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Veraflox

Veraflox Veraflox is one of the most recently developed antibiotics for use in dogs and cats. It is exceptionally effective against the major pathogens most often involved in infections involving the skin, mouth, respiratory system and urinary tract. Veraflox comes in 3 different sizes of tablets and as a liquid suspension.
Veraflox should not normally be used in dogs under 12 months of age (18 months for giant breeds) due to possible effects on the growing joints. It is safe to use in adults.
Veraflox
15mg » Priced per Tablet
• Usually ships in 24 hours, subject to prescription.
• Veterinary prescription from your vet required. (what's this?)
 £0.79 
(inc. VAT)
• Quick Find: 126651
60mg » Priced per Tablet
• Usually ships in 24 hours, subject to prescription.
• Veterinary prescription from your vet required. (what's this?)
 £1.90 
(inc. VAT)
• Quick Find: 126652
120mg » Priced per Tablet
• Usually ships in 24 hours, subject to prescription.
• Veterinary prescription from your vet required. (what's this?)
 £2.84 
(inc. VAT)
• Quick Find: 126650
Oral Suspension for Cats » 15ml Bottle
• Usually ships in 24 hours, subject to prescription.
• Veterinary prescription from your vet required. (what's this?)
 £10.54 
(inc. VAT)
• Quick Find: 126653

Below is the product datasheet. This has been provided by the manufacturer and should always be provided with the medication.

Introduction

vet004
Company name: Bayer plc
Address: Animal Health Division
Bayer House, Strawberry Hill,
Newbury
Berkshire RG14 1JA
Telephone: 01635 563000
Fax: 01635 563622
Email: animal.health@bayer.com
Website: www.bayer.co.uk/­animalhealth

Presentation

Veraflox 15 mg tablets are brownish single scored tablets for oral administration to cats and dogs, they contain 15 mg Pradofloxacin and have been marked with “P15” on one side.
Veraflox 60 mg tablets are brownish single scored tablets for oral administration to dogs, they contain 60 mg Pradofloxacin and have been marked with “P60” on one side.
Veraflox 120 mg tablets are brownish single scored tablets for oral administration to dogs, they contain 120 mg Pradofloxacin and have been marked with “P120” on one side. -

Uses

Cats: Treatment of acute infections of the upper respiratory tract caused by susceptible strains of Pasteurella multocida, Escherichia coli and the Staphylococcus intermedius group (including S. pseudintermedius).
Dogs: Treatment of:
· wound infections caused by susceptible strains of the Staphylococcus intermedius group (including S.pseudintermedius)
· superficial and deep pyoderma caused by susceptible strains of the Staphylococcus intermedius group (including S. pseudintermedius)
· acute urinary tract infections caused by susceptible strains of Escherichia coli and the Staphylococcus intermedius group (including S. pseudintermedius) and
· as adjunctive treatment to mechanical or surgical periodontal therapy in the treatment of severe infections of the gingiva and periodontal tissues caused by susceptible strains of anaerobic organisms, for example Porphyromonas spp. and Prevotella spp.

Dosage and administration

Administration is via the oral route.
The recommended dose is 3.0 mg/kg bodyweight of pradofloxacin once daily. Due to the available tablet sizes the resulting dose range is 3.0 to 4.5 mg/kg bodyweight according to the following tables. To ensure a correct dosage, bodyweight should be determined as accurately as possible to avoid underdosing.
Cats:

Bodyweight of Cat (kg)
No. of Tablets
Pradofloxacin dose (mg/kg bw)
15mg
>3.4 - 5
1
3.0 - 4.4
5 - 7.5

3.0 - 4.5
7.5 - 10
2
3.0 - 4.0

Dogs:
Bodyweight of Dog (kg)
No. of Tablets
Pradofloxacin dose (mg/kg bw)
 
15 mg
60 mg
120 mg
 
> 3.4 - 5
1
 
 
3.0 - 4.4
5 - 7.5

 
 
3.0 - 4.5
7.5 - 10
2
 
 
3.0 - 4.0
10 - 15
3
 
 
3.0 - 4.5
15-20
 
1
 
3.0 - 4.0
20-30
 

 
3.0 - 4,5
30 - 40
 
 
1
3.0 - 4.0
40 - 60
 
 

3.0 - 4.5
60 - 80
 
 
2
3.0 - 4.0

Duration of treatment
The duration of the treatment depends on the nature and severity of the infection and on the response to treatment. For most infections the following treatment courses will be sufficient:
Cats:
Indication
Duration of treatment (days)
Acute infections of the upper respiratory tract
5

The treatment should be re-considered if no improvement of the clinical condition is observed within 3 days after starting the treatment.
Dogs:
Indication
Duration of treatment (days)
Infections of the skin:
 
Superficial pyoderma
14 - 21
Deep pyoderma
14 - 35
Wound infections
7
Acute infections of the urinary tract
7 - 21
Severe infections of the gingiva and periodontal tissues
7

The treatment should be re-considered if no improvement of the clinical conditions is observed within 3 days, or in cases of superficial pyoderma 7 days, and in cases of deep pyoderma 14 days, after starting the treatment.
Use during pregnancy and lactation The safety of this veterinary medicinal product has not been established during pregnancy and lactation in cats and dogs.
Pregnancy: Do not use during pregnancy. Pradofloxacin induced eye malformations at foetal and maternal toxic dosages in rats.
Lactation: Do not use during lactation. Laboratory studies in puppies have shown evidence of arthropathy after systemic administration of fluoroquinolones. Fluoroquinolones are known to cross the placenta and to be distributed into milk.
Fertility: Pradofloxacin has been shown to have no effects on fertility in breeding animals.

