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  • 10ml Bottle £85.11
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Description


Presentation

Torbugesic Injection is a clear colourless, sterile solution containing as active ingredient butorphanol 10 mg/ml (as butorphanol tartrate 14.58 mg/ml). The product also contains 0.1 mg/ml benzethonium chloride as an antimicrobial preservative.

Uses

HORSE

As an analgesic

Torbugesic Injection is a centrally acting analgesic and may be used for the relief of moderate to severe pain in the horse. Clinical studies in the horse have shown that Torbugesic Injection alleviates abdominal pain associated with torsion, impaction, intussusception, parturition and spasmodic and tympanic colic.

As a sedative

When given after the administration of detomidine hydrochloride: Clinical studies have shown that this combination achieved a profound sedation in the horse. The degree of sedation achieved rendered horses unaffected by sound, tactile stimuli or any surrounding activity.

The sedative combination of Torbugesic Injection and detomidine hydrochloride has been successfully used for the following procedures: radiography, clipping, wound suturing, dentistry, standing castration, hoof care, rectal examination and passing a stomach tube.

Profound sedation is also achieved using Torbugesic after the administration of romifidine.

DOG

As an analgesic

For the relief of moderate to severe pain in dogs. Clinical studies have shown that Torbugesic Injection can provide suitable analgesia after a variety of surgical procedures such as orthopaedic and soft tissue surgery.

As a sedative in combination with medetomidine hydrochloride

For sedation in conjunction with medetomidine hydrochloride. Although sedation can occur with Torbugesic Injection alone, clinical studies have verified that deep to profound sedation is achieved by Torbugesic Injection in conjunction with a dose range of medetomidine making it suitable for a range of procedures including ear cleaning, wound management, anal gland flush, cast application, radiography and (at the higher dose rate) as a premedicant to ketamine anaesthesia (see below).

As a pre-anaesthetic

It has also been shown that pre-anaesthetic use of Torbugesic Injection has resulted in a dose-related reduction in the dose of thiopental sodium needed to induce anaesthesia, which will also reduce the risk of anaesthetic respiratory depression.

Clinical studies have verified that the use of Torbugesic Injection in conjunction with acepromazine provides a suitable analgesic and sedative premedicant to general anaesthesia. The dose of the Torbugesic can be adjusted according to the level of analgesia required. The use of the combination has resulted in a dose related reduction in the dose of either thiopental sodium or propofol needed to induce anaesthesia.

As an anaesthetic in combination with medetomidine and ketamine

Torbugesic Injection may be used as a triple anaesthetic combination with medetomidine and Ketamine. This provides surgical anaesthesia suitable for a range of procedures including castrations and spays.

CAT

As an analgesic

Torbugesic Injection may be used for the relief of pain in the cat. Pre-operative use of Torbugesic Injection can provide analgesia during surgery. Clinical studies have demonstrated that Torbugesic Injection can provide analgesia after a variety of surgical procedures such as spays, orthopaedic and soft tissue surgery.

As a sedative in combination with medetomidine hydrochloride

Although no sedation occurs when using Torbugesic Injection alone in the cat, clinical studies have verified that profound sedation is achieved by using Torbugesic Injection in conjunction with medetomidine, making it suitable for radiography, fracture examination/casting, dematting, ear cleaning, wound management and other minor procedures.

As an anaesthetic in combination with medetomidine and ketamine

Torbugesic Injection may be used as a triple anaesthetic combination with medetomidine and Ketamine. This provides surgical anaesthesia suitable for a range of procedures including castrations and spays.

Dosage and administration

HORSE

For analgesia

Dose rate: 5 ml/500 kg (equivalent to 0.1 mg butorphanol/kg) bodyweight, by intravenous injection. The dose may be repeated as required. Analgesic effects are seen within 15 minutes of injection.

