Nora Apothecary Nora Apothecary

Drug Chart For Transdermal Therapy on Cats

 

Drug
Pharmacokinetic Considerations

Oral Dose

Injectable Dose
Recommended Initial TD Dose
Target For Efficacy
Monitoring For Toxicity
Aminophylline
100% bioavailability for non-SR orals; injectable does not equal to oral doses; transdermal forms have been used successfully in human neonates.
4mg/kg q 8-12h
4 mg/kg q 8-12 h
4 mg/kg q 8-12 h
Serum theophylline blood levels in therapeutic range. (These values are not firmly established for veterinary patients, but human range is 10-20 mcg/ml); evidence of controlled astma

Tachycardias, arrhythmias, seizures, hyperthermia.

Amitriptyline
48% oral bioavailablility (humans); extensive first pass hepatic extraction; accumulation after multiple doses; active metabolites must be conjugated with glucuronic acid to inactiveate (cats cannot do this).
5-10mg per cat q 24h
None Published
1.25 mg/cat q 24 h; behaviorists who have utilized TD amitripytyline in cats advise careful monitoring to avoid accumulation. Cessation of undesirable behavior; cessation of cystitis; onset of action as early as 3-5 days. Dry mouth; gastric distress; constipation, ataxia, tachycardia, weakness, sedation, urinary retention.
Amlodipine
Oral bioavailability 75% in humans, undetermined in cats; slowly but extensively metabolized to inactive compounds in the liver.
0.625mg per cat q 24h
None Published
0.5mg per cat q 24 h Reduction in blood pressure. Hypotension, headache is reported most commonly in humans although this may be difficult to recognize in veterinary patients.
Amoxicillin Clavulanate
Not recommended due to doses > 50 mg and possiblility of induction of bacterial resistance.
62.5mg per cat q 24h
None Published
Not Recommended Not Recommended Not Recommended
Atenolol
50% oral bioavailability; minimal (<50%) metabolism
6.25mg per cat
None Published
3.25 mg per cat q 24 h Reduction in pulse to 140-200 bpm. Hypotension, bradycardia, bronchospasm, cardiac failure, hypoglycemia.
Azithromycin
Not recommeded due to doses > 50 mg and possibility of induction of bacterial resistance.
7-15mg/kg q 12h
None Published
Not Recommended Eradication of bacterial infection. Head tilt(otic toxicity), elevated hepatic enzymes
Buprenorphine
Injectable form available; high degree of first pass extraction with gut wall and liver metabolism; conjugation with gllucuronide.
.01-.03mg/kg up to q 8h
.005-.015mg/kg IM, IV .01mg/kg q 8h Apparent analgesia; animal benefiting from pain management. Respiratory depression.
Buspirone
Not recommended until further studies available. Extensive first pass extraction (95% of oral dose removed by hepatic extraction.)
2.5mg per cat q 12h
None Published
Not Recommended Cessation of undesirable behavior or phobia Sedation, nausea, anorexia, tachycardia
Butorphanol
Extensive first pass extraction (84% of oral dose removed by hepatic extraction)
1mg per cat PO 1 12 h
.4mgkg SQ q 6h .4mg/kg q 6h Apparent analgesia; animal benefiting from pain management. Overly sedated; respiratory depression.
Carboplatin
Cytotoxic agent; not recommeded; tissue necrosis occurs at concentrations > .5 mg/ml.
Not Recommended
Not Recommended
Not Recommended Not Recommended Not Recommended
Chloramphenicol
Not recommended. High toxicity to humans; bacterial resistance, large doses preclude transdermal dosing.
Not Recommended
Not Recommended
Not Recommended Not Recommended Not Recommended
Cisapride
Oral bioavailability 35-40%; recommended extreme caution to caregiver who may be taking interacting drugs such as antihistamines and benzimidazole antibiotics.
5mg per cat q 8-12h
None Published
2.5mg per cat q 12h Resolution of ileus; evidence of colonic motility with no constipation or obstruction. Diarrhea, abdominal pain and craming, arrhythmias from drug interactions.
Clomipramine
Substantial first ass hepatic extraction; orl bioavailaility 50%; cats are very sensitive to TCDs; may accumulate in cats
2.5mg per cat q 24h
None Published
1.25mg per cat q 24h Cessation of undesirable behavior. Excessive sedation; dry mouth; urinary retetion.
Cyclophosphamide
Not recommended. Cytotoxic agent
Not Recommended
Not Recommended
Not Recommended Not Recommended Not Recommended
Cyproheptadine
Good oral bioavailability, extensive hepatic metabolism and conjugation with glucuronide with metabolites excreted in urine, accumulates in renal failure.
2mg per cat q 12h
None Published
2mg per cat q 12 h monitor for accumulation Evidence of appetite stimulation; relief of pruritis; cessation of undesirable behavior. Excessive sedation, dry mouth, urinary retention.
