Detailed description CERENIA Cerenia contains maropitant, a potent and selective neurokinin (NK1) receptor antagonist that blocks the pharmacological action of substance P in the CNS. Each mL of CERENIA® injection contains 10 mg of maropitant as the medicinal ingredient and 3.3 mg metacresol as a preservative. USES Dogs: For the symptomatic treatment of acute vomiting (e.g. parvovirus infection, gastro-enteritis and pancreatitis) and the prevention of vomiting associated with the use of an emetogenic medication (e.g. chemotherapy, anesthesia). Cats: For the symptomatic treatment of acute vomiting. DOSAGE & ADMINISTRATION Dogs: For the symptomatic treatment of acute vomiting in dogs: Dogs 10 weeks to 4 months of age: administer CERENIA injection subcutaneously at 1 mg/kg equal to 1 mL/10 kg body weight once daily for up to 5 days. Dogs 4 months of age and older: administer CERENIA injection intravenously over 1-2 minutes or subcutaneously at 1 mg/kg equal to 1 mL/10 kg body weight once daily for up to 5 days. CERENIA injection may be used interchangeably with CERENIA tablets for once daily dosing of the acutely vomiting dogs. The dose (and duration of treatment) is different depending on the formulation. For the prevention of vomiting associated with the use of an emetogenic medication in dogs 4 months of age and older: administer CERENIA injection intravenously over 1-2 minutes or subcutaneously at 1 mg/kg equal to 1 mL/10 kg body weight one time, 45 minutes prior to a pre-anesthetic drug or 60 minutes prior to chemotherapy. Cats: For the symptomatic treatment of acute vomiting in cats 4 months of age and older: administer CERENIA injection intravenously over 1-2 minutes or subcutaneously at 1 mg/kg equal to 1 mL/10 kg body weight once daily for up to 5 days. CERENIA injection may be administered at room temperature (15-30°C) or refrigerated temperature (2-8°C). Injecting at refrigerated temperature may reduce the pain response associated with the subcutaneous injection. CONTRAINDICATIONS & WARNINGS Contraindications: There are no known contraindications for the use of SIMPARICA chewable tablets. CERENIA injection is contraindicated in dogs and cats suspected of having a gastrointestinal obstruction or toxin ingestion. Immediate treatment should be directed at addressing the underlying cause not the sign of vomiting. Cautions: Safety in dogs and cats used for breeding, pregnant, or lactating bitches and queens and puppies less than 10 weeks of age or kittens less than 16 weeks of age has not been established (See the ANIMAL SAFETY section for complete information). Emesis may be associated with serious, severely debilitating conditions, and therefore appropriate diagnostic evaluations should be employed. Hypovolemia in combination with maropitant may increase the risk for hypotension; all dogs and cats with ongoing emesis should receive rehydration therapy. CERENIA injection should be used with caution in dogs and cats with bradycardia or underlying heart disease since maropitant may increase the risk of arrhythmias. A mild and transient hypotension can occur shortly after IV administration in dogs. Maropitant is metabolized in the liver and therefore should be used with caution in dogs and cats with hepatic disease. Maropitant is a highly protein bound drug; use caution when administering other drugs that are highly protein bound. Drug interactions between maropitant injectable and other drugs have not been thoroughly investigated in dogs and cats. Hypoproteinemic dogs and cats being treated with maropitant should be monitored closely; if adverse effects are seen, treatment should be discontinued. If maropitant therapy has not been effective after 3 days of use, alternative treatment to control vomiting should be pursued. The concurrent use of maropitant with other antiemetic agents has not been assessed in dogs and cats. Food consumption and weight gain of puppies being treated with CERENIA should be closely monitored. Anorexia and weight loss may occur. CERENIA causes dose related decreases in appetite and body weight. In puppies younger than 11 weeks of age, histological evidence of bone marrow hypocellularity was observed at higher frequency and greater severity in puppies treated with CERENIA compared to control puppies. In puppies, 16 weeks and older, bone marrow hypocellularity was not observed. WARNINGS: Keep out of reach of children. In case of accidental injection or exposure, seek medical advice. Topical exposure may elicit localized allergic skin reactions in some individuals. Repeated or prolonged exposure may lead to skin sensitization. In case of accidental skin exposure, wash with soap and water. CERENIA is also an ocular irritant. In case of accidental eye exposure, flush with water for 15 minutes and seek medical attention. PHARMACEUTICAL PRECAUTIONS Store at controlled room temperature 20 and 25°C with excursions between 15 and 30°C. After first vial puncture, CERENIA injection should be stored at refrigerated temperature 2 and 8°C. Use within 90 days of first vial puncture. Stopper may be punctured a maximum of 25 times. Presentation: CERENIA injection is available in 20 mL amber glass vials.