Cerenia for dogs is a great medication for pups who suffer from motion sickness or are nauseous for various reasons. Plus, it has some exciting bonus uses. Integrative veterinarian Dr. Julie Buzby explains what Cerenia is and how it works, provides dosing and administration guidelines, reviews Cerenia’s safety and contraindications and discusses a few alternatives to Cerenia.
Imagine this…it is the middle of the night and your peaceful sleep is suddenly interrupted by the unmistakable sound of your dog retching and vomiting all over your bed.
Or perhaps you’re traveling in the car and, out of nowhere, your dog throws up all over the backseat… and you still have three hours left to drive. As the stench of dog vomit fills your car, you quickly realize your relaxing road trip with your furry buddy just got a lot less enjoyable.
These scenarios—a dog with an upset stomach or a dog vomiting due to motion sickness—are no fun for you or your dog. Thankfully, though, the anti-nausea medication Cerenia can help save the day.
What is Cerenia for dogs?
Cerenia is a medication that is FDA-approved to treat vomiting in dogs and cats and help prevent motion sickness in dogs. To understand how it accomplishes this feat, you first need a crash course on the vomiting center of the brain. As the name implies, activation of the vomiting center leads to vomiting.
Regardless of the exact vomit-inducing stimuli, the vomiting center uses the same process to trigger the dog to vomit. Creating this “vomit signal” involves having the neurotransmitter substance P binding to NK1 receptors in the brain, much like a key fits in a lock.
As you can imagine, stopping substance P from binding to the NK1 receptors would be an effective method of preventing vomiting. And this is exactly what the anti-emetic drug Cerenia does. The active ingredient in Cerenia, maropitant citrate, is an NK1 receptor antagonist (i.e. blocker). It binds to the NK1 receptors to fill the spot where substance P would normally attach. This makes activation of the vomiting center in the central nervous system much more difficult (but not impossible).
What is Cerenia used for in dogs?
Based on that mechanism of action, it makes sense that in veterinary medicine Cerenia’s main uses center around vomiting. However, there are also some other uses for Cerenia that are pretty neat too.
When a dog is already vomiting or has a condition that is likely to lead to vomiting, Cerenia is often one of the first medications a vet will reach for. It frequently makes up a key component of “supportive therapy” (i.e. treatment aimed at keeping a dog more comfortable).
Specifically, Cerenia can aid in the prevention of vomiting due to:
- Kidney failure in dogs and kidney disease in dogs
- Nausea following chemotherapy (as demonstrated by a study looking at the efficacy of injectable maropitant (Cerenia) for prevention and treatment of cisplatin-induced emesis in dogs)
- Dietary indiscretion (i.e. eating something that upset a dog’s stomach)
- Nausea after surgery
- Vestibular disease in dogs
- Nausea after inducing vomiting (such as after a dog ate chocolate or another toxin)
- Cancer in dogs
- Pancreatitis in dogs
Additionally, in healthy dogs, the vet might suggest giving a dog Cerenia before a drive to help prevent carsickness.
Since substance P also plays a role in inflammation, Cerenia has some anti-inflammatory properties. This can be helpful in conditions such as:
- Collapsed trachea in dogs— Cerenia may reduce inflammation in the airways. This can relieve coughing and improve symptoms in dogs with collapsing trachea.
- Chronic rhinitis—Dogs who suffer from chronic rhinitis experience inflammation and irritation in the nasal passages. Cerenia can help reduce some of the inflammation associated with rhinitis.
Due to its anti-inflammatory properties, Cerenia works as a mild pain reliever too. Most veterinarians will not reach for Cerenia as the primary way to manage pain because it is not as strong as other pain medications like non-steroidal anti-inflammatories (NSAIDs) or gabapentin for dogs. However, in a dog who is both nauseous and painful, such as one with pancreatitis or who recently had surgery, the pain relief from Cerenia is a great additional benefit.
Recently, Cerenia also has been found to help with several other diseases:
- Vestibular disease in dogs—The vestibular system is one of the areas of the brain that can send stimuli to the vomiting center. Since dogs with old dog syndrome have abnormalities of the vestibular system, Cerenia can help counteract resulting nausea. Additionally, Cerenia might have anti-anxiety properties as well, which can help reduce the anxiety that some dogs with vestibular disease seem to experience.
- Generalized anxiety—Cerenia is thought to help manage anxiety. While it is not usually a first-line anxiety medication like trazodone for dogs, it could be useful for anxious dogs in some situations.
- Elongated soft palate—Dogs who have an elongated soft palate can be prone to increased gagging. Cerenia may help these dogs by decreasing stimulation of the gag reflex.
- Chronic bronchitis in dogs—Cerenia can act as a cough suppressant in some dogs with chronic bronchitis.
