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<p>There are three Metacam products authorised for use in cats in the UK:</p><p> </p><p>-
Metacam 5 mg/ml solution for injection for dogs and cats</p><p>- Metacam 2mg/ml solution
for injection for cats</p><p>- Metacam 0.5 mg/ml oral suspension for cats and guinea
pigs</p><p> </p><p>All three products already include warnings relating to renal failure
and therefore veterinary surgeons in the UK are aware of the risk of renal failure
with the use of Metacam in cats.</p><p> </p><p>In 2019, the marketing authorisation
holder for Metacam was requested to provide an analysis of all cases of renal failure
and death in cats. The company provided data comparing the use of the product and
the frequency of cases in the United States (US) with those in the EU. This demonstrated
a significantly higher incidence of off-label use (use of the product not in accordance
with the product information), renal failure and fatalities in the US compared with
the EU. Vets are allowed to use veterinary medicinal products off-label in certain
circumstances. However, the Metacam data does not indicate that the incidence of such
use is as prevalent in the EU or the UK as in the US. It was concluded that vets in
the EU and UK were already aware of the risks of renal failure with off-label use
and the product information included sufficient warnings relating to the correct use
and associated risks. The company was requested to continue specifically to monitor
cases of renal failure in cats.</p><p> </p><p>Based on a review of the data over the
past 10 years, the incidence of renal failure in the UK following use of Metacam in
cats has gradually decreased from one in 200,000 to one in a million, supporting the
view that vets are now even more aware of the risks associated with off-label use.</p><p>
</p><p>The Veterinary Medicines Directorate will continue to consider the scientific
evidence to inform further action as required and the consistency of product information
and warnings for all meloxicam products.</p>
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