Digoxin
Not recommended. Narrow therapeutic index; cats are very sensitive to digoxin. Expoure potentially dangerous to caregiver.
.007-.015mg/kg; q 24-48h Do not use for HCM in cats
None Published
Not Recommended
Achievement of theraeutic serum levels .9-2.0 nanogram/ml for cats. Cats are very sensitive. Bradycardia, worsening of arrhythmias, serum levels > 2.0 nanogram/ml.
Diltiazem
10% transdermal bioavailability in cats( compared to IV), extensive first pass hepatic extraction. (50-80% oral bioavailability in cats.)
7.5mg per cat (non SR) q 8h
.25mg/kg IV bolus up to .75mg/kg 7.5mg per cat q 12h Reduction in pulse rate to 140-200 range. Bradycardia, vomiting, heart block.
Doxycycline
Known to irritate gastric and esophageal mucosa of cats; do not recommend rubbing this chemical into ears. Also a potent photosensitizer, do not recommend putting on ears that might be exosed to sunlight. Bacterial or rickettsial resistance to this drug from subtherapeutic concentrations woud leave few other alternatives in treating tick-bourne disease.
5mg/kg q 12h
5mg/kg IV q 12h Not Recommended Not Recommended Not Recommended
Enalapril
Prodrug that is hepatically metabolized to active drug enalaprilat; 60% oral bioavailability.
.25-.5mg/kg q 24h
None Published
.25mg/kg q 24h Improvement of clinical signs of heart failure. GI distress, hypotension.
Enrofloxacin
Not recommended. Risk of retinal toxicity in cats; risk of inducing bacterial resistance; of hallucinations in caregiver. Raw chmical is FDA targeted high priority drug for regulatory action.
2.5mg/kg q 12h DO NOT EXCEED 5mg/kg/day
2.5mg/kg SQ q 12h DO NOT EXCEED 5mg/kg/day Not Recommended Eradication of bacterial infection. Pupillary dilation(early indicator of retinal toxicity); lameness (indicator of joint erosion in immature animals.) Seizures, behavior change(auditory and visual hallucinations commony reported in humans.)
Fluoxetine
Not Recommended. Extremely long terminal half life in cats (60hr+); likely to accumulate.
1-5mg per cat q 24h, obtain baseline labwork; assess after 1-4 weeks
None Published
Not Recommended Eradication of bacterial infection. Pupillary dilation (early indicator of retinal toxicity); lameness(indicator of joint erosion in immature animals.) Seizures, behavior change (auditory and visual hallucination commonly reported in humans.)
Furosemide
Not recommended. Very unstable at acid pH.
.5-2.0mg/kg per day
Up to 4.4mg/kg IV or Im to effect Not Recommended Improvement in respiratory rate and/or character; resolution of effusion or edema. Head tilt(ototoxicity); electrolyte imbalances; weakness, lethargy.
Glipizide
100% oral bioavailability in humans.
2.5mg per cat q 12h
None Published
2.5mg per cat q 12h Reduction in blood glucose <200. GI distress, hypoglycemia, icterus, increased ALT; hyperglycemia from therapeutic failure.
Insulin
Not recommended. Although, ther are anecdotal reports of efficacy, none of these cases have sustained an effect nor documented blood glucose levels during treatment. Risk of lipodystrophy also potentially increased due to larger surface area exposed to insulin.
Not Available
Variable
Not Recommended Achievement of blood glucose values. Hypoglycemia (too much insulin deivered.) hyperglycemia (therapeutic failure).
Methimazole
Oral bioavailability 45-98%, hepatic metabolism; large interpatient variation; alow 1-3 weeks for assesment.
4mg per cat q 8-12h
None Published
2.5mg per cat q 12h Reduction in serum T4 levels; improvement in clinical symptoms. Worsening of vomiting; dermal excoriations; leukopenias, hepatopathies, thrombocytopenia.
Metoclopramide
Large interpatient variation in oral bioavailability, may be as low as 30% in some patients, conjugation with glucuronide, may accumulate in cats.
.2-.4mg/kg q 6-8h
.2-.4mg/kg SQ q 6-8h .2-.4mg/kg q 8h Cessation of vomiting. Frenzied behavior; disorentation, constipation.
Phenobarbital
Oral bioavailability 90%; conjugation with glucuronide; very polar; very low lipid solubility; t 1/2 34-43hrs in cats.
2mg/kg q 12h
2-4mgkg IV bolus for status epilepticus persisting after diaepam. 2mg/kg q 12h Seizure free, serum plaxma concentrations of 10-30 mcg/ml. Ataxia, overly sedated, lethargy, bone marrow suppression, immune medicated reactions, hepatotoxicity in dogs(cats not as likely to experience hepatotoxicity).
Prednisolone
Not Recommended. Risk of epidermal attrophy is great.
1-2mg/kg q 12-24h
1-3mg/kg IV or IM (prednisolone sodium succinate) Not Recommended Cessation of inflammator signs. Epidermal or cartilage atrophy; igns of hyperadrenocorticism with chronic use; signs of diabetes mellitus.