Maropitant: veterinary dose and monograph

At a glance

Drug class

Antiemetic

Also known as

Cerenia

Species with doses

Dogs, Cats, Sugar gliders and Primates

General dose range

1–2 mg/kg SC q24h — check the species tables for the indication

Routes

SC, PO

Last reviewed

1 October 2026

Indications

• Acute vomiting — prevention and treatment (dogs)
• Motion-sickness vomiting prophylaxis (dogs, oral)
• Chemotherapy-induced vomiting (cisplatin, doxorubicin)
• Extra-label antiemetic in cats (well tolerated in published case series)
• Visceral analgesic / sevoflurane MAC reduction (research use)

Maropitant dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Acute vomiting — prevention or treatment: Papich 5e and Plumb’s p.758 (Cerenia label): 1 mg/kg SC (or IV, Papich) once daily for up to 5 consecutive days (dogs 2–7 months); for prevention give at least 1 h before the emetogenic event. A 48-h washout is recommended before a further course. Refrigerating the injection reduces sting.
• Acute vomiting — oral: Papich 5e and Plumb’s p.758 (label): 2 mg/kg PO once daily for up to 5 days, given at least 2 h before an anticipated emetogenic event. Opioid-induced vomiting: 2–4 mg/kg PO before anaesthesia (Papich).
• Motion sickness prophylaxis: Papich 5e and Plumb’s p.758 (label): 8 mg/kg (minimum) PO at least 2 h before travel, once daily for up to 2 consecutive days; a 72-h washout is recommended before repeating.

Cats

• Acute vomiting (extra-label): Papich 5e: 1 mg/kg once daily IV, SC or PO for all causes of vomiting; before highly emetic drugs give at least 2–2.5 h beforehand. Plumb’s p.758: 1 mg/kg SC or PO (Richter); 0.5–1 mg/kg SC once daily for up to 5 days (Marks).
• Acute vomiting (oral, extra-label): Plumb’s p.758 (Richter 2009; Marks 2008): 0.5–1 mg/kg once daily for up to 5 days. Papich 5e: 1 mg/kg PO once daily; CKD-associated nausea 4 mg per cat per day PO; pre-anaesthetic 8 mg per cat PO 18 h before.

Sugar gliders

• Antiemetic: Carpenter Exotic Animal Formulary 6th ed, Table 7-5 (p.501): sugar gliders 0.2 mg/kg SC q24h. Chilling the injection may reduce SC injection-site discomfort.

Primates

• Antiemetic (macaques, siamangs): Carpenter Exotic Animal Formulary 6th ed, Table 13-7 (p.709): macaques/siamangs 1 mg/kg SC or IV for reduction of emesis.

Contraindications

Use cautiously in puppies <16 weeks (label) — bone marrow hypoplasia seen in <11-week-old puppies on toxicology studies. Use cautiously in dogs with hepatic dysfunction (hepatically metabolised). Highly protein-bound (>99%) — caution with other highly protein-bound drugs. Pregnancy / lactation: safety not established — risk-benefit assessment only. SC injection causes pain — refrigerate vial before drawing for SC use.

Species-specific warnings

Dogs: Standard first-line anti-emetic. CAUTION in dogs ≤8 weeks (US) / ≤16 weeks (EU) — bone marrow hypoplasia at high chronic doses.

Cats: Extra-label in many regions but widely used at 1 mg/kg SC q24h. Refrigerate vial to reduce stinging.

Horses: Used extra-label for nausea-related anorexia at 1 mg/kg IV q24h — limited published data.

Birds: Extra-label use reported in raptors / psittacines for opioid-induced nausea at 1–2 mg/kg IM/PO q24h.

