Reconcile Chewable Tablets (pack of 30)

4.1 Target species
Dogs
4.2 Indications for use, specifying the target species
As an aid in the treatment of separation-related disorders in dogs manifested by destruction and
inappropriate behaviours (vocalisation and inappropriate defaecation and/or urination) and only in
combination with behavioural modification techniques.
4.3 Contraindications
Do not use in dogs weighing less than 4 kg.
Do not use in dogs with epilepsy or in dogs with a history of seizures.
Do not use in case of hypersensitivity to fluoxetine or other Selective Serotonin Re-Uptake Inhibitors
(SSRIs) or to any of the excipients.
4.4 Special warnings for each target species
None.
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4.5 Special precautions for use
Special precautions for use in animals
The safety of the product has not been established in dogs less than 6 months of age or weighing less than
4 kg.
Though rare, seizures may occur in dogs treated with Reconcile. Treatment should be stopped if seizures
occur.
Special precautions to be taken by the person administering the veterinary medicinal product to
animals
In case of accidental self-ingestion, seek medical advice immediately and show the package leaflet or the
label to the physician. In humans, the most common symptoms associated with overdose include seizures,
somnolence, nausea, tachycardia, and vomiting.
4.6 Adverse reactions (frequency and seriousness)
To minimize the risk of adverse reactions, the recommended dose should not be exceeded.
- Decreased appetite (including anorexia); lethargy (very common).
- Urinary tract disorders (cystitis, urinary incontinence, urinary retention, stranguria); central nervous
system signs (incoordination, disorientation) (common).
- Weight loss/loss of condition; mydriasis (uncommon).
- Panting, seizures, vomiting (rare).
The frequency of adverse reactions is defined using the following convention:
- very common (more than 1 in 10 animals treated displaying adverse reaction(s)
- common (more than 1 but less than 10 animals in 100 animals treated)
- uncommon (more than 1 but less than 10 animals in 1,000 animals treated)
- rare (more than 1 but less than 10 animals in 10,000 animals treated)
- very rare (less than 1 animal in 10,000 animals treated, including isolated reports)
4.7 Use during pregnancy, lactation or lay
The safety of the veterinary medicinal product has not been established during pregnancy and lactation,
thus the use is not recommended during pregnancy and lactation.
Laboratory studies in rats and rabbits have not produced any evidence of a teratogenic, foetotoxic or
maternotoxic effect. No effect on the reproductive capacity in male and female rats was noted.
Do not use in breeding animals.
4.8 Interaction with other medicinal products and other forms of interaction
Reconcile should not be given concomitantly with veterinary medicinal products that lower the seizure
threshold (e.g. phenothiazines such as acepromazine or chlorpromazine).
Do not use the product in conjunction with other serotonergic agents (e.g. sertraline) and monoamine
oxidase inhibitors (MAOIs) [e.g., selegiline hydrochloride (L-deprenyl), amitraz] or tricyclic amines
(TCAs) (e.g. amitriptyline and clomipramine).
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A 6-week washout interval should be observed following discontinuation of therapy with the product
prior to the administration of any veterinary medicinal product that may adversely interact with fluoxetine
or its metabolite, norfluoxetine.
Fluoxetine is largely metabolised by the P-450 enzyme system, although the precise isoform in dogs is
unknown. Therefore, fluoxetine should be used with caution with other veterinary medicinal products.
4.9 Amounts to be administered and administration route
Reconcile should be administered orally at a once daily dose of 1 to 2 mg/kg bodyweight according to
the dosage table below:
Bodyweight (kg) Tablet strength (mg) Number of tablets
per day
4 - 8 Reconcile 8mg tablet 1
> 8 - 16 Reconcile 16mg tablet 1
> 16 - 32 Reconcile 32mg tablet 1
> 32 - 64 Reconcile 64mg tablet 1
Clinical improvement with the product is expected within 1 to 2 weeks. If no improvement is noted
within 4 weeks, case management should be re-evaluated. Clinical studies have shown that a beneficial
response has been demonstrated for up to 8 weeks treatment with fluoxetine.
Reconcile tablets may be given with or without food. The tablets are flavoured and most dogs will
consume the tablet when offered by the owner.
