
DOSAGE FOR EACH SPECIES, ROUTE(S) AND METHOD OF ADMINISTRATION
5 mg/kg once daily.
For the reduction of post-operative pain and inflammation, the animals can be dosed starting
approximately 2 hours before surgery for up to 3 consecutive days as needed. Following orthopaedic
surgery and depending on the response observed, treatment using the same daily dosing schedule may
be continued after the first 3 days, upon judgement of the attending veterinarian.
For oral use as per table below.
Body weight (kg)
Number of chewable tablets by size
57 mg
227 mg
3 – 5.5
0.5
5.6 – 10
1
10.1 – 15
1.5
15.1 – 22
0.5
22.1 – 45
1
45.1 – 68
1.5
68.1 – 90
2
9.
ADVICE ON CORRECT ADMINISTRATION
Tablets can be administered with or without food. Do not exceed the recommended dose.
Duration of treatment will be dependent on the response observed. As field studies were limited to 90
days, longer-term treatment should be considered carefully and regular monitoring undertaken by the
veterinarian.
10. WITHDRAWAL PERIOD
Not applicable
11. SPECIAL STORAGE PRECAUTIONS
Keep out of the reach and sight of children.
28
 
Do not store above 30°C.
In order to protect from moisture, store in the original package.
Do not use after the expiry date stated on the label
Half tablets should be returned to the original market container and may be stored for up to 7 days
12. SPECIAL WARNING(S)
Use in very young animals, or animals with suspected or confirmed impairment of renal, cardiac or
hepatic function may involve additional risk. If such use cannot be avoided, those dogs require careful
veterinary monitoring. Appropriate laboratory testing is recommended prior to treatment in order to
detect subclinical (asymptomatic) renal or hepatic disorders that may predispose to adverse effects.
Avoid use in any dehydrated, hypovolaemic or hypotensive animals, as there is a risk of increased
renal toxicity. Concurrent administration of potentially nephrotoxic drugs should be avoided.
Use this product under strict veterinary monitoring where there is a risk of gastro-intestinal bleeding,
or if the animal previously displayed intolerance to NSAIDs. The treatment should be discontinued if
any of these signs are observed: repeated diarrhoea, vomiting, faecal occult blood, sudden weight loss,
anorexia, lethargy, degradation of renal or hepatic biochemistry parameters.
As anaesthetic drugs may affect renal perfusion, the use of parenteral fluids during surgery should be
considered to decrease potential renal complications when using NSAIDs peri-operatively.
Pre-treatment with other anti-inflammatory substances may result in additional or increased adverse
effects and accordingly a treatment-free period with such drugs should be observed for at least 24
hours before the commencement of treatment with Previcox. The treatment-free period, however,
should take into account the pharmacokinetic properties of the products used previously.
Previcox must not be administered in conjunction with other NSAIDs or glucocorticosteroids.
Gastrointestinal tract ulceration may be exacerbated by corticosteroids in animals given non-steroidal
anti-inflammatory drugs.
Concomitant treatment with molecules displaying action on renal flow, e.g. diuretics or Angiotensin
Converting Enzyme (ACE) inhibitors, should be subject to clinical monitoring. Concurrent
administration of potentially nephrotoxic drugs should be avoided as there might be an increased risk
for renal toxicity. Concurrent use of other active substances that have a high degree of protein binding
may compete with firocoxib for binding and thus lead to toxic effects.
In case of accidental ingestion, seek medical advice immediately and show the package insert or the
label to the physician.
Wash hands after use of the product.
13. SPECIAL PRECAUTIONS FOR THE DISPOSAL OF UNUSED PRODUCT OR WASTE
MATERIALS, IF ANY
Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal
products should be disposed of in accordance with local requirements.
14. DATE ON WHICH THE PACKAGE LEAFLET WAS LAST APPROVED
01/2010
Detailed information on this product is available on the website of the European Medicines Agency
15. OTHER INFORMATION
29
Mode of action:
Firocoxib is a non-steroidal anti-inflammatory drug (NSAID) that acts by selective inhibition of
cyclooxygenase-2 (COX-2) – mediated prostaglandin synthesis. COX-2 is the isoform of the enzyme
that has been postulated to be primarily responsible for the synthesis of prostanoid mediators of pain,
inflammation, and fever. In in-vitro canine whole blood assays, firocoxib exhibited approximately
380-fold selectivity for COX-2 over COX-1.
Previcox Chewable tablets are scored to facilitate accurate dosing and contain caramel and smoke
flavours to facilitate administration to dogs. Not all pack sizes may be marketed.
The chewable tablets are available in the following pack sizes:
57 mg: 1 carton box containing one blister of 10 tablets
1 carton box containing three blisters of 10 tablets each
1 carton box containing eighteen blisters of 10 tablets each
227 mg: 1 carton box containing one blister of 10 tablets
1
box
containing
three
blisters
of
10
tablets
each
1 carton box containing eighteen blisters of 10 tablets each
