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Changes in Firocoxib (Previcox/Equioxx)

You may have heard that there are some changes in our prescribing of Previcox for horses. Many of our horses, from young to old, have benefited in the last few years from the use of firocoxib to control pain from a variety of different conditions. Many of our senior citizens have been given immense relief from arthritic pain with this NSAID (Non-Steroidal Anti-Inflammatory Drug). Horses with chronic eye conditions such as uveitis respond well to this medication. From laminitis to fever, this drug has been a welcome tool in our tool box.

Firocoxib is Bute-like in its drug profile. It is equal to Bute in its anti-inflammatory action, being neither more nor less potent. The advantage that firocoxib offers over Bute is in its reduced side effects on the GI tract, reducing the risk of ulcers, and its ease of administration with the off-label use of the dog labeled product, Previcox.

When firocoxib first came to the equine market it was in the form of a paste, Equioxx. Cost concerns for the long term use of this product forced the off-label use of Previcox. This usage was legal as there was no other similar FDA approved product.

The off-label use of Previcox tablets, particularly the 227mg tablet, has now come to an end. Merial, the manufacturer of Equiox and Previcoxx, has now introduced an FDA approved, equine labelled 57mg tablet (comparable to the 57mg Preivcox tablet). This means that by law, we can no longer prescribe the Previcox 57 or 227 mg tablets. We are legally obligated to now use the 57mg Equioxx tablets.
The pricing of the 57mg Equiox tablets is the same as their Previcox counterpart. The cost of the 57mg tablet versus the ¼ tablet 227mg Previcox will be higher. Merial, recognizing this dilemma, is, for at least the short-term, offering rebates which reduces the cost to a 227mg level. These rebates are available through the on-line pharmacies, such as our VetsFirstChoice pharmacy. We have rebate forms in our office as well.

The bottom line is that you, the client, will now see Equioxx instead of Previcox and only in the 57mg form. We are unable, by law, to now prescribe the 227mg tablet. Horses that were prescribed ¼ of a 227 mg tablet will now get (1) 57 mg tablet. If your horse was on ½ of the 227 mg tablet, they will now get (2) of the 57 mg tablets.
Your horse will still benefit from firocoxib. It will now be supplied under a different label and dosage form and with the same palatability that we have all come to rely on. Please call us with any questions about how many Equioxx tablets your horse should get.