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Cartrophen Vet is given by injection to treat degenerative joint disease or arthritis in dogs. It has been found that it provides relief from pain, stiffness and lameness as effectively as the non-steroidal anti-inflammatory drugs commonly used in veterinary medicine. Normally a course of 4 injections is given at 5-7 day intervals. The beneficial effects are normally noticed after the second or third injection. The improvement usually continues until after the last injection is given, and then this is usually maintained for a few months after the fourth injection. If some deterioration is noted in future, the course can be repeated, of some vets will give a single injection once per month to help maintain the beneficial effects.
Please Note: Cartrophen Vet Injection does not come with a syringe or needle. To obtain these items separately, click here.
Cartrophen Vet contains Pentosan Polysulphate Sodium which is a semi-synthetic polymer. It has anti-inflammatory properties which particularly affect the cartilage within synovial joints. Cartrophen modifies the metabolism of the cartilage and the production of the lubricating synovial fluid. Cartrophen influences the underlying disease processes occurring in arthritis, reducing pain and helping regenerate damaged joint components.
Cartrophen is not recommended for young, growing dogs or for pregnant bitches. Cartrophen is sometimes prescribed by vets for use in horses. (It is exactly the same product which is used in both species.)
Previously it was recommended that Cartrophen should be stored at fridge temperatures. The manufacturer has now updated the storage information so that cold storage is not required. It is now recommended that Cartrophen is not stored above 25°C and that once the first dose has been used, the remainder is used or discarded within three months. Cartrophen is no longer shipped in a cold pack. Cartrophen will continue to be supplied in old packaging for a while which shows the old storage instructions. However the new requirements are as per the datasheet below. The official datasheet can also be viewed at www.noahcompendium.co.uk.
All prices include VAT where applicable.
SUMMARY OF PRODUCTS CHARACTERISTICS
Each ml contains:
Active substance Pentosan Polysulfate Sodium 100.00 mg
Excipients Benzyl Alcohol 10.45 mg
For the full list of excipients, see section 6.1 3. PHARMACEUTICAL FORM Solution for injection
A clear colourless to slightly yellow aqueous solution for subcutaneous administration. 4. CLINICAL PARTICULARS 4.1 Target species Dog 4.2 Indications for use, specifying the target species For the treatment of lameness and pain of degenerative joint disease/osteoarthrosis (non-infectious arthrosis) in the skeletally mature dog. 4.3 Contraindications Do not use for the treatment of septic arthritis. In this case, appropriate antimicrobial therapy should be instigated.
Do not use in dogs with advanced liver or kidney impairment, or evidence of infection.
Do not use in dogs with blood disorders, coagulation disorders, bleeding or malignancy (especially haemangiosarcoma). Pentosan polysulfate has an anticoagulant effect.
Do not use during the peri-operative period.
Do not use in the skeletally immature dog (i.e. dogs whose long bone growth plates have not closed). 4.4 Special warnings for each target species
A clinical effect may not be observed until after the second injection of the course of treatment. 4.5 Special precautions for use i. Special precautions for use in animals Dogs should be weighed prior to administration to ensure accurate dosing.
Use with caution in dogs with history of pulmonary lacerations. Caution is also recommended in cases of hepatic impairment.
Do not exceed the standard dose. Increasing the recommended dose may result in exacerbation of stiffness and discomfort.
No more than 3 courses of 4 injections should be administered in a 12 month period. ii. Special precautions for the person administering the veterinary medicinal product to animals Care should be taken to avoid accidental self-injection. In the event of accidental injection, seek medical advice immediately and show the package leaflet or label to the physician. Wash splashes from eyes and skin immediately with water. Wash hands after use. 4.6 Adverse reactions (frequency and seriousness) Emesis, diarrhoea, lethargy and anorexia have been reported following the use of pentosan polysulfate. These signs may be the result of a hypersensitivity reaction and may require appropriate symptomatic treatment including antihistamine administration.
