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Metacam Oral Suspension

Metacam Oral Suspension

Metacam treats arthritis and other causes of pain and inflammation, especially those affecting the musculo-skeletal system. It can also be used to relieve pain and reduce inflammation after surgical operations, or to aid treatment in certain types of infection. Metacam belongs to the group of drugs known as non-steroidal anti-inflammatory drugs and is one of the safest available for use in dogs, cats and horses. Metacam is supplied as a pleasantly flavoured liquid to be given by mouth or with food. If the dose is given directly into the mouth, this is best done after a meal. Metacam side effects are reduced through its ability to target the sites of inflammation while having much less effect than many other medications on the gut lining and kidneys.

Metacam is not advised for animals which are dehydrated, and care is needed where conditions affecting the kidneys or gut lining are suspected.

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Description

Metacam 0.5 mg/ml Oral Suspension for Cats

Presentation

One ml of Metacam Oral Suspension for Cats contains 0.5 mg meloxicam as active ingredient (equivalent to 0.017 mg per drop) and 1.5 mg sodium benzoate (equivalent to 0.05 mg per drop).

Uses

Metacam is a non-steroidal anti-inflammatory drug (NSAID) for use in cats. For alleviation of mild to moderate post-operative pain and inflammation following surgical procedures in cats, e.g. orthopaedic and soft tissue surgery. For alleviation of pain and inflammation in acute and chronic musculo-skeletal disorders in cats.

Dosage and administration

Post-operative pain and inflammation following surgical procedures:

After initial treatment with Metacam 2 mg/ml solution for injection for cats, continue treatment 24 hours later with Metacam 0.5 mg/ml oral suspension for cats at a dosage of 0.05 mg meloxicam/kg body weight. The oral follow-up dose may be administered once daily (at 24-hour intervals) for up to four days.

Acute musculo-skeletal disorders:

Initial treatment is a single oral dose of 0.2 mg meloxicam/kg body weight on the first day. Treatment is to be continued once daily by oral administration (at 24-hour intervals) at a dose of 0.05 mg meloxicam/kg body weight for as long as acute pain and inflammation persist.

Chronic musculo-skeletal disorders:

Initial treatment is a single oral dose of 0.1 mg meloxicam/kg body weight on the first day. Treatment is to be continued once daily by oral administration (at 24-hour intervals) at a maintenance dose of 0.05 mg meloxicam/kg body weight.

A clinical response is normally seen within 7 days. Treatment should be discontinued after 14 days at the latest if no clinical improvement is apparent.

Route and method of administration

Dosing procedure using the drop dispenser of the bottle:

Dose of 0.1 mg meloxicam/kg body weight:6 drops /kg body weight

Dose of 0.05 mg meloxicam/kg body weight:3 drops /kg body weight

Dosing procedure using the measuring syringe:

The syringe fits onto the drop dispenser of the bottle and has a kg-body weight scale which corresponds to dose of 0.05 mg meloxicam/kg body weight. Thus for initiation of the treatment of chronic musculo-skeletal disorders on the first day, twice the maintenance volume will be required.

Shake well before use. To be administered orally either mixed with food or directly into the mouth.

The suspension can be given using the drop dispenser of the bottle for cats of any body weight. Alternatively and for cats with a body weight of at least 2 kg, the measuring syringe provided in the package can be used.

Particular care should be taken with regard to the accuracy of dosing. The recommended dose should not be exceeded.

Avoid introduction of contamination during use.

Contra-indications, warnings, etc

Do not use in pregnant or lactating animals.

Do not use in cats suffering from gastrointestinal disorders such as irritation and haemorrhage, impaired hepatic, cardiac or renal function and haemorrhagic disorders.

Do not use in case of hypersensitivity to the active substance or to any of the excipients.

Do not use in cats less than 6 weeks of age.

Avoid use in any dehydrated, hypovolaemic or hypotensive animal, as there is a potential risk of renal toxicity.

Post-operative pain and inflammation following surgical procedures: In case additional pain relief is required, multimodal pain therapy should be considered.

Chronic musculoskeletal disorders: Response to long-term therapy should be monitored at regular intervals by a veterinary surgeon.

Typical adverse reactions of NSAIDs such as loss of appetite, vomiting, diarrhoea, faecal occult blood, lethargy and renal failure have occasionally been reported. In very rare cases elevated liver enzymes have been reported.

