Table 4 Drug and patient factors evaluated for inappropriate use of omeprazole and maropitant in dogs.
Drug factors | Considered inappropriate | ||
Omeprazole | Route | IV or PO | No |
Frequency | BID | No | |
Dosage | 1Â mg/kg per dose, with margin of 10% above or below | No | |
Drug interactions | Concurrent administration with azole antifungal | Yes | |
Maropitant | Route | IV or PO | No |
Frequency | SID | No | |
Dosage | 1Â mg/kg per dose if IV or 2Â mg/kg if PO, with margin of 10% above or below | No | |
Patient factors | |||
Omeprazole | Indication | Vomiting if:  Less than 3-week duration  No evidence of haematemesis, melaena, or haemorrhage on endoscopy  No concurrent regurgitation  No evidence of ulceration on imaging | Yes |
Chronic vomiting, or vomiting with regurgitation | No | ||
Regurgitation with risk of oesophagitis | No | ||
Gastro-oesophageal reflux under GA | No | ||
Prophylactic administration before GA if reason to prevent gastro-oesophageal reflux | No | ||
Evidence of gastroduodenal ulceration or erosion (e.g. ulcer observed by endoscopy or imaging, haematemesis, melaena) | No | ||
Symptomatic hepatic disease* | No | ||
IRIS stage 1–3 chronic kidney disease without GI signs | Yes | ||
IRIS stage 1–3 chronic kidney disease with vomiting, regurgitation, or GI bleeding* | No | ||
IRIS stage 4 chronic kidney disease, with or without GI signs* | No | ||
Pancreatitis without evidence of gastroduodenal ulceration | Yes | ||
GI bleeding with thrombocytopenia* | No | ||
Anorexia or decreased appetite | Yes | ||
Administration of glucocorticoids at immunosuppressive dosage without GI signs or evidence of ulceration | Yes | ||
Administration of non-steroidal anti-inflammatory drugs in the absence of GI signs | Yes | ||
Diarrhoea without melaena or occult blood | Yes | ||
Indication not known | Yes | ||
Stated indication ‘continued from referring vet’ | Yes | ||
Signs of nausea | Yes | ||
Maropitant | Indications | Vomiting | No |
Signs of nausea | No | ||
Diarrhoea | Yes | ||
Gastro-oesophageal reflux under GA | Yes | ||
Prophylactic administration before GA if reason to anticipate gastro-oesophageal reflux | Yes | ||
Anorexia/decreased appetite | No | ||
Indication not known | Yes | ||
Stated indication ‘continued from referring vet’ | Yes | ||
Regurgitation in the absence of vomiting | Yes | ||
Pancreatitis in the absence of vomiting, nausea, or decreased appetite | Yes | ||
