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| Category | POM-V |
| Temperature | Ambient |
| MA/VM/EU No: | 42058/4154 |
| Species |
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| VMD Link | https://www.vmd.defra.gov.uk/productinformationdatabase/files/SPC_Documents/SPC_139402.PDF |
| NOAH Link | |
| Dosage | Amounts to be administered and administration route HORSE For analgesia: For use at a dose rate of 5 ml per 500 kg, equivalent to 0.1 mg butorphanol/kg bodyweight by intravenous injection. The dose may be repeated as required. Analgesic effects are seen within 15 minutes of injection. Torbugesic for Equine Analgesia - (IV) Weight of Horse – kg 50 100 150 200 250 300 350 400 450 500 550 Dose of Torbugesic (10 mg/ml) – mls 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 4.50 5.00 5.50 For sedation in combination with detomidine hydrochloride: A dose rate of 0.1 ml DomosedanTM/100 kg (equivalent to 0.012 mg/kg detomidine hydrochloride) should be given intravenously followed within 5 minutes by a dose rate of 0.025 mg/kg butorphanol intravenously (equivalent to 0.25 ml Torbugesic Injection/100 kg). Clinical experience has shown that a total dose rate of 0.5 ml Domosedan and 1.0 ml Torbugesic Injection affords effective, safe sedation in horses above 200 kg bodyweight. Weight of horse – kg 50 100 150 200 250 300 350 400 450 500 550 Dose of detomidine (10 mg/ml) – mls 0.05 0.10 0.20 0.25 0.50 0.50 0.50 0.50 0.50 0.50 0.50 Dose of Torbugesic (10 mg/ml) - mls 0.10 0.25 0.40 0.50 1.00 1.00 1.00 1.00 1.00 1.00 1.00 NB. Detomidine should be administered up to 5 minutes before the Torbugesic dose. For sedation in combination with romifidine: A dose of 0.4-1.2 ml SedivetTM per 100 kg bodyweight (equivalent to 40-120 µg romifidine/kg) followed by 0.2 ml Torbugesic per 100 kg bodyweight (equivalent to 20 µg butorphanol/kg) should be administered intravenously. Torbugesic and romifidine Combination for Equine Sedation - (IV) Weight of horse - kg 50 100 150 200 250 300 350 400 450 500 550 *Dose of romifidine (10 mg/ml) - mls 0.30 0.60 0.90 1.20 1.50 1.80 2.10 2.40 2.70 3.00 3.30 Dose of Torbugesic (10 mg/ml) - mls 0.10 0.20 0.30 0.40 0.50 0.60 0.70 0.80 0.90 1.00 1.10 *Above example based on a dose rate of 60 µg romifidine/kg bodyweight. NB. Romifidine should be administered up to 5 minutes before the Torbugesic dose. DOG For analgesia: Administer by intravenous, intramuscular, or subcutaneous injection using aseptic technique. Rapid IV injection should be avoided. Dose rate: 0.2-0.3 ml/10 kg (equivalent to 0.2-0.3 mg butorphanol per kg) bodyweight. Torbugesic Injection should be administered before terminating anaesthesia to provide analgesia in the recovery phase. Analgesic effects are seen within 15 minutes. For continuous analgesia the dose may be repeated as required. Torbugesic for Canine Analgesia - (IV, IM, or SC) Weight of dog - kg 1 3 5 10 15 20 25 30 40 # Dose of Torbugesic (10 mg/ml) - mls 0.03 0.07 0.10 0.30 0.40 0.50 0.60 0.80 1.00 # Based on a mean dose rate of 0.25 mg butorphanol/kg For sedation in combination with medetomidine hydrochloride: Torbugesic Injection should be administered at 0.1 ml/10 kg bodyweight (equivalent to 0.1 mg butorphanol/kg) together with 0.1-0.25 ml DomitorTM/10 kg bodyweight (equivalent to 10-25 µg medetomidine/kg), depending on degree of sedation required, both by intramuscular or intravenous injection. Allow 20 minutes for profound sedation to develop before commencing the procedure. Domitor and Torbugesic may be combined and