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Revision as of 21:44, 29 August 2011 editCheMoBot (talk | contribs)Bots141,565 edits Updating {{drugbox}} (changes to watched fields - updated 'ChemSpiderID_Ref', 'ChEMBL_Ref', 'ChEBI_Ref', 'StdInChI_Ref', 'StdInChIKey_Ref', 'ChEBI_Ref') per Chem/Drugbox validation (report [[Wiki← Previous edit		Latest revision as of 13:05, 30 October 2024 edit undo2600:1700:8750:9890:b152:f0aa:706a:f53d (talk) →AdministrationTags: Mobile edit Mobile web edit
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			{{Short description|NSAID analgesic veterinary drug}}
	{{Drugbox		{{Drugbox
			| Verifiedfields = changed
	| Watchedfields = changed		| Watchedfields = changed
	| verifiedrevid = 437138149		| verifiedrevid = 447383576
	| IUPAC_name = 2-<nowiki>amino]pyridine-3-carboxylic acid		| IUPAC_name = 2-<nowiki>amino]pyridine-3-carboxylic acid
	| image = Flunixin Structural Formulae V.1.svg		| image = Flunixin Structural Formulae V.1.svg
			| ChEMBL_Ref = {{ebicite|changed|EBI}}
			| ChEMBL = 1652146
	<!--Clinical data-->		<!--Clinical data-->
	| tradename =		| tradename =
	| Drugs.com = {{drugs.com|international|flunixin}}		| Drugs.com = {{drugs.com|international|flunixin}}
	| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->		| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
	| pregnancy_US = <!-- A / B / C / D / X -->		| pregnancy_US = <!-- A / B / C / D / X -->
	| pregnancy_category =		| pregnancy_category =
	| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled-->		| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled-->
	| legal_CA = <!-- Schedule I, II, III, IV, V, VI, VII, VIII -->		| legal_CA = <!-- Schedule I, II, III, IV, V, VI, VII, VIII -->
	| legal_UK = <!-- GSL, P, POM, CD, or Class A, B, C -->		| legal_UK = <!-- GSL, P, POM, CD, or Class A, B, C -->
	| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V -->		| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V -->
	| legal_status =		| legal_status =
	| routes_of_administration =		| routes_of_administration =
	<!--Pharmacokinetic data-->		<!--Pharmacokinetic data-->
	| bioavailability =		| bioavailability =
	| protein_bound =		| protein_bound =
	| metabolism =		| metabolism =
	| elimination_half-life =		| elimination_half-life =
	| excretion =		| excretion =
	<!--Identifiers-->		<!--Identifiers-->
			| CAS_number_Ref = {{cascite|correct|??}}
	| CAS_number = 38677-85-9		| CAS_number = 38677-85-9
	| ATCvet = yes		| ATCvet = yes
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	| PubChem = 38081		| PubChem = 38081
	| DrugBank_Ref = {{drugbankcite|correct|drugbank}}		| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
	| DrugBank =		| DrugBank =
	| UNII_Ref = {{fdacite|correct|FDA}}		| UNII_Ref = {{fdacite|correct|FDA}}
	| UNII = 356IB1O400		| UNII = 356IB1O400
	| KEGG_Ref = {{keggcite|correct|kegg}}		| KEGG_Ref = {{keggcite|correct|kegg}}
	| KEGG = D04215		| KEGG = D04215
			| ChEBI_Ref = {{ebicite|changed|EBI}}
			| ChEBI = 76138
			| ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}}
			| ChemSpiderID = 34911
			| smiles = CC1=C(C=CC=C1NC2=C(C=CC=N2)C(=O)O)C(F)(F)F
			| StdInChI_Ref = {{stdinchicite|changed|chemspider}}
			| StdInChI = 1S/C14H11F3N2O2/c1-8-10(14(15,16)17)5-2-6-11(8)19-12-9(13(20)21)4-3-7-18-12/h2-7H,1H3,(H,18,19)(H,20,21)
			| StdInChIKey_Ref = {{stdinchicite|changed|chemspider}}
			| StdInChIKey = NOOCSNJCXJYGPE-UHFFFAOYSA-N
	<!--Chemical data-->		<!--Chemical data-->
	| C=14 | H=11 | F=3 | N=2 | O=2		| C=14 | H=11 | F=3 | N=2 | O=2
	| molecular_weight = 296.24 g/mol
	}}		}}
	'''Flunixin''' is a ] (NSAID), ], and ] used in horses. It is often formulated as the ] ]. In the United States, it is regulated by the ] (FDA), and may only be lawfully distributed by order of a licensed veterinarian.		'''Flunixin''' is a ] (NSAID), ], and ] used in horses, cattle and pigs. It is often formulated as the ] ]. In the United States, it is regulated by the ] (FDA), and may only be lawfully distributed by order of a licensed veterinarian. There are many trade names for the product.