These side effects are in most cases transient and disappear following termination of the treatment but in very rare cases may be serious or fatal.

If adverse reactions occur, treatment should be discontinued and the advice of a veterinarian should be sought.

Other NSAIDs, diuretics, anticoagulant, aminoglycoside antibiotics and substances with high protein binding may compete for binding and thus lead to toxic effects. Metacam must not be administered in conjunction with other NSAIDs or glucocorticosteroids. Concurrent administration of potential nephrotoxic drugs should be avoided.

Pre-treatment with anti-inflammatory substances other than Metacam 2 mg/ml solution for injection for cats at a single dose of 0.2 mg/kg may result in additional or increased adverse effects and accordingly a treatment-free period with such veterinary medicinal products should be observed for at least 24 hours before commencement of treatment. The treatment-free period, however, should take into account the pharmacological properties of the products used previously.

The safety of the veterinary medicinal product has not been established during pregnancy and lactation.

Meloxicam has a narrow therapeutic safety margin in cats and clinical signs of overdose may be seen at relatively small overdose levels.

In case of overdose, adverse reactions as listed above are expected to be more severe and more frequent. In case of overdose symptomatic treatment should be initiated.

User precautions

People with known hypersensitivity to Non Steroidal Anti-Inflammatory Drugs (NSAIDs) should avoid contact with the veterinary medicinal product.

In case of accidental ingestion, seek medical advice immediately and show the package leaflet or the label to the physician.

Disposal advice

Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.

For animal treatment only.

Keep out of reach and sight of children.

Pharmaceutical precautions

Shelf-life after first opening the immediate packaging:

3 ml bottle: 14 days

10ml, 15 ml and 30ml bottle: 6 months

Legal category

POM-V

Packaging Quantities

Polyethylene bottles containing 3 ml, 10ml, 15 ml or 30ml with a polyethylene dropper, a tamper-proof child resistant closure and a polypropylene measuring syringe. The 1 ml measuring syringe has a kg-bodyweight scale for cats (2 to 10 kg) and has a pictogram showing a cat. Not all pack sizes may be marketed.

Further information

Pharmacodynamic properties

Meloxicam is a Non-Steroidal Anti-Inflammatory Drug (NSAID) of the oxicam class which acts by inhibition of prostaglandin synthesis, thereby exerting anti-inflammatory, analgesic, anti-exudative and antipyretic effects. It reduces leukocyte infiltration into the inflamed tissue. To a minor extent it also inhibits collagen-induced thrombocyte aggregation. In vitro and in vivo studies demonstrated that meloxicam inhibits cyclooxygenase-2 (COX-2) to a greater extent than cyclooxygenase-1 (COX-1).

Pharmacokinetic properties

Absorption

If the animal is fasted when dosed, the maximal plasma concentrations are obtained after approximately 3 hours. If the animal is fed at the time of dosing, the absorption may be slightly delayed.

Distribution

There is a linear relationship between the dose administered and plasma concentration observed in the therapeutic dose range. Approximately 97 % of meloxicam is bound to plasma proteins.

Metabolism

Meloxicam is predominantly found in plasma and is also a major biliary excretion product whereas urine contains only traces of the parent compound. Five major metabolites have been identified. Meloxicam is metabolised to an alcohol, an acid derivative and to several polar metabolites. As for other species investigated, the main pathway of meloxicam biotransformation in cats is oxidation and there are no pharmacologically active metabolites.

Elimination

Meloxicam is eliminated with a half-life of 24 hours. The detection of metabolites from the parent compound in urine and faeces, but not in plasma is indicative for their rapid excretion. 21% of the recovered dose is eliminated in urine (2% as unchanged meloxicam, 19% as metabolites) and 79% in the faeces (49% as unchanged meloxicam, 30% as metabolites).

Marketing Authorisation Holder (if different from distributor)

Boehringer Ingelheim Vetmedica GmbH

55216 Ingelheim am Rhein

Germany

Marketing authorisation number

EU/2/97/004/034 – 3 ml.

EU/2/97/004/033 – 10 ml.

EU/2/97/004/026 – 15 ml.

EU/2/97/004/049 – 30 ml.