administered in the same syringe. However the vials should have separate needles inserted for withdrawal to minimise the risk of cross contamination. Reversal with 0.1-0.25 ml AntisedanTM/10 kg bodyweight (equivalent to 50-125 µg atipamezole/kg) results in sternal recumbency approximately 5 minutes later and standing approximately a further 2 minutes later. Torbugesic and medetomidine Combination for Canine Sedation - (IM or IV) For sedation and as a premedicant to barbiturate anaesthesia Weight of dog - kg 1 3 5 10 15 20 25 30 40 # Dose of Torbugesic (10 mg/ml) - mls 0.01 0.03 0.05 0.10 0.15 0.20 0.25 0.30 0.40 # Dose of medetomidine (1 mg/ml) - mls 0.01 0.03 0.05 0.10 0.15 0.20 0.25 0.30 0.40 # Based on a dose rate of 0.1 mg butorphanol/kg and 10 µg medetomidine/kg Torbugesic and medetomidine Combination for Canine Sedation - (IM or IV) For profound sedation and as a premedicant to ketamine anaesthesia Weight of dog - kg 1 3 5 10 15 20 25 30 40 * Dose of Torbugesic (10 mg/ml) - mls 0.01 0.03 0.05 0.10 0.15 0.20 0.25 0.30 0.40 * Dose of medetomidine (1 mg/ml) - mls 0.03 0.08 0.13 0.25 0.38 0.50 0.63 0.75 1.00 * Based on a dose rate of 0.1 mg butorphanol/kg and 25 µg medetomidine/kg For use as a pre-anaesthetic: Used as a pre-anaesthetic, the Torbugesic Injection dose should be reduced to 0.1-0.2 ml/10 kg (0.1-0.2 mg butorphanol/kg), given 15 minutes prior to induction. Torbugesic for Canine analgesia Pre-Anaesthetic - (IV, IM, or SC) Weight of dog - kg 1 3 5 10 15 20 25 30 40 # Dose of Torbugesic (10 mg/ml) - mls 0.01 0.03 0.05 0.10 0.15 0.20 0.25 0.30 0.40 # Pre-anaesthetic doses:- Based on a dose rate of 0.10 mg butorphanol/kg For use as a pre-anaesthetic in combination with acepromazine: Torbugesic Injection should be administered at 0.1 ml/10 kg bodyweight (equivalent to 0.1 mg butorphanol/kg) together with 0.1 ml of 2 mg/ml acepromazine/10 kg bodyweight (equivalent to 0.02 mg acepromazine/kg) by intramuscular or intravenous injection. Torbugesic and acepromazine may be combined and administered in the same syringe. However the vials should have separate needles inserted for withdrawal to minimise the risk of cross contamination. Allow at least 20 minutes for onset of action but the time between premedication and induction is flexible from 20-120 minutes. The dose of butorphanol may be increased to 0.2 mg/kg (equivalent to 0.2 ml Torbugesic /10 kg bodyweight) if the animal is already experiencing pain before the procedure commences, or if a higher plane of analgesia is required during surgery. Torbugesic and acepromazine Combination for Canine Analgesia and Sedation Pre-Anaesthetic – (IM or IV) Weight of dog - kg 1 3 5 10 15 20 25 30 40 Dose of *Torbugesic (10 mg/ml) – mls:- 0.01 0.03 0.05 0.10 0.15 0.20 0.25 0.30 0.40 Dose of **acepromazine (2 mg/ml) – mls:- 0.01 0.03 0.05 0.10 0.15 0.20 0.25 0.30 0.40 * Based on a dose rate of 0.1 mg butorphanol/kg bodyweight ** Based on a dose rate of 0.02 mg acepromazine/kg bodyweight For anaesthesia in combination with medetomidine and ketamine: Administer Torbugesic Injection at 0.1 ml/10 kg (equivalent to 0.1 mg butorphanol/kg) and Domitor at 0.25 ml/10 kg (equivalent to 25 µg medetomidine/kg) by intramuscular injection. Domitor and Torbugesic may be combined and administered in the same syringe. However the vials should have separate needles inserted for withdrawal to minimise the risk of cross contamination. Dogs become recumbent in approximately 6 minutes and lose their pedal reflex in approximately 14 minutes. Ketamine (100 mg/ml) should