Torbugesic for Equine Analgesia – (IV)

Weight of Horse - kgs

Dose of Torbugesic (10 mg/ml) - mls

50

0.5

100

1.0

150

1.5

200

2.0

250

2.5

300

3.0

350

3.5

400

4.0

450

4.5

500

5.0

550

5.5

For sedation in combination with detomidine hydrochloride

A dose rate in the region of 0.1 ml Domosedan™/100 kg (equivalent to 12 μg detomidine hydrochloride/kg) should be given intravenously followed within 5 minutes by a dose rate in the region of 0.25 ml Torbugesic Injection/ 100 kg (equivalent to 25 μg butorphanol/kg) intravenously.

Clinical experience has shown that a total dose 0.5 ml Domosedan and 1.0 ml Torbugesic Injection affords effective, safe sedation in horses above 200 kg bodyweight.

Torbugesic and detomidine Combination for Equine Sedation – (IV)

Weight of Horse – kgs:—

Dose of detomidine (10 mg/ml) – mls:—

Dose of Torbugesic (10 mg/ml) – mls:—

50

0.05

0.10

100

0.10

0.25

150

0.20

0.4

200

0.25

0.5

250

0.50

1.0

300

0.50

1.0

350

0.50

1.0

400

0.50

1.0

450

0.50

1.0

500

0.50

1.0

550

0.50

1.0

NB. Detomidine should be administered up to 5 minutes before the Torbugesic dose

For sedation in combination with romifidine

A dose of 0.4–1.2 ml Sedivet™/100 kg bodyweight (equivalent to 40–120 μg romifidine/kg) followed by 0.2 ml Torbugesic Injection/100 kg bodyweight (equivalent to 20 μg butorphanol/kg) should be administered intravenously.

Torbugesic and romifidine Combination for Equine Sedation – (IV)

Weight of Horse – kgs:—

* Dose of romifidine (10 mg/ml) – mls:—

Dose of Torbugesic (10 mg/ml) – mls:—

50

0.3

0.1

100

0.6

0.2

150

0.9

0.3

200

1.2

0.4

250

1.5

0.5

300

1.8

0.6

350

2.1

0.7

400

2.4

0.8

450

2.7

0.9

500

3.0

1.0

550

3.3

1.1

* Above example based on a dose rate of 60 μg romifidine/kg bodyweight.

NB. Romifidine should be administered up to 5 minutes before the Torbugesic dose.

DOG

For analgesia

Administer by intravenous, intramuscular or subcutaneous injection routes using aseptic technique. Rapid IV injection should be avoided.

Dose rate

0.2–0.3 ml/10 kg (equivalent to 0.2–0.3 mg butorphanol/kg) bodyweight. Torbugesic Injection should be administered before terminating anaesthesia to provide analgesia in the recovery phase. Analgesic effects are seen within 15 minutes. For continuous analgesia the dose may be repeated as required.

Torbugesic for Canine Analgesia – (IV, IM or SC)

Weight of Dog – kgs:—

*Dose of Torbugesic (10 mg/ml) – mls:—

1

0.03

3

0.07

5

0.1

10

0.3

15

0.4

20

0.5

25

0.6

30

0.8

40

1.0

* Based on a mean dose rate of 0.25mg butorphanol/kg.

For sedation in combination with medetomidine hydrochloride

Torbugesic Injection should be administered at 0.1 ml/10 kg bodyweight (equivalent to 0.1 mg butorphanol/kg) together with 0.1–0.25 ml Domitor™/10 kg bodyweight (equivalent to 10–25 μg medetomidine/kg) depending on degree of sedation required, both by either intramuscular or intravenous injection. Domitor and Torbugesic may be combined and administered in the same syringe. However, the vials should have separate needles inserted for withdrawal to minimise the risk of cross contamination. Allow 20 minutes for profound sedation to develop before commencing the procedure.

Reversal with 0.1–0.25 ml Antisedan™/10 kg bodyweight (equivalent to 50–125 μg atipamezole/kg) results in sternal recumbency approximately 5 minutes later and standing approximately a further 2 minutes later.