Additionally, there are some veterinarians who believe Cerenia may treat even more conditions (like joint inflammation, skin disease, diarrhea, etc.). However, currently, there is not enough research or a sufficient number of clinical cases to determine whether Cerenia actually works for these diseases or not.
Where do I get Cerenia for dogs?
If your dog has an upset stomach or is suffering from any of the conditions mentioned above, you may be wondering if Cerenia could help your pup. If this is the case, your best first step is a veterinary visit.
The vet will start by performing an exam and possibly running some diagnostics to determine what is going on with your dog. Then, if the vet thinks your dog could benefit from Cerenia, he or she will decide which form of Cerenia—injectable solution, oral tablets, or both—is right for your dog.
Your veterinarian will primarily administer injectable Cerenia in the vet hospital. It tends to be a good choice for cases where the dog will only need a single dose.
Some instances where the vet may recommend a Cerenia injection include:
- Before or after surgery (to reduce nausea from the anesthesia or other medications and decrease pain)
- After inducing vomiting in your dog (usually as part of the treatment for toxin ingestion during an emergency vet visit)
- Minor and acute cases of gastrointestinal upset (i.e. vomiting and diarrhea)
- Dogs who do not take oral medications well
- As treatment for nausea from vestibular disease
- Prior to administering chemotherapy or another drug that is likely to cause nausea or vomiting
If your dog is going to need Cerenia for multiple days in a row (or you are going to keep it on hand for when you travel in the car), your veterinarian will probably recommend Cerenia tablets. Cerenia is available in 16 mg, 24 mg, 60 mg, and 160 mg tablets.
What is the Cerenia dosage for dogs?
Your veterinarian will tell you the proper Cerenia dosage for your dog based on his or her weight. It is important to note that the dose for preventing car sickness is much higher than for treating vomiting. Please ensure you follow your vet’s instructions rather than assuming you know how much you should give your dog based on past situations.
Whether your veterinarian gives your dog an injection of Cerenia or recommends the tablets, Cerenia is only dosed once every 24 hours (once daily).
According to the package label, dogs who are four months old or older can take it for two consecutive days for motion sickness. Dogs with acute vomiting who are between 2 and 7 months old should take Cerenia for no more than five days in a row. In dogs older than 7 months old, the FDA has approved long-term use of Cerenia until symptoms resolve or your veterinarian recommends discontinuing it.
Additional dosing information
In addition to dosage frequency, my clients often ask me, “How long does Cerenia for dogs last?” and “How long does it take to work?” These are great questions and are very important to know any time you give your dog medication.
Cerenia usually takes effect within 1 to 2 hours of administration. (This is the case for both Cerenia forms—tablets and injections.) And once you (or your vet) gives the medication, it usually lasts for about 24 hours.
How do I give Cerenia to my dog?
Your veterinarian will tell you any specific instructions they have regarding Cerenia administration, but some general rules are:
- Do not change the dosage if the Cerenia is not working for your dog. Instead, consult your veterinarian for help and new treatment ideas. This is especially important if your dog is receiving Cerenia for GI upset and continues to vomit. While not always the case, vomiting despite Cerenia may mean your dog has an intestinal obstruction or other serious condition.
- Cerenia is best administered as whole or half pills. However, this can be challenging because it is bitter tasting and can cause dogs to salivate. If you are having trouble getting your dog to take Cerenia, check out my blog Your Dog Won’t Take Pills? 5 Easy Solutions for Uncooperative Pooches (and be sure to read the comments section of that blog for more great tips). Also, please talk to your vet before trying to crush the pills or make them chewable.
- You can give your dog Cerenia with or without food, depending on the reason your dog is taking the medication. It is best to ask your veterinarian about what is ideal for your dog’s specific case.
Instruction for giving Cerenia to prevent car sickness
If giving Cerenia for car sickness, feed your dog a small amount of food three hours before traveling. This will help reduce nausea associated with having an empty stomach. Then, give the Cerenia tablet two hours prior to getting in the car. Do not give your dog more food or feed a large meal before leaving.
Human health warning
I don’t want to neglect to also tell you that you need to use caution when handling Cerenia. Topical exposure may elicit localized allergic skin reactions and repeated or prolonged exposure may lead to skin sensitization. To help prevent this, always wash your hands thoroughly with soap and water after administering your dog’s Cerenia.
Following these guidelines and your veterinarian’s instructions can help keep you and your dog safe and reduce the risk of side effects.
What are the side effects of Cerenia for dogs?
Interestingly, the most common side effects associated with Cerenia for dogs are an upset stomach, vomiting, or increased salivation (i.e. drooling). I know these side effects sound a lot like the reasons a dog may need Cerenia in the first place. But I assure you that they don’t mean Cerenia is ineffective or unsafe.
