Frequently asked questions about EQUIOXX® (firocoxib)

EQUIOXX is a non-steroidal anti-inflammatory drug (NSAID) of the coxib class used to control pain and inflammation associated with osteoarthritis in horses.

EQUIOXX should be given according to your veterinarian’s instructions. Do not change the way you give EQUIOXX to your horse without first speaking with your veterinarian. Do not exceed 14 days of treatment.

The recommended dosage of EQUIOXX for oral administration in horses is 0.045 mg/lb (0.1 mg/kg) of body weight once daily for up to 14 days. Each marking on the syringe will treat 250 pounds of body weight, and each notch corresponds to approximately a 50 lb weight increment. To deliver the correct dose, round the horse’s body weight up to the nearest 50 pound increment (if the body weight is an exact 50 pound increment, do not round up). Unlock the knurled ring on the syringe plunger by rotating it ¼ turn counter-clockwise. Slide the knurled ring along the plunger shaft so that the side nearest the barrel is at the appropriate 50 lb weight notch. Rotate the plunger ring ¼ turn clockwise to lock it in place and ensure it is locked.

EQUIOXX may be given with or without food.

While EQUIOXX is not a cure for osteoarthritis, it can control the pain and inflammation associated with OA and can improve your horse’s mobility.

• Response varies from horse to horse, but improvement can be quite dramatic.
• Improvement can be seen in just a few hours in most horses.

Your horse should not be given EQUIOXX if it

• Has an allergic reaction to firocoxib, the active ingredient in EQUIOXX.
• Has previously had an allergic reaction (such as hives, facial or lower limb swelling, or red or itchy skin) to aspirin or other NSAIDs.
• Is presently taking aspirin, phenylbutazone, flunixin meglumine, diclofenac, ketoprofen, or other NSAIDs or corticosteroids.
• The safety of EQUIOXX has not been determined in horses less than one year of age or in breeding horses, pregnant or lactating mares.

• People should not take EQUIOXX. Keep EQUIOXX and all medications out of the reach of children.
• Consult a physician in case of accidental ingestion by humans.

Talk to your veterinarian about:

• The signs of OA you have observed in your horse, such as limping or stiffness.
• If any tests, such as X-rays, will be done before EQUIOXX is prescribed.
• How often your horse may need to be examined by your veterinarian.
• The risks and benefits of using EQUIOXX.

Tell your veterinarian if your horse has ever had the following medical problems:

• Any side effects from taking EQUIOXX or other NSAIDs, such as aspirin or phenylbutazone.
• Any kidney disease.
• Any liver disease.
• Any gastrointestinal ulcers.

Tell your veterinarian about:

• Other medical problems or allergies that your horse has now, or has had in the past.
• All medicines that you are giving or plan to give to your horse, including those you can get without a prescription and any dietary supplements.

Tell your veterinarian if you plan to breed your horse, or if your mare is pregnant or nursing a foal.

EQUIOXX, like other NSAIDS, may cause some side effects. Serious side effects associated with NSAID therapy in horses can occur with or without warning. The most common side effects associated with therapy with EQUIOXX involve the tongue, lips and skin of the mouth and face (erosions and ulcers of the mucosa and skin) and the kidney. Gastrointestinal, kidney and liver problems have also been reported with other NSAIDs. Look for the following side effects that may indicate your horse is having a problem with EQUIOXX or may have another medical problem:

• Sores or ulcers on the tongue and inside of the mouth.
• Sores, scabs, redness, or rubbing of the facial skin, particularly around the mouth.
• Change in eating and drinking habits (frequency or amount consumed).
• Change in urination habits (frequency or color).
• Yellowing of gums, skin, or whites of the eyes (jaundice).
• Unexpected weight loss.
• Change in behavior (such as increased or decreased activity level).

It is important to stop therapy and contact your veterinarian if you think your horse has a medical problem or side effect while taking EQUIOXX paste. If you have additional questions about possible side effects, talk with your veterinarian or call 1-877-217-3543.

EQUIOXX should not be given with other NSAIDs (for example, aspirin, phenylbutazone, diclofenac, ketoprofen, or flunixin) or systemic corticosteroids (for example, prednisone, cortisone, dexamethasone, or triamcinolone).

Tell your veterinarian about all medications that you have given your horse in the past, and any medications you are planning to give with EQUIOXX paste. This should include other medicines that you can get without a prescription or any dietary supplements. Your veterinarian may want to check that all of your horse’s medicines can be given together.

Consult your veterinarian if your horse receives more than the prescribed amount of EQUIOXX.

• This FAQ provides a summary of information about EQUIOXX paste and general information about NSAIDs. If you have any questions or concerns about EQUIOXX or osteoarthritis pain, talk with your veterinarian.
• As with all prescribed medicines, EQUIOXX paste should only be given to the horse for which it is prescribed. It should be given to your horse only for the condition for which it is prescribed, at the labeled dose and duration.
• It is important to periodically discuss your horse’s response to EQUIOXX paste with your veterinarian. Your veterinarian will determine if your horse is responding as expected and if your horse should continue receiving EQUIOXX paste.

Nearly every show organization has their own rules and regulations about the use of NSAIDs while competing – so be sure to check with the governing body of an event before using any medication.

Both the USEF and the AQHA (and many of the groups that use these organizations for their guidelines) have approved the use of EQUIOXX at the recommended dose 12 hours prior to competition.^1,2 EQUIOXX is the only NSAID approved for use up to 14 days by these two groups. For other associations, rules may vary, so be sure to check before using EQUIOXX.

¹ United States Equestrian Federation. Drugs and Medications Guidelines. 2007:2-3. Available at: http://www.usef.org/documents/competitions/2007/2007DrugsMedsGuidelines.pdf. Accessed February 13, 2008.
² American Quarter Horse Association. Show rules and regulations. Official Handbook of Rules and Regulations. 2008:128. Available at: http://www.aqha.com/association/registration/pdf/showrules_08.pdf. Accessed February 1, 2008.

As with any prescription medication, prior to use, a veterinarian should perform a physical examination and review the horse's medical history. A veterinarian should advise horse owners to observe for signs of potential drug toxicity. As a class, nonsteriodal anti-inflammatory drugs may be associated with gastrointestinal and renal toxicity. Use with other NSAIDs, corticosteroids or nephrotoxic medication should be avoided. EQUIOXX has not been tested in horses less than 1 year of age or in breeding horses, or pregnant or lactating mares. For additional information please refer to the prescribing information or visit www.equioxx.com.