SMZ- how much to dose?

Miniature Horse Talk Forums

Help Support Miniature Horse Talk Forums:

solupe

Well-Known Member
Joined
Feb 15, 2004
Messages
61
Reaction score
0
Hello,

I heard that SMZ are good to treat horses with a snotty nose or heavy breathing.

I was woundering how many pills to give a foal? or an adult? Are these medicines specially for horses or are they a human medicine. I appreciate all input.....pm is also OK in case some idiot
does not agree with the advice you want to give......
 

sfmini

Well-Known Member
Joined
Nov 30, 2002
Messages
3,088
Reaction score
136
You should always contact your vet for advice on treating an illness as you might select the wrong medication.

And no, that advice is the advice I always give.

I would tell you why, but your vet should do that to.

That last sentence is new, I used to just say why....
 

solupe

Well-Known Member
Joined
Feb 15, 2004
Messages
61
Reaction score
0
Well I am in Europe,and medicines are not always the same as in the US. Overhere they tend to prescribe medicines that make them more money even if they know aspirine will do the trick also!!!! This is why I ask about smz.....
 

ChrystalPaths

Well-Known Member
Joined
Aug 31, 2003
Messages
8,277
Reaction score
1
Ok this sucks, sorry...
.....I'll risk it...one can get the info by doing a google search. I preface this by saying I am not a vet and in no way is this advice on dosage or usage of this drug...sheesh!


SMZ TABS: One tablet for every 70/140 lbs.

And yes it is good for those things but do double check with your qualified vet to be sure before dosing any animals with a drug. Even antibiotics. Reactions adverse can and do happen on rare occasions.

HOWZ THAT!
 

Dr. Pam

Well-Known Member
Joined
Aug 22, 2003
Messages
737
Reaction score
0
Location
Princeton, TX
Hey Deb--pretty good! I'll go you one better:

from Plumb's Veterinary Drug Handbook (Fifth Edition)

Sulfadiazine/Trimethoprim | Sulfamethoxazole/Trimethoprim
Note: In the practice of veterinary medicine in the United States, two separate combinations with trimethoprim are used clinically. There are trimethoprim/sulfadiazine products approved for use in dogs, cats and horses in both parenteral and oral dosage forms. Many veterinarians also use the human approved, trimethoprim/sulfamethoxazole oral products. In Canada, sulfadoxine is available in combination with trimethoprim for veterinary use.

Prescriber Highlights

Potentiated sulfonamide antimicrobial agent

Contraindications: hypersensitive to sulfas, thiazides, or sulfonylurea agents; severe renal or hepatic impairment

Caution: diminished renal or hepatic function, or urinary obstruction or urolithiasis.

Adverse Effects: Dogs: keratoconjunctivitis sicca, hypersensitivity (type 1 or type 3) acute neutrophilic hepatitis with icterus, vomiting, anorexia, diarrhea, fever, hemolytic anemia, urticaria, polyarthritis, facial swelling, polydipsia, crystalluria, hematuria, polyuria, cholestasis, hypothyroidism, anemias, agranulocytosis, idiosyncratic hepatic necrosis in dogs. Cats: anorexia, crystalluria, hematuria, leukopenias and anemias. Horses: transient pruritic (after IV injection). Oral: diarrhea, hypersensitivity reactions and hematologic effects (anemias, thrombocytopenia, or leukopenias

Local injection effects possible (check label for product recommendation for injection technique)

Potentially teratogenic, weigh risk vs. benefit

Drug Interactions

Chemistry

Trimethoprim occurs as odorless, bitter-tasting, white to cream-colored crystals or crystalline powder. It is very slightly soluble in water and slightly soluble in alcohol.

Sulfadiazine occurs as an odorless or nearly odorless, white to slightly yellow powder. It is practically insoluble in water and sparingly soluble in alcohol.

Sulfamethoxazole occurs as a practically odorless, white to off-white, crystalline powder. Approximately 0.29 mg is soluble in 1 ml of water and 20 mg are soluble in 1 ml of alcohol.

Storage/Stability/Compatibility

Unless otherwise instructed by the manufacturer, trimethoprim/sulfadiazine and co-trimoxazole products should be stored at room temperature (15-30°C) in tight containers.

