Uniprim one or twice daily?

[Mistral]

I’m curious how common it is for vets to prescribe Uniprim with twice a day dosing? According to the label, and every vet I’ve had give it to horses in the past, it is given once a day.

Now I have a new vet (we moved) and he is asking me to give 2 scoops (normal dose) every 12 hours. The label says every 24 hours. Yes, I have a call in to him to verify double is what he wants. But I got quite a bit of flack from the receptionist about the question. He always has clients give it 2x a day.

So now I am wondering how common that actually is…would love it if you could share your experiences. Thanks!

[JB]

I can’t find any reference to dosing Uniprim (or Tucoprim) twice a day. There’s another product called Equisul which is a different dosage (ie lower mg/kg), but it’s still sulfadiazine and trimethorpim, just in a suspension, and it’s dosed twice a day.

Even the Neogen site says once a day
http://animalsafety.neogen.com/en/uniprim

Maybe there’s a specific reason, but I’d love to know his reasoning.

[Mistral]

The reasoning was this- “It needs to be at that dosage to get the right levels of antibiotics into the tissues.”

I wondered if this was a commonly done, albeit off label, usage. So far it doesn’t seem to be true.

Thank you, JB.

[JB]

Huh.

It’s dosage (30mg/kg iirc), and every dosage and every frequency, IS to get the right level into the tissues. That’s why it’s dosed at 30, and not 15.

Some abx have a shorter half life than others, so need to be dosed every 4, 8, 10, 12 hours, whatever. Or longer, like Excede - once every 4 days for 2 shots for a coverage of 10 days.

So his reasoning still doesn’t make sense.

Maybe @Ghazzu or @Ryle can chime in?
(man I love being able to tag now! :D)

[one1horse]

I’ve always been instructed to give one scoop twice a day. That said, it’s always been for short-term usage after hock injections so I don’t know if that changes things at all.

[theresak]

I asked a recent veterinary graduate about this as I was sick of going out 2x daily to dose SMZs. She said there is a lot of discussion in the industry right now about 1x daily Uniprim not providing enough exposure/effectiveness and there are vets prescribing 2x daily.

[TWH_Girl]

I’ve always been told it’s a once a day formula, but it appears to be dosed by weight of the animal: https://www.fda.gov/AnimalVeterinary/Products/ApprovedAnimalDrugProducts/FOIADrugSummaries/ucm118106.htm

[JB]

AFAIK all abx are dosed by weight. Uniprim is 30mg/kg. That newer Equisul is 24mg/kg. Different formulations of penicillin are different amounts per kg.

If there’s some newer information/studies out there showing that the Uniprim/Tucoprim abx is more effective at the 30mg/kg twice a day instead of once, that would be something good to know.

[knic13]

My vet prescribed it 2x/day on two separate occasions.

[JB]

@knic13

My vet prescribed it 2x/day on two separate occasions.

This is really interesting. Did he say why? Was it the full 30mg/kg?

[kremeroyale]

@one1horse

I’ve always been instructed to give one scoop twice a day. That said, it’s always been for short-term usage after hock injections so I don’t know if that changes things at all.

That’s what my vet does. I think it works out to be about the same as 15 SMZ tabs if you are just looking at mg buuuuut I don’t know the difference in how sulfamethoxazole (SMZ tabs) and sulfadiazine (uniprim) are metabolized.

[knic13]

@JB

This is really interesting. Did he say why? Was it the full 30mg/kg?

It was one scoop 2x per day, which works out to 37.5 g/d which is the label dose for a 500 kg horse.

I did not ask why but also didn’t realize it was off label. It had been a looong time since I had last treated a horse with uniprim and I didn’t recall the dosing schedule. I will ask in the future.

[Groom_amp_Taxi]

My most recent experiences have been with Tucoprim - and in those experiences, not all the dose makes it into the horse - some gets lost in the crushing and mixing of the tablets, some gets left in the dosing syringe, some ends up on me… I’ve always meant to ask my vet if he accounts for these losses when he specifies the number of tablets he tells me to give… 2x a day!

[alterhorse]

I’ve never given Uniprim more than 1x a day. Never had it not treat a horse effectively either. But I’m old school and out of touch with the latest treatment protocols.

I found this information on a google search.

