Indicated for the treatment of pain and inflammation associated with osteoarthritis (or degenerative joint disease) in dogs.1

Daxocox product
What is Breakthrough Pain

“An abrupt, short-lived, and intense pain that breaks through the analgesia that controls pain”

2014 WSAVA Recognition Assessment and Treatment of Pain Guidelines.

  • On average, vets say that nearly half their canine OA cases experience breakthrough pain6
  • Owners may experience breakthrough pain as their pet having ‘off days’
  • 8 out of 10 of owners say their dog experiences an ‘off’ day due to OA
    at least once a week7

87% of vets agree that avoiding
breakthrough pain is critical
in
the management of canine OA6

OWNER COMPLIANCE

OWNER COMPLIANCE

Missed doses risk breakthrough pain

1 in 2 pet owners admit to poor compliance with daily NSAID dosing7

FLARE UPS

FLARE UPS

Over-exercise or natural disease flare-ups risk breakthrough pain

90% of vets agree that canine OA pain is variable, oen occurring in flare ups6

END OF DOSE PLASMA LEVELS

END OF DOSE PLASMA LEVELS

Variable plasma levels between doses risks breakthrough pain

58% of vets believe daily dosing makes it difficult to achieve stable/consistent OA pain control6

DISEASE PROGRESSION

DISEASE PROGRESSION

OA is a progressive disease and if management strategies don’t evolve with this progression, breakthrough pain is a risk

Consequences of breakthrough pain

Compromised welfare of the dog (and owner!)

Breakthrough pain can significantly affect a dog’s quality of life and can be really distressing for owners to experience

Wind-up pain

Repeated pain signals lead to be peripheral and eventual central sensitisation, causing amplified and exaggerated response to pain signals which can become chronically non-responsive to analgesics

Loss of owner confidence

Witnessing breakthrough pain in their dog, despite following veterinary advice, can damage the trust that owners have in their vet and may even push some to stray from the treatment plan, in an attempt to help their dog7

1 in 2 owners say they would feel worried that their dog’s OA must be getting worse if their pet showed signs of pain or discomfort, despite following their vet’s advice7

Daxocox® is a
breakthrough pain
breakthrough

Daxocox helps stop breakthrough
OA pain haunting dogs

Consistent plasma levels

CONSISTENT PLASMA LEVELS

Consistent Pain Control for 7 days

Reaches minimum effective concentration within 24 hours after the 1st dose and stays at the required therapeutic level for 7 days until the next dose is due5

Disease Progression

DISEASE PROGRESSION

Licensed for all stages of OA

Can be given continuously, with no mandatory treatment breaks,1 making Daxocox® a suitable NSAID cornerstone of a responsive multi-modal management approach

Owner compliance

OWNER COMPLIANCE

Simple weekly dosing with a flavoured tablet

7x less risk of a missed dose, compared to daily dosing

Flare Ups

FLARE UPS

Reliable analgesia

A combination of compliance friendly administration and proven 7-day efficacy provides reassurance that the clinical consequences of unavoidable OA flare-ups are minimised

Daxocox® is effective

Once weekly dosing with Daxocox® achieves significant improvement of clinical signs associated with OA pain2,3

  • Owners report that 90% of dogs with OA improve after treatment with Daxocox and 84% of dogs improved their quality of life from “poor or fair” to “good, very good or excellent”2
  • According to veterinary assessment 74% of the dogs do not show clinical signs of osteoarthrit is2

Clinical study design:

Multicentre, randomised, single blinded clinical field trials (x2) to assess the efficacy of Daxocox®

The study inclusion criteria included:

  • > 12 months
  • > 5kg body weight
  • Clinical signs of osteoarthritis for > 3 weeks
  • Confirmed radio graphic evidence of osteoarthritis
  • Minimum clinical sum scores (CSS)
  • Basal haematology and biochemistry within normal limits
  • Received no OA treatment or nutraceutical for an appropriate period of time prior to the study

Both veterinary and owner assessment of improvement was included:

  • The following clinical signs were assessed by vets separately, to generate a clinical sum score (CSS) at each examination:
    • Posture, stance and weight bearing
    • Lameness at walk
    • Lameness at trot
    • Pain on palpation and manipulation
  • Owners completed a subjective assessment, via a questionnaire with a series of set ‘ranking questions’, to generate comparable Canine Brief Pain inventory Scores and QoL analysis
    • Investigated perceived pain levels over varying time periods and during different daily activities

Daxocox® is well tolerated

Daxocox has a broad margin of safety:

  • Clinical field trials noted that, as with all NSAIDs, adverse effects are mostly related to the gastrointestinal system and most cases recovered without treatment1
  • The target animal safety study demonstrates that administering up to 5xthe recommended therapeutic dose did not show any relevant treatment related adverse effects4
  • Suitable for long-term use, with no evidence of drug over-accumulation
    and no need for therapeutic breaks1

Elevated blood urea and serum cholesterol levels were observed in some cases, at both the recommended dose and overdose.

In case of adverse reactions, the use of the veterinary medicinal product should be stopped and general supportive therapy, as for clinical overdose with NSAIDs, should be applied until complete resolution of the signs.

Daxocox product

How Daxocox®
works

Daxocox® provides consistent pain control for a whole
week without over-accumulation, due to its 7-day
phasic pharmacology.