Adverse effects

• Pain or swelling at SC injection site (improved by chilling solution)
• Hypersalivation and pre-travel vomiting at the high motion-sickness oral dose
• Diarrhoea (~4–8% of treated dogs)
• Anorexia (~1.5–5%)
• Cats: localised injection-site reactions; otherwise well tolerated

Drug interactions

• CYP3A4 substrates / inhibitors (ketoconazole, erythromycin, cyclosporine): may alter maropitant metabolism — limited clinical impact at label doses
• Calcium channel blockers (amlodipine, diltiazem): theoretical CYP3A4 interaction
• Other anti-emetics (ondansetron, metoclopramide): synergistic — used together for refractory vomiting
• NSAIDs / opioids: complementary anti-emetic + analgesic — common multimodal use
• Highly protein-bound — caution co-administering other highly protein-bound drugs (warfarin, NSAIDs) in low-albumin states

Pregnancy and lactation

Studies in pregnant bitches at therapeutic doses show no teratogenicity. Generally avoided in pregnancy unless clinically necessary. Excreted in milk in low amounts. Avoid in puppies / kittens <8 weeks (bone marrow effects in young dogs).

Monitoring

• Anti-emetic efficacy — re-dose at 24 h if vomiting persists; switch to ondansetron + maropitant if refractory
• Hydration status — most vomiting patients are dehydrated
• Cause of vomiting — NK-1 blockade may MASK serious underlying disease (GI obstruction, pancreatitis); pursue diagnosis in parallel
• CBC if used >2 weeks or in juvenile patients — bone marrow check
• Injection-site swelling — rotate SC sites

Toxicity and overdose

Bone marrow hypoplasia / leukopaenia in juvenile (≤11 weeks) dogs at chronic high doses — labelled CAUTION in puppies <8 weeks (US) or <16 weeks (EU). Injection-site pain — refrigeration of vial blunts pain. Sedation, vomiting, anorexia uncommon. No significant cardiac, renal, or hepatic toxicity at label doses.

Management: Wide therapeutic index — overdose generally well tolerated. Supportive care. Single doses up to 10× label tolerated in healthy adult dogs. Discontinue and monitor CBC in juvenile patients.

Clinical pearls

• Dogs/cats acute vomiting: 1 mg/kg SC q24h × up to 5 days (or 2 mg/kg PO q24h × 5 days in dogs)
• Motion sickness: 8 mg/kg PO q24h (Cerenia tablet) starting 2 h before travel
• Chemotherapy-induced nausea: 2 mg/kg PO q24h × 1–5 days starting day of chemo
• Pre-operative anti-emetic: 1 mg/kg SC 45–60 min before opioid premedication — eliminates morphine/hydromorphone vomiting
• Cats: 1 mg/kg SC q24h is widely used though oral suspension is being studied; refrigerate vial to reduce stinging
• Parvo puppies: 1 mg/kg SC q24h is first-line anti-emetic — outperforms metoclopramide
• Pancreatitis adjunct: 1 mg/kg SC q24h + opioid + IV fluids
• AVOID treating vomiting as monotherapy without diagnostic workup — NK-1 block can mask GI obstruction, pancreatitis, intoxication

Mechanism of action

Selective neurokinin-1 (NK-1) receptor antagonist. Substance P is the principal emetogenic neurotransmitter binding NK-1 in the chemoreceptor trigger zone (area postrema) and emetic centre. Blocking NK-1 prevents central and peripheral activation of the vomiting reflex, regardless of the upstream emetogenic stimulus (motion, chemotherapy, uraemia, hepatic disease, parvo). Also has anti-visceral-pain effects (substance P is a primary visceral nociceptor neurotransmitter).

Formulations and products

• Cerenia injection 10 mg/mL
• Cerenia tablet 16 mg
• Cerenia tablet 24 mg
• Cerenia tablet 60 mg
• Cerenia tablet 160 mg

Storage

Tablets: 15–30 °C, dry, protected from light. Injection: 15–25 °C — REFRIGERATE BEFORE SC INJECTION (reduces stinging) — re-warm before IV use. Multidose vial: discard 28 days after broaching, but oral suspension single-dose preferred.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other antiemetics

• Dolasetron
• Ondansetron

Frequently asked questions