NSAIDs for Horses: 3 Types of Equine Anti-Inflammatories

Updated Jan. 14, 2025
A veterinarian standing beside a bay horse

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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.

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.

Key Takeaways

  • The three main NSAIDs for horses are flunixin meglumine, phenylbutazone, and firocoxib.
  • Always consult your veterinarian before giving a new medication to your horse.

3 Types of Anti-Inflammatories for Horses

1. Flunixin Meglumine (Banamine)

Banamine is the common name for the medication flunixin meglumine. This FDA-approved NSAID prescription medication is typically used for its anti-fever, anti-inflammatory, and pain relief properties.

Banamine is more suited for internal pain and inflammation associated with colic. 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. If a horse is “blowing through” (appears to be in more pain) after taking Banamine, this is an indicator that the episode may be more severe. In these cases, contact your veterinarian immediately.  

Banamine 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.

2. Phenylbutazone (Bute)

Phenylbutazone, commonly called Bute, is another frequently used equine anti-inflammatory.

Bute is a prescription medication FDA-approved to help treat musculoskeletal pain, used for conditions such as:

Phenylbutazone is available as an injectable, powder, tablet, and paste. Always follow your veterinarian’s instructions for administration, 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 give the paste or powder form for you to have on hand in case of emergencies, because they are the easiest to administer. The injectable form should never be given intramuscularly (IM), for similar reasons as Banamine.

3. Firocoxib (Equioxx)

Firocoxib, or Equioxx, is an FDA-approved prescription medication for horses that helps treat pain and inflammation, and it might be prescribed over phenylbutazone or Banamine for horses who need long-term pain relief, including those with:

  • Arthritis

  • Laminitis

  • Septic joints or fever, specifically among foals (Equioxx is less harsh on their underdeveloped kidneys and intestinal system, which is already prone to ulceration).

Equioxx typically comes in tablet or paste form.

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.

Here’s how to administer your horse’s paste, powder, tablet, liquid, or IV medication:

Paste Medication Administration

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 the horse’s mouth, direct toward the back of the throat, and push the plunger.

Powder Medication Administration

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” to mix into the water or food to cover the flavor.

Tablet Medication Administration

Equioxx comes in a small tablet form, and many horses will eat their daily tablet if it’s mixed in with their food. Because the tablet is so small, however, it can be easily dropped and not ingested.

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.

Liquid Medication Administration

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.

Injectable Medication Administration

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-arterial administration of equine NSAIDs 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.

Potential Problems With Long-Term NSAID Use

NSAIDs can interfere with helpful functions of the kidney and gastrointestinal (GI) systems, which will possibly limit the amount of time your horse is on one of these medications.

For example, horses on long-term NSAIDs may experience ulcers over the course of their anti-inflammatory treatment. In addition to the NSAID, your veterinarian may also prescribe a gastroprotectant such as GastroGardsucralfate, or a supplement such as Purina Outlast, especially if your horse is prone to GI ulcers.

If 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, NSAIDs can provide immense pain relief or provide some daily comfort for an aging or chronically painful horse.

NSAIDs for Horses FAQs

What is the different between Bute and Banamine?

Bute and Banamine are medications with different chemical makeups that have essentially the same effect—pain relief and anti-inflammation.

Can you give two NSAIDs at the same time?

No, it can be very dangerous to give two NSAIDs at once as this can lead to worse and possible life-threatening side effects. These can include severe GI bleeding and renal failure.

What is the best over-the-counter anti-inflammatory?

There are pros and cons to each of the NSAIDs and each one may perform better under certain circumstances.

For example, Equioxx may be better for a horse who needs chronic pain management but might not help a horse who is colicking. Banamine can be very effective for a colic but may cause GI side effects if used long term.

It is important to consult your veterinarian before starting any new medication.


Courtnee Morton, DVM, CVA, CVC

WRITTEN BY

Courtnee Morton, DVM, CVA, CVC

Veterinarian

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


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