Cerenia is a safe and effective medication that can be given at home or in the veterinary hospital to treat vomiting.
Cerenia for Dogs Stops Vomiting and Nausea
Cerenia® (maropitant citrate) is an FDA-approved medication used most to treat vomiting in dogs and cats.
Cerenia comes in tablet form and as an injectable liquid. The injectable liquid form is typically given in the veterinary hospital either intravenously (into the vein) or subcutaneously (under the skin). The tablets can be given at home and come in 16mg, 24mg, 60mg, and 160mg sizes.1
How Cerenia for Dogs Works
Vomiting is caused by many different stimuli (drugs, motion, over-eating, emotional responses, etc.). All these stimuli go to the vomiting center of the brain to stimulate vomiting.
NK-1 receptors are found in the vomiting center of the brain, and when substance P (a neurotransmitter) binds to them, it will stimulate a dog to vomit. Cerenia blocks the NK-1 receptor so that substance P cannot bind to the receptor, thus preventing the dog from vomiting.2
You may sometimes see Cerenia referred to as a neurokinin-1 (NK-1) receptor antagonist for this reason.
Common Uses for Cerenia in Dogs
Cerenia is often used for cancer patients but is routinely used in many other situations. It can be used around the time of surgery, to prevent or treat motion sickness, and for many other conditions that cause vomiting in dogs.
Cerenia for Dog Cancer Patients
Cerenia is considered safe and effective at reducing the amount and severity of vomiting related to chemotherapy.3,5
- Studies have also shown that Cerenia can be effective at treating vomiting for up to 23 hours after chemotherapy with no side effects, making it a safe option for dogs undergoing cancer treatments.4
- Cerenia can be given intravenously (into the vein) or subcutaneously (under the skin) prior to chemotherapy in the veterinary hospital to prevent vomiting at the time of chemotherapy administration.
- The tablet form can also be sent home to be given as needed for nausea and vomiting that is seen in the days following chemotherapy.
Cerenia for Dogs Who Have Motion Sickness
Cerenia is often prescribed to prevent motion sickness in dogs who are four months or older. It is given in tablet form two hours prior to travel. The Cerenia dose for dogs given for car sickness is a significantly higher dose than is used for vomiting.6,7
Cerenia for Dogs Facing Surgery
Cerenia is often used to prevent vomiting before, during, and after surgery.
Opioids, a known to cause vomiting, are commonly given to dogs as part of a pre-anesthetic protocol. Multiple studies have shown that giving Cerenia prior to pre-medicating with opioids reduces the risk of vomiting before anesthesia, which decreases the risk of aspiration and makes the surgery safer.8,9,10
Cerenia has also been shown to reduce the amount of inhalant anesthesia (gas anesthetics) needed for surgical procedures by decreasing the amount of visceral (organ) pain.11
Pain specialist Tasha McNerney explains pain protocols, including the use of Cerenia, on this episode of DOG CANCER ANSWERS.
Cerenia for General Treatment of Vomiting Dogs
Cerenia has been found to be a safe and effective treatment for vomiting due to a wide variety of causes including gastrointestinal disorders, cancer, endocrine disorders, and organ dysfunction. It can be given orally, intravenously, or subcutaneously and is shown to significantly decrease vomiting.12
When Cerenia Should Not Be Used
There are situations when Cerenia is not an appropriate medication.1,13,14
- Do not give to dogs with suspected gastrointestinal tract obstructions.
- Do not give to dogs who have ingested toxic substances.
- Do not give to puppies less than 11 weeks (about 2 and a half months) old, as it may cause problems with bone marrow.
- This medication has not been tested for safety in breeding, pregnant, or lactating dogs.
- Cerenia may compete with or displace highly protein-bound drugs, although there has not been research into drug interactions with these drugs at this point. Examples of highly protein-bound drugs include:
- valproic acid
- oral anticoagulants (rivaroxiban, warfarin)
- sulfonylurea anti-diabetic drugs
- Caution should be used in dogs with severe liver disease. The metabolism of Cerenia may be decreased if it is given with any of the following drugs: cimetidine, fluoxetine, terbinafine, amiodarone, diltiazem, erythromycin, ketoconazole, and/or itraconazole.
- Caution should be used in patients with arrythmias. Cerenia has not been tested in dogs with arrhythmias or on anti-arrhythmic drugs. Caution should be used with patients taking drugs such as: cisapride, domperidone, quinidine, sotalol.
- The U.K. label for maropitant (Cerenia) states that the drug should not be given with calcium channel blockers such as amlodipine, diltiazem, or verapamil.
What If Cerenia Doesn’t Stop a Dog Vomiting?
Because Cerenia works by stopping the neurotransmitters that signal the brain to vomit, it is very effective. If vomiting continues after treatment with Cerenia, your veterinarian will want to conduct further testing to find the cause of the vomiting.
Dr. Nancy Reese helps us understand when vomiting is an emergency that needs a trip to the vet on DOG CANCER ANSWERS.
How to Give Cerenia for Dogs
Cerenia can be given as injectable or subcutaneous injections or as an oral tablet.
For patients in the veterinary hospital for chemotherapy or surgery, the medication can be given via injection (either IV or subcutaneous).
If giving at home, your veterinarian will likely dispense the tablets.
Cerenia Dosing for Dogs
The dosing is dependent on the form it is being given in and the reason for giving the medication, so follow your veterinarian’s instructions.
- Cerenia is given once daily, whether your dog is getting an injection in the hospital or a tablet at home.
- Cerenia for dogs is given for anywhere from 1-28 days, depending on the reason for giving it.
