What is compounding?
Drug compounding is often regarded as the process of combining or mixing drugs to create a medication tailored to the needs of an individual patient.
The generic form of Vetmedin is Pimobendan.
Vetmedin is in limited supply. Orders placed will be shipped as product continues to come off backorder.
Credelio® is a small chewable tablet that's gentle on dogs and tough on ticks and fleas. Credelio protects puppies and dogs against ticks, kills adult fleas, and treats and prevents flea infestations. It provides fast-acting protection that works hard all month long. Credelio is approved for puppies and dogs 8 weeks of age and older that weigh 4.4 pounds or more.
Credelio is given orally once a month, at the minimum dosage of 9 mg/lb (20 mg/kg).
|Body Weight||Lotilaner Per Chewable Tablet (mg)||Chewable Tablets Administered|
|4.4 to 6.0 lbs||56.25||One|
|6.1 to 12.0 lbs||112.5||One|
|12.1 to 25.0 lbs||225||One|
|25.1 to 50.0 lbs||450||One|
|50.1 to 100.0 lbs||900||One|
|Over 100.0 lbs||Administer the appropriate combination of chewable tablets|
Credelio must be administered with food (see Clinical Pharmacology)
Treatment with Credelio can begin at any time of the year and can continue year-round without interruption.
There are no known contraindications for the use of Credelio.
Not for human use. Keep this and all drugs out of the reach of children. Keep Credelio in a secure location out of reach of dogs, cats, and other animals to prevent accidental ingestion or overdose.
Lotilaner is a member of the isoxazoline class. This class has been associated with neurologic adverse reactions including tremors, ataxia, and seizures. Seizures have been reported in dogs receiving isoxazoline class drugs, even in dogs without a history of seizures. Use with caution in dogs with a history seizures or neurologic disorders. The safe use of Credelio in breeding, pregnant or lactating dogs has not been evaluated.
In a well-controlled U.S. field study, which included 284 dogs (198 dogs treated with credelio and 86 dogs treated with an oral active control), there were no serious adverse reactions.
Over the 90-day study period, all observations of potential adverse reactions were recorded. Reactions that occurred at an incidence of 1% greater are presented in the following table.
|Dogs with Adverse Reactions in the Field Study|
|Adverse Reaction (AR)||Credelio Group: Number (and Percent) of Dogs with the AR (n=198)||Active Control Group: Number (and Percent) of Dogs with the AR (n=86)|
|Weight Loss||3 (1.5%)||2 (2.3%|
|Elevated Blood Urea Nitrogen (BUN)||2 (1.0%)||0 (0.0%)|
|Polyuria||2 (1.0%)||0 (0.0%)|
|Diarrhea||2 (1.0%)||2 (2.3%)|
*Two geriatric dogs developed mildly elevated BUN (34 to 54 mg/dL; reference range: 6 to31 mg/dL) during the study. One of these dogs also developed polyuria and a mildly elevated potassium (6.5 mEq/L; reference range: 3.6 to 5.5 mEq/L) and phosphorous (6.4 mg/dL; reference range: 2.5 to 6.0 mg/dL). The other dog also developed a mildly elevated creatinine (1.7 to 2.0 mg/dL; reference range: 0.5 to 1.6 mg/dL) and weight loss.
In addition, one dog experienced intermittent head tremors within 1.5 hours of administration of vaccines, an ear cleaning performed by the owner, and its first dose of credelio. The head tremors resolved within 24 hours without treatment. The owner elected to withdraw the dog from the study.
In an Australian field study, one dog with a history of seizures experienced seizure activity (tremors and glazed eyes) six days after receiving credelio. The dog recovered without treatment and completed the study. In the U.S field study, two dogs with a history of seizures received credelio and experience no seizures throughout the study.
In three well-controlled European field studies and one U.S. laboratory study, seven dogs experience episodes of vomiting and four dogs experienced episodes of diarrhea between 6 hours and 3 days after receiving credelio.
To report suspected adverse events, for technical assistance or to obtain a copy of the Safety Data Sheet (SDS), contact Elanco US Inc. at 1-888-545-5973. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS or http://www.fda.gov/reportanimalae.
Following oral administration of 43 mg/kg (approximately 1X the maximum labeled dose), peak lotilaner concentrations were achieved between 6 hours and 3 days in dogs 2 months of age and between 1 and 7 days in dogs 10 months of age. Dogs 2 months of age had a shorter elimination half-life (average of 9.6 days) than at 10 months of age (average of 28.4 days). Due to reduced drug bioavailability in the fasted state, Credelio must be administered with a meal or within 30 minutes after feeding.
Lotilaner is an ectoparasiticide belonging to the isoxazoline group. Lotilaner inhibits insect and acarine gamma-aminobutyric acid (GABA)-gated chloride channels. This inhibition blocks the transfer of chloride ions across cell membranes, which results in uncontrolled neuromuscular activity leading to death of insects and acarines. The selective toxicity of lotilaner between insects and acarineds and mammals may be inferred by the differential sensitivity of the insects and acarines' GABA receptors versus mammalian GABA receptors.
