In general, preferred compositions of the present invention contain up to about 5% by weight of a corticosteriod, up to about 60% by weight drying agent, one or more optional ingredients (for example, one or more anti-itch agents; anti-foaming agents; buffers, neutralizing agents, and agents to adjust pH; coloring agents and decoloring agents; emollients; emulsifying agents, emulsion stabilizers and viscosity builders; humectants; odorants; preservatives, antioxidants, and chemical stabilizers; solvents; and thickening, stiffening, and suspending agents), and a balance of water or solvent.
Horses should undergo a thorough history and physical examination by a veterinarian before the initiation of any Surpass therapy. Using more than the recommended amount of Surpass topical cream (for example, by treating multiple joints) has not been tested and is not recommended. Excessive doses to the skin have been shown to enter the bloodstream and this may increase the risk of side effects. Adverse reactions associated with NSAIDs may include: weight loss, colic, diarrhea, or yellowing of the gums, skin, or whites of the eyes (jaundice). Serious adverse reactions associated with this drug class can occur without warning and, in rare situations, result in death. Discontinue the use of Surpass Cream and contact your veterinarian immediately if these signs are observed. The majority of patients with drug-related adverse reactions recover when the signs are recognized, drug administration is stopped, and veterinary care, if appropriate, is initiated.
1 mg/kg IV every 8 to 12 hours for 1 to 5 days has been studied in premature and term neonates (combined n from 3 studies = 89, gestational age 23 to 40 weeks). An initial loading dose of 2 mg/kg IV was used in 1 retrospective study and another prospective, observational study used a higher maintenance dose of 3 to 6 mg/kg/day IV divided 2 to 4 times daily in a small number of patients (n = 5) with severe capillary leak syndrome and/or previous steroid treatment. In the largest prospective, randomized, placebo controlled study (n = 48, gestational age to weeks), patients receiving hydrocortisone 1 mg/kg IV every 8 hours for 5 days required significantly less vasopressor support (lower doses of dopamine and dobutamine, shorter duration of vasopressor therapy, and fewer patients requiring more than 1 vasopressor) compared to patients receiving placebo. The trend of the average mean arterial blood pressure (MAP) was also significantly higher in patients receiving hydrocortisone compared to patients receiving placebo.