be administered 15 minutes following the first injection at 0.5 ml/10 kg (equivalent to 5 mg ketamine/kg) by intramuscular injection. The pedal reflex returns approximately 53 minutes following administration of the ketamine injection. Sternal recumbency is attained approximately 35 minutes later followed by standing a further 36 minutes later. Torbugesic, medetomidine, and ketamine for Canine Anaesthesia - (IM) Weight of dog - kg 1 3 5 10 15 20 25 30 40 * Dose of Torbugesic (10 mg/ml) - mls 0.01 0.03 0.05 0.10 0.15 0.20 0.25 0.30 0.40 * Dose of medetomidine (1 mg/ml) - mls 0.03 0.08 0.13 0.25 0.38 0.50 0.63 0.75 1.00 ADMINISTER TORBUGESIC AND MEDETOMIDINE BY INTRAMUSCULAR INJECTION AT THE ABOVE DOSE RATES WAIT 15 MINUTES BEFORE ADMINISTERING THE KETAMINE BY IM INJECTION AT THE DOSE RATES BELOW *** Dose of ketamine (100 mg/ml) - mls 0.05 0.15 0.25 0.50 0.75 1.00 1.25 1.50 2.00 * Based on a dose rate of 0.1 mg butorphanol/kg. ** Based on a dose rate of 25 µg medetomidine/kg. *** Based on a dose rate of 5 mg ketamine/kg NB: It is NOT advisable to reverse this combination in the dog with atipamezole. CAT For pre-operative analgesia: 0.2 ml/5 kg bodyweight (equivalent to 0.4 mg butorphanol/kg), should be administered either by subcutaneous or intramuscular injection. Clinical studies have shown that administering the butorphanol dose 5 minutes prior to induction with either acepromazine/ketamine or xylazine/ketamine given intramuscularly will provide analgesia when surgery commences. The arousal time will not be significantly altered. With intravenous induction agents, butorphanol should be administered 15-30 minutes prior to administration of the anaesthetic. For post-operative analgesia: 0.2 ml/5 kg bodyweight (equivalent to 0.4 mg butorphanol/kg), should be administered by either subcutaneous or intramuscular injection 15 minutes prior to recovery. Alternatively, 0.05 ml per 5 kg (equivalent to 0.1 mg butorphanol/kg), by intravenous injection can be used. Torbugesic for Feline Analgesia Weight of cat - kg 1 1.5 2 2.5 3 3.5 4 4.5 5 IM or SC Dose (ml) # Torbugesic Injection (10 mg/ml) 0.04 0.06 0.08 0.10 0.12 0.14 0.16 0.18 0.20 IV Dose (ml) ## Torbugesic Injection (10 mg/ml) 0.01 0.02 0.02 0.03 0.03 0.04 0.04 0.05 0.05 # Based on a mean dose rate of 0.4 mg butorphanol/kg. ## Based on a mean dose rate of 0.1 mg butorphanol/kg. For sedation in combination with medetomidine hydrochloride: Torbugesic Injection should be administered at 0.2 ml/5 kg bodyweight (equivalent to 0.4 mg butorphanol/kg) together with 0.25 ml Domitor/5 kg bodyweight (equivalent to 50 µg medetomidine/kg) both by either intramuscular or subcutaneous injection. Domitor and Torbugesic may be combined and administered in the same syringe. However the vials should have separate needles inserted for withdrawal to minimise the risk of cross contamination. Local anaesthetic infiltration should be used for wound suturing. Reversal with 0.125 ml Antisedan/5 kg bodyweight (equivalent to 125 µg atipamezole/kg) results in sternal recumbency approximately 4 minutes later and standing 1 minute later. Torbugesic and medetomidine combination for Feline Sedation - (IM or SC) Weight of cat - kg 1 1.5 2 2.5 3 3.5 4 4.5 5 * Dose of Torbugesic (10 mg/ml) - mls 0.04 0.06 0.08 0.10 0.12 0.14 0.16 0.18 0.20 ** Dose of medetomidine (1 mg/ml) - mls 0.05 0.08 0.10 0.13 0.15 0.18 0.20 0.23 0.25 * Based on a dose rate of 0.4 mg butorphanol/kg. ** Based on a dose rate of 50 µg medetomidine/kg For anaesthesia in combination with medetomidine and