Pharmacology

Alone, sulfonamides are bacteriostatic agents and trimethoprim is bactericidal, but in combination, the potentiated sulfas are bactericidal.

The potentiated sulfas have a fairly broad spectrum of activity. Gram-positive bacteria that are generally susceptible include most streptococci, many strains of staphylococcus and Nocardia. Approximately 30% of strains tested of Streptococcus zooepidemicus are resistant to TMP/Sulfa in horses. Many gram-negative organisms of the family Enterobacteriaceae are susceptible to the potentiated sulfas, but not Pseudomonas aeruginosa. Some protozoa (Pneumocystis carinii, Coccidia and Toxoplasma) are also inhibited by the combination. Potentiated sulfas reportedly have little activity against most anaerobes, but opinions on this vary.

Resistance will develop slower to the combination of drugs than to either one alone. In gram-negative organisms, resistance is usually plasmid-mediated.

Uses/Indications

Although only approved for use in dogs and horses, trimethoprim/sulfadiazine et al is used in many species to treat infections caused by susceptible organisms. See Dosage section for more information.

Pharmacokinetics

Trimethoprim/sulfa is well absorbed after oral administration, with peak levels occurring about 1-4 hours after dosing. The drug is more slowly absorbed after subcutaneous absorption, however.

Trimethoprim/sulfa is well distributed in the body. When meninges are inflamed, the drugs enter the CSF in levels of about 50% of those found in the serum. Both drugs cross the placenta and are distributed into milk.

Because of the number of variables involved, it is extremely difficult to apply pharmacokinetic values in making dosage recommendations with these combinations. Each drug (trimethoprim and the sulfa) has different pharmacokinetic parameters (absorption, distribution, elimination) in each species. .

There is considerable controversy regarding the frequency of administration of these combinations. The veterinary product, trimethoprim/sulfadiazine is labeled for once daily administration in dogs and horses, but many clinicians believe that the drug is more efficacious if given twice daily, regardless of which sulfa is used.

Contraindications/Precautions

The manufacturer states that trimethoprim/sulfadiazine should not be used in dogs or horses showing marked liver parenchymal damage, blood dyscrasias, or in those with a history of sulfonamide sensitivity. It is not for use in horses (or approved for other animals) intended for food.

This combination should be used with caution in patients with pre-existing hepatic disease.

Reproductive/Nursing Safety

Safety of trimethoprim/sulfa has not been clearly established in pregnant animals. Reports of teratogenicity (cleft palate) have been reported. Studies thus far in male animals have not demonstrated any decreases in reproductive performance. (Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in humans; or there are no animal reproduction studies and no adequate studies in humans.) In a separate system evaluating the safety of drugs in canine and feline pregnancy (Papich 1989), this drug is categorized as in class: B (Safe for use if used cautiously. Studies in laboratory animals may have uncovered some risk, but these drugs appear to be safe in dogs and cats or these drugs are safe if they are not administered when the animal is near term.)

Use TMP/sulfa products in nursing animals with caution. TMP-SMZ is not recommended for human use in the nursing period as sulfonamides are excreted in milk and may cause kernicterus. Premature infants and infants with hyperbilirubinemia or G-6-PD deficiency are also at risk for adverse effects.

Adverse Effects/Warnings

Adverse effects noted in  horses, transient pruritus has been noted after intravenous injection. Oral therapy has resulted in diarrhea development in some horses. Previous administration of potentiated sulfas has been implicated in increasing the mortality rate of equine diarrhea. If the 48% injectable product is injected IM, SC, or extravasates after IV administration, swelling, pain and minor tissue damage may result. Hypersensitivity reactions and hematologic effects (anemias, thrombocytopenia, or leukopenias) may also be seen; long-term therapy should include periodic hematologic monitoring.

Overdosage/Acute Toxicity

Manifestations of an acute overdosage can include symptoms of GI distress (nausea, vomiting, diarrhea), CNS toxicity (depression, headache, and confusion), facial swelling, bone marrow depression and increases in serum aminotransferases. Oral overdoses can be treated by emptying the stomach, (following usual protocols), and initiating symptomatic and supportive therapy. Acidification of the urine may increase the renal elimination of trimethoprim, but could also cause sulfonamide crystalluria, particularly with sulfadiazine containing products. Complete blood counts (and other laboratory parameters) should be monitored as necessary. Bone marrow suppression associated with chronic overdoses may be treated with folinic acid (leucovorin) if severe. Peritoneal dialysis is not effective in removing TMP or sulfas from the circulation.

