Contra-indications
Do not use in cases of hypersensitivity to the active substances or to any of the excipients.
Do not use in cases of:
- gastro-intestinal ulceration
- chronic gastro-intestinal disorders
- mechanic stenoses in the gastro-intestinal system
- paralytic ileus in horses
- disorders of the haematopoietic system
- blood clotting disorders
- renal insuciency
- tachyarrhythmia
- glaucoma
- prostate adenoma.
Adverse reactions
In horses and cattle, a slight increase in heart rate may be observed occasionally due to the parasympathetic activity of hyoscine butylbromide.
In dogs painful reactions at the injection site can occur immediately after injection, which abate rapidly and have no negative impact on the expected therapeutic benefit.
In very rare cases, anaphylactic reactions may occur and should be treated symptomatically.
Based on pharmacological properties of hyoscine butylbromide, dryness of mucous membranes, paralytic ileus, constipation and urinary retention may occur.
The frequency of adverse reactions is defined using the following convention:
- very common (more than 1 in 10 animals treated displaying adverse reaction(s))
- common (more than 1 but less than 10 animals in 100 animals treated)
- uncommon (more than 1 but less than 10 animals in 1,000 animals treated)
- rare (more than 1 but less than 10 animals in 10,000 animals treated)
- very rare (less than 1 animal in 10,000 animals treated, including isolated reports).
Special precautions for use in animals
Due to the risk of anaphylactic shock metamizole-containing solutions should be administered slowly when given intravenously.
Special precautions to be taken by the person administering the veterinary medicinal product to animals
In a very small number of people, metamizole can cause reversible, but potentially serious agranulocytosis and other reactions such as skin allergy. Take care to avoid self-injection. In case of accidental self-injection, seek medical advice immediately and show the package leaflet or the label to the physician.
People with known hypersensitivity to metamizole or hyoscine butylbromide should avoid contact with the veterinary medicinal product. Avoid use of the product if you are known to be sensitive to pyrazolones, or are sensitive to acetylsalicylic acid.
Wash splashes from skin and eyes immediately.
Use during pregnancy and lactation
Studies in laboratory animals (rabbit, rat) have not produced any evidence of a toxic effect on reproduction. No information on use during pregnancy in the target species is available. An effect upon the smooth muscles of the birth canal can occur. Metabolites of metamizole cross the placental barrier and penetrate into milk. Therefore this product should be used only according to the benefit-risk assessment by the responsible veterinarian.
Interaction with other medicinal products and other forms of interaction
The effects of metamizole and/or hyoscine butylbromide may be potentiated by concurrent use of other anticholinergic or analgesic substances.
Concomitant use of inducers of hepatic microsomal enzymes (e.g. barbiturates, phenylbutazone) reduces the half-life period and hence the duration of action of metamizole.
Simultaneous administration of neuroleptics, especially phenothiazine derivatives, may lead to severe hypothermia. Furthermore the risk of gastro-intestinal bleeding is increased upon concurrent use of glucocorticoids. The diuretic effect of furosemide is attenuated.
Co-administration of other weak analgesics increases the effects and side-effects of metamizole.
The anticholinergic action of chinidin and antihistaminics as well as the tachycardic effects of β-sympathomimetics may be enhanced by this veterinary medicinal product.
Overdose (symptoms, emergency procedures, antidotes)
The acute toxicity of both active substances is very low. In studies with rats the symptoms were non-specific and included: ataxia, dilation of pupils, increased heart rate, exhaustion, convulsions, unconsciousness and respiratory signs.
In case of overdosage treatment should be discontinued. Physostigmin is recommended as an antidote to hyoscine butylbromide. A specific antidote for metamizole sodium is not available. Therefore symptomatic treatment should be initiated in case of overdosage.
Due to the inhibitory effect of hyoscine butylbromide on the parasympathetic system a slight increase in the heart rate was observed in some cases in horses and cattle following administration of the double therapeutic dose.
Incompatibilities
In the absence of compatibility studies, this veterinary medicinal product must not be mixed with other veterinary medicinal products.
Withdrawal periods
Meat and offal:
Horse, cattle (IV) 12 days
Pig (IM) 15 days
Milk:
Cattle (IV) 96 hours
Do not use in mares whose milk is intended for human consumption.