ketamine: Intramuscular Administer Torbugesic Injection at 0.2 ml/5 kg (equivalent to 0.4 mg butorphanol/kg), 0.4 ml Domitor/5 kg (equivalent to 80 µg medetomidine/kg) and ketamine (100 mg/ml) at 0.25 ml/5 kg (equivalent to 5 mg ketamine/kg). Domitor and Torbugesic (and Ketaset – where registered) may be combined and administered in the same syringe. However the vials should have separate needles inserted for withdrawal to minimise the risk of cross contamination. Cats become recumbent in 2-3 minutes following injection. Loss of the pedal reflex occurs 3 minutes post-injection. Torbugesic, medetomidine, and ketamine for Feline Anaesthesia - (IM) Weight of cat - kg 1.5 2 2.5 3 3.5 4 4.5 5 * Dose of Torbugesic (10 mg/ml) - mls 0.06 0.08 0.10 0.12 0.14 0.16 0.18 0.20 ** Dose of medetomidine (1 mg/ml) - mls 0.12 0.16 0.20 0.24 0.28 0.32 0.36 0.40 *** Dose of ketamine (100 mg/ml) - mls 0.08 0.10 0.13 0.15 0.18 0.20 0.23 0.25 * Based on a dose rate of 0.4 mg butorphanol/kg. ** Based on a dose rate of 80 µg medetomidine/kg *** Based on a dose rate of 5 mg ketamine/kg Reversal with 0.2 ml Antisedan/5 kg (equivalent to 200 µg atipamezole/kg) results in return of the pedal reflex 2 minutes later, sternal recumbency 6 minutes later, and standing 31 minutes later. Intravenous Administer Torbugesic Injection at 0.05 ml/5 kg (equivalent to 0.1 mg butorphanol/kg), 0.2 ml Domitor/5 kg (equivalent to 40 µg medetomidine/kg) and ketamine (100 mg/ml), depending on depth of anaesthesia required, at a dose rate of 0.06-0.13 ml/5 kg bodyweight (equivalent to 1.25-2.5 mg ketamine/kg) by intravenous injection. Domitor and Torbugesic (and Ketaset – where registered) may be combined and administered in the same syringe. However the vials should have separate needles inserted for withdrawal to minimise the risk of cross contamination. Approximate time scales when using the triple combination intravenously Ketamine* Dose mg/kg Time to recumbency Time to loss of pedal reflex Time to return of pedal reflex Time to sternal recumbency Time to standing 1.25 32 secs 62 secs 26 mins 54 mins 74 mins 2.50 22 secs 39 secs 28 mins 62 mins 83mins * In conjunction with butorphanol at 0.1 mg/kg and medetomidine at 40 µg/kg Torbugesic, medetomidine, and ketamine for Feline Anaesthesia - (IV) Dosage chart for 2.5 mg ketamine/kg (duration of anaesthesia approximately 28 minutes). Weight of cat - kg 1.5 2 2.5 3 3.5 4 4.5 5 * Dose of Torbugesic (10 mg/ml) - mls 0.02 0.02 0.03 0.03 0.04 0.04 0.05 0.05 ** Dose of medetomidine (1 mg/ml) - mls 0.06 0.08 0.10 0.12 0.14 0.16 0.18 0.20 *** Dose of ketamine (100 mg/ml) - mls 0.04 0.05 0.06 0.08 0.09 0.10 0.11 0.13 * Based on a dose rate of 0.1 mg butorphanol/kg. ** Based on a dose rate of 40 µg medetomidine/kg *** Based on a dose rate of 2.5 mg ketamine/kg Reversal with 0.1 ml Antisedan/5 kg (equivalent to 100 µg atipamezole/kg) results in return of the pedal reflex 4 minutes later, sternal recumbency 7 minutes later, and standing 18 minutes later. 4.10 Overdose (symptoms, emergency procedures, antidotes), if necessary The most important result of overdosage is respiratory depression. This can be reversed with naloxone. To reverse the effect of combinations, atipamezole may be used, except when a combination of butorphanol, medetomidine, and ketamine has been used intramuscularly to produce anaesthesia in the dog. In this case, atipamezole should not be used. See “Amounts to be administered and administration route” for details of doses. |
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