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How safe is Cartrophen Vet?

DOG

Cartrophen Vet has a history of over 20 years of safe use in the dog. Cartrophen Vet has a low incidence of side effects and of those they are mild and transitory. Based on commercial history, the number of adverse events reported on a per course basis (per 4 weekly injections) was 0.058% (Hannon et al., 2003).

Of total reported events, 50.9% were probably or possibly related to the administration of Cartrophen Vet. Hence the number of adverse effects reported that were possibly or probably related to a Cartrophen Vet treatment were 0.0296% or one adverse event reported per 3,300 courses administered (4 weekly injections).

Based on the Hannon RL, et al. (2003) paper and information from the UK Veterinary Medicines Directorate, it is believed that 10 per cent of all adverse events for all products including Cartrophen Vet are reported. Hence for an estimated % of adverse events for a veterinary pharmaceutical the raw adverse event rates should be multiplied by 10.


 

HORSE

Cartrophen Vet has a history of 20 years of safe use in the horse. Based on commercial history, the number of adverse events reported in the horse on a per course basis (per 4 weekly injections) is 0.033% or one adverse event reported per 3,000 courses administered (data on file at Biopharm Australia Pty Ltd). The majority of adverse events related to poor administration technique.

Cartrophen Vet is not an irritant at the injection site and like any injectable drug requires proper antiseptic cleaning of the injection site and appropriate needle selection and administration.

 

Are there any side effects?

In very rare cases, 5-15 minutes after the first injection a dog might vomit or be a little quieter than usual for up to 24 or maybe 48 hours. These transitory effects are rare and are only seen in some dogs. Overall the safety of Cartrophen Vet is well respected and understood after 20 years of use in dogs.

Cartrophen Vet has a temporary effect on blood coagulation. Investigations in the dog of the blood clotting parameters activated partial thromboplastin time (aPTT) and prothrombin time (PT) following subcutaneous administration of 3mg/kg Cartrophen Vet on twelve occasions at weekly intervals showed aPTT increased 2 hours following administration but returned to near normal at 8 hours and importantly the extrinsic pathway of coagulation PT remained within the normal range.

Substance-related local intolerance reactions (eg. haematoma) and evidence of systemic bleeding (eg. ecchymosis or gastrointestinal bleeding) were not observed, even at doses up to and including 30mg/kg applied for twelve weeks (10x the recommended dose and 3x times the normal treatment duration). With this drug's pharmacological profile, bleeding would not be expected in an animal with normal haemostasis and Cartrophen Vet presents a low risk despite temporary effects on some clotting parameters (Data on file, Biopharm Australia Pty Ltd).

Following intravenous bolus injection of pentosan polysulfate in the rabbit ear bleeding model, a minimal but significant haemorrhagic effect was observed at 3x the recommended dose of Cartrophen Vet. Pentosan polysulfate in humans and laboratory animals shows a mild anticoagulant effect, which is between one sixth to one tenth of the potency of heparin. However, pentosan polysulfate is a potent activator of the fibrinolytic system since it stimulates the release of tissue plasminogen activator from the endothelium. The net result of pentosan polysulfate on these activities is the dissolution of thrombotic emboli in blood vessels without a pronounced anticoagulant effect. Thus pentosan polysulfate, unlike heparin, does not exhibit a global alteration of the blood clotting system (Maffrand et al., 1991).

 

Can NSAIDs be used concurrently with Cartrophen Vet?

It is generally safe to use non-steroidal anti-inflammatory drugs (NSAIDs) concurrently with Cartrophen Vet however, it is recommended that NSAIDs not be used concurrently with Cartrophen Vet due to their conflicting modes. Additionally, the pain relief offered by NSAIDs can lead to greater activity earlier than should occur given the progression of the healing process. The premature resumption of vigorous exercise can aggravate the disease.

With severe pain responses between Cartrophen Vet and NSAIDs at one week following the commencement of treatment being similar (Smith et al., 2002), should immediate pain relief be required, a painkiller can be a better solution than the use of NSAIDs, which will not interfere with the healing process.

 

REFERENCES

Hannon RL, et al. (2003) Safety of Cartrophen Vet in the dog: review of adverse reaction reports in the UK. J. Small. Anim. Pract. 44(5): 202-208

Maffrand J-P, Herbert JM, Bemat A. (1991). Experimental and clinical pharmacology of pentosan polysulphate Semin Thromb Hemost 17(Suppl 2): 186-198

Smith JG, Hannon RL, Brunnberg L, Gebski V, Cullis-HiII D (2001) A Randomised double blind comparator clinical study of the efficacy of sodium pentosan Polysulfate injection and carprofen capsules in arthritic dogs, Journal of the Osteoarthritis Research Society International, 9(b):S21-S22