Torbugesic and medetomidine Combination for Canine Sedation – (IM or IV)

For sedation and as a premedicant to barbiturate anaesthesia

Weight of Dog – kgs:—

*Dose of Torbugesic (10 mg/ml) – mls:—

*Dose of medetomidine (1 mg/ml) – mls:—

1

0.01

0.01

3

0.03

0.03

5

0.05

0.05

10

0.10

0.10

15

0.15

0.15

20

0.20

0.20

25

0.25

0.25

30

0.30

0.30

40

0.40

0.40

* Based on a dose rate of 0.1 mg butorphanol/kg and 10μg medetomidine/kg

Torbugesic and medetomidine Combination for Canine Sedation – (IM or IV)

For profound sedation and as a premedicant to Ketaset anaesthesia

Weight of Dog – kgs:—

Dose of *Torbugesic (10 mg/ml) – mls:—

Dose of *medetomidine (1 mg/ml) – mls:—

1

0.01

0.03

3

0.03

0.08

5

0.05

0.13

10

0.10

0.25

15

0.15

0.38

20

0.20

0.50

25

0.25

0.63

30

0.30

0.75

40

0.40

1.00

* Based on a dose rate of 0.1 mg butorphanol/kg and 25μg medetomidine/kg

For use as a pre-anaesthetic

Used as a pre-anaesthetic, the Torbugesic Injection dose should be reduced to 0.1-0.2 ml/10 kg (0.1-0.2 mg butorphanol/kg), given 15 minutes prior to induction.

Torbugesic for Canine Analgesia Pre-Anaesthetic – (IV, IM, or SC)

Weight of Dog – kgs:—

*Dose of Torbugesic (10 mg/ml) – mls:—

1

0.01

3

0.03

5

0.05

10

0.10

15

0.15

20

0.20

25

0.25

30

0.30

40

0.40

*Pre-anaesthetic doses: based on dose rate of 0.10 mg butorphanol/kg

For use as a pre-anaesthetic combination with acepromazine

Torbugesic Injection should be administered at 0.1ml/10kg bodyweight (equivalent to 0.1 mg butorphanol/kg) together with 0.1 ml of 2 mg/ml acepromazine/10 kg bodyweight (equivalent to 0.02 mg acepromazine/kg) by intramuscular or intravenous injection.

Torbugesic and acepromazine may be combined and administered in the same syringe. However the vials should have separate needles inserted for withdrawal to minimise the risk of cross contamination.

Allow at least 20 minutes for onset of action but the time between premedication and induction is flexible from 20-120 minutes.

The dose of butorphanol may be increased to 0.2 mg/kg (equivalent to 0.2 ml Torbugesic Injection/10 kg bodyweight) if the animal is already experiencing pain before the procedure commences, or if a higher plane of analgesia is required during surgery.

Torbugesic and acepromazine Combination for Canine Analgesia and Sedation

Pre Anaesthetic (IM or IV)

Weight of dog - kgs:-

Dose of *Torbugesic (10 mg/ml) - mls:-

Dose of **acepromazine (2 mg/ml) - mls:-

1

0.01

0.01

3

0.03

0.03

5

0.05

0.05

10

0.1

0.1

15

0.15

0.15

20

0.2

0.2

25

0.25

0.25

30

0.3

0.3

40

0.4

0.4

* Based on a dose rate of 0.1 mg butorphanol/kg bodyweight

** Based on a dose rate of 0.02 mg acepromazine/kg bodyweight

For anaesthesia in combination with medetomidine and ketamine

Administer Torbugesic Injection at 0.1 ml/10 kg (equivalent to 0.1 mg butorphanol/kg) and Domitor at 0.25 ml/10 kg (equivalent to 25 μg medetomidine/kg) by intramuscular injection.

Domitor and Torbugesic may be combined and administered in the same syringe. However, the vials should have separate needles inserted for withdrawal to minimise the risk of cross-contamination.

Dogs become recumbent in approximately 6 minutes and lose their pedal reflex in approximately 14 minutes.