30
carton
PACKAGE LEAFLET
Previcox 8.2 mg/g oral paste for horses
1.
NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER AND OF
THE MANUFACTURING AUTHORISATION HOLDER RESPONSIBLE FOR BATCH
RELEASE
Marketing authorisation holder :
MERIAL, 29 avenue Tony Garnier, 69007 Lyon, France.
Manufacturer for the batch release :
MERIAL, 4 chemin du Calquet, FR-31300 Toulouse, France.
2.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Previcox 8.2 mg/g oral paste for horses.
3.
STATEMENT OF THE ACTIVE SUBSTANCE AND OTHER INGREDIENTS
Firocoxib 8.2 mg/g
4.
INDICATIONS
Alleviation of pain and inflammation associated with osteoarthritis and reduction of associated
lameness in horses .
5.
CONTRAINDICATIONS
Do not use in animals suffering from gastrointestinal disorders and haemorrhage, impaired hepatic,
cardiac or renal function and bleeding disorders.
Do not use in breeding, pregnant or lactating animals.
Do not use concomitantly with corticosteroids or other NSAIDs.
6.
ADVERSE REACTIONS
Lesions (erosion/ulceration) of the oral mucosa and of the skin around the mouth may occasionally be
observed in treated animals. Typically, these lesions are mild and resolve without treatment, but oral
lesions may be associated with salivation and labial and tongue oedema.
If you notice any serious effects or other effects not mentioned in this leaflet, please inform your
veterinary surgeon.
7.
TARGET SPECIES
Horses.
8.
DOSAGE FOR EACH SPECIES, ROUTE AND METHOD OF ADMINISTRATION
0.1 mg firocoxib per kg bodyweight, once daily for up to 14 days.
31
Oral use.
9.
ADVICE ON CORRECT ADMINISTRATION
To administer Previcox at the dose of 0.1 mg firocoxib/kg, set the syringe plunger to the appropriate
dose division for the horse’s weight. Each full dose division on the syringe plunger delivers sufficient
firocoxib to treat 100 kg body weight. The contents of one syringe will treat horses weighing up to
600 kg.
To deliver firocoxib at the appropriate dosage, unlock the knurled ring on the syringe plunger by
rotating it ¼ turn and slide it along the plunger shaft to the appropriate dose division for the horse’s
weight. Rotate the plunger ring ¼ turn to lock it in place and ensure it is locked.
Make sure the horse’s mouth contains no feed. Remove the cover from the tip of the syringe. Insert the
syringe tip into the horse’s mouth at the interdental space and deposit the paste on the base of the
tongue.
10. WITHDRAWAL PERIOD
Withdrawal period: Meat and offal: 26 days.
Do not use in mares producing milk for human consumption.
11. SPECIAL STORAGE PRECAUTIONS
Keep out of the reach and sight of children.
This veterinary medicinal product does not require any special storage conditions.
Replace cap after use.
Do not use after the expiry date stated on the label.
Shelf-life after first opening the syringe: 3 months.
12. SPECIAL WARNINGS
If side effects occur, treatment should be discontinued and the advice of a veterinarian should be
sought. Avoid use in any dehydrated, hypovolaemic or hypotensive animal, as there may be potential
risk of increased renal toxicity. Concurrent administration of potentially nephrotoxic drugs should be
avoided.
Do not use in animals less than 10 weeks.
The recommended treatment dose and duration should not be exceeded.
In case of accidental ingestion, seek medical advice immediately and show the package leaflet or the
label to the physician.
Avoid contact with eyes and skin. If it occurs, rinse affected area immediately with water.
Wash hands after use of the product.
Pregnant women should avoid contact with the medicinal product.
Other NSAIDs, diuretic and substances with high protein binding may compete for binding and lead to
toxic effects. Do not use concomitantly with corticosteroids or other NSAIDs.
Pre-treatment with other anti-inflammatory substances may result in additional or increased adverse
effects and a treatment-free period with such products should therefore be observed. The treatment-
free period should take into account the pharmacological properties of the products used previously.
32
Concomitant treatment with molecules displaying action on renal flow (e.g. diuretics) should be
subject to clinical monitoring. Concurrent administration of potentially nephrotoxic drugs should be
avoided as there might be an increased risk of renal toxicity.
No data on use during pregnancy is available in horses. Therefore, do not use in breeding, pregnant or
lactating animals.
13. SPECIAL PRECAUTIONS FOR THE DISPOSAL OF UNUSED PRODUCT OR WASTE
MATERIALS, IF ANY
Ask your veterinary surgeon how to dispose of medicines no longer required. These measures should
help to protect the environment.
14. DATE ON WHICH THE PACKAGE LEAFLET WAS LAST APPROVED
Detailed information on this product is available on the website of the European Medicines Agency
15. OTHER INFORMATION
Firocoxib is a non-steroidal anti-inflammatory drug (NSAID) belonging to the Coxib group, which
acts by selective inhibition of cyclooxygenase-2 (COX-2)-mediated prostaglandin synthesis.
Each syringe is packaged in an individual carton box.
33


Source: European Medicines Agency



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