Drug Interactions

Trimethoprim/sulfa may prolong the clotting times in patients receiving coumarin (warfarin) anticoagulants. Sulfonamides may displace other highly bound drugs, such as methotrexate, phenylbutazone, thiazide diuretics, salicylates, probenecid and phenytoin.Although the clinical significance of these interactions is not entirely clear, patients should be monitored for enhanced effects of the displaced agents. Antacids may decrease the bioavailability of sulfonamides if administered concurrently. Trimethoprim may decrease the therapeutic effect of cyclosporine (systemic) and increase the risk of nephrotoxicity developing.

.

Doses

Note: There is significant controversy regarding the frequency of dosing these drugs. See the pharmacokinetic section above for more information. Unless otherwise noted, doses are for combined amounts of trimethoprim/sulfa.

Horses

For susceptible infections:

1.  For respiratory tract infections: 15-30 mg/kg PO q12h. Give 30 minutes prior to feeding hay (grain is OK) (Foreman 1999)

2.  Foals: 15 mg/kg IV q12h; 30 mg/kg PO q12h (Brumbaugh 1999)

3.  22 mg/kg IV q24h or 30 mg/kg, PO q24h (Upson 1988)

4.  30 mg/kg PO once daily or 21.3 mg/kg IV once daily (Package inserts; Tribrissen®--Coopers)

5.  Foals: 15 mg/kg PO or IV twice daily (Furr 1999)

6.  For EPM: Sulfadiazine 20 mg/kg (either alone or as a potentiated sulfa) PO once or twice a day with Pyrimethamine (1 mg/kg PO once a day) for 90-120 days (or longer). Monitor: CBC's (Moore 1999)

Monitoring Parameters

1) Clinical efficacy; 2) Adverse effects; with chronic therapy, periodic complete blood counts should be considered; 3) Thyroid function tests should be considered (baseline and ongoing) particularly in dogs receiving long term treatment

Client Information

If using oral suspension, shake well before using. Does not need to be refrigerated. Animals must be allowed free access to water and must not become dehydrated while on therapy.

Dosage Forms/Approval Status/Withholding Times

Veterinary-Approved Products:

Trimethoprim (TMP)/Sulfadiazine (SDZ) Oral Tablets:

30's: 5 mg TMP/25 mg SDZ (coated tablets)

120's: 20 mg TMP/100 mg SDZ (coated tablets)

480's: 80 mg TMP/400 mg SDZ (uncoated, scored tablets)

960's: 160 mg TMP/800 mg SDZ (uncoated, unscored tablets)

Tribrissen® (Schering-Plough); (Rx). Approved for use in dogs.

Trimethoprim (TMP)/Sulfadiazine (SDZ) Oral Paste: Each gram contains 67 mg trimethoprim and 333 mg sulfadiazine. Available in 37.5 gram (total weight) syringes; Tribrissen® 400 Oral Paste (Schering-Plough); (Rx). Approved for use in horses not intended for food.

Trimethoprim/Sulfadiazine Sterile Injection: 48% in 100 ml vials. Approved for use in horses not intended for food. Di-Biotic 48%® (Phoenix Pharmaceutical), Tribrissen® 48% Injection (Schering-Plough); (Rx)

Trimethoprim/Sulfadiazine Powder: 67 mg trimethoprim and 333 mg sulfadiazine per gram. Approved for use in horses not intended for food. Tucoprim® Powder (Pfizer) in 200 g bottles and 2000 g pails, Uniprim® Powder (Macleod) in 37.5 g and 1,125 g packets; (Rx)

In Canada, trimethoprim and sulfadoxine are available for use in cattle and swine (Trivetrin® --Wellcome; Borgal® --Hoechst). They have a slaughter withdrawal of 10 days and milk withdrawal of 96 hours.

