Patient Counseling Services: Potassium Bromide Oral Solution (Veterinary)

Veterinary Use Only

Ingredients

Potassium Bromide solution contains potassium bromide powder, distilled water and flavouring.  Standard flavour is beef, but if your dog does not enjoy this taste we can change it to another flavor such as chicken, salmon, or cheese.

Common Uses of this Medication

It is used in animals as an anticonvulsant for seizure control.  It is considered to be a safe and effective medication for dogs with epilepsy.

Usage Instructions

Potassium bromide is to be given as directed by your veterinarian.  If refrigerated, the solution is good for 30 days from the day it is made and must be shaken well before use.  If you miss a series of doses your dog will most likely be okay due to the long half-life of the medication, but you may want to contact the veterinarian to advise him/her of the missed doses and ask if an increase in the dose for a few days might be required.

Dosing

This medication has a 24 day half-life and it may take three to four months before seizure control occurs.  This lengthy time line can be decreased by the administration of a loading dose.  A loading dose is a high dose of medication given for a period of time in order to achieve optimal levels of medication in the dog’s system.  Dogs that receive a loading dose are more likely to experience side effects, especially during those first five days.

We dispense this liquid medication in various sizes of amber coloured bottles with either an Adapta-cap or a ‘Stay-Safe’ closure along with an oral syringe for easy and accurate dosing.  The Adapta-cap screws onto the medication container and allows the dose to be accurately drawn up into the syringe without the risk of spilling.   The Adapta-cap remains on the bottle but can be transferred to any new medication bottles once the prescription is refilled.

Monitoring Levels

In order for Potassium Bromide to be effective a certain level of medication in the blood stream must be obtained.  Blood testing, which may be done by the veterinarian, helps to monitor this level.  This will help the veterinarian to adjust the dosage of Potassium Bromide.   Blood tests can also be used to monitor potassium levels.  If your dog receives a loading dose, the levels should be checked after one week and then again in one month.  If these two values are not similar, the veterinarian may change the maintenance dose.  If your dog does not receive a loading dose a blood test will be done after one month and then approximately every six months.

Precautions

Give only as directed by your veterinarian.  It is important to consult with your veterinarian if your dog is experiencing any side effects before discontinuing the medication.  You should also discuss any changes to your dogs’ diet with the veterinarian, as this may alter the effect of the potassium bromide.

Side Effects

Common side effects of potassium bromide include excessive hunger, thirst, urination, tiredness and loss of coordination.  Initial therapy may cause sedation and depression, which usually stops with continued use.  Potassium bromide may cause stomach upset, nausea and vomiting.  If your dog is experiencing this, you may try giving the solution with food or in two doses.

More severe side effects of potassium bromide are pancreatitis and decreased kidney function which can possibly be recognized by decreased frequency of urination but normal intake of water.  It is important to remember that these effects are much less common.

Drug Interactions

As explained later, salt consumption causes a decreased level of potassium bromide and may result in an increased number of seizures.  Other drugs that decrease the effect of potassium bromide are diuretics.  Food preservatives such as Ethoxyquin, BHT, and BHA can also result in seizures, as a result of interactions with Potassium Bromide.

Storage

Potassium bromide suspension must be stored in the refrigerator and expires after 30 days.   After the expiry date, the Potassium Bromide degrades such that the product becomes ineffective for seizure control.

Additional Information About Seizures and Potassium Bromide

What is a seizure?

A seizure is caused by a neurological dysfunction in the brain.  The disorder can be inherited or caused by other medical conditions such as low blood sugar, brain tumors, low thyroid, and brain infections.

Nervousness, wandering, increased saliva, and whining may identify the start of a seizure.  Once the seizure begins, the dog may lose consciousness, begin drooling and thrashing around, and lose control of bladder function.  Sometimes the dog will show mood or behavior changes during the days before a seizure occurs.

What should I do if my dog is having a seizure?

It is important to let the seizure take its course and move any objects out of the way that may harm the dog.  The dog will be disoriented after the seizure and require a great deal of rest and may be very thirsty, thus food and water should be made available.   This disorientation can last from minutes to days.

What is Potassium bromide?

Potassium bromide is a combination of bromide salt and potassium salt.  It has been used since the late 1800’s as a sedative and anticonvulsant.  In dogs, the half-life of potassium bromide is 24 days.  Thus, it takes about 3 – 4 months to determine if anticonvulsant properties of the drug are being maintained.

What is the difference between potassium bromide and sodium bromide?

Potassium bromide and sodium bromide are equally effective in preventing seizures.  The potassium salt may be used if the dog is on a restricted sodium diet.   The sodium salt is used if the dog is on a restricted potassium diet.

Why must I notify the veterinarian prior to switching my dogs’ food?

Different brands of food contain varying amounts of salt.  Salt will affect the levels of bromide in the system.  If salt intake is suddenly increased, the medication will be eliminated faster, thus causing a decreased and less effective concentration of potassium bromide in the dogs’ system.  If it is necessary to switch foods, inform the veterinarian if the chloride level has changed so that the dose can be adjusted if needed.

If potassium bromide does not work are there other medications that I can use?

A variety of other medications are used in the treatment of canine epilepsy.  These include Phenobarbital, Valium, Primadone, and potentially Gabapentin.  Phenobarbital is often the drug of choice for canine epilepsy, but if the dog continues to have seizures or experiences side effects, potassium bromide may replace it or be used in combination.  Phenobarbital also has a long half-life, is relatively cheap, and has limited toxicity.  Although unlike potassium bromide it is able to cause liver toxicity.  If Potassium Bromide is added to Phenobarbital to increase the seizure threshold, the Phenobarbital dose will be decreased by 30-50%.

 If you have any concerns or additional questions about this product and its use, contact us in person or call (403) 320-6500 and ask to speak to a pharmacist.

 

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