When to Give Cerenia for Dogs
Cerenia can be given at any time of day, and then given at about the same time every day (as directed by your veterinarian).
Given by tablet, Cerenia absorbs best if given at least 1 hour prior to a full meal. Your dog will probably need a treat to take it, but use a small treat, because a large treat may decrease the amount of the drug that can be absorbed in the stomach.13
What If I Miss a Dose of Cerenia?
If a dose is missed, it can be given at any time. Do not double up on doses, just give Cerenia when you remember, and then give at the same time of day from then on.
Storage and Handling
Tablets should be stored at room temperature (68-77° F) with excursions between 59-86° F considered acceptable.
The injectable solution should be stored at or below 86° F, until it is first punctured, after which time it should be refrigerated and stored between 36-46° F. It should be used within 90 days of opening.1
Cerenia Side Effects
Overall, Cerenia is considered to be a very safe drug with side effects considered uncommon. This is not a drug that veterinarians worry about causing problems for dogs in general.
However, side effects can occur with any medication, supplement, or dietary change. For Cerenia, allergic reactions can happen but are rare and should resolve within 48 hours of discontinuing the medication.
Pain at the injection site has been reported in dogs when given subcutaneously. Injections are typically tolerated better if the medication is refrigerated and given immediately after being drawn into the syringe.
Possible side effects include (but happen in less than 5% of dogs):1
- Depression and lethargy
- Ataxia (poor muscle control)
- Dyspnea (labored breathing)
- Collapse/loss of consciousness
Additional Resources to Learn More About Cerenia for Dogs
To learn more about Cerenia, you can visit the Cerenia website at Cerenia | Zoetis Petcare.
- Zoetis. (2022). Cerenia (maropitant citrate) Tablets and Injectable Solution. [US Product Label for Dogs and Cats]. Cerenia-Tablets-and-Injectable-Solution-Combined-Marketing-Package-Insert.pdf (zoetisus.com)
- Brooks W. Maropitant citrate (Cerenia). VETzInsight. Published September 3, 2020. https://www.vin.com/vetzinsight/default.aspx?pid=756&catld=-1&id=4952775
- Vail DM, Rodabaugh HS, Conder GA, Boucher JF, Mathur S. Efficacy of injectable maropitant (Cerenia) in a randomized clinical trial for prevention and treatment of cisplatin-induced emesis in dogs presented as veterinary patients. Vet Comp Oncol. 2007;5(1):38-46. doi:10.1111/j.1476-5829.2006.00123.x
- de la Puente-Redondo VA, Tilt N, Rowan TG, Clemence RG. Efficacy of maropitant for treatment and prevention of emesis caused by intravenous infusion of cisplatin in dogs. American Journal of Veterinary Research. 2007;68(1):48-56. doi:10.2460/ajvr.68.1.48
- Rau SE, Barber LG, Burgess KE. Efficacy of Maropitant in the Prevention of Delayed Vomiting Associated with Administration of Doxorubicin to Dogs. Journal of Veterinary Internal Medicine. 2010;24(6):1452-1457. doi:10.1111/j.1939-1676.2010.0611.x
- Benchaoui HA, Siedek EM, De La Puente-Redondo VA, Tilt N, Rowan TG, Clemence RG. Efficacy of maropitant for preventing vomiting associated with motion sickness in dogs. Veterinary Record. 2007;161(13):444-447. doi:10.1136/vr.161.13.444
- Conder GA, Sedlacek HS, Boucher JF, Clemence RG. Efficacy and safety of maropitant, a selective neurokinin1receptor antagonist, in two randomized clinical trials for prevention of vomiting due to motion sickness in dogs. Journal of Veterinary Pharmacology and Therapeutics. 2008;31(6):528-532. doi:10.1111/j.1365-2885.2008.00990.x
- Hay Kraus BL. Efficacy of orally administered maropitant citrate in preventing vomiting associated with hydromorphone administration in dogs. Journal of the American Veterinary Medical Association. 2014;244(10):1164-1169. doi:10.2460/javma.244.10.1164
- Hay Kraus BL. Efficacy of maropitant in preventing vomiting in dogs premedicated with hydromorphone. Veterinary Anaesthesia and Analgesia. 2013;40(1):28-34. doi:10.1111/j.1467-2995.2012.00788.x
- Johnson RA. Maropitant prevented vomiting but not gastroesophageal reflux in anesthetized dogs premedicated with acepromazine-hydromorphone. Veterinary Anaesthesia and Analgesia. 2014;41(4):406-410. doi:10.1111/vaa.12120
- Alvillar BM, Boscan P, Mama KR, Ferreira TH, Congdon J, Twedt DC. Effect of epidural and intravenous use of the neurokinin-1 (NK-1) receptor antagonist maropitant on the sevoflurane minimum alveolar concentration (MAC) in dogs. Vet Anaesth Analg. 2012;39(2):201-205. doi:10.1111/j.1467-2995.2011.00670.x
- RAMSEY DS, KINCAID K, WATKINS JA, et al. Safety and efficacy of injectable and oral maropitant, a selective neurokinin1receptor antagonist, in a randomized clinical trial for treatment of vomiting in dogs. Journal of Veterinary Pharmacology and Therapeutics. 2008;31(6):538-543. doi:10.1111/j.1365-2885.2008.00992.x
- Plumb, D. C. (2018). Plumb’s veterinary drug handbook. John Wiley & Sons, Inc.
- CERENIA 10 Mg/ML Solution for Injection for Dogs and Cats [UK Datasheet]. Zoetis UK Limited; 2017.
Cerenia® is a registered trademark owned by Zoetis Services, LLC
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