Meloxicam + Paracetamol

Applications: Acute inflammation, Castration, Chronic Pain, Chronic inflammation, Dehorning, Fever, Inflammation, Lameness, Pain, Spaying, Neutering

Contraindicated to cats as paracetamol causes toxicity.

Meloxicam has antiinflammatory, analgesic, and antipyretic activity similar to other NSAIDs. Like other NSAIDs, meloxicam exhibits analgesic, antiinflammatory, and antipyretic activity probably through its inhibition of cyclooxygenase, phospholipase A2, and inhibition of prostaglandin synthesis. It is considered COX-2 preferential (not COX-2 specific) as at higher dosages its COX-2 specificity is diminished.

Paracetamol is an analgesic drug. Exact mechanism of action is not known. There is evidence that acetaminophen inhibits centrally mediated pain transmission via inhibition of cyclo-oxygenase (COX)-3 a variant of COX-1 found in the central nervous system (CNS). Other evidence indicates that acetaminophen may inhibit prostaglandins in some cells and tissue in which low concentrations of arachidonic acid are present.

GI distress is the most commonly reported adverse effect, and in US field trials vomiting, soft stools, diarrhea, and inappetence were the most common adverse effects reported. Renal toxicity appears to be quite low. Post-approval adverse effects reported have included GI effects (vomiting, anorexia, diarrhea, melena, ulceration), elevated liver enzymes, pruritus, azotemia, elevated creatinine, and renal failure.

In cats, single doses of meloxicam appear relatively safe. In field trials some cats developed elevated BUN, post-treatment anemia and, rarely, residual pain at the injection site. In other studies, meloxicam has caused GI effects (vomiting, diarrhea, inappetence), behavior changes, and lethargy. Repeated use of meloxicam in cats is controversial, as repeated doses have been associated with renal failure and death.

Due to its long half-life in dogs, a 5–7 day washout period after stopping meloxicam has been recommended before starting a new NSAID.