Feline Transdermal Medications
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Feline Transdermals: An Evidence Based Approach to Medication Selection
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The ideal transdermal (TD) medication should be non-irritating to the skin, have a low molecular weight (< 400g/mol is ideal), with a low melting point (<200°C) for increased solubility in skin lipids, and a relatively high (but balanced) partition coefficient (logP of 1-3). Adequate solubility in oil and water is optimal for transdermal medications. Typical volume is restriced to 0.05 - 0.1 ml rarely exceeding 0.15 ml. Ideal concentrations are not to exceed12.5mg/0.1ml to maintain properties of transdermal formulation. For determination of transdermal dosing, available injectable dosages should be referenced first and assume 100% bioavailability; if injectable dosing is unavailable, oral dosage comparision may be utilized. The vast majority of provided transdermal formulations are anhydrous and according to United States Pharmacopeia compounding standards are assigned a Beyond Use Date of no longer than 180 days stored at room temperature. Be assured by our policy which limits the day supply of no longer than 90 days and refrigeration of certain formulations to alleviate solubity and stability concerns.
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Best evidence for use in TD application Green = GoodNeed more studies to determine safe effective doseEvidence does not support use in TD applications. Blue = Bad
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Drug Name | Evidence SummaryMolecular WeightMelting PointlogPConcentrationEvidence Summary | Monitoring / Alternative UseReference
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Acepromazine326.46< 254.2N/A
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Alprazolam308.762292.1Would not be appropriate for acute treatment.
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Aminophylline420.43270-3.03Narrow therapeutic index | Unstable
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Amitriptyline313.871974.9250mg/mL May reach therapeutic levels after more applications. | Historic Use1. Mealey et al.
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Amlodipine408.1517836.25mg/ml Efficacy for TD < PO. Consider dose increase for TD use. Blood pressure. 1. Helms. 2. Mixon et al.
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Amoxicillin 602.65N/AN/AMicrobial resistance
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Atenolol266.381470.2Evidence doesn't use PLO or Lipoderm formulations. Blood pressure and heart rate1. Gupta et al. 2. MacGregor et al.
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Azithromycin748.981154.02Microbial resistance
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Benazepril424.491491.3N/A | Prodrug hepatic conversion to benazaprilat. | Use Amlodipine as alternative.
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Bethanechol161.222200N/A | Difficult Q8H dosing.
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Buprenorphine5042684.98Per evidence - TD patch not preferred. | Buccal buprenorphine better alternative. 1. Murrell et al. 2. Robertson
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Buspirone385.252032.6Undetectable levels with PLO formulation1. Mealey et al.
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Butorphanol327.462743.3N/A | Buccal buprenorphine better alternative.
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Calcitriol416.641157.6400 Ng/mLN/A | Refrigerate Serum ionized calcium, PTH, phosphate, creatinine
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Captopril217.291040.3Potential TD use based on evidence from rabbits and rats. | Enalapril and benazepril are preferred. (not TD dosage form)
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Carbimazole186.23120.7Evidence indicates efficacy for treatment of feline hyperthyroidism. | Not available in US. Methimazole preferred. COnverted to methimazole in vivo.
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Carboplatin373.27N/AN/ACytotoxic drug
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Chlorambucil301.21661.7Cytotoxic drug
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Chloramphenicol323.131511.14Microbial resistance
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Cisapride465.951103.4100 mg/mLN/A | Historic Use
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Clomipramine314.8521925.21 article using in vitro pig ear. | Hepatic metabolism to active metabolite. 1. Yonar et al.
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Clopidogrel321.821583.8N/A
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CyclophosphamideN/AN/AN/ACytotoxic drug
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Cyclosporine A (not modified)1202.6111517.5100 mg/mLPotential TD efficacy; [TD] < [PO]. | Suspect oral absorption via self grooming | Historic Use1. Robson et al. 2. Siak et al. 3. Miller et al.
