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Equioxx Oral Paste
Equioxx Oral Paste 6.93gm
Equioxx Oral Paste 6.93gm

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Equioxx, by Merial Ltd, is for horses, and is the first coxib class NSAID. Equioxx eases the pain and inflammation of equine osteoarthritis. Equioxx is a highly selective COX-2 inhibitor, which blocks prostaglandins responsible for inflammation while sparing beneficial prostaglandins. BUY IN CASES AND GET FREE SHIPPING!

Item# Item Name List Price Our Price Sale Price Qty Add
898-030348 Equioxx Oral Paste 6.93gm
$ 7.95
898-037107 Equioxx Oral Paste 6.93gm, 72ct
$ 178.28
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for Horses


Non-steroidal anti-inflammatory drug for oral use in horses only.

CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian.

Description: EQUIOXX® (firocoxib) belongs to the coxib class of non-narcotic, non-steroidal anti-inflammatory drugs. Firocoxib is a white crystalline compound described chemically as 3-(cyclopropylmethoxy)-4-(4-(methylsulfonyl)phenyl-5,5-dimethylfuranone. The empirical formula is C17H20O5S, and the molecular weight is 336.4. The structural formula is shown below:

Indications: EQUIOXX Oral Paste is administered for up to 14 days for the control of pain and inflammation associated with osteoarthritis in horses.

Dosage and Administration: Always provide the Client Information Sheet with the prescription. The recommended dosage of EQUIOXX (firocoxib) for oral administration in horses is 0.045 mg/lb (0.1 mg/kg) of body weight once daily for up to14 days. In target animal safety studies, toxicity was seen at the recommended dose when the duration of treatment exceeded 30 days.

Each marking on the syringe will treat 250 pounds of body weight, and each notch corresponds to approximately a 50 Ib 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 1/4 turn. Slide the knurled ring along the plunger shaft so that the side nearest the barrel is at the appropriate 50 Ib weight notch. Rotate the plunger ring 1/4 turn to lock it in place and ensure it is locked.

EQUIOXX may be given with or without food.

Contraindications: Horses with hypersensitivity to firocoxib or other NSAIDs should not receive EQUIOXX Oral Paste.

Warnings: For oral use in horses only. Do not use in horses intended for human consumption.

Human Warnings: Not for use in humans. Keep this and all medications out of the reach of children. Consult a physician in case of accidental ingestion by humans.

Animal Safety: Clients should be advised to observe for signs of potential drug toxicity and be given a Client Information Sheet with each prescription.

For technical assistance or to report suspected adverse events, call 1-877-217-3543.

Precautions: Horses should undergo a thorough history and physical examination before initiation of NSAID therapy. Appropriate laboratory tests should be conducted to establish hematological and serum biochemical baseline data before and periodically during administration of any NSAID. Clients should be advised to observe for signs of potential drug toxicity and be given a Client Information Sheet with each prescription. See Information for Owner or Person Treating Horse section of this package insert.

Treatment with EQUIOXX should be terminated if signs such as inappetance, colic, abnormal feces, or lethargy are observed.

As a class, cyclooxygenase inhibitory NSAIDs may be associated with renal and gastrointestinal toxicity. Sensitivity to drug-associated adverse events varies with the individual patient. Patients at greatest risk for adverse events are those that are dehydrated, on diuretic therapy, or those with existing renal, cardiovascular, and/or hepatic dysfunction. Concurrent administration of potentially nephrotoxic drugs should be carefully approached or avoided. NSAIDs may inhibit the prostaglandins that maintain normal homeostatic function. Such anti-prostaglandin effects may result in clinically significant disease in patients with underlying or pre-existing disease that has not been previously diagnosed. Since many NSAIDs possess the potential to produce gastrointestinal ulcerations, concomitant use with other anti-inflammatory drugs, such as NSAIDs or corticosteroids, should be avoided or closely monitored. The concomitant use of protein bound drugs with EQUIOXX Oral Paste has not been studied in horses. The influence of concomitant drugs that may inhibit the metabolism of EQUIOXX Oral Paste has not been evaluated. Drug compatibility should be monitored in patients requiring adjunctive therapy.

The safe use of EQUIOXX Oral Paste in horses less than one year in age, horses used for breeding, or in pregnant or lactating mares has not been evaluated.

Consider appropriate washout times when switching from one NSAID to another NSAID or corticosteroid.

Adverse Reactions: In controlled field studies, 127 horses (ages 3 to 37 years) were evaluated for safety when given EQUIOXX Oral Paste at a dose of 0.045 mg/lb (0.1 mg/kg) orally once daily for up to 14 days. The following adverse reactions were observed. Horses may have experienced more than one of the observed adverse reactions during the study.