			==Dosage and uses in horses==
	==Uses==
			Flunixin is administered at a dose of 1.1&nbsp;mg/kg.<ref name="McIlwraith">{{cite journal | vauthors = McIlwraith CW, Frisbie DD, Kawcak CE | title = Nonsteroidal Anti-Inflammatory Drugs | journal = Proc. AAEP | date = 2001 | volume = 47 | pages = 182–187 }}</ref> The full analgesic and antipyretic effects usually occur 1–2 hours following treatment, but there is often an effective analgesic effect within approximately 15 minutes. Despite its short ] of 1.6–2.5 hours, effects can persist for up to 30 hours,<ref>{{cite book | vauthors = May SA, Lees P | chapter = Nonsteroidal anti-inflammatory drugs | veditors = McIlwraith CW, Trotter GW | title = Joint Disease in the Horse | location = Philadelphia | publisher = WB Saunders | date = 1996 | pages = 223–237 }}</ref> with maximal effects occurring between 2 and 16 hours. This is likely due to accumulation of the drug at inflammatory foci. Flunixin is primarily eliminated by the kidneys.<ref name="pmid3247913">{{cite journal | vauthors = Soma LR, Behrend E, Rudy J, Sweeney RW | title = Disposition and excretion of flunixin meglumine in horses | journal = American Journal of Veterinary Research | volume = 49 | issue = 11 | pages = 1894–8 | date = November 1988 | pmid = 3247913 }}</ref>
	Because it targets the inflamed tissue, flunixin is mainly used for ] pain, muscle pain, and joint disease, as well as to alleviate fevers and pain, and prevent ]. It is also effective in injuries of the eye.
			Because it targets the inflamed tissue, flunixin is mainly used for ] pain, musculoskeletal pain, and ocular pain.<ref name="Foreman_2012">{{cite journal | vauthors = Foreman JH, Bergstrom BE, Golden KS, Roark JJ, Coren DS, Foreman CR, Schumacher SA | title = Dose titration of the clinical efficacy of intravenously administered flunixin meglumine in a reversible model of equine foot lameness | journal = Equine Veterinary Journal. Supplement | issue = 43 | pages = 17–20 | date = December 2012 | volume = 44 | pmid = 23447872 | doi = 10.1111/j.2042-3306.2012.00655.x | doi-access = free }}</ref><ref name="pmid9118091">{{cite journal | vauthors = Jochle W, Moore JN, Brown J, Baker GJ, Lowe JE, Fubini S, Reeves MJ, Watkins JP, White NA | title = Comparison of detomidine, butorphanol, flunixin meglumine and xylazine in clinical cases of equine colic | journal = Equine Veterinary Journal. Supplement | issue = 7 | pages = 111–6 | date = June 1989 | volume = 21 | pmid = 9118091 | doi = 10.1111/j.2042-3306.1989.tb05668.x }}</ref><ref name="pmid21781166">{{cite journal | vauthors = Hilton HG, Magdesian KG, Groth AD, Knych H, Stanley SD, Hollingsworth SR | title = Distribution of flunixin meglumine and firocoxib into aqueous humor of horses | journal = Journal of Veterinary Internal Medicine | volume = 25 | issue = 5 | pages = 1127–33 | date = 2011 | pmid = 21781166 | doi = 10.1111/j.1939-1676.2011.0763.x | doi-access = free }}</ref> It is also used as an ] and to reduce the effects of ].<ref name="pmid12602591">{{cite journal | vauthors = Bryant CE, Farnfield BA, Janicke HJ | title = Evaluation of the ability of carprofen and flunixin meglumine to inhibit activation of nuclear factor kappa B | journal = American Journal of Veterinary Research | volume = 64 | issue = 2 | pages = 211–5 | date = February 2003 | pmid = 12602591 | doi = 10.2460/ajvr.2003.64.211 | doi-access = free }}</ref>
	The full analgesic and antipyretic effects usually occur 1-2 hours following treatment, but there is often an effective analgesic effect within approximately 15 minutes.