GTIN (Global Trade Item No)

Metacam 0.5 mg/ml Oral Suspension for Cats - 3ml

5012917010152

Metacam 0.5 mg/ml Oral Suspension for Cats - 15ml

5012917010176

Metacam 0.5 mg/ml Oral Suspension for Cats - 30ml

5012917010367

Metacam 1.5 mg/ml Oral Suspension for Dogs

Presentation

One ml of Metacam Oral Suspension for Dogs contains 1.5 mg meloxicam as active ingredient (equivalent to 0.05 mg per drop) and 1.5 mg sodium benzoate (equivalent to 0.05 mg per drop).

Uses

Metacam is a non-steroidal anti-inflammatory drug (NSAID) for use in dogs.

For alleviation of inflammation and pain in both acute and chronic musculo-skeletal disorders.

Dosage and administration

Initial treatment is a single dose of 0.2 mg meloxicam/kg bodyweight on the first day. Treatment is to be continued once daily by oral administration (at 24-hour intervals) at a maintenance dose of 0.1 mg meloxicam/kg bodyweight.

For longer term treatment, once clinical response has been observed (after > 4 days), the dose of Metacam can be adjusted to the lowest effective individual dose reflecting that the degree of pain and inflammation associated with chronic musculo-skeletal disorders may vary over time.

Particular care should be taken with regard to the accuracy of dosing.

Shake well before use. To be administered orally either mixed with food or directly into the mouth. The suspension can be given using either the drop dispenser of the bottle (for very small breeds) or the Metacam measuring syringe provided in the package.

Dosing procedure using the drop dispenser of the bottle.

Initial dose : 4 drops/kg bodyweight.

Maintenance dose : 2 drops/kg bodyweight.

Dosing procedure using the measuring syringe.

The syringe fits onto the drop dispenser of the bottle and has a kg-bodyweight scale which corresponds to the maintenance dose (ie. 0.1 mg meloxicam/kg bodyweight). Thus for the first day of treatment, twice the maintenance volume will be required.

Alternatively, treatment may be initiated with Metacam 5 mg/ml solution for injection.

A clinical response is usually seen within 3-4 days. Treatment should be discontinued after 10 days at the latest if no clinical improvement is apparent.

Avoid the introduction of contamination during use.

Contra-indications, warnings, etc

Do not use in pregnant or lactating animals.

Do not use in dogs suffering from gastrointestinal disorders such as irritation and haemorrhage, impaired hepatic, cardiac or renal function and haemorrhagic disorders.

Do not use in case of hypersensitivity to the active substance or to any of the excipients.

Do not use in dogs less than 6 weeks of age.

Avoid use in any dehydrated, hypovolaemic or hypotensive animal, as there is a potential risk of renal toxicity.

This product for dogs should not be used in cats as it is not suitable for use in this species. In cats, Metacam 0.5 mg/ml oral suspension for cats should be used.

Typical adverse reactions of NSAIDs such as loss of appetite, vomiting, diarrhoea, faecal occult blood, lethargy and renal failure have occasionally been reported. In very rare cases haemorrhagic diarrhoea, haematemesis, gastrointestinal ulceration and elevated liver enzymes have been reported.

These side effects occur generally within the first treatment week and are in most cases transient and disappear following termination of the treatment but in very rare cases may be serious or fatal.

If adverse reactions occur, treatment should be discontinued and the advice of a veterinarian should be sought.

Other NSAIDs, diuretics, anticoagulants, aminoglycoside antibiotics and substances with high protein binding may compete for binding and thus lead to toxic effects. Metacam must not be administered in conjunction with other NSAIDs or glucocorticosteroids.

Pre-treatment with 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 commencement of treatment. The treatment-free period, however, should take into account the pharmacological properties of the products used previously.

The safety of the veterinary medicinal product has not been established during pregnancy and lactation.

In case of overdose, symptomatic treatment should be initiated.

User precautions

People with known hypersensitivity to Non Steroidal Anti-inflammatory Drugs (NSAIDs) should avoid contact with the veterinary medicinal product. In case of accidental ingestion, seek medical advice immediately and show the package leaflet or the label to the physician.

Disposal advice

Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.

For animal treatment only.

Keep out of reach and sight of children.

Pharmaceutical precautions

After first opening the bottle, use contents within 6 months and then discard any remaining unused product.

Legal category

POM-V

Packaging Quantities

Polyethylene bottles containing 10 ml, 32 ml, 100 ml or 180 ml with a polyethylene dropper, a tamper-proof child resistant closure and a polypropylene measuring syringe.

