Credelio (Iotilaner) for Cats

Description

Cats are born explorers, sneaking their way into anything and everything. Owners might not even realize how often their “indoor” cat ventures out on the patio or escapes into the yard. The first and only oral flea and tick product for cats, Credelio Cat was specifically designed to meet cats’ flea and tick protection needs in a form previously unavailable in the United States.

When a cat presents to your clinic with itchy skin, hair loss or small,  crusted bumps, fleas are a likely culprit — even if you don’t see the fleas. In fact, both fleas and ticks are difficult to detect in cats.

• Infrequent veterinarian visits and challenges of examining a cat
• Cats groom off the fleas and ticks they can reach
• Cats’ reactions to fleas and ticks may seem like typical cat behavior (i.e., increased grooming)
• Ticks only spend a few days out of the year on the cat
• Fleas and immature tick stages are difficult to see

Because fleas can resemble many other skin conditions, flea control should be one of the first steps for any cat that presents with hair loss from excessive grooming or rubbing, miliary dermatitis, eosinophilic granuloma complex or itching and rubbing around the head and neck.

Uniquely Designed with Cats in Mind

Many cat parasiticides have been formulated with less thought given to the specific needs of cats.

Credelio Cat development focused on cats’ needs for:

• Lasting flea and tick control
• Easy oral administration
• Appealing smell and flavor

Credelio Cat kills fleas before they can lay eggs, preventing further infestation after the start of treatment. It maintains fast-acting and sustained flea efficacy throughout the entire month — no drop-off. Credelio Cat is approved for the treatment and prevention of flea infestations in cats 8 weeks and older weighing 2.0 pounds or more.

Indications

CREDELIO CAT kills adult fleas and is indicated for the treatment and prevention of flea infestations (Ctenocephalides felis) for one month in cats and kittens 8 weeks of age and older, and weighing 2.0 pounds or greater. CREDELIO CAT is also indicated for the treatment and control of Ixodes scapularis (black-legged tick) infestations for one month in cats and kittens 6 months of age and older, and weighing 2.0 pounds or greater.

Dosage and Administration

CREDELIO CAT is given orally once a month, at the minimum dosage of 2.7 mg/lb (6 mg/kg).

Dosage Schedule

CREDELIO CAT must be administered with food (see Clinical Pharmacology).

Treatment with CREDELIO CAT can begin at any time of the year and can continue year-round without interruption.

Contraindications

There are no known contraindications for the use of CREDELIO CAT.

Warnings

Not for human use. Keep this and all drugs out of the reach of children. Keep CREDELIO CAT in a secure location out of reach of dogs, cats, and other animals to prevent accidental ingestion or overdose.

Precautions

Lotilaner is a member of the isoxazoline class. This class has been associated with neurologic adverse reactions including tremors, ataxia, and seizures. Neurologic adverse reactions have been reported in cats receiving isoxazoline class drugs, even in cats without a history of neurologic disorders. Use with caution in cats with a history of neurologic disorders. The safety of CREDELIO CAT has not been established in breeding, pregnant and lactating cats (see Foreign Market Experience). The effectiveness of CREDELIO CAT against Ixodes scapularis in kittens less than 6 months of age has not been evaluated.

Adverse Reactions

In a well-controlled U.S. field study, which included 341 cats (228 cats treated with CREDELIO CAT and 113 cats treated with a topical active control), there were no serious adverse reactions. Cats with Adverse Reactions in the Field Study*. Two geriatric cats developed mildly elevated blood urea nitrogen (BUN) (42 to 58 mg/dL; reference range: 14 to 36 mg/dL) during the study. One of these cats, which had suspected pre-existing kidney disease, also developed a mildly elevated serum creatinine (2.5 mg/dL; reference range: 0.6 to 2.4 mg/dL) during the study. Foreign Market Experience: The following adverse events were reported voluntarily during post-approval use of the product in cats in foreign markets: hyperactivity, pruritus, tachypnea, dyspnea, lethargy, vomiting, anorexia, hyperthermia, hypersalivation, tachycardia, mydriasis, tremors, ataxia, seizures, hepatopathy, anaphylactic reactions resulting in death, pancreatitis, immune mediated hemolytic anemia, and glomerulopathy. Five 3- to 4-week-old nursing kittens (one litter of 2 kittens and one litter of 3) died within three days of the queens receiving CREDELIO CAT. Two pregnant cats spontaneously aborted or had fetal and perinatal deaths within a few days of receiving CREDELIO CAT. To report suspected adverse events, for technical assistance or to obtain a copy of the Safety Data Sheet (SDS), contact Elanco US, Inc. at 1-888-545-5973. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS or http://www.fda.gov/reportanimalae.