Ketamine (100mg/ml) should be administered 15 minutes following the first injection at 0.5 ml/10 kg (equivalent to 5 mg ketamine/kg) by intramuscular injection.

The pedal reflex returns approximately 53 minutes following administration of the Ketamine Injection. Sternal recumbency is attained approximately 35 minutes later followed by standing a further 36 minutes later.

Torbugesic, medetomidine and Ketaset for Canine Anaesthesia – (IM)

Weight of Dog – kgs:—

Dose of *Torbugesic (10 mg/ml) – mls:—

Dose of **medetomidine (1 mg/ml) – mls:—

1

0.01

0.03

3

0.03

0.08

5

0.05

0.13

10

0.10

0.25

15

0.15

0.38

20

0.20

0.50

25

0.25

0.63

30

0.30

0.75

40

0.40

1.00

ADMINISTER TORBUGESIC & MEDETOMIDINE BY INTRAMUSCULAR INJECTION AT THE ABOVE DOSE RATES

WAIT 15 MINUTES BEFORE ADMINISTERING THE KETASET BY INTRAMUSCULAR INJECTION AT THE DOSE RATES BELOW

Weight of Dog - kgs:

Dose of ***Ketamine (100 mg/ml) - mls:

1

0.05

3

0.15

5

0.25

10

0.50

15

0.75

20

1.00

25

1.25

30

1.50

40

2.00

* Based on a dose rate of 0.1 mg butorphanol/kg

** Based on a dose rate of 25μg medetomidine/kg

*** Based on a dose rate of 5 mg ketamine/kg

NB: It is NOT advisable to reverse this combination in the dog with atipamezole.

CAT

For pre-operative analgesia

0.2 ml Torbugesic injection/ 5 kg bodyweight (equivalent to 0.4 mg butorphanol/kg), should be administered either by subcutaneous or intramuscular injection. Clinical studies have shown that administering the butorphanol dose 5 minutes prior to induction with either acepromazine/ketamine or xylazine/ketamine given intramuscularly will provide analgesia when surgery commences. The arousal time will not be significantly altered. With intravenous induction agents, butorphanol should be administered 15–30 minutes prior to administration of the anaesthetic.

For post-operative analgesia

0.2 ml Torbugesic Injection/ 5 kg bodyweight (equivalent to 0.4 mg butorphanol/kg), should be administered by either subcutaneous or intramuscular injection 15 minutes prior to recovery. Alternatively, 0.05 ml Torbugesic Injection/5 kg (equivalent to 0.1 mg butorphanol/kg), by intravenous injection can be used.

Torbugesic for Feline Analgesia

Body weight – kgs:—

Dose(ml) *IV Torbugesic Injection™ (10 mg/ml)

Dose(ml)**IM or SC Torbugesic Injection (10mg/ml)

1

0.01

0.04

1.5

0.02

0.06

2.0

0.02

0.08

2.5

0.03

0.10

3.0

0.03

0.12

3.5

0.04

0.14

4.0

0.04

0.16

4.5

0.05

0.18

5.0

0.05

0.20

* Based on a mean dose rate of 0.1 mg butorphanol/kg

**Based on a mean dose rate of 0.4 mg butorphanol/kg

For sedation in combination with medetomidine hydrochloride

Torbugesic Injection should be administered at 0.2 ml/5 kg bodyweight (equivalent to 0.4 mg butorphanol/kg) together with 0.25 ml Domitor/5 kg bodyweight (equivalent to 50 μg medetomidine/kg) both by either intramuscular or subcutaneous injection.

Domitor and Torbugesic may be combined and administered in the same syringe. However, the vials should have separate needles inserted for withdrawal to minimise the risk of cross contamination.

Local anaesthetic infiltration should be used for wound suturing. Reversal with 0.125 ml Antisedan/5 kg bodyweight (equivalent to 125 μg atipamezole/kg) results in sternal recumbency approximately 4 minutes later and standing 1 minute later.