Further information

Pharmacodynamic properties

Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) of the oxicam class which acts by inhibition of prostaglandin synthesis, thereby exerting anti-inflammatory, analgesic, anti-exudative and antipyretic effects. It reduces leukocyte infiltration into the inflamed tissue. To a minor extent it also inhibits collagen-induced thrombocyte aggregation. In vitro and in vivo studies demonstrated that meloxicam inhibits cyclooxygenase-2 (COX-2) to a greater extent than cyclooxygenase-1 (COX-1).

Pharmacokinetic particulars

Absorption

Meloxicam is completely absorbed following oral administration and maximal plasma concentrations are obtained after approximately 4.5 hours. When the product is used according to the recommended dosage regime, steady state concentrations of meloxicam in plasma are reached on the second day of treatment.

Distribution

There is a linear relationship between the dose administered and plasma concentration observed in the therapeutic dose range. Approximately 97% of meloxicam is bound to plasma proteins. The volume of distribution is 0.3 l/kg.

Metabolism

Meloxicam is predominantly found in plasma and is also a major biliary excretion product whereas urine contains only traces of the parent compound. Meloxicam is metabolised to an alcohol, an acid derivative and to several polar metabolites. All major metabolites have been shown to be pharmacologically inactive.

Elimination

Meloxicam is eliminated with a half-life of 24 hours. Approximately 75% of the administered dose is eliminated via faeces and the remainder via urine.

Marketing Authorisation Holder (if different from distributor)

Boehringer Ingelheim Vetmedica GmbH

55216 Ingelheim am Rhein

Germany

Marketing authorisation number

EU/2/97/004/003 : 10 ml.

EU/2/97/004/004 : 32 ml.

EU/2/97/004/005 : 100 ml.

EU/2/97/004/029 : 180 ml.

GTIN (Global Trade Item No)

Metacam 1.5 mg/ml Oral Suspension for Dogs - 10ml

5012917010053

Metacam 1.5 mg/ml Oral Suspension for Dogs - 32ml

5012917010060

Metacam 1.5 mg/ml Oral Suspension for Dogs - 100ml

5012917010077

Metacam 1.5 mg/ml Oral Suspension for Dogs - 180ml

5012917010251

Metacam 15mg/ml Oral Suspension for Horses

Presentation

One ml of Metacam 15 mg/ml oral suspension contains Meloxicam 15 mg as active substance and Sodium benzoate 1.5 mg

Uses

Alleviation of inflammation and relief of pain in both acute and chronic musculo-skeletal disorders.

Dosage and administration

To be administered either mixed with food or directly into the mouth at a dosage of 0.6 mg/kg body weight, once daily, up to 14 days. Where the product is mixed with food, it should be added to a small quantity of food, prior to feeding.

The suspension should be given using the Metacam measuring syringe provided in the package. The syringe fits onto the bottle and has a kg-body weight scale.

Shake well before use.

Avoid introduction of contamination during use.

Contra-indications, warnings, etc

Do not use in pregnant or lactating mares.

Do not use in horses suffering from gastrointestinal disorders such as irritation and haemorrhage, impaired hepatic, cardiac or renal function and haemorrhagic disorders.

Do not use in case of hypersensitivity to the active substance or to any of the excipients.

Do not use in horses less than 6 weeks of age.

Avoid use in any dehydrated, hypovolaemic or hypotensive animal, as there is a potential risk of renal toxicity.

Isolated cases of adverse reactions typically associated with NSAIDs were observed in clinical trials (slight urticaria, diarrhoea). Symptoms were reversible. In very rare cases loss of appetite, lethargy, abdominal pain and colitis have been reported. In very rare cases anaphylactoid reactions, which may be serious (including fatal), may occur and should be treated symptomatically.

If adverse reactions occur, treatment should be discontinued and the advice of a veterinarian should be sought.

Laboratory studies in cattle have not provided any evidence for teratogenic, foetotoxic, or maternotoxic effects. However, no data have been generated in horses. Therefore the use in this species is not recommended during pregnancy and lactation.

Do not administer concurrently with glucocorticoids, other non-steroidal anti-inflammatory drugs or with anti-coagulant agents.

In the case of overdose symptomatic treatment should be initiated.

Withdrawal period

Meat and offal: 3 days.