Adverse Reactions Seen in U.S. Field Studies

Adverse Reactions


Active Control n=125

Abdominal pain












Loose stool









EQUIOXX (firocoxib) Oral Paste was safely used concomitantly with other therapies, including vaccines, anthelmintics, and antibiotics, during the field studies.

Information for Owner or Person Treating Horse: You should give a Client Information Sheet to the person treating the horse and advise them of the potential for adverse reactions and the clinical signs associated with NSAID intolerance. Adverse reactions may include erosions and ulcers of the gums, tongue, lips and face, weight loss, colic, diarrhea, or icterus. Serious adverse reactions associated with this drug class can occur without warning and, in rare situations, result in death. Clients should be advised to discontinue NSAID therapy and contact their veterinarian immediately if any of these signs of intolerance are observed. The majority of patients with drug-related adverse reactions recover when the signs are recognized, drug administration is stopped, and veterinary care is initiated.

Clinical Pharmacokinetics / Pharmacodynamics:

Pharmacokinetics: When administered as a 0.045 mg/lb (0.1 mg/kg) dose in oral paste to adult horses with normal access to roughage, feed, and water, the absolute bioavailability of firocoxib from EQUIOXX paste is approximately 79%. Following oral administration, drug peak concentration (Cmax) of 0.08 mcg/mL can be reached at 4 hours (Tmax) post-dosing. However, in some animals, up to 12 hours may be needed before significant plasma concentrations are observed. Little drug amount distributes into blood cells. The major metabolism mechanism of firocoxib in the horse is decyclopropylmethylation followed by glucuronidation of that metabolite. Based upon radiolabel studies, the majority of label is eliminated in the urine as the decyclopropylmethylated metabolite. Despite a high rate of plasma protein binding (98%), firocoxib exhibits a large volume of distribution (mean Vd(ss) = 1652 mL/kg). The terminal elimination half-life (T 1/2) in plasma averages 30-40 hours after IV or oral paste dosing. Therefore, drug accumulation occurs with repeated dose administrations and steady state concentrations are achieved beyond 6-8 daily oral doses in the horse. Dose linearity exists from 1X-2X of 0.1 mg/kg/day.

Mode of action: EQUIOXX (firocoxib) is a cyclooxygenase-inhibiting (coxib) class, non-narcotic, non-steroidal anti-inflammatory drug (NSAID) with anti-inflammatory, analgesic and antipyretic activity in animal models.

Effectiveness: Two hundred fifty-three client-owned horses of various breeds, ranging in age from 2 to 37 years and weighing from 595 to 1638 Ibs, were randomly administered EQUIOXX or an active control drug in multi-center field studies. Two hundred forty horses were evaluated for effectiveness and 252 horses were evaluated for safety. Horses were assessed for lameness, pain on manipulation, range of motion, joint swelling, and overall clinical improvement in a non-inferiority evaluation of EQUIOXX compared to an active control. At study's end, 84.4% of horses treated with EQUIOXX were judged improved on veterinarians' clinical assessment, and 73.8% were also rated improved by owners. Horses treated with EQUIOXX showed improvement in veterinarian-assessed lameness, pain on manipulation, range of motion, and joint swelling that was comparable to the active control.

Acceptability: EQUIOXX Oral Paste was rated both convenient to administer (95.3%) and acceptable to the horse (97.6%) by owners in the multi-center field study.

Animal Safety: In a target animal safety study, firocoxib was administered orally to healthy adult horses (two male castrates and four females per group) at 0, 0.1, 0.3 and 0.5 mg firocoxib/kg body weight (1, 3 and 5X the recommended dose) for 30 days. Administration of firocoxib at 0.3 and 0.5 mg/kg body weight was associated with an increased incidence of oral ulcers as compared to the control group but, no oral ulcers were noted with 0.1 mg/kg. There were no other drug-related adverse findings in this study.

In another target animal safety study, firocoxib was administered orally to healthy adult horses (four males or male castrates and four females per group) at 0, 0.1, 0.3 and 0.5 mg firocoxib/kg body weight (1, 3 and 5X the recommended dose) for 42 days. Administration of firocoxib at 0.1, 0.3 and 0.5 mg/kg body weight was associated with delayed healing of pre-existing oral (lip, tongue, gingival) ulcers. In addition, the incidence of oral ulcers was higher in all treated groups as compared to the control group.

Clinical chemistry and coagulation abnormalities were seen in several horses in the 0.5 mg/kg (5X) group. One 5X male horse developed a mildly elevated BUN and creatinine over the course of the study, prolonged buccal mucosal bleeding time (BMBT), and a dilated pelvis of the right kidney. Another 5X male had a similar mild increase in creatinine during the study but did not have any gross abnormal findings. One female in the 5X group had a prolonged BMBT, bilateral tubulointerstitial nephropathy and bilateral papillary necrosis.

