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Carprofen (name brand Rimadyl®) is an NSAID (non-steroidal anti-inflammatory) approved by the FDA for use in dogs. Due to a massive marketing campaign, it is one of the most widely-used canine anti-inflammatories and non-narcotic pain medications.
Like other NSAIDs, carprofen targets cyclooxygenase enzymes to block the inflammation process in the body. This has the added benefit of reducing pain. It also decreases fever, which can be beneficial in treating the pain and inflammation in a wound with concurrent infection.
Carprofen stands apart from nonselective NSAIDs like aspirin due to its ability to selectively target cyclooxygenase-2 (COX-2) enzymes more than cyclooxygenase-1 (COX-1) enzymes. This means that carprofen can reduce pain and inflammation while also reducing the risk of causing gastrointestinal issues like ulcers. It is thought to be safer than non-selective NSAIDs like aspirin, which binds to COX-1 as well as COX-2. In other words, carprofen has the potential to provide relief from pain and inflammation with fewer side effects.
Can I Get Carprofen Without a Prescription?
No, carprofen is a prescription medication in the United States and must be prescribed by a vet. This is due to its potential for adverse side effects and the need for close monitoring by a professional.
How is Carprofen Given?
Carprofen is used as an injection, tablet, and chewable tablet. Injections are usually only given by a professional for operative or post-operative purposes.
Oral (by mouth) carprofen is available in three strengths: 25mg, 75mg, and 100mg tablets and chewable tablets.
What is Carprofen Used For?
Carprofen is typically prescribed for short-term use to reduce pain and inflammation associated with injury, as well as for postoperative pain relief associated with soft tissue and orthopedic surgeries in dogs. It is also sometimes used for long-term pain relief associated with conditions like arthritis. Carprofen is not intended to be used as a long-term pain management solution, however, and should only be used as directed by a veterinarian.
Carprofen is also commonly used to treat conditions like hip dysplasia, arthritis, tendonitis, ligament injuries, and other conditions in senior dogs that cause inflammation and pain in the joints or soft tissues.
In addition to its use in treating pain and inflammation, Carprofen can also be used to reduce fever and swelling associated with some illnesses and infections. It is important to note, however, that Carprofen is not an antibiotic and should not be used to treat bacterial infections; it should only be used to treat conditions that cause inflammation and pain.
Is Carprofen Safe?
Carprofen safety (and NSAID safety in general) is a controversial subject in dogs. Drugs approved by the FDA are considered “safe and effective” when used appropriately — the right dose for the right dog for no longer than the right length of time.
NSAIDs are hard on a dog’s body. They can lead to ulcers, excessive bleeding, kidney damage, liver damage, and sudden death. Even with these concerns, marketing for NSAIDs like carprofen often portrays them as safe and effective for long-term use. The manufacturer’s website for carprofen states:
While OA is progressive, a comprehensive treatment plan can manage your dog’s pain and help keep your furry friend active and playful. Learn how ****long-term treatment with Rimadyl can provide continuous improvement in your dog’s OA pain and mobility, so you can keep enjoying each other to the fullest.
What the website does not emphasize for Rimadyl (the brand name for carprofen) is that the drug was associated with sudden deaths and other serious outcomes in dogs, yet this information is critical for dog owners who need to make an informed choice on their dog’s care.
These reported deaths and other outcomes helped shape the FDA’s current policy and approach to their current guidelines on NSAID prescribing for pets.
One of the concerns cited by the FDA’s Center for Veterinary Medicine (CVM) is as follows:
In many dogs, the use of NSAIDs is not an elective therapeutic choice, but the primary therapy available for maintaining an acceptable standard of life due to the long-term debilitating effects of osteoarthritis. As an NSAID with potentially serious side effects, however, the use of Rimadyl should be carefully considered before being incorporated in any therapeutic plan. Moreover, dog owners should have an active role in making that decision. CVM, along with drug sponsors, is actively pursuing a number of avenues to improve the management of NSAID safety issues in order to minimize the risks and maximize the benefits of using these products in dogs.
This tension between profit-oriented marketing and safety-oriented education is one of the reasons why it’s so important for dog owners to be well-informed about the medications their dogs use. As the FDA says, owners need to have an active role in making the decision for their pets.
While NSAIDs are currently considered one of the best options for pain relief and quality of life improvement in dogs, they have serious risks that are not publicized as well as their benefits. These risks include:
- Sudden death without warning
- Severe kidney damage
- Severe liver damage
- Vomiting
- Stomach ulcers
- Intestinal ulcers
- Diarrhea or black, tarry stools (due to internal bleeding)
- Scabbing or harm to skin resulting in increased scratching
The conditions NSAIDs like carprofen treat can also be very serious, crippling dogs and leaving them with low quality of life.
The takeaway? Dogs need to be screened properly as candidates for NSAID use, especially for dogs that will be using them for long-term conditions like osteoarthritis. Vets and owners need to have serious discussions about the risks, what to watch for, and how often the dog will need labs to check for organ damage, and the owner needs to commit to getting their dog to these labs and watching for signs of harm.
The FDA-required package insert for carprofen (brand name Rimadyl) states:
All dogs should undergo a thorough history and physical examination before initiation of NSAID therapy.
Appropriate laboratory tests to establish hematological and serum biochemical baseline data prior to and periodically during the administration of any NSAID should be considered.
Many dogs may benefit from other approaches that allow for a lower dose of NSAIDs like carprofen or even avoiding NSAIDs entirely. We’ll quote the package insert for Rimadyl as it’s published today:
Carefully consider the potential benefits and risks of Rimadyl and other treatment options before deciding to use Rimadyl. Use the lowest effective dose for the shortest duration consistent with individual response.