Contra-indications, warnings, etc

Do not use in animals with known hypersensitivity to fluoroquinolones.
Cats: Due to the lack of data, pradofloxacin should not be used in kittens aged less than 6 weeks. Pradofloxacin has no effects on the developing cartilage of kittens of 6 weeks of age and older. However, the product should not be used in cats with persisting articular cartilage lesions, as these lesions may worsen during treatment with fluoroquinolones.
Do not use in cats with central nervous system (CNS) disorders, such as epilepsy, as fluoroquinolones could potentially cause seizures in predisposed animals.
Do not use in cats during pregnancy and lactation.
Dogs: Do not use in dogs during the period of growth as developing articular cartilage may be affected. The period of growth depends on the breed. For the majority of breeds, pradofloxacin-containing veterinary medicinal products must not be used in dogs of less than 12 months of age and in giant breeds less than 18 months.
Do not use in dogs with persisting articular cartilage lesions, since lesions may worsen during treatment with fluoroquinolones.
Do not use in dogs with central nervous system (CNS) disorders, such as epilepsy, as fluoroquinolones could possibly cause seizures in predisposed animals.
Do not use in dogs during pregnancy and lactation.
Whenever possible, the veterinary medicinal product should only be used based on susceptibility testing. Official and local antimicrobial policies should be taken into account when the veterinary medicinal product is used.
Fluoroquinolones should be reserved for the treatment of clinical conditions which have responded poorly, or are expected to respond poorly, to other classes of antimicrobials.
Use of the veterinary medicinal product deviating from instructions given in the SPC may increase the prevalence of bacteria resistant to the fluoroquinolones and may decrease the effectiveness of treatment with other fluoroquinolones due to the potential for cross-resistance.
Pyoderma occurs mostly secondary to an underlying disease, thus, it is advisable to determine the underlying cause and to treat the animal accordingly.
This veterinary medicinal product should only be used in severe cases of periodontal disease. Mechanical cleaning of teeth and removal of plaque and calculus or extraction of teeth are prerequisites for a persistent therapeutic effect. In case of gingivitis and periodontitis, the veterinary medicinal product should only be used as an adjunct to mechanical or surgical periodontal therapy. Only those dogs for which periodontal treatment goals cannot be achieved by mechanical treatment alone should be treated with this veterinary medicinal product.
Pradofloxacin may increase sensitivity of the skin to sunlight. During treatment, animals should therefore not be exposed to excessive sunlight.
Excretion via kidneys is an important elimination route for pradofloxacin in dogs. As for other fluoroquinolones, the renal excretion rate of pradofloxacin may be decreased in dogs with impaired kidney function and, therefore, pradofloxacin should be used with caution in such animals.
Mild transient gastro-intestinal disturbances including vomiting have been observed in rare cases in dogs and cats.
Concurrent administration with metal cations such as those contained in antacids or sucralfate made with magnesium hydroxide or aluminium hydroxide, or multivitamins containing iron or zinc, and dairy products containing calcium, has been reported to decrease the bioavailability of fluoroquinolones. Therefore, Veraflox should not be administered concurrently with antacids, sucralfate, multivitamins or dairy products, as absorption of Veraflox may be decreased.
Further, fluoroquinolones should not be used in combination with non-steroidal anti-inflammatory drugs (NSAIDs) in animals with a history of seizures because of potential pharmacodynamic interactions in the CNS.
The combination of fluoroquinolones with theophylline could increase the plasma levels of theophylline by altering its metabolism and thus should be avoided.
The combined use of fluoroquinolones with digoxin should also be avoided because of potentially increased oral bioavailability of digoxin.
No specific antidotes for pradofloxacin (or other fluoroquinolones) are known, therefore, in case of overdose, symptomatic treatment should be given.
Intermittent vomiting and soft faeces were observed in dogs after repeated oral administration of 2.7 times the maximum recommended dose. Infrequent vomiting was observed in cats after repeated oral administration of 2.7 times the maximum recommended dose.
User Safety:
Due to potential harmful effects, the tablets must be kept out of the reach and sight of children.
People with known hypersensitivity to quinolones should avoid any contact with the veterinary medicinal product.
Avoid skin and eye contact with the veterinary medicinal product.
Wash hands after use.
Do not eat, drink or smoke while handling the veterinary medicinal product.
In case of accidental ingestion, seek medical advice and show the package leaflet or the label to the physician.
Environmental Safety:
Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.