Tubulointerstitial nephropathy occurred in one 3X female, two 3X male horses, and the 5X female horse discussed above with the prolonged BMBT. Papillary necrosis was present in one 1X male horse and the 5X female horse discussed above. Despite the gross and microscopic renal lesions, all of the horses were clinically healthy and had normal hematology, clinical chemistry and urinalysis values.

In another target animal safety study, firocoxib was administered orally to healthy adult horses (three females, two male castrates and one male per group) at 0, 0.25 mg/kg, 0.75 mg/kg and 1.25 mg/kg (2.5, 7.5 and 12.5X the recommended dose of 0.1 mg/kg) for 92 days. An additional group of three females, two male castrates and one male per group, was dosed at 1.25 mg/kg for 92 days but was monitored until Days 147-149. There were treatment-related adverse events in all treated groups. These consisted of ulcers of the lips, gingiva and tongue and erosions of the skin of the mandible and head. Gross and microscopic lesions of the kidneys consistent with tubulointerstitial nephropathy were seen in all treated groups. Papillary necrosis was seen in the 2.5X and 12.5X groups. In addition, several 12.5X horses had elevated liver enzymes (GGT, SDH, AST and ALT). One 2.5X horse had increased urine GGT and urine protein levels which was due to renal hemorrhage and nephropathy. Gastric ulcers of the margo plicatus and glandular area were more prevalent in the 2.5X and 7.5X groups, but not seen in the 12.5X group. The group of horses that were monitored until Days 147-149 showed partial to full recovery from oral and skin ulcers, but no recovery from tubulointerstitial nephropathy.

Storage Information: Store below 86°F (30°C). Brief excursions up to 104°F (40°C) are permitted.

How Supplied: EQUIOXX is available in packs of 20, 72 and 216 individually-boxed syringes. Each syringe contains 6.93 grams of EQUIOXX paste, sufficient to treat a 1250 lb. horse.

For technical assistance or to report suspected adverse reactions, call 1-877-217-3543.

NADA 141-253, Approved by FDA

Copyright® 2006 Merial Limited. All Rights Reserved.

U.S. Pat. No.: 5981576, 6020343

®EQUIOXX is a registered trademark of Merial Limited, Duluth, Georgia, USA.

Merial Limited, a company limited by shares registered in England and Wales (registered number 3332751) with a registered office at PO Box 327, Sandringham House, Sandringham Avenue, Harlow Business Park, Harlow, Essex CM19 5QA, England, and domesticated in Delaware, USA as Merial LLC.

Marketed by Merial Limited, 3239 Satellite Blvd., Duluth, GA 30096-4640, USA.

1050-2012-01 Rev. 02-06

Net Wt.



6.93 g


1030-1992-01 Rev. 02-06

1021-2010-01 Rev. 02-06

NAC No.: 11111110

Extended Information:

In a recently completed 429-horse trial, researchers reinforced the effectiveness and safety profile of Equioxx (firocoxib), the first equine oral, nonsteroidal anti-inflammatory drug (NSAID) to be approved in more than 20 years.

"This research helps prove the benefits of Equioxx, and it also demonstrates the commitment to continued research for all Merial products," said Doug Carithers, DVM, director of marketing trials and publications at Merial. "This is one of the largest equine NSAID studies conducted after product launch, and the results validate what we know veterinarians and owners nationwide see in horses after using Equioxx."

Equioxx is proven to control the joint pain and inflammation associated with equine osteoarthritis, which is one of the most common causes of lameness in horses. Also known as degenerative joint disease, osteoarthritis can develop in horses as young as 2 years old.

From May 2007 to February 2008, horses diagnosed with osteoarthritis were enrolled in the Equioxx Experience Trial by veterinarians at 80 sites in 25 states. The study included horses from 1 to 33 years old, representing more than 10 breeds. After a 14-day trial of Equioxx, both veterinarians and their handlers reported results. Some of the key findings include:

  • Improvement continued through duration of 14-day trial
  • Improvement was consistent regardless of breed, age, or weight of horse
  • Improvement was consistent regardless of the joint(s) involved
  • 87.6% of handlers reported horses as "moving better"
  • 96% of handlers believed Equioxx was palatable for their horse(s)

The trial evaluated horses with both single- and multiple-joint osteoarthritis diagnoses. Of those cases, 50% of horses were diagnosed with osteoarthritis in the tarsus (hock) joint, and more than 27% of horses showed osteoarthritis in the fetlock joint.

In previous research, Equioxx was shown to work quickly to provide 24 hours of pain relief and is easily administered as an oral paste.

Since its launch in 2007, Equioxx is the only NSAID approved for use up to 14 consecutive days by the American Quarter Horse Association (AQHA) and United States Equestrian Federation (USEF) when used at the recommended dose.

"We believe in demonstrating the results of Equioxx in practical, everyday situations both with continued research and with customers across the country," Carithers said.

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