Administration of the product at recommended dose rates results in increases of activated partial thromboplastin time (aPTT) and thrombin time (TT) which may persist for up to 24 hours after administration in healthy dogs. This very rarely results in clinical effects, but because of the fibrinolytic action of pentosan polysulfate sodium, the possibility of internal bleeding from a tumour or vascular abnormality should be considered if signs develop. It is recommended that the animal should be monitored for signs of blood loss and treated appropriately
Bleeding disorders such as nasal bleeding, haemorrhagic diarrhoea and haematomas have been reported.
Local reactions such as a transient swelling have been observed post injection. 4.7 Use during pregnancy, lactation or lay Laboratory studies in rabbits showed embryotoxic effects associated with a primary effect on the parent at repeated daily doses 2.5 times the recommended dose.
The safety of the product in the pregnant bitch has not been studied, therefore use is not recommended in these circumstances.
The product should not be used at the time of parturition due to its anticoagulant effects.
4.8 Interaction with other medicinal products and other forms of interaction NSAIDs and in particular aspirin should not be used in combination with pentosan polysulfate sodium as they may affect thrombocyte adhesion and potentiate the anticoagulant activity of the product. Corticosteroids have been shown to be antagonistic to a number of actions of pentosan polysulfate sodium. Furthermore, use of anti-inflammatory drugs may result in a premature increase in the dog’s activity, which may interfere with the therapeutic activity of the product.
Do not use concurrently with steroids or non-steroidal anti-inflammatory drugs, including aspirin and phenylbutazone.
Do not use concurrently with heparin, warfarin or other anti-coagulants. 4.9 Amount(s) to be administered and administration route Dosage: 3mg pentosan polysulfate sodium/kg bodyweight (equivalent to 0.3ml/10kg bodyweight) on four occasions, with an interval of 5-7 days between each administration.
Administration: By aseptic subcutaneous injection only of 0.3ml/10kg of bodyweight. An appropriately graduated syringe must be used to allow accurate administration of the required dose volume. This is particularly important when injecting small volumes.
Each case should be assessed individually by the veterinarian and an appropriate treatment program determined. 4.10 Overdose (symptoms, emergency procedures, antidotes), if necessary Repeated daily overdoses of five times the recommended dose or more results in anorexia and depression, which are reversible upon withdrawal of the drug.
At overdose there may be hepatocellular damage and an associated, dose-dependent, elevation in ALT.
Increases in aPTT and TT are dose-dependent. At repeated doses greater than five times that recommended, these increases may persist beyond 1 week after administration in healthy dogs. Signs associated with these defects may include bleeding into the gastro-intestinal tract, body cavities and ecchymoses. At repeated doses greater than ten times that recommended there may be fatality as a result of gastro-intestinal haemorrhage.
If overdose occurs dogs should be hospitalised and observed and supportive therapy provided as deemed necessary by the veterinarian. 4.11 Withdrawal period(s) Not applicable. 5. PHARMACOLOGICAL PROPERTIES Pharmacotherapeutic group: Anti-inflammatory and anti-rheumatic products, non-steroids
ATC Vet Code: QM01AX90
5.1 Pharmacodynamic properties The product contains Pentosan Polysulfate Sodium (NaPPS), a semi-synthetic polymer with a mean molecular weight of 4000 Daltons.
In a model of osteoarthritis in dogs, when NaPPS was administered at similar to therapeutic doses, levels of metalloproteinases in cartilage were reduced and levels of tissue inhibitor of metalloproteinase (TIMP) increased, thereby preserving proteoglycan content and protecting cartilage matrix from degradation.
In dogs with osteoarthritis administration of NaPPS caused fibrinolysis, lipolysis and decreased platelet aggregability.
In in vitro studies and in vivo studies in laboratory species using doses above those proposed for therapeutic use, NaPPS suppressed levels of anti-inflammatory mediators and stimulated hyaluron synthesis from fibroblasts. 5.2 Pharmacokinetic properties Absorption: In the dog, a peak plasma concentration of 7.40 g-eq pentosan polysulfate sodium/mL is achieved 15 minutes after subcutaneous administration.