Torbugesic and medetomidine Combination for Feline Sedation – (IM or SC)

Weight of Cat – kgs:—

Dose of *Torbugesic (10 mg/ml) – mls:—

Dose of **medetomidine (1 mg/ml) – mls:—

1

0.04

0.05

1.5

0.06

0.08

2

0.08

0.10

2.5

0.10

0.13

3

0.12

0.15

3.5

0.14

0.18

4

0.16

0.20

4.5

0.18

0.23

5

0.20

0.25

*Based on a dose rate of 0.4mg butorphanol/kg

**Based on a dose rate of 50μg medetomidine/kg

For anaesthesia in combination with medetomidine and ketamine

(a) Intramuscular

Administer Torbugesic Injection at 0.2 ml/5 kg (equivalent to 0.4 mg butorphanol/kg), 0.4 ml Domitor/5 kg (equivalent to 80 μg medetomidine/kg) and Ketamine (100mg/ml) at 0.25 ml/5 kg (equivalent to 5 mg ketamine/kg).

Domitor, Torbugesic and Ketaset may be combined and administered in the same syringe. However, the vials should have separate needles inserted for withdrawal to minimise the risk of cross-contamination.

Cats become recumbent in 2–3 minutes following injection. Loss of the pedal reflex occurs 3 minutes post-injection.

Torbugesic, medetomidine and Ketaset Combination for Feline Anaesthesia – (IM)

Weight of Cat – kgs:

Dose of *Torbugesic (10 mg/ml) – mls:

Dose of **medetomidine (1 mg/ml) – mls:

Dose of ***Ketaset (100 mg/ml) – mls:

1.5

0.06

0.12

0.08

2

0.08

0.16

0.10

2.5

0.10

0.20

0.13

3

0.12

0.24

0.15

3.5

0.14

0.28

0.18

4

0.16

0.32

0.20

4.5

0.18

0.36

0.23

5

0.20

0.40

0.25

* Based on a dose rate of 0.4 mg butorphanol/kg

** Based on a dose rate of 80μg medetomidine/kg

*** Based on a dose rate of 5 mg ketamine/kg

Reversal with 0.2 ml Antisedan/5 kg (equivalent to 200 μg atipamezole/kg) results in return of the pedal reflex 2 minutes later, sternal recumbency 6 minutes later and standing 31 minutes later.

(b) Intravenous

Administer Torbugesic Injection at 0.05 ml/5 kg bodyweight (equivalent to 0.1 mg butorphanol/kg), 0.2 ml Domitor/5 kg bodyweight (equivalent to 40 μg medetomidine/kg) and Ketamine (100 mg/ml), depending on depth of anaesthesia required, at a dose rate of 0.06–0.13 ml/5 kg (equivalent to 1.25–2.5 mg ketamine/kg) by intravenous injection.

Domitor and Torbugesic and ketaset may be combined and administered in the same syringe. However, the vials should have separate needles inserted for withdrawal to minimise the risk of cross-contamination.

Approximate time scales when using the triple combination intravenously.

*Ketamine™ dose mg/kg

1.25

2.5

Time to recumbency

32 secs

22 secs

Time to loss of pedal reflex

62 secs

39 secs

Time to return of pedal reflex

26 mins

28 mins

Time to sternal recumbency

54 mins

62 mins

Time to standing

74 mins

83 mins

*In conjunction with butorphanol at 0.1mg/kg and medetomidine at 40 μg/kg.

Torbugesic, medetomidine and Ketamine for Feline Anaesthesia – (IV)

Dosage chart for 2.5 mg ketamine/kg (duration of anaesthesia approximately 28 minutes)

Weight of Cat – kgs:

Dose of *Torbugesic (10 mg/ml) – mls:

Dose of **medetomidine (1 mg/ml) – mls:

Dose of ***Ketamine (100 mg/ml) – mls:

1.5

0.02

0.06

0.04

2

0.02

0.08

0.05

2.5

0.03

0.10

0.06

3

0.03

0.12

0.08

3.5

0.04

0.14

0.09

4

0.04

0.16

0.10

4.5

0.05

0.18

0.11

5

0.05

0.20

0.13

* Based on a dose rate of 0.1 mg butorphanol/kg bodyweight.

