Thursday, September 5, 2013

Bute vs. Banamine: Banamine, Part II

Banamine is the heavy hitter pain reliever, known for being effective in colic situations -- much more effective than Bute, although no one seems to know why. 

  • Is four times stronger than Bute.
  • Is used in horses for a variety of inflammatory and painful conditions: colic, colitis, exertional rhabdomyolysis ("tying up"), endotoxic shock, respiratory disease, eye injuries and diseases, general surgery, laminitis, and other musculoskeletal disorders.
  • Banamine is more effective than bute for eye inflammation and abdominal pain, and you rarely see it used for those issues.
  • Usually prescribed at 1.1 mg/kg bodyweight, or about 10 cc of the injectable form once per day.
  • Fever reducer
  • Dosage window is much bigger than Bute (Bue is more toxic).
  • Flunixin does affect normal platelet function, but blood clotting failure is not seen with clinical use and administration prior to surgery is safe. 
  • flunixin was twice as efficacious as phenylbutazone in elevating HCT and reducing lameness
  • Banamine appears to have a reduced risk of right dorsal colitis, because unlike bute that's active in the colon, Banamine is absorbed in the small intestine. Doesn't mean it can't do any damage there, it actually prevents the SI from re-sealing for 18 hrs, but it's not showing signs of interfering with the colon healing.
  • Banamine is given to pregnant mares, and significant amounts will not pass through to the milk of lactating mares.  Still – consult your veterinarian before giving pregnant or lactating mares any amount of Banamine.
  • Studies show that when given orally in a paste or powder form, Banamine starts producing effects within two hours with peak periods of relief between 12-16 hours.  The duration is generally 24-36 hours.
    With IV injections, some studies report that the drug is active within 15 minutes. Banamine has been shown to provide relief from colic pain in 15-30 minutes, but may take days to be effective for musculoskeletal pain.
  • Something interesting I found but this is more when using Banamine longterm, it is thought to accumulate in the inflamed tissues, which may well explain its stronger painrelieving effects and in the CNS it interacts with the opioid receptors as would with morphine. ($department/deptdocs.nsf/all/hrs3708)
 Use in colic
 Low dose therapy with flunixin, at one quarter the label dose administered three to four times a day, has anti-endotoxic effects without masking signs of colic pain or causing toxicity. Conversely, extremely high doses of flunixin may mask signs of surgical colic pain and prevent the veterinarian from recognizing the need for surgical intervention. Flunixin does affect normal platelet function, but blood clotting failure is not seen with clinical use and administration prior to surgery is safe.


  1. Also, FYI, injectable banamine can be given orally.

  2. I've had two impaction colics with my OTTB this year due to the wonky weather--vet says if there is more than a 40 degree difference between high and low in a day, horses aren't drinking enough and colic ensues. He made up a "care package" with banamine paste, syringes and Diperone, and a jug of mineral oil, which he said I can top dress on the grain so the food "keeps moving through." Said corn oil doesn't work because horses digest it; mineral oil doesn't get digested.

    My horse doesn't like bute paste (bitter). He got it a lot on the track. After all these years (15 last July 31 ;o) he will let me drench him and I can give Banamine, which is apparently rather tasty.

  3. I have to take issue with folks who adamantly say to not give the horse Banamine IM. There is a very very very small chance your horse will develop necrotizing fasciitis, but people wig out because it *might* happen. For goodness' sake, if your horse is colicking and it needs Banamine and you don't know how to give it IV, give it IM! Let's see... Horse *will* die from colic vs. *might* develop a rare but treatable condition but yay it's alive!

    Why aren't these people freaked out about Ace? It's not that hard to accidentally go through the vein and into the artery and *boom* horse is dead. No horse has ever recovered from that!

  4. Hi All, re: IM injection read

    I have to tell you, my first introduction to this reaction was on facebook, where some idiot posted a horrible graphic photo of what happens to a horse with this reaction. You go to FB and you do it to socialize, not to look at shocking photos of severe tissue damage in a horse. The photo was deeply upsetting to me, and for many days it was hard to erase the image.

    To me, the easiest way to avoid the risk of this reaction is to buy the Banamine paste. Even if the chance of it happening to your horse is small, it is still non-zero, and it's a completely avoidable risk. Get the paste and be done with it. My .02.

  5. Hello Amanda Rose - It is not necrotizing fasciitis that is the concern, really. That describes something different. The issue with injecting Banamine IM is that the drug is caustic enough to damage the muscle tissues. This damage allows for clostridium, an incredibly opportunistic bacteria, to begin growing. It causes massive amounts of inflammation, tissue death and gas production - clostridial myositis. The article that Stacey shared is spot on - it's NOT worth it.

    I think that something that needs to be understood is that colic isn't a death sentence, and Banamine is not going to stop your horse from dying from the cause of the colic. Colic can be mild, and the use of Banamine can get them through that uncomfortable period. But Banamine eases the pain, and it may or may not cover up the signs of colic, but it absolutely will not cure a displacement or a torsion. So from my professional stance, it's not worth it to inject Banamine IM in the face of colic - it's either going to ease the pain enough, or you are going to need to seek more help than Banamine. Either way, clostridial myositis is painful and destructive enough, you don't want to have to treat that, ever. It can be costly to your wallet and it sets owners back a long, long time in their training as the horse recovers. Buy the paste. Also, Acepromazine can be given IM, which is why you don't often hear about people freaking out so much about Ace being given in the artery.

    This is good info, Stacey. The best part of Banamine is its antiendotoxic effects, which is why it is so superior to Bute in the sick horse. I'm glad you mentioned that.:)


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