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• Propranolol

  Propranolol (brand names Inderal®, Detensol®, Hemangeol®, Innopran®) is a beta-blocker used off label (extra label) to treat abnormal heart rhythms (arrhythmias) in cats, dogs, ferrets, and horses. It has also been used short-term to treat hypertension caused by thyrotoxicosis or pheochromocytoma. It is given by mouth or injection.

• Pyrantel Pamoate

  Pyrantel pamoate is given by mouth and is used on and off label to treat intestinal parasites in many species. Give as directed. Side effects are uncommon but may include stomach upset, such as vomiting or diarrhea. Do not use in pets that are allergic to it. If a negative reaction occurs, call your veterinarian.

• Pyridostigmine Bromide

  Pyridostigmine bromide is given by mouth or injection and is used off label to treat symptoms related to myasthenia gravis. Give as directed. Dose-related side effects include drooling, diarrhea, increased urination, abdominal pain, muscle cramps, and increased tear production. Do not use in pets that are allergic to it or other bromides, or in pets that have urinary or gastrointestinal tract obstructions or blockages. If a negative reaction occurs, please call your veterinary office.

• Pyrimethamine

  Pyrimethamine is an antiprotozoal tablet given by mouth and used off-label to treat certain parasitic infections. Common side effects include vomiting, low appetite, tiredness, and low blood cell counts. Cats are more likely to have more severe side effects. Pregnant women should handle this medication carefully.

• Ranitidine

  Ranitidine is given by mouth or injection and is used off-label to treat ulcers and erosions in the stomach and upper small intestine, reflux, or gastrointestinal motility issues. Give as directed. Side effects are uncommon but may include stomach upset. Do not use in pets with a history of allergies to this class of drugs. If a negative reaction occurs, call your veterinarian.

• Rifampin

  Rifampin is commonly used off label to treat infections in horses, and occasionally in dogs and cats. It is usually given by mouth in the form of a capsule or compounded liquid. The most common side effects are vomiting, diarrhea, or reduced appetite. Liver dysfunction is possible. A change in the color of urine, tears, and saliva to a red/orange color is expected but may stain fabrics. Use with caution in pets that have pre-existing liver disease, are pregnant, are elderly, or are lactating. If a negative reaction occurs, call your veterinary office.

• Robenacoxib

  Robenacoxib (brand name: Onsior) is given by mouth in the form of a tablet to treat pain and inflammation associated with surgery or other musculoskeletal conditions in dogs and cats. Do not use this medication in pets that are allergic to it, or in pets concurrently using corticosteroids or other NSAIDs. If a negative reaction occurs, call your veterinary office.

• Ronidazole

  Ronidazole is given by mouth and is used off label to treat Tritrichomonas foetus, trichomonas, and giardia in dogs, cats, and birds. It should not be used in farmed animals. Common side effects include vomiting and decreased appetite. Do not use in pets that are allergic to it or other nitroimidazoles such as metronidazole. If a negative reaction occurs, please call your veterinary office.

• S-Adenosyl-Methionine (SAMe)

  SAMe is given by mouth and is used on label and over the counter to treat liver disease and other conditions. Give as directed by your veterinarian. Side effects are uncommon but may include mild stomach upset. Antidepressants, dextromethorphan, meperidine, pentazocine, and tramadol should be used with caution when given with SAMe. Inform your veterinarian of all medications, vitamins, and supplements that your pet is taking. If a negative reaction occurs, please call your veterinary office.

• S-Adenosyl-Methionine (SAMe) + Silybin

  SAMe or S-adenosyl-methionine + Silybin (brand name: Denamarin®) is a combination supplement commonly used to support liver health in cats and dogs. The body uses SAMe for many important functions, such as brain, heart, hormone, antioxidant, detoxifying, and other metabolic functions. The combination of SAMe and Silybin is used to support liver and brain health. This article discusses side effects, interactions, monitoring, and storage.