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Dosage and administration
Oral use.
Administer twice daily with food in order to reduce the risk of gastrointestinal irritation.
In dogs with severe and frequent seizures or when a dog is being switched rapidly from phenobarbital to potassium bromide, a loading dose of 60 mg/kg bodyweight twice daily, for 5 days (equivalent to a total daily dose of 120 mg/kg) can be administered in order to quickly reach therapeutic serum concentrations.
The maintenance dose should be titrated to the individual dog as the required dosage and therapeutic serum bromide concentration may vary between animals and depends on the nature and severity of the underlying disease.
The recommended starting dose is 30 mg/kg bodyweight twice daily (equivalent to a total daily dose of 60 mg/kg).
Adjunctive treatment, in combination with phenobarbital:
The recommended starting dose is 15 mg/kg bodyweight twice daily (equivalent to a total daily dose of 30 mg/kg). Use in dogs with a bodyweight of less than 10 kg should be subject to a risk/benefit assessment.
At the beginning of treatment, bromide serum concentrations should be checked regularly, e.g. 1 week and 1 month after the loading period and three months after treatment initiation at maintenance dosage. Therapeutic serum levels vary between 1000 mg/L to 3000 mg/L when potassium bromide is used as monotherapy and between 800 mg/L and 2000 mg/L, when used as adjunctive treatment. Close monitoring for side effects is advisable, particularly when serum bromide concentrations have reached the upper limit of the therapeutic range for monotherapy.
It is recommended to administer at least half of the initial starting dose to dogs with mild or moderate renal insufficiency, with more frequent monitoring of serum bromide levels.
If the clinical response is not satisfactory or if adverse reactions occur, the dose may be adjusted based on the dog’s serum bromide levels. Serum concentrations should be measured after each dose adjustment once steady state serum levels have been reached (typically 3 months after a change), unless earlier evaluation is necessary.
Long term monitoring of serum bromide concentrations should be performed as clinically justified by the individual case.