	==Side effects and precautions==		==Side effects and precautions==
			Flunixin is labeled for no more than 5 days of consecutive use and prolonged use increases the risk of toxicity. In horses, this includes ],<ref name="pmid19580940">{{cite journal | vauthors = Videla R, Andrews FM | title = New perspectives in equine gastric ulcer syndrome | journal = The Veterinary Clinics of North America. Equine Practice | volume = 25 | issue = 2 | pages = 283–301 | date = August 2009 | pmid = 19580940 | doi = 10.1016/j.cveq.2009.04.013 }}</ref> right dorsal colitis,<ref name="pmid18980433">{{cite journal | vauthors = McConnico RS, Morgan TW, Williams CC, Hubert JD, Moore RM | title = Pathophysiologic effects of phenylbutazone on the right dorsal colon in horses | journal = American Journal of Veterinary Research | volume = 69 | issue = 11 | pages = 1496–505 | date = November 2008 | pmid = 18980433 | doi = 10.2460/ajvr.69.11.1496 | doi-access = free }}</ref> and ].<ref name="pmid3487106">{{cite journal | vauthors = Black HE | title = Renal toxicity of non-steroidal anti-inflammatory drugs | journal = Toxicologic Pathology | volume = 14 | issue = 1 | pages = 83–90 | date = 1986 | pmid = 3487106 | doi = 10.1177/019262338601400110 | s2cid = 28865193 }}</ref>
	Flunixin should not be given for more than five days. Like most NSAIDs, it can produce ] (GI) side effects if the drug is given in high doses or over several days. GI ulceration is the most common side effect, especially in the animal's large colon or stomach, and is most likely to occur if the drug is given for a prolonged period. Other side effects include kidney damage and bleeding problems. It should be used with caution in horses with kidney or liver disease.
			Flunixin is a prohibited substance under ] rules,<ref>{{cite web|title=FEI Prohibited Substances List|date=28 October 2013 |url=http://www.fei.org/fei/cleansport/ad-h/prohibited-list|access-date=23 January 2016}}</ref> and its use is prohibited or restricted by many other equestrian organizations. At labeled dose (1.1&nbsp;mg/kg) given IV, detection time was found to be 144 hours.<ref>{{cite web|title=FEI List of Detection Times|url=http://www.fei.org/system/files/FEI%20detection%20times%20lab%202015.pdf|access-date=23 January 2016}}</ref> However, drug recycling from bedding contamination by treated horses has been shown to potentially increase the clearance time.<ref name="pmid21995754">{{cite journal | vauthors = Popot MA, Garcia P, Bonnaire Y | title = Doping control in horses: housing conditions and oral recycling of flunixin by ingestion of contaminated straw | journal = Journal of Veterinary Pharmacology and Therapeutics | volume = 34 | issue = 6 | pages = 612–4 | date = December 2011 | pmid = 21995754 | doi = 10.1111/j.1365-2885.2011.01276.x }}</ref>
	Flunixin does not treat the underlying problem causing the fever or pain, only the symptoms. Additionally, pain is often useful for a veterinarian to diagnose a horse's condition, and masking it with flunixin may do more harm than good. For this reason, there are many veterinarians who do not wish for the animal to be given flunixin if colic is suspected, instead preferring to withhold the drug until the need for colic surgery has been determined. It is therefore advisable to ask the horse's veterinarian before giving the drug.
		⚫	==Administration==
	Flunixin is a prohibited class A drug under ] rules, and its use is prohibited or restricted by many other equestrian organizations. It can be detected in the blood for 2-3 days, and in the urine up to 15 days following administration.
			Flunixin may be given orally as a paste, as granules in feed, or intravenously(IV). It is strongly recommended that it not be administered intramuscularly (IM) as it is very irritating to tissue and IM administration has been associated with ] in horses,<ref name="pmid12553469">{{cite journal | vauthors = Peek SF, Semrad SD, Perkins GA | title = Clostridial myonecrosis in horses (37 cases 1985-2000) | journal = Equine Veterinary Journal | volume = 35 | issue = 1 | pages = 86–92 | date = January 2003 | pmid = 12553469 | doi = 10.2746/042516403775467513 }}</ref> so IV administration is preferred.
