3 Types of NSAIDs for Horses

Courtnee Morton, DVM
By Courtnee Morton, DVM on Dec. 5, 2022

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NSAIDs (non-steroidal anti-inflammatories) in horses are one category of medication your veterinarian may find necessary for you to have on hand in case of emergencies or possible incidents. These NSAIDs work by inhibiting certain enzymes that play a role in feeling pain in the presence of inflammation or infection.

Reducing the action of some of these enzymes is the main goal of NSAIDs to stop or decrease the pain pathway; however, they can also inhibit helpful functions of the kidney and gastrointestinal systems. Since helpful functions can be interfered with, this will possibly limit the amount of time your horse is on one of these anti-inflammatories. Your veterinarian may also prescribe an addition medication gastroprotectant such as GastroGard, Sucralfate, or a supplement such as Purina Outlast, especially if your horse is prone to GI ulcers, during the course of their anti-inflammatory treatment.

Flunixin Meglumine (Banamine®)

Banamine is the common name for the medication flunixin meglumine. This NSAID is typically used for its antipyretic (anti-fever), anti-inflammatory, and pain relief properties. Banamine is more suited for visceral (internal) pain in horses such as colic rather than musculoskeletal pain. This is a medication commonly prescribed by veterinarians for horse owners to keep on hand in case of emergency.

In the situation that your horse is showing signs of colic, it may be an hour or more before your mobile equine veterinarian can make it to you, or for you to load your horse in a trailer and get to the clinic; in this time, Banamine can start working to try to make your horse more comfortable.

Banamine typically comes in injectable or paste form. You should always follow your veterinarian’s instructions for dosing. A horse “blowing through” Banamine after it should be working, or appears to be in more painful after administration is an indicator that this episode may be more severe, contact your veterinarian immediately.  

This medication should not be given intramuscularly (IM), even though some of the bottles might have these instructions listed; it can cause tissue damage and muscle necrosis (death), and severe bacterial infections such as clostridial myositis. The paste form of this medication typically has a weight dial on the size for proper administration amount.

Phenylbutazone (Bute)

Phenylbutazone, commonly called “Bute,” is another commonly used NSAID in horses. Bute is recommended for musculoskeletal pain, reserved for conditions such as:

Phenylbutazone is available as an injectable, powder, tablet, and paste. Administration should always follow your veterinarian’s instructions, as the potential dose can range widely depending on the size of your horse and the condition it is being used for. Veterinarians will often leave the paste or powder form to have on hand in case of emergencies, since they are the easiest to administer. The injectable form should never be given intramuscularly (IM), for similar reasons as Banamine.

Firocoxib (Equioxx®)

Firocoxib, or Equioxx, is the third most used NSAID in horses. It is more selective medication in what it limits, which makes it less likely to cause some of the potential negative side effects of the above NSAIDs. Equioxx might be prescribed over Phenylbutazone or Banamine for horses who need long-term pain relief, including those with:

  • Arthritis

  • Difficult to manage laminitis

  • Foals with septic joints or fever; it is less harsh on their underdeveloped kidneys and intestinal system, which is already prone to ulceration

Equioxx typically comes in tablet or paste form; there is also a generic form available on the market.

How to Administer NSAIDs to Horses

At home, horse owners will usually administer NSAIDs orally. It is important to never give or start your horse on a new drug or change their daily medication regimen without discussing it with your veterinarian first. Depending on the formulation, there are options when it comes to administering these NSAIDs to your horse:

Paste Medication

These medications can be given like a dewormer. After ensuring the medication dial is set to dispense the appropriate amount, place the tip of the syringe into horse’s mouth, direct towards the back of the throat, and push the plunger.

Powder Medication

Powdered medication is often mixed into a horse’s daily grain. Sometimes adding a small amount of water to the grain can help the powder adhere better, rather than falling to the bottom of the feed bucket.

If your horse is a picky eater, the powder can be mixed into a small amount of applesauce or mixed with water to become a paste and be syringed orally. Other options include adding a small amount of syrup or other “sweetener” (sugar free for metabolic horses) to mix into the water or food to cover the flavor.

Tablet Medication

Equioxx comes in a small tablet form, and many horses will eat their daily tablet if it’s mixed in with their food. Because it is so small however–it can be easily dropped. A good way to ensure your horse gets their daily dose is by hand feeding the tablet in a small amount of grain before the rest of their meal is given.

If the tablet is bigger or your horse requires multiple pills, depending on the medication, it may be able to be crushed and given like a powder medication. Ask your veterinarian before crushing any medication for your horse, as some antibiotics and other meds can either be harmful to you or lose their effectiveness if they are broken down before being given.

There are also several pill treats available on the market; you can easily hide your horse’s medication in a treat and feed it, which ensures your horse has ingested their tablet.

Injectable Medication

As is the case with Banamine, keeping a liquid form in the barn is often more cost-effective than a paste alternative. For an average-sized horse, a 100 ml bottle is ten full doses, whereas the paste tubes typically hold three, for a higher price. This may be more economical if you have multiple horses.

Liquids are pulled out of the bottle using a syringe and needle to the appropriate prescribed amount. After the medication is drawn up, cap and remove the needle from the syringe. Ensure you are following your state’s laws on appropriate needle disposal. Then, administer orally like the paste.

Intravenous injections should only be performed by veterinarians or under their direct supervision by trained professionals. The artery and vein in the horse’s neck lay directly on top of each other; accidental intra-artery administration of these medications will cause an immediate seizure. Your horse may flip over backward, seize uncontrollably, and there is great potential for trauma to the neck and limbs. These episodes often only last a few minutes, but the risk of more permanent damage is high.

If you feel your horse may be experiencing a painful condition, call your veterinarian right away. Never start your horse on a medication without their guidance, as NSAIDs can be detrimental in some conditions. When used appropriately, these medications can provide immense pain relief or provide some daily comfort for an aging horse.

Featured Image: iStock.com/Group4 Studio

Courtnee Morton, DVM


Courtnee Morton, DVM


Dr. Courtnee Morton is a 2017 Ross University School of Veterinary Medicine graduate. Since graduation, she completed an equine internship...

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