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Cyproheptadine287.3981144.720 mg/mLN/A Body weight | Historic use
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Dexamethasone392.472641.9Single TD dose < PO dose | Prednisolone alternative
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Diazepam284.741323No feline studies; 36% TD bioavailability in rabbits | Avoid use due to hepatic failure risk
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Digoxin780.942351.3Narrow therapeutic window
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Diltiazem414.521883.1Porcine use - passive diffusion ↑ w/ propylene glycol (PG) formulation; consider properties of pig vs. cat skin1. Sarkar et al. 2. Silva et al.
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Dolasetron324.372783.4If studies similar to ondansetron do not recommend
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Doxycycline444.43201-0.07Photosensitizing | Microbial resistance
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Enalapril376.45144-0.01Converted to active metabolite in the liver
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Enrofloxacin359.39220-0.2N/A | Microbial resistance
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Famotidine337.45164-0.06N/A
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Fluoxetine309.33182450 mg/mLLonger TD absorption and t1/2 increases toxicity risk (vs. oral); Consider risk vs. benefit. Considered a contact irritant. Serotonin syndrome. | Historic use. 1. Ciribassi, 2. JAVMA
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Furosemide330.743312N/A
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Gabapentin171.24166-1.1Clinical trial in progress for safety and efficacy of TD gel for cats
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Glipizide445.432031.9Evidence suggests inadequate TD absorption1. Bennett
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Granisetron312.412192.8N/A
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Hydroxyzine374.91933.7N/A | Rapidly metabolized to active cetirizine
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Imipramine280.411754.8N/A
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Insulin (porcine)5777.54N/A-12.5N/A
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Ivermectin875.091554.1N/A
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Levothyroxine888.932362.4N/A
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Loperamide477.022225N/A | Controversial Use
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Loratadine382.881365.2Rat studies - TD penetration may be adjustable and may require dose adjustment1. Cho et al. 2. Song et al.
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Lorazepam312.161942.4N/A
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Maropitant678N/A7N/A
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Megestrol acetate384.512203.1N/A
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Methimazole114.17146-0.0325, 50, 75 mg/mlEfficacy for hyperthyroidism treatment; Longer time to euthyroid state (vs. PO); Fewer GI SE. Serum T4 | BUD 60 days 1. Boretti. 2. Trepanier. 3. Sartor et al. 4. Boretti et al.
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Metoclopramide299.81482.6N/A - Rat studies lack opinion for/against feline use1. Calpena et al.
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Metoprolol267.361201.9Potential TD application w/ Metoprolol tartrate based on porcine and rabbit evidence; consider feline skin similarities
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Mirtazapine265.351163.337.5 mg/ml2 articles that provided good evidence for use. 1. Benson et al. 2. Benson et al.
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Morphine sulfate285.342550.8TD opioid use not recommended; Risk to caregivers, patients, & other animals
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Naltrexone341.41691.9N/A
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Ondansetron293.362942.4Evidence shows lack of efficacy1. Silva et al.
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Paroxetine329.371503.525 mg/mL1 study using liposomal gel TD patch in rabbits. Serotonin syndrome
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Phenobarbital232.241741.5100 mg/mLStudy reached therapeutic concentration w/ 9 mg/kg dosed Q12H. Serum phenobarbital1. Gasper et al.
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Piroxicam331.352003.1No TD feline studies; 1 study used rat skin | Use extreme caution when using NSAIDs in felines
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Prazosin383.427925 mg/mLCase report of TD use - initial BP decrease did not last; consider dose increase. Blood pressure1. Rudner et al.
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Prednisolone360.442351.650, 100 mg/mLN/A | TD Corticosteroid SE = skin thinning, cartilage atrophy | Historic use
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Sertraline306.232454.8N/A. Serotonin syndrome
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Telmisartan514.622636.9N/A
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Theophylline180.162740N/A
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Tramadol263.381812.6Drug able to pass through excised rat skin. Serotonin syndrome
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Vitamin E430.7310.7N/A
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