Watch how Daxocox works

7-DAYPhasicPHARMACOLOGY

Allowing ONE dose of Daxocox® to sustain a consistent therapeutic blood level for ONE whole week

7-Day Phasic Pharmacology
  • Enflicoxib is absorbed and slowly metabolised into an active pyrazol metabolite, with long lasting COX-2 selective inhibitory action
  • Once formed, the active pyrazol metabolite binds to red blood cells and plasma proteins
  • Phases of slow formation and slow elimination of the active pyrazole metabolite create a balance which maintains the levels required in the blood for consistent pain management for 7 days
  • Pyrazol metabolite levels remain stable above the minimum effective concentration (MEC), providing consistent pain management while staying far below levels where toxicity may be observed (MTC)
  • Enflicoxib concentrations are reduced to basal levels before the next dose is due

This is what gives Daxocox® its unique extended efficacy – consistent pain relief that reduces the risk of breakthrough pain, with no risk of over accumulation after repeated weekly administration.

daxocox 170321_580 a4@2x

Dosing & administration

  • Convenient, once weekly oral dosing
  • Flavoured tablet
  • To be administered immediately before or with the dog’s meal1

Dosing Guide

First dose:
8mg/kg

This loading dose facilitates plasma concentrations of the active metabolite to reach therapeutic levels within 24 hours5

Subsequent maintenance doses:
4mg/kg

Dosing Chart

Daxocox®support
resources

Take advantage of Daxocox® educational and support tools, for you and your clients

Learn more about breakthrough pain from Matt Gurney,
RCVS & EBVS® European Veterinary Specialist in Anaesthesia & Analgesia


Learn More

Further educational materials and practice support materials can be found at www.the-pac.co.uk


Learn More

Daxocox® FAQs

Answers to some of the common questions relating to Daxocox®

How does Daxocox® work?

Daxocox® is a non-steroidal anti-inflammatory it acts by selective inhibition of the enzyme cyclooxygenase (COX-2) and therefore avoiding the production of PGE2, the main prostaglandin involved in inflammatory processes.

How often should Daxocox® be given?

Only once per week

What is the minimum age and weight of dog that can be prescribed Daxocox®?

Daxocox® can be used in dogs of all ages. Careful monitoring is advised during the treatment of young dogs aged less than 6 months. The 15mg tablet can be used in dogs from 3kg of weight.

How long does Daxocox® take to become fully effective?

Onset of efficacy is achieved 24 hours after the initial loading dose of 8mg/kg.

Should Daxocox® be given with food?

Yes, Daxocox® should be given immediately before or with the dog’s meal.

What’s the recommended dose?

First dose: 8 mg enflicoxib per kg body weight. There after maintenance dose every 7 days at the dose of 4 mg enflicoxib per kg body weight.

Can it be used in cats?

No. Daxocox® is only indicated for dogs and should not be used in any other species.

Can we reduce below the licenced dose to find the lowest effective dose?

No. Daxocox® dose has been adjusted for optimum efficacy and safety and should be used according to the data sheet. Lower doses could result in lack of efficacy, especially in severe cases.

How long can you give it for, is it a longterm treatment?

There is no restriction on how long Daxocox® can be given in continuous therapy.

How do I switch a case onto Daxocox® from another NSAID?

Before administering any Daxocox® dose, ensure a treatment free period according to the pharmacokinetic characteristics of the other NSAID the dog is currently receiving. If the reason to switch is related to safety problems, add an additional recovery period before restarting NSAID treatment. Once that period has elapsed, use Daxocox® following the data sheet instructions.

What alternative pain relief can be given whilst Daxocox® is taking effect?

Daxocox® onset of action is within 24 hour after the first loading dose. As osteoarthritis is a chronic process, no additional analgesia should beneeded.

Is there a cumulative increase in active ingredient levels that will mean a break in treatment will be necessary?

No. The balance between the slow formation and the slow elimination of the active metabolite of enflicoxib provides consistent blood levels for one week, with no overaccumulation after repeated administrations. Therefore there is no need for a treatement break. If Daxocox® medication is stopped voluntarily, the treatment should be restarted with the initial loading dose, as per label instructions.

How do the side effects compare to other NSAIDsWhat are the common side effects?

In clinical trials, the incidence and type of adverse effects after the use Daxocox® are similar to those previously described for other COX-2 selectiveNSAIDs. Studies in healthy beagle dogs have shown a wide safety margin when overdosed for long treatment periods.

What happens if an owner overdoses and gives daily?

In case of overdose, no further doses should be given and the dog must be closely monitored (including blood analysis). Daxocox ® has a broad safety margin and, if no adverse events are detected, treatment can be resumed after a treatment free period of 2 weeks.

Can I give Daxocox® to an allergic dog? (animal proteins)

Daxocox® does not contain animal proteins in its formulation. However, it cannot be administered to dogs with known hypersensitivity to the active substance, any of the excipients or suphonamides.

Can tablets be split?

No. The data sheet / SPCs instructs that tables should not be split and no trial evidence exists to show that split tablets work or are safe to use.

How many sizes of Daxocox® are there?

At launch there are 5 sizes: 15mg, 30mg, 45mg, 70mg, and 100mg.

How many tablets are in a pack?

Each size tablet comes in a 4 tablet pack.

What is the shelf life?

30 months at launch.

Is there an injectable?

No. Daxocox® is intended for oral use in dogs only and there is no injectable or liquid formulations available at this time