Human-Approved Products:

Trimethoprim (alone) Tablets: 100 mg and 200 mg; Proloprim® (Glaxo Wellcome); Trimpex® (Roche); generic; (Rx)

Trimethoprim 80 mg and Sulfamethoxazole 400 mg Tablets; Trimethoprim 160 mg and Sulfamethoxazole 800 mg Tablets: Bactrim®, Bactrim-DS® (Roche); Septra®, Septra®; DS, (Glaxo Wellcome); generic; (Rx)

Trimethoprim 8 mg/ml and Sulfamethoxazole 40 mg/ml oral suspension in 20 ml, 100 ml, 150 ml, 200 ml, 473 ml, and 480 mls; Septra® (GlaxoWellcome); Cotrim Pediatric® (Lemmon), Sulfatrim®, (various); generic; (Rx)

Trimethoprim 16 mg and Sulfamethoxazole 80 mg per 5 ml for injection in 5 ml Carpuject; 80 mg trimethoprim and 400 mg sulfamethoxazole/5 ml in 10 ml, 20 ml, 30 ml multi-dose vials and 5 ml vials; Bactrim® IV (Roche); Septra® IV (Monarch); generic; (Rx)

In combination, these products may be known as: Co-trimoxazole, SMX-TMP, TMP-SMX, trimethoprim-sulfamethoxazole, sulfamethoxazole-trimethoprim, sulfadiazine-trimethoprim, trimethoprim-sulfadiazine, TMP-SDZ, SDZ-TMP, Co-trimazine or by their various trade names.
Souple, I usually buy these in 1000 count bottles from my drug reps--and they are often human labeled bottles. Sometimes the human labeled drugs are cheaper and sometimes the veterinary labeled drugs are cheaper--and I can choose either one.

**Note--I deleted sections on several other species plus some of the technical info--let me know if you really want the whole thing**
 
Last edited by a moderator:

justaboutgeese

Well-Known Member
Joined
Jan 14, 2005
Messages
1,038
Reaction score
0
Location
ontario canada
There have been times when my vet recommended a drug he did not have on hand. Being a prescription drug I could not buy it over the counter so he would call the local pharmacy and they would dispense on his phoning it in. I wonder how many other drug stores fill veterinary scripts ????
 

Dr. Pam

Well-Known Member
Joined
Aug 22, 2003
Messages
737
Reaction score
0
Location
Princeton, TX
I have never had a problem phoning in veterinary rx's to pharmacies--all they need to have on file is my state licence and DEA number. There are many drugs we use that are "extra label", some drugs are too expensive/not used very often to keep in inventory, plus sometimes we just plain run out.
 

Dream

Well-Known Member
Joined
Dec 30, 2003
Messages
387
Reaction score
0
Location
Ontario
Dr. Pam,

Do you anyone made it through that whole passage from Plumb<G>? It was hard enough for me in school! Very PC everyone!

Keep up the good work.

Michelle DVM
 

Dr. Pam

Well-Known Member
Joined
Aug 22, 2003
Messages
737
Reaction score
0
Location
Princeton, TX
Dream said:
Dr. Pam,Do you anyone made it through that whole passage from Plumb<G>?  It was hard enough for me in school!  Very PC everyone!

Keep up the good work.

Michelle DVM

473629[/snapback]

teehee just being politically correct


I just edited it--and I'd be happy to interpret by PM if someone truely doesn't understand...
 
Last edited by a moderator:

ChrystalPaths

Well-Known Member
Joined
Aug 31, 2003
Messages
8,277
Reaction score
1
Well "I" read the entire thing and copied it to my meds file.

Thanks for nice words Pam, my friend. I did neglect to say my tabs are 960s and I also try to keep some on hand.

I should have said: 960's/ 160 mg TMP/800 mg SDZ (uncoated, unscored tablets) one tab per70 to 140 lbs.

I get them from my small animal vet and he was very fussy about looking up the proper dose for a small equine.

I also put them(tablets) in a larger syringe and fill the syringe with applesauce, the tab(s) get very smushy and they open their little mouths eagerly for the "treat".

Again I am not a vet (got a picture of Nixon in my head
)but this is my experience and as you see a real live vet says


Thanks DR. Pam.
 

solupe

Well-Known Member
Joined
Feb 15, 2004
Messages
61
Reaction score
0
Thank you all so much for that information....
and a special thanks to Dr. Pam ....
 

Latest posts

Top