"ANIMAL SAFETY: Toxicity is low. The acute toxicity (LD[SUB]50[/SUB]) of trimethoprim/sulfadiazine is more than 5 g/kg orally in rats and mice. No significant changes were recorded in rats given doses of 600 mg/kg per day for 90 days.

Horses treated intravenously with trimethoprim/sulfadiazine 48% injection have tolerated up to five times the recommended daily dose for 7 days or on the recommended daily dose for 21 consecutive days without clinical effects or histopathological changes.

Lengthening of clotting time was seen in some of the horses on high or prolonged dosing in one of two trials. The effect, which may have been related to a resolving infection, was not seen in a second similar trial.

Slight to moderate reductions in hematopoietic activity following high, prolonged dosage in several species have been recorded. This is usually reversible by folinic acid (leucovorin) administration or by stopping the drug. During long-term treatment of horses, periodic platelet counts and white and red blood cell counts are advisable."

https://www.drugs.com/vet/uniprim-powder-for-horses.html

https://www.fda.gov/ohrms/dockets/98fr/200244fi.pdf

https://vetlabel.com/lib/vet/meds/uniprim-powder-for-horses-1/page/2/

[JB]

@Groom&Taxi

My most recent experiences have been with Tucoprim - and in those experiences, not all the dose makes it into the horse - some gets lost in the crushing and mixing of the tablets, some gets left in the dosing syringe, some ends up on me… I’ve always meant to ask my vet if he accounts for these losses when he specifies the number of tablets he tells me to give… 2x a day!

I know my vet always rounds up a little. 50lb gets rounded to 100, 1/2 pills rounded to 1, and she starts with a decently liberal weight adjustment from her tape.

[luvmyhackney]

In the past three years my vet has aways instructed 2X a day for Uniprim.
“The twice-daily administration will result in higher blood concentrations of the drugs, which means it will be effective against a greater number of bacteria” is what I was told and sent this article.

http://www.veterinarypracticenews.com/Straight-from-the-Horses-Mouth-Antibiotics-Antifungals-Antivirals/

[JB]

That quote is for the Equisul, which I mentioned above:

"A new broad-spectrum antimicrobial called Equisul-SDT from Aurora Pharmaceutical is available and licensed for use in horses.

This product is similar to other licensed products, such as Uniprim from Neogen Corp. and Tucoprim from Zoetis, in that it’s a combination of sulfadiazine and trimethorpim, but it is an easy-to-use suspension that is labeled for twice-daily administration, Davis said.

“The twice-daily administration will result in higher blood concentrations of the drugs, which means it will be effective against a greater number of bacteria,” she said.

"

[luvmyhackney]

@JB

That quote is for the Equisul, which I mentioned above:

"A new broad-spectrum antimicrobial called Equisul-SDT from Aurora Pharmaceutical is available and licensed for use in horses.

This product is similar to other licensed products, such as Uniprim from Neogen Corp. and Tucoprim from Zoetis, in that it’s a combination of sulfadiazine and trimethorpim, but it is an easy-to-use suspension that is labeled for twice-daily administration, Davis said.

“The twice-daily administration will result in higher blood concentrations of the drugs, which means it will be effective against a greater number of bacteria,” she said.

"

Same reasoning why my vet wanted me to give Uniprim twice a day. They found during research via the new drug that it is more effective when given twice a day using that combo of drugs.

[JB]

If you can find that research I’d love to see it I haven’t found anything.

The new drug is a different formulation, even though it’s the same active abx, and I don’t begin to know how to tell the difference. It’s a lower dose - 24mg/kg vs 30 for Uni/Tucoprim, so obviously something is different enough.

[luvmyhackney]

@JB

If you can find that research I’d love to see it I haven’t found anything.

The new drug is a different formulation, even though it’s the same active abx, and I don’t begin to know how to tell the difference. It’s a lower dose - 24mg/kg vs 30 for Uni/Tucoprim, so obviously something is different enough.

Here is one. It compares it to Equilsul-SDT but shows the research regarding giving Uniprim 2X a day. My vet stays up to date and between her and my sources at Merial that do research, I’m used to using drugs different than the label based on their experiences and research.
https://aurorapharmaceutical.com/wp-content/uploads/2016/03/EQUISUL-SDT-versus-Uniprim-Comparison-Charts-9-5-13.pdf