In well-controlled European laboratory studies, Credelio began to kill fleas four hours after administration or infestation, with greater than 99% of fleas killed within eight hours after administration or infestation for 35 days. In a well controlled U.S. laboratory study, Credelio demonstrated 100% effectiveness against adult fleas 12 hours after administration or infestation for 35 days.
In a 90 day well-controlled U.S. field study conducted in households with existing flea infestation of varying severity, the effectiveness of Credelio against fleas on Days 30, 60 and 90 compared to baseline was 99.5%, 100% and 100%, respectively. Dogs with signs of flea allergy dermatitis showed improvement in erythema, papules, scaling, alopecia, dermatitis/pyodermatitis and pruritus as a direct result of eliminating fleas.
In a well-controlled laboratory study, Credelio killed fleas before they could lay eggs, thus preventing subsequent flea infestations for 30 days after the start of treatment of existing flea infestations.
In well-controlled laboratory studies, Credelio demonstrated > 97% effectiveness against Amblyomma americanum, Dermacentor variabilis, Ixodes scapularis and Rhipicephalus sanguineus ticks 48 hours after administration or infestation for 30 days. In a well-controlled European laboratory study, Credelio started killing Ixodes ricinus ticks within four hours after administration.
Palatability: In the U.S. field study, which included 567 doses administered to 198 dogs, 80.4% of dogs voluntarily consumed credelio when offered by hand or in an empty bowl, an additional 13.6% consumed credelio when offered with food, and 6.0% required placement of the chewable tablet in the back of the dog's mouth.
In a margin of safety study, Credelio was administered orally to 24 (8 dogs/group) 8 week old Beagle puppies at doses of 43 mg/kg, 129 mg/kg, and 215 mg/kg (approximately 1, 3, and 5x the maximum labeled dose, respectively) every 28 days for eight consecutive doses. The 8 dogs in the control group (0X) were untreated. There were no clinically-relevant, treatment-related effects on clinical observations, physical and neurological examinations, body weights, food consumption, electrocardiograms, clinical pathology (hematology, clinical chemistries, coagulation profiles and urinalysis), gross systemic exposure of all treated dogs, although the exposure was less than dose proportional at 5X.
In a well-controlled field study, Credelio was used concurrently with other medications, such as vaccines, anthelmintics, antibiotics, steroids, NSAIDS, anesthetics, and antihistamines. No adverse reactions were observed from the concomitant use of Credelio with other medications.
Store at 15-25°C (59-77°F) excursions permitted between 5 to 40°C (41 to 104°F).
Credelio has a rapid onset of action and starts to kill fleas in just 4 hours.
In a well-controlled laboratory study, Credelio demonstrated 100% effectiveness against adult fleas within 12 hours after administration, up to day 35.
Credelio starts to kill ticks (Ixodes ricinus) within 4 hours of administration, with 98.7% of ticks killed within 8 hours.1
Credelio kills 100% of fleas in 12 hours and lasts throughout the entire month.
1Murphy M, Cavalleri D, Seewald W, et al. Laboratory evaluation of the speed of kill of lotilaner (Credelio™) against Ixodes ricinus ticks on dogs. Parasite Vector. 2017;10:541
Not at all. Credelio kills adult fleas quickly and effectively when used monthly according to the label directions.
If there are fleas in your dog's environment, it can take up to 6 weeks for flea larvae to emerge and grow into adults. Credelio kills adult fleas before they can lay eggs. If you see fleas on your dog, they are most likely new adult fleas that will die very quickly.
All animals in the household should be treated with an approved flea product to minimize the likelihood of flea reinfestation. It may also be necessary to apply an approved flea treatment product to your carpet and furniture in an attempt to remove the presence of fleas in your dog's environment.
Maintain consistent monthly administration of Credelio to provide continual flea protection for your dog.
Like all oral parasite protection products, Credelio is a systemic medication, meaning that ticks have to bite a dog to be exposed to Credelio and for Credelio to start to work. It could be that the ticks you are seeing are those that have just recently crawled onto the dog and have yet started to bite. Therefore, the ticks have not yet been exposed to Credelio.
It could also be that you are seeing dead ticks that are still attached to your dog. Rest assured, Credelio provides effective, reliable protection throughout the entire month from ticks.
Credelio must be administered with food or given within 30 minutes after feeding. We have not conducted any studies where a crushed Credelio chewable was added to food or water and fed to a dog.
Credelio may be chewed or swallowed whole. It's easy and convenient to administer and in a field study, Credelio was accepted by 100% of dogs.
The safety of Credelio in breeding, pregnant or lactating dogs has not been established.
As with any product, consult your veterinarian before using the product on medicated, debilitated, aged, pregnant or nursing animals.
The small and tasty4 beef-flavored monthly chewable was accepted and tolerated by 70 different dog breeds that were tested, including Chihuahuas and Yorkshire Terriers.5
In a field trial, the acceptability of Credelio was tested at 10 different locations across the U.S.6, and 94% of dogs accepted Credelio from the hand, in the bowl or with food. The remaining 6% accepted Credelio when placed in the mouth. There were no reports of unsuccessful dosing.