Pharmaceutical precautions

This veterinary medicinal product does not require any special storage conditions.
Shelf-life of the veterinary medicinal product as packaged for sale: 3 years.

Legal category

POM-V

Packaging Quantities

Folding cartons containing aluminium blister packs. One blister contains 7 tablets. The following pack size is available: 70 tablets.

Further information

Pharmacotherapeutic group: Antibacterials for systemic use, fluoroquinolones. ATCvet code: QJ01MA. The primary mode of action of the fluoroquinolones involves interaction with enzymes essential for major DNA functions such as replication, transcription and recombination. The primary targets for pradofloxacin are the bacterial DNA gyrase and topoisomerase IV enzymes. Reversible association between pradofloxacin and DNA gyrase or DNA topoisomerase IV in the target bacteria results in inhibition of these enzymes and rapid death of the bacterial cell. The rapidity and extent of bacterial killing are directly proportional to the drug concentration.
Although pradofloxacin has in-vitro activity against a wide range of Gram-positive and Gram-negative organisms, including anaerobic bacteria, this veterinary medicinal product should only be used for the approved indications and in accordance with the prudent use recommendations.
MIC-Data
Dogs:

Bacterial species
No. of strains
MIC50 (µg/ml)
MIC90 (µg/ml)
MIC range (µg/ml)
Staphylococcus intermedius group (incl S. pseudintermedius)
1097
0.062
0.062
0.002-4
Escherichia coli
173
0.031
0.062
0.008-16
Porphyromonas spp.
310
0.062
0.125
≤0.016-0.5
Prevotella spp.
320
0.062
0.25
≤0.016-1

The bacteria were isolated between 2001 and 2007 from clinical cases in Belgium, France, Germany, Hungary, Italy, Poland, Sweden and UK.
Cats:
Bacterial species
No. of Strains
MIC50(µg/ml)
MIC90(µg/ml)
MIC range (µg/ml)
Pasteurella multocida
323
0.016
0.016
0.002-0.062
Escherichia coli
135
0.016
4
0.008-8
Staphylococcus intermedius group (incl S. pseudintermedius)
184
0.062
0.125
0.016-8

The bacteria were isolated between 2001 and 2007 from clinical cases in Belgium, France, Germany, Hungary, Poland, Sweden and UK.
Resistance to fluoroquinolones has been reported to arise from five sources, (i) point mutations in the genes encoding for DNA gyrase and/or topoisomerase IV leading to alterations of the respective enzyme, (ii) alterations of drug permeability in Gram-negative bacteria, (iii) efflux mechanisms, (iv) plasmid mediated resistance and (v) gyrase protecting proteins. All mechanisms lead to a reduced susceptibility of the bacteria to fluoroquinolones. Cross-resistance within the fluoroquinolone class of antimicrobials is common.
In laboratory studies the bioavailability of pradofloxacin was reduced in fed dogs and cats compared to fasted animals. However in the clinical studies feeding did not reveal any impact on the treatment effect.
Dogs:
After oral administration of the therapeutic dose to dogs, pradofloxacin is rapidly (Tmax of 2 hours) and almost completely (approximately 100%) absorbed reaching peak concentrations of 1.6 mg/l.
A linear relationship between pradofloxacin serum concentrations and the administered dose is observed in dogs within a tested dose range of 1 to 9 mg/kg body weight. Long-term daily treatment has no impact on the pharmacokinetic profile, with an accumulation index of 1.1. In vitro plasma protein binding is low (35%). The high volume of distribution (Vd) >2 l/kg bodyweight indicates good tissue penetration. Pradofloxacin concentrations in skin homogenates of dogs exceed those in serum by up to seven times. Pradofloxacin is eliminated from serum with a terminal half-life of 7 hours. Major elimination pathways are glucuronidation as well as renal excretion. Pradofloxacin is cleared from the body at 0.24 l/h/kg. Approximately 40% of the administered product is excreted unchanged via the kidneys.
Cats:
In cats, absorption of orally administered pradofloxacin at the therapeutic dose is rapid reaching peak concentrations of 1.2 mg/l within 0.5 hours. The bioavailability of the tablet is at least 70%. Repeated dosing shows no impact on the pharmacokinetic profile (accumulation index = 1.0). In vitro plasma protein binding is low (30%). The high volume of distribution (Vd) >4 l/kg body weight indicates good tissue penetration. Pradofloxacin is eliminated from serum with a terminal half-life of 9 hours. The major elimination pathway in cats is glucuronidation. Pradofloxacin is cleared from the body at 0.28 l/h/kg.

Marketing authorisation number

Veraflox® 15 mg tablets for dogs and cats 70 Tablets EU/2/10/107/003.
Veraflox® 60 mg tablets for dogs 70 Tablets EU/2/10/107/007.
Veraflox® 120 mg tablets for dogs 70 Tablets EU/2/10/107/009.

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