Clinical Pharmacology

Following oral administration of 26 mg/kg (the maximum labeled dose), peak lotilaner concentrations were achieved in most cats at the 24-hour sampling point. Cats 3 months of age had a shorter elimination half-life (average of 7.5 days) than at 7 months of age (average of 32 days). Due to reduced drug bioavailability in the fasted state, CREDELIO CAT must be administered with a meal or within 30 minutes after feeding.

Mode of Action

Lotilaner is an ectoparasiticide belonging to the isoxazoline group. Lotilaner inhibits insect and acarine gamma-aminobutyric acid (GABA)-gated chloride channels. This inhibition blocks the transfer of chloride ions across cell membranes, which results in uncontrolled neuromuscular activity leading to death of insects and acarines. The selective toxicity of lotilaner between insects and acarines and mammals may be inferred by the differential sensitivity of the insects and acarines’ GABA receptors versus mammalian GABA receptors.

Effectiveness

In a well-controlled laboratory study, CREDELIO CAT began to kill fleas six hours after administration, with greater than 98% of fleas killed within 12 hours after administration. In another well-controlled laboratory study, CREDELIO CAT demonstrated 100% effectiveness against adult fleas 24 hours after administration or infestation for 35 days. In a 90-day well-controlled U.S. field study conducted in cats with existing flea infestations of varying severity, the effectiveness of CREDELIO CAT against fleas on Days 30, 60 and 90 compared to baseline was 98.5%,100% and 100%, respectively. Cats with signs of flea allergy dermatitis showed improvement in erythema, papules, scaling, alopecia, dermatitis/pyodermatitis, and pruritus as a direct result of eliminating fleas. In a well-controlled laboratory study, CREDELIO CAT killed fleas before they could lay eggs, thus preventing subsequent flea infestations after the start of treatment of existing flea infestations for 30 days. In well-controlled laboratory studies, CREDELIO CAT demonstrated >97% effectiveness against Ixodes scapularis ticks 72 hours after administration or infestation for 31 days.

Palatability

In the U.S. field study, which included 648 doses administered to 225 cats, 21.1% of the doses were voluntarily consumed when CREDELIO CAT was offered by hand, on the floor, or in an empty bowl, an additional 25.8% of doses were voluntarily consumed when CREDELIO CAT was offered with food, and 52.6% of doses required placement of the chewable tablet in the back of the cat’s mouth. Owners were unable to administer CREDELIO CAT for 0.5% of doses.

Animal Safety

In a margin of safety study, CREDELIO CAT was administered orally to 24 (8 cats/group) 8-week-old cats at 1, 3 and 5X the maximum labeled dose of 26 mg/kg every 28 days for eight consecutive doses. The 8 cats in the control group (0X) were untreated.

There were no clinically-relevant, treatment-related effects on physical and neurologic examinations or gross pathology. Dry food consumption was reduced in male cats in all treated groups compared to control cats. Body weights of male cats in the 3X group were less than the control male cats. Vomiting occurred post-dosing in cats in all groups, including the control group, but was increased in the 5X group. At multiple time points, neutrophil counts were decreased (750-2710/μL; low end of normal: approximately 2800/μL) in cats in all treated groups compared to control cats, including in a cat in the 3X group that died during anesthesia to obtain the electrocardiogram (ECG). From Days 28 to 92, two and three female cats in the 3X and 5X group, respectively, had elevations in blood urea nitrogen (BUN) at least at one time point (37-43 mg/dL; high end of normal: 36 mg/dL). Three cats each in the control, 1X and 5X groups and six cats in the 3X group had minimal, usually unilateral, tubular regeneration of the kidneys. One cat each in the control, 1X and 5X groups and four cats in the 3X group had minimal generalized lymphoid depletion of the thymus. Four of the five cats in the two high-dose groups (3X and 5X) with the thymus changes also had neutropenia at 25% or more of the time points. Blood concentrations of lotilaner confirmed systemic exposure in all cats administered lotilaner, although the exposure was less than dose proportional.

Storage Information

Store at 15-25°C (59 -77°F), excursions permitted between 5 to 40°C (41 to 104°F).

How Supplied

CREDELIO CAT is available in two chewable tablet sizes for use in cats: 12 and 48 mg lotilaner. Each chewable tablet size is available in color-coded packages containing 1 chewable tablet. The 48 mg chewable tablet size is also available in color-coded packages containing 3 or 6 chewable tablets.