Operator warnings

People with known hypersensitivity to NSAIDs should avoid contact with the veterinary medicinal product.

In case of accidental ingestion, seek medical advice immediately and show the package leaflet or the label to the physician.

Disposal Advice

Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.

For animal treatment only.

Keep out of reach and sight of children.

Pharmaceutical precautions

Use within 6 months of first opening.

Do not use after the expiry date stated on the carton and on the bottle.

Legal category

POM-V

Packaging Quantities

Polyethylene bottle containing 100 ml or 250 ml with a polyethylene tip adapter, a tamper proof child resistant closure and a polypropylene measuring syringe.

Further information

Pharmacodynamic properties

Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) of the oxicam class which acts by inhibition of prostaglandin synthesis, thereby exerting anti-inflammatory, analgesic, anti-exudative and antipyretic effects. It reduces leukocyte infiltration into the inflamed tissue. To a minor extent it also inhibits collagen-induced thrombocyte aggregation. Meloxicam also has anti-endotoxic properties because it has been shown to inhibit production of thromboxane B2 induced by intravenous E. coli endotoxin administration in calves and pigs.

Pharmacokinetic particulars

Absorption

When the product is used according to the recommended dosage regime the oral bioavailability is approximately 98%. Maximal plasma concentrations are obtained after approximately 2 - 3 hours. The accumulation factor of 1.08 suggests that meloxicam does not accumulate when administered daily.

Distribution

Approximately 98% of meloxicam is bound to plasma proteins. The volume of distribution is 0.12 l/kg

Metabolism

The metabolism is qualitatively similar in rats, mini-pigs, humans, cattle and pigs although quantitatively there are differences. The major metabolites found in all species were the 5-hydroxy- and 5-carboxy-metabolites and the oxalyl-metabolite. The metabolism in horses was not investigated. All major metabolites have been shown to be pharmacologically inactive.

Elimination

Meloxicam is eliminated with a terminal half-life of 7.7 hours.

Marketing Authorisation Holder (if different from distributor)

Boehringer Ingelheim Vetmedica GmbH

55216 Ingelheim am Rhein

Germany

Marketing authorisation number

EU/2/97/004/009 : 100 ml.

EU/2/97/004/030 : 250 ml.

GTIN (Global Trade Item No)

Metacam 15 mg/ml Oral Suspension for Horses - 100ml

5012917010107

Metacam 15 mg/ml Oral Suspension for Horses - 250ml

5012917010169

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Reviews of Metacam Oral Suspension

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Questions & Answers for Metacam Oral Suspension

Below are some recent questions we've received regarding Metacam Oral Suspension, including answers from our team.

Ask Your Own Question

Can Metacam cause a blocked bladder?

16th Dec 2013
Donald Field

Our customer asked if the Metacam given to her lame cat could have caused the blocked bladder which happened 36 hours later.

John Cousins
  • Veterinary Surgeon at VioVet

There will not be a direct link with the Metacam, but possibly an indirect one:

Any male cat prone to any cystitis type problem is at risk of developing urethral obstruction at some point in future. It is not rare. Various factors increase that risk, including illness of some other type, altered eating and drinking habits, reduced mobility for a while (and holding on to the urine for longer than normal) etc. These other things might have triggered the cystitis, but it could have happened just the same, with or without the Metacam.

Personally I would suggest that in future you do not give your cat any dried food. If he eats only moist food, he is very unlikely ever to get these urinary problems, because they are rare in cats producing dilute urine. Cats on dried food can produce very concentrated urine at times, which is a risk factor in itself.

Cat/dog

26th Jul 2013
liz b

Can I use the metacam I have for dogs for my arthritic cat? Presumably with reduced dosage?

John Cousins
  • Veterinary Surgeon at VioVet

Metacam for dogs came out long before the cat version. Until that time, Metacam for dogs was commonly used in cats. This can however cause serious trouble if it is done inappropriately and if the cat has kidney or gastro-intestinal trouble, or is ill in some other way. Therefore we would not be able to recommend you do this without talking to your own vet first. Doing as you suggest is in fact against current prescribing regulations, so your vet might not feel able to help much either. (Metacam for dogs is three times as strong as the cat version, and the dose rate for dogs is twice that for cats anyway, so a cat should receive one sixth of the amount recommended for a dog of the same weight.)

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