NSAIDs and Corticosteroids Interaction in Dogs: Risks and Management

References

1. DailyMed - COXIBA- deracoxib tablet, chewabledailymed.nlm.nih.gov · Feb 16, 2026
   Passage read from this source

   Since NSAIDs possess the potential to produce gastrointestinal ulceration and/or perforation, concomitant use of Coxiba Chewable Tablets with other anti-inflammatory drugs, such as NSAIDs or corticosteroids, should be avoided. As a class, NSAIDs may be associated with gastrointestinal, renal and hepatic toxicity. The following collective group of clinical signs has been reported with some serious gastrointestinal events, in decreasing order of reported frequency: anorexia, tachycardia, tachypnea, pyrexia, ascites, pale mucous membranes, dyspnea. In some cases, circulatory shock, collapse and cardiac arrest have also been reported. Sensitivity to drug-associated adverse events varies with the individual patient. Dogs that have experienced adverse reactions from one NSAID may experience adverse reactions from another NSAID.

   Patients at greatest risk for adverse events are those that are dehydrated, on concomitant diuretic therapy, or those with existing renal, cardiovascular, and/ or hepatic dysfunction. Plasma levels of deracoxib may increase in a greater than dose- proportional fashion above 8 mg/kg/day. Deracoxib tablets have been safely used during field studies in conjunction with other common medications, including heartworm preventatives, anthelmintics, anesthetics, pre-anesthetic medications, and antibiotics. If additional pain medication is needed after a daily dose of Coxiba Chewable Tablets, a non- NSAID/non-corticosteroid class of analgesic may be necessary. It is not known whether dogs with a history of hypersensitivity to sulfonamide drugs will exhibit hypersensitivity to Coxiba Chewable Tablets. The safe use of deracoxib tablets in dogs younger than…

   The use of concomitantly protein-bound drugs with deracoxib tablets has not been studied in dogs. Commonly used protein-bound drugs include cardiac, anticonvulsant and behavioral medications. The influence of concomitant drugs that may inhibit metabolism of deracoxib tablets has not been evaluated. Drug compatibility should be monitored in patients requiring adjunctive therapy. Consider appropriate washout times when switching from one NSAID to another or when switching from corticosteroid use to NSAID use. - Animal Safety:

   • Change in behavior, such as depression, restlessness, aggression or apprehension • Change in bowel movements such as diarrhea or change in stool color (black, tarry or bloody stool) • Change in drinking or urination • Yellowing of gums, skin or whites of the eyes (jaundice) Can Coxiba Chewable Tablets be given with other medications? Coxiba Chewable Tablets should not be given with other non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids (for example, aspirin, carprofen, etodolac, prednisone). Tell your veterinarian about all medications that you have given your dog in the past, and any medications that you are planning to give with Coxiba Chewable Tablets. This should include any medications that you can get without a prescription and any dietary supplements.…

2. Controlling Pain and Inflammation in Your Dog with NSAIDswww.fda.gov · Jan 6, 2025
   Passage read from this source

   - Never give aspirin or corticosteroids (such as prednisone) along with an NSAID to your dog. - NSAIDs should be used cautiously in dogs with kidney, liver, heart, and digestive problems. - Don’t assume an NSAID for one dog is safe to give to another dog. Always talk to your veterinarian before giving any drug to your dog. - Never give your dog an NSAID unless your veterinarian says to do so and always follow your veterinarian’s directions. Do not give a higher dose, give it more often, or give it for longer than originally prescribed unless you first discuss this with your veterinarian.

3. SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE VETERINARY ...www.vmd.defra.gov.uk
   Passage read from this source

   Gastrointestinal tract ulceration may be exacerbated by corticosteroids in animals given non-steroidal anti-inflammatory drugs. Concomitant treatment with molecules displaying action on renal flow, e.g. diuretics or Angiotensin Converting Enzyme (ACE) inhibitors, should be subject to clinical monitoring. Concurrent administration of potentially nephrotoxic drugs should be avoided as there might be an increased risk of renal toxicity. As anaesthetic drugs may affect renal perfusion, the use of parenteral fluid therapy during surgery should be considered to decrease potential renal complications when using NSAIDs peri- operatively. Concurrent use of other active substances that have a high degree of protein binding may compete with firocoxib for binding and thus lead to toxic effects. 4.9 Amount(s) to be administered and administration route Oral use.

4. PREVICOX® (firocoxib) Chewable Tablets - DailyMeddailymed.nlm.nih.gov
   Passage read from this source

   As a class, cyclooxygenase inhibitory NSAIDs may be associated with renal, gastrointestinal and hepatic toxicity. Sensitivity to drug-associated adverse events varies with the individual patient. Dogs that have experienced adverse reactions from one NSAID may experience adverse reactions from another NSAID. Patients at greatest risk for adverse events are those that are dehydrated, on concomitant diuretic therapy, or those with existing renal, cardiovascular, and/or hepatic dysfunction. Concurrent administration of potentially nephrotoxic drugs should be carefully approached and monitored. NSAIDs may inhibit the prostaglandins that maintain normal homeostatic function. Such anti-prostaglandin effects may result in clinically significant disease in patients with underlying or pre-existing disease that has not been previously diagnosed.

   Since NSAIDS possess the potential to produce gastrointestinal ulceration and/or gastrointestinal perforation, concomitant use of Previcox Chewable Tablets with other anti-inflammatory drugs, such as NSAIDs or corticosteroids, should be avoided. The concomitant use of protein bound drugs with PREVICOX Chewable Tablets has not been studied in dogs. Commonly used protein-bound drugs include cardiac, anticonvulsant, and behavioral medications. The influence of concomitant drugs that may inhibit the metabolism of PREVICOX Chewable Tablets has not been evaluated. Drug compatibility should be monitored in patients requiring adjunctive therapy.

   PREVICOX should not be given with other NSAIDs (for example, aspirin, carprofen, etodolac, deracoxib, meloxicam, or tepoxalin) or corticosteroids (for example, prednisone, cortisone, dexamethasone, or triamcinolone). Tell your veterinarian about all medications that you have given your dog in the past, and any medications you are planning to give with PREVICOX tablets. This should include other medicines that you can get without a prescription or any dietary supplements. Your veterinarian may want to check that all of your dog's medicines can be given together. What do I do in case my dog eats more than the prescribed amount of PREVICOX? Consult your veterinarian immediately if your dog eats more than the prescribed amount of PREVICOX. What else should I know…

5. Dog Owner Information about Chewable Tablets (carprofen)animaldrugsatfda.fda.gov
   Passage read from this source

   frequently reported effects have been gastrointestinal signs. Events involving suspected renal, hematologic, neurologic, dermatologic, and hepatic effects have also been reported. Patients at greatest risk for renal ­toxicity are those that are dehydrated, on concomitant diuretic therapy, or those with renal, cardiovascular, and/or hepatic dysfunction. Concurrent administration of potentially nephrotoxic drugs should be approached cautiously, with appropriate monitoring. Concomitant use of Rimadyl with other anti-inflammatory drugs, such as other NSAIDs or corticosteroids, should be avoided because of the potential increase of adverse reactions, including gastrointestinal ulcerations and/or perforations. Sensitivity to drug-associated adverse reactions varies with the individual patient.

6. Corticosteroid & NSAID Interactionswww.cliniciansbrief.com
   Passage read from this source

   Both corticosteroids and NSAIDs are known to cause adverse effects in dogs and cats. However, some disease conditions may benefit from the combination.