If a dose is missed, the next scheduled dose should be administered as prescribed. At the end of
treatment it is not necessary to taper or reduce doses because of the long half-life of this veterinary
medicinal product.
4.10 Overdose (symptoms, emergency procedures, antidotes), if necessary
At doses in excess of the recommended dose, observed side effects at the therapeutic dose, including
seizures, are exacerbated. In addition, aggressive behaviour was observed. In clinical studies these side
effects were stopped immediately upon intravenous administration of a standard dose of diazepam.
4.11 Withdrawal period(s)
Not applicable.
5. PHARMACOLOGICAL PROPERTIES
Pharmacotherapeutic group: selective serotonin reuptake inhibitors (SSRI)
ATCvet code: QNO6ABO3
5.1 Pharmacodynamic properties
Fluoxetine and its active metabolite nor-fluoxetine have been shown to be highly selective inhibitors of
serotonin uptake both in vitro and in vivo. Fluoxetine does not act as a sedative. Fluoxetine inhibits
catecholamine uptake only at high concentrations in vitro and has no effect on catecholamine uptake in
vivo at doses that are used to inhibit serotonin uptake. As a result of inhibiting serotonin uptake,
fluoxetine enhances serotonergic neurotransmission and produces functional effects resulting from
increased activation of serotonin receptors. Fluoxetine lacks any significant affinity for neurotransmitter
receptors, including the muscarinic cholinergic receptor, adrenergic receptors, or histaminergic H1
receptors, and does not have direct effects on the heart.
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5.2 Pharmacokinetic particulars
Fluoxetine is well absorbed after oral administration (approximately72%) and the absorption is not
affected by feeding. Fluoxetine is metabolised to norfluoxetine, an equipotent SSRI that contributes to
the efficacy of the veterinary medicinal product.
In a 21 day study, fluoxetine was administered daily at a dose of 0.75, 1.5 and 3.0 mg/kg body weight to
laboratory Beagles. The maximum plasma concentration (Cmax) and area under the plasma concentration
time curve (AUC) for fluoxetine were approximately dose proportional between 0.75 and 1.5 mg/kg,
with a greater than dose proportional increase at 3 mg/kg. After administration, fluoxetine readily
appeared in plasma with mean Tmax values ranging from 1.25 to 1.75 hours on day 1 and from 2.5 to 2.75
hours on day 21. Plasma levels readily declined with mean t values ranging from 4.6 to 5.7 hours on
day 1 and from 5.1 to 10.1 hours on day 21. Norfluoxetine plasma levels slowly appeared in plasma and
were slowly eliminated with t values ranging from 44.2 to 48.9 hours on day 21. Norfluoxetine Cmax
and AUC were generally dose proportional but these values were 3 to 4 fold higher on day 21 than on
day 1.
Accumulation of fluoxetine and norfluoxetine occurred following multiple doses until reaching a steadystate within approximately 10 days. Following the last dose administration, fluoxetine and norfluoxetine
plasma levels declined steadily in a log-linear fashion. Elimination studies in dogs have shown that
29.8% and 44% of the dose were excreted in urine and faeces, respectively by 14 days following dosing.
6. PHARMACEUTICAL PARTICULARS
6.1 List of excipients
Microcrystalline cellulose
Sucrose (as compressible sugar )
Crospovidone
Artificial beef flavour
Silica, colloidal anhydrous
Calcium hydrogen phosphate dihydrate
Magnesium stearate
6.2 Major incompatibilities
Not applicable.
6.3 Shelf life
Shelf life of the veterinary medicinal product as packaged for sale: 2 years.
Shelf life after first opening the immediate packaging: 30 days.
Discard any tablets remaining in the container after the shelf life has expired.
6.4. Special precautions for storage
Do not store above 30 C.
Store in the original container. Keep the bottle tightly closed in order to protect from moisture.
Do not remove the desiccant.
6.5 Nature and composition of immediate packaging
White high density polyethylene (HDPE) bottle with a child resistant closure, cotton coil and a desiccant
pack.
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Each bottle contains 30 tablets.
Pack size of one bottle.
Not all pack sizes may be marketed.
6.6 Special precautions for the disposal of unused veterinary medicinal product or waste
materials derived from the use of such products
Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal
product should be disposed of in accordance with local requirements