Distribution: Pentosan polysulfate sodium binds many plasma proteins with a variable strength of association and dissociation resulting in a complex equilibrium between bound and unbound drug. Pentosan polysulfate sodium is concentrated in the liver and kidneys and reticuloendothelial system. Low levels occur in connective tissue and muscle. In studies carried out with rabbits, it has been shown that therapeutic concentrations of the active ingredient remain in the joint cartilage for 4-5 days after administration. The volume of distribution in dogs is 0.43L.
Biotransformation: Desulfation of pentosan polysulfate sodium occurs in the hepato-reticulo-endothelial system, the liver being the main site of activity. Depolymerisation may also occur in the kidney.
Elimination: The product is eliminated with a half life of approximately 3 hours in the dog. Forty eight hours after injection approximately 70% of the dose administered is eliminated via urine. 6. PHARMACEUTICAL PARTICULARS 6.1 List of excipients Benzyl alcohol Disodium phosphate dodecahydrate Sodium dihydrogen phosphate dihydrate Sodium hydroxide Hydrochloric acid Water for injection.
6.2 Incompatibilities The product should not be administered in the same syringe with other substances.
6.3 Shelf life Shelf-life of the veterinary medicinal product as packaged for sale: 3 years Shelf-life after first opening the immediate packaging: 3 months
6.4 Special precautions for storage Do not store above 25°C. Keep the container in the outer carton in order to protect from light.
Following withdrawal of the first dose, use the product within 3 months. Discard unused material. 6.5 Nature and composition of immediate packaging A 10 ml Type 1 clear glass vial fitted with a 20 mm rubber stopper and closed by a plastic flip off seal attached to an aluminium seal. 6.6 Special precautions for the disposal of unused veterinary medicinal product or waste materials derived from the use of such products, if appropriate Any unused veterinary medicinal product or waste material derived from such veterinary medicinal product should be disposed of in accordance with local requirements. 7 MARKETING AUTHORISATION HOLDER Arthropharm Europe Limited 50 Bedford St Belfast BT2 7FW Northern Ireland 8. MARKETING AUTHORISATION NUMBER Vm 15519/4001 9. DATE OF FIRST AUTHORISATION
Date: 7 September 2009
Date: November 2014
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Below are some recent questions we've received regarding Cartrophen Vet Injection, including answers from our team.
Please could you tell me if there are any known side effects to this medication?
Cartrophen is a well known safe medication with only very mild, transitory side effects if at all. Very rarely it can cause dogs to vomit after the first injection or be a little quieter for 24 hours after.
My vet has prescribed cartrophen course of 4 injections followed by 3mthly injections. He is a well used stud dog of 5 years. Will this affect his fertility in any way. His next bitch is due to be mated in 6 weeks approximately.
Cartrophen is not known to adversely affect the fertility of male dogs so his performance as a stud dog should not be affected.
How do you gage dosage for a 600kg horse? How many bottles do you need for a course?
You would have to talk to your vet about this. Generally a 10ml bottle is given to a 450kg horse once weekly for 4 doses. A 600kg horse would ideally receive one and a third bottles per week for 4 weeks, so 6 bottles would be needed for your horse with some left over at the end of the course. Many vets would give one bottle per week even for a 600kg horse, so 4 bottles would do, though this is a slight under-dose.
Is this Cartrophen suitable for horses? It's unclear if there are differences between the canine and the equine type.
There is only one type of Cartrophen. It is licensed and manufactured for use in dogs only. However it has been used widely in horses by many equine vets and so has become regarded as safe and effective for horses too. This is regarded officially as "off-license use" but since there is nothing like it manufactured for horses, the canine product has to be used.
Does it have to go in the fridge once opened?
Cartrophen Vet Injection doesn't require refrigeration but should be stored below 25°C. After opening, any unused contents must be discarded after 3 months.
Can I order Carrtophen jnjection from Australia without a vet prescription. What would be the cost for postage. Thank you Chris
We believe you cannot legally import Cartrophen without a prescription and we would require one for export to Australia. Now that Cartrophen no longer requires to be stored at fridge temperature, the current Royal Mail standard international postage fee (August 2013) to Australia is £10. It is possible to choose courier delivery during the checkout process and the cost of this is higher. All costs are itemised in the shopping cart before you need to make payment. You can always decide not to proceed with payment if you are not happy with charges, and amendor delete your order as you wish.