** Based on a dose rate of 40 μg medetomidine/kg bodyweight.

*** Based on a dose rate of 2.5 mg ketamine/kg bodyweight.

Reversal with 0.1 ml Antisedan/5 kg (equivalent to 100 μg atipamezole/kg) results in return of the pedal reflex 4 minutes later, sternal recumbency 7 minutes later and standing 18 minutes later.

Contra-indications, warnings, etc

Before using any combinations consult the contra-indications and warnings that appear on the other products' data sheets.

HORSE

Withdrawal Period:

Meat & Offal: Zero days.

Torbugesic

Do not use in horses with a history of liver disease. The most commonly observed side-effect is slight ataxia which may persist for 3–10 minutes. Mild sedation may occur in approximately 15% of horses.

Torbugesic/detomidine hydrochloride combination

Do not use in horses with a history of liver disease. The combination should not be used in pregnant animals nor in animals suffering from colic. Routine cardiac auscultation should be performed prior to use of this combination.

Do not use the combination in horses with a pre-existing cardiac dysrhythmia or bradycardia. Mild to severe ataxia may be encountered but clinical studies have shown that horses are unlikely to collapse. Normal precautions should be observed to prevent patient self-injury.

Torbugesic/romifidine combination

Do not use in horses with a history of liver disease. The combination should not be used during the last month of pregnancy.

DOG

If respiratory depression occurs, naloxone may be used as an antidote. Do not use in dogs with a history of liver disease. Transient ataxia, anorexia and diarrhoea have been reported as occurring rarely. When using Torbugesic as a pre-anaesthetic the use of an anti-cholinergic, such as atropine will protect the heart against possible narcotic-induced bradycardia. When administering as an intravenous injection do not inject as a bolus.

CAT

If respiratory depression occurs, naloxone may be used as an antidote. Do not use in cats with a history of liver disease. Cats should be weighed to ensure that the correct dose is calculated. Use of either insulin syringes or 1 ml graduated syringes is recommended to ensure accurate dosing. Marked sedation does not occur in cats when Torbugesic Injection is used as a sole agent. Mydriasis is likely to occur.

Operator warning

Butorphanol has opioid-like activity. Precautions should be taken to avoid accidental injection/self-injection with this potent drug. If accidental self-injection occurs, seek immediate medical attention showing a copy of product literature. Do not drive. The effects of butorphanol include sedation, dizziness and confusion. Effects can be reversed with an opioid antagonist. Wash splashes from skin and eyes immediately.

Pharmaceutical precautions

Do not store above 25°C. Protect from light.

Torbugesic Injection must not be mixed with other products with the exception of the following combinations:

i)Torbugesic and Domitor

ii)Torbugesic, Domitor and Ketaset

iii)Torbugesic and acepromazine

Following withdrawal of the first dose, use the product within 28 days.

When the container is broached (opened) for the first time, using the in-use shelf-life which is specified on this datasheet, the date on which any product remaining in the carton should be discarded should be worked out. The discard date should be written in the space provided.

Avoid the introduction of contamination during use. Should any apparent growth or discolouration occur the product should be discarded.

Discard unused material.

Keep container in outer carton.

Disposal Advice

Dispose of any unused product and empty containers in accordance with guidance from your local waste regulation authority.

General precautions

For animal treatment only.

Keep out of reach and sight of children.

There may be some pain on intramuscular injection.

Legal category

POM-V

Packaging Quantities

10 ml and 50 ml amber glass vials. Not all pack sizes may be marketed.

Further information

Nil

Marketing authorisation number

Vm 00057/4415.

GTIN (Global Trade Item No)

10 ml:

08714015006965

50 ml:

08714015006972

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