We’ll talk about alternatives or other approaches to reduce the need for NSAIDs below!
What About Pregnancy?
No.
NSAIDs, including carprofen, are NOT safe in pregnancy. If there’s a chance your dog might be pregnant or become pregnant while using carprofen, discuss it with your vet BEFORE starting.
What About Lactating/Nursing?
No.
NSAIDs, including carprofen, are NOT safe in lactation — or for dogs less than 6 weeks of age. Discuss this with your vet if your dog is nursing, younger than six weeks, or a pup of indeterminant age who might be less than 6 weeks old.
What If I Miss a Dose?
Do not double up doses or give a “catch-up” dose. If you remember the dose and it’s still the same day around the same time, you can still give the dose (i.e., if your dog takes carprofen twice daily and you give them the first dose at 10am instead of 8am). If you’re unsure, call your vet or pharmacist.
Otherwise, simply continue the usual dosing as listed on the bottle you got from your veterinarian or pharmacy. Doubling doses will not “make up” for a skipped dose and unnecessarily increases risks of side effects and toxicity.
Carprofen Dosage for Dogs
Carprofen is usually dosed at 2 milligrams per pound (2mg/lb) either in one daily dose or split into two doses, morning and evening. It's important to know about and be comfortable with the side effects that carprofen can cause before giving it to your dog.
The actual dose for your dog as well as once daily or twice daily dosing, will be decided by your veterinarian — always follow their instructions and ask any questions you have before giving the medication to your dog!
Carprofen Dosing Table
| Dog’s Weight (lb) | Usual Dosage of Carprofen per day (mg) |
|---|---|
| 10 | 20 |
| 20 | 40 |
| 30 | 60 |
| 40 | 80 |
| 50 | 100 |
| 60 | 120 |
| 70 | 140 |
| 80 | 160 |
| 90 | 180 |
| 100 | 200 |
Carprofen Cost
Carprofen is moderately expensive, with a single tablet or chewable tablet costing around $0.50 - $1.00. The cost of carprofen will depend on the strength of the tablet, the number of tablets prescribed, and the pharmacy you use.
Carprofen Alternatives or Adjuncts
As we’ve discussed, NSAIDs are not without risk. Good sense (and the FDA!) recommend using the lowest effective dose for the shortest time possible.
In a perfect world, there would be a good alternative to NSAIDs, something that is safer and just as effective. Right now, that option may not exist for many dogs. NSAIDs work quickly, and they work well!
Another strategy to reduce risk is to use a lower dose of NSAID.
One way to use lower doses and get the same or better results is to use adjunct therapy — something else that helps reduce pain and inflammation that’s not an NSAID, safely works with the NSAID, and helps the dog feel just as comfortable as the dose required with the NSAID by itself.
Avocado Soybean Unsaponifiables (ASUs)
Avocado soybean unsaponifiables, or ASUs, are extracts made from the fruits and seeds of avocado and soybeans. The mixtures commonly used in supplements were first made and marketed in France. The products are sold to help stimulate cartilage formation, which can help with osteoarthritis and scleroderma (a disease where the body attacks its own connective tissue).
Studies show they do work in humans, and the good news is there are studies showing they can help dogs too! They have been shown in live dog arthritis models to help stop the damage arthritis causes in the joint.
ASUs do this by blocking one of the pathways that leads to lesion (a form of damage) formation in the dog’s joints.
ASUs are used in dogs and humans and are considered safe at the recommended doses.
Boswellia
Boswellia serrata, also known as Indian frankincense, is a tree species native to India, Northern Africa, and the Middle East. It has been used in traditional medicine for centuries to treat a variety of conditions, including arthritis.
Extracts from the tree’s resin are researched and have been shown to have anti-inflammatory and analgesic properties, although this research is still limited.
Studies in humans and animals have shown that boswellia may be helpful in reducing joint pain and stiffness, as well as decreasing inflammation. Boswellia is considered safe for use in dogs, and multiple formulations have been used and tested in studies.
Boswellia is thought to be safe in dogs, although there is limited data on drug interactions.
Boswellia is thought to work by blocking a particular enzyme called 5-lipoxygenase, which is a part of the inflammation pathway. By blocking it, Boswellia extracts stop the inflammatory process and helps with arthritis symptoms.
CBD
CBD, or cannabidiol, is an extract from the hemp plant. It has been used in various forms by many cultures for thousands of years.
It is non-psychoactive and is used for a variety of medical conditions, including inflammation and pain relief. CBD has been studied in humans and animals for its potential anti-inflammatory and anti-pain properties, with promising results for both.
CBD has been studied and shown to help reduce inflammation and improve functionality in dogs with arthritis. It works as both an anti-inflammatory and by directly supporting the nervous system to help reduce pain. Dogs that take it usually experience relief from pain, stiffness, and other symptoms associated with arthritis.
Millions of humans, dogs, and other animals have been dosed with CBD without ill effects, and no research has shown more than minor side effects as long as it is used at the appropriate doses and the extract is THC-free.
You can read more about CBD extracts here.
Recap
Carprofen is a non-steroidal anti-inflammatory drug approved by the FDA for use in dogs to reduce pain and inflammation associated with acute injury, post-operative pain relief, and chronic conditions like arthritis. It is important to note that it is a prescription medication and must be prescribed by a vet, and that it has serious risks associated with it, such as sudden death, kidney and liver damage, vomiting, ulcers, and skin scabbing. It is important for dog owners to be educated and informed on the medications their dogs use, and for vets and owners to have serious discussions about the risks and to screen dogs properly as candidates for NSAID use. Lastly, it is appropriate to consider alternatives like CBD or ASUs that may decrease the need for NSAIDs — lower doses and less use mean a safer, healthier, happier dog!