Many dogs tolerate Cerenia just fine, and side effects tend to be more common when using the higher dosage of Cerenia (i.e. the dose for preventing motion sickness). Also, contacting your veterinarian for a dosage change can usually help decrease those adverse effects.
It is also worth noting that dogs who receive an injection of Cerenia may have minor localized swelling or itching at the site of the injection.
Other adverse reactions that are less common include:
- Decreased appetite
- Being a lethargic dog or having decreased energy
- Allergic reactions
- Muscle tremors
- Uncoordinated walking
If your dog is experiencing side effects or you suspect a Cerenia overdose, stop administering Cerenia to your dog immediately and contact your veterinarian. Once he or she knows about the side effects your dog is experiencing, your vet can advise you on the best plan of action.
The good news is that in many cases, side effects are mild and resolve within 24 hours of stopping the medication. This makes Cerenia a drug that is safe for most dogs when used appropriately.
Which dogs should not get Cerenia?
However, there are still some cases where the veterinarian may avoid giving Cerenia or alter the dose. These include:
- Liver disease in dogs— The liver metabolizes Cerenia, so dogs with liver disease (i.e. poorly functioning livers) cannot break down the medication properly. This can cause the medication to not work and increase the chance of adverse reactions.
- Heart disease in dogs—Veterinarians should use Cerenia with caution in pets with heart disease.
- Gastrointestinal obstruction—If your dog possibly ate something that he or she shouldn’t have, please tell your veterinarian before starting Cerenia. Since Cerenia decreases vomiting, it can mask symptoms associated with stomach or intestinal blockages and decrease GI motility.
- Breeding female dogs—Cerenia has not been evaluated for use in pregnant or nursing dogs. If your dog is pregnant or nursing, please discuss her case with your veterinarian before using Cerenia.
- Young dogs—According to the drug label, dogs less than two months old should not take Cerenia for acute vomiting and dogs less than four months old should not receive Cerenia to prevent carsickness.
- Dogs taking certain medications—Cerenia should be used with caution in dogs who are currently taking non-steroidal anti-inflammatories (NSAIDs), cimetidine, erythromycin, ketoconazole, itraconazole, fluoxetine, phenobarbital, and some heart medications.
If your dog falls into one of these categories, your veterinarian may discuss some alternative options to control your dog’s nausea.
Alternatives to Cerenia
Since it is something my clients ask me about, I wanted to briefly mention some other drugs that have a similar effect to Cerenia. However, your vet is still the best person to consult about your dog’s medication choices.
Cerenia vs Dramamine for dogs
The first alternative I often get asked about is Dramamine®. This makes sense because Dramamine is a common anti-nausea medication that humans use for motion sickness. The biggest difference between Dramamine and Cerenia is that Dramamine is an antihistamine (just like Benadryl for dogs). Therefore, Dramamine can make your dog sleepy.
In my experience, it is also less effective for dogs when compared to Cerenia. Plus, please note that Dramamine is not a good option for upset stomachs or vomiting unrelated to motion sickness.
Cerenia vs Zofran for dogs
Another alternative to Cerenia is ondansetron (Zofran®), which is also an anti-emetic medication. Ondansetron can be more expensive than Cerenia but still has an important place in my medication toolbox. One of the great things about it is that it comes in a dosage form you can dissolve in water. This makes Zofran much easier to give to dogs who are difficult to pill.
Additionally, in dogs with severe cases of persistent vomiting, your veterinarian might recommend using ondansetron and Cerenia together.
Cerenia and Pepcid for dogs
While it is an antacid, Pepcid (i.e. famotidine) does have some anti-nausea effects in certain species, including dogs. More frequently though, your vet will use Pepcid (or a different antacid like omeprazole for dogs) to reduce stomach acid amounts. This can be helpful in cases of acid reflux in dogs.
Plus, the antacid effects of Pepcid can protect the lining of the esophagus from being “burned” by stomach acid when a dog is frequently or chronically vomiting. Thus, there are times when the vet may recommend using Cerenia and Pepcid together. This is generally a safe combination. But like any medication, it is best to consult your vet before giving your dog any new medication.
Cerenia and Pepto-Bismol
While these three medications we just discussed are safe for dogs, I do not recommend using Pepto-Bismol for dogs. It is not a good alternative to Cerenia because it can cause gastric ulcers, may interact negatively with other medications and could turn your dog’s stool black.
Talk with your vet about Cerenia
As we just discussed, there are some other anti-nausea medications available. But I still think Cerenia is a great choice for many of my patients. It works quickly to reduce or prevent nausea and vomiting, only needs to be given once a day, and is safe and effective for most dogs.
If car sickness is putting a damper on your trips or your dog wakes up feeling a bit queasy, give your vet a call. He or she can help you figure out if Cerenia (or something else) is the solution you are looking for. And then you can get back to enjoying life to the fullest with your pup.
Did Cerenia work well for your dog?
Please share your experiences below.