			Administration of ] to a horse also receiving flunixin has been shown to increase the risk of toxicity without improving analgesia.<ref name="pmid22082440">{{cite journal | vauthors = Foreman JH, Ruemmler R | title = Phenylbutazone and flunixin meglumine used singly or in combination in experimental lameness in horses | journal = Equine Veterinary Journal. Supplement | issue = 40 | pages = 12–7 | date = November 2011 | volume = 43 | pmid = 22082440 | doi = 10.1111/j.2042-3306.2011.00485.x | doi-access = free }}</ref><ref name="pmid16506899">{{cite journal | vauthors = Reed SK, Messer NT, Tessman RK, Keegan KG | title = Effects of phenylbutazone alone or in combination with flunixin meglumine on blood protein concentrations in horses | journal = American Journal of Veterinary Research | volume = 67 | issue = 3 | pages = 398–402 | date = March 2006 | pmid = 16506899 | doi = 10.2460/ajvr.67.3.398 }}</ref> For this reason, concurrent administration with another NSAID is not recommended. Doubling the dose of flunixin produces no improvement in analgesia, while potentially increasing the risk of toxicity.<ref name="Foreman_2012" />
	==Combining with other drugs==
	Flunixin should not be combined with other NSAIDs or corticosteriods, as this increases the risk of gastric ulcers, right dorsal colitis, and kidney disease. Additionally, veterinarians should use caution when combining it with anticoagulants or aminoglycoside antibiotics. Flunixin is commonly used with omeprazole, sucralfate, and cimetidine to protect the gastrointestinal tract.....
			In the US, the only labeled route for flunixin administration in cattle is intravenous and pour-on. This is not the case in other countries; for example, in the UK, Allevenix is licensed for IV and intramuscular use,<ref name="NOAH1">{{cite web|title=Allevinix 50 mg/ml solution for injection for cattle, pigs and horses|url=http://www.noahcompendium.co.uk/?id=-453339|website=NOAH Compendium|publisher=National Office of National Health|access-date=19 April 2017}}</ref> and a pour-on product also exists.<ref name="NOAH2">{{cite web|title=Finadyne Transdermal 50 mg/ml pour-on solution for cattle|url=http://www.noahcompendium.co.uk/?id=-454763|website=NOAH Compendium|publisher=National Office of National Health|access-date=19 April 2017}}</ref>
⚫	==Administration==
	Flunixin may be given orally as a paste or as granules in feed. It can also be used intramuscularly or intravenously, although because it is very irritating to tissue, the IV route is preferred, and in cattle it is the labeled route of administration.
			In the US flunixin is not labelled for goat use, however, flunixin may be used in goats in an extra-label fashion under appropriate veterinary guidance. Flunixin administered subcutaneously to dairy goats may carry a milk withdraw recommendation of 36-60 hours.<ref name="pmid32509803">{{cite journal | vauthors = Smith JS, Marmulak TL, Angelos JA, Lin Z, Rowe JD, Carlson JL, Shelver WL, Lee EA, Tell LA | title = Pharmacokinetic Parameters and Estimated Milk Withdrawal Intervals for Domestic Goats (Capra Aegagrus Hircus) After Administration of Single and Multiple Intravenous and Subcutaneous Doses of Flunixin Meglumine | journal = Frontiers in Veterinary Science | volume = 7 | pages = 213 | date = 2020 | pmid = 32509803 | pmc = 7248982 | doi = 10.3389/fvets.2020.00213 | doi-access = free }}</ref> Interestingly, when given subcutaneously to goats in that study, tissue injury, such as seen in horses with intramuscular administration, was not observed.
	Dosages are usually reduced for ponies, who are more at-risk for NSAID side effects, as well as horses with decreased liver or kidney function (such as older horses).
	==Trade names==		==See also==
			* ]
	In the USA the trade names are '''Banamine''', '''Flunixamine''', '''Citation''', '''Equileve''', and '''Meflosyl Solution'''. In the UK the trade names are '''Flunixin''', '''Finadyne''' and '''Cronyxin'''. In South Africa and Australia a common trade name is '''Finadyne'''.
	==Sources==		==References==
			{{Reflist}}
	# Forney, Barbara C, MS, VMD.Equine Medications, Revised Edition. Blood Horse Publications. Lexington, KY. Copyright 2007.
	==External links==		==External links==
	*		* {{Webarchive|url=https://web.archive.org/web/20070927031717/http://www.ivis.org/products/product.asp?BID=639 |date=2007-09-27 }}
	*		*
			*
			{{Anti-inflammatory products}}
			{{Prostanoidergics}}
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