Tiamulin: veterinary dose and monograph

At a glance

Drug class

Antibiotic

Also known as

Denagard

Species with doses

Pigs and Poultry

General dose range

8.8–15 mg/kg PO q24h — check the species tables for the indication

Routes

PO, IM

Last reviewed

1 October 2026

Indications

• Swine dysentery (Brachyspira hyodysenteriae)
• Porcine proliferative enteropathy (Lawsonia)
• Enzootic / mycoplasmal pneumonia in pigs
• Mycoplasmosis in poultry

Tiamulin 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.

Pigs

• Swine dysentery (drinking water): Plumb’s p.1116 (Denagard Liquid Concentrate label): 7.7 mg/kg PO daily in drinking water for 5 days for swine dysentery; slaughter withdrawal 3 days at this dose (3.5 mg/lb). See package directions for dilution. Never give with ionophores (monensin, salinomycin, narasin) — the interaction is fatal.
• Pneumonia (injectable): Label-sourced (tiamulin injection) — no injectable dose in Papich 5e or Plumb’s 10e. Plumb’s 10e p.1231 lists a 162 mg/mL injection (Vetmulin, not available in the US) for treating and preventing dysentery in individual pigs with known exposure (not herd-level treatment), with a 21-day withdrawal, but prints no dose. Follow the local product label for dose and slaughter withdrawal. Never give with ionophores.
• Pneumonia (drinking water): Plumb’s p.1116 (Denagard Liquid Concentrate label): 23.1 mg/kg/day in drinking water for 5 days for Actinobacillus (Haemophilus) pleuropneumoniae; slaughter withdrawal 7 days at this dose (10.5 mg/lb). No ionophores.

Poultry

• Mycoplasma — chickens (drinking water): Plumb’s 10e p.1231 (extra-label): Mycoplasma spp disease in chickens — 25 mg/kg bodyweight in drinking water as a 0.025% solution for 3–5 days. Withdrawal (UK label, Plumb’s 10e p.1231): 2 days slaughter for chickens; no withdrawal for eggs. NEVER with ionophores (monensin, salinomycin, narasin) — fatal.
• Mycoplasma — turkeys (drinking water): Plumb’s 10e p.1231 (extra-label): Mycoplasma spp disease in turkeys — 25 mg/kg bodyweight in drinking water as a 0.025% solution for 5 days. Withdrawal (UK label, Plumb’s 10e p.1231): 5 days slaughter for turkeys. NEVER with ionophores (monensin, salinomycin, narasin) — fatal.

Birds

• No reference dose for this species: Neither Papich 5e nor Plumb’s 10e gives a tiamulin dose for companion birds — Plumb’s 10e p.1231 doses only chickens and turkeys (see the Poultry rows). Tiamulin must never be given with ionophores (monensin, salinomycin, narasin) — the interaction is fatal.

Contraindications

DO NOT use with, or within ~7 days of, ionophores (monensin, salinomycin, narasin) — tiamulin blocks their metabolism causing fatal ionophore toxicity. Hypersensitivity.

Species-specific warnings

Pigs: Lethal interaction with ionophore coccidiostats (monensin, salinomycin, narasin) — confirm feed is ionophore-free before medicating.

Poultry: Lethal interaction with ionophore coccidiostats (monensin, salinomycin, narasin) — broiler feed commonly contains them; confirm the feed is ionophore-free before medicating.

Adverse effects

• Transient erythema / skin reddening (pigs), especially if feed not consumed promptly
• Injection-site reaction

Drug interactions

• Ionophores (monensin, salinomycin, narasin, maduramicin): tiamulin inhibits their CYP-mediated metabolism → FATAL ionophore toxicity (myopathy, ataxia, death). Never co-administer; allow ≥7-day separation
• Other CYP3A substrates: potential altered metabolism

Pregnancy and lactation

No specific contraindication at therapeutic label doses in breeding pigs — follow the product label.

Monitoring

• Confirm the ration contains no ionophore before medicating
• Group response (resolution of dysentery / enteritis / respiratory signs)
• Meat withdrawal time

Toxicity and overdose

Overdose or ionophore co-exposure causes hypersalivation, CNS depression, ataxia, recumbency and skeletal / cardiac myopathy. Transient skin erythema occurs in pigs that do not promptly consume medicated feed.

Clinical pearls

• The ionophore interaction is the headline safety point — never co-administer with monensin / salinomycin / narasin, and allow a clearance gap
• Most effective for Brachyspira and Lawsonia enteric disease in grow-finish pigs
• Usually delivered through medicated feed or water for whole-group treatment

Mechanism of action

Pleuromutilin. Binds the peptidyl-transferase centre of the 50S ribosomal subunit, inhibiting protein synthesis → bacteriostatic, with strong activity against Brachyspira, Lawsonia and Mycoplasma. Highly lipophilic, giving good lung and gut penetration for in-feed / in-water group medication.

Formulations and products

• Tiamulin liquid concentrate 12.3 % (Denagard Liquid Concentrate) — water medication, mix per label (Plumb’s p.1116)
• Tiamulin soluble powder 45 % (450 mg/g; 29.1 g tiamulin per 2.28-oz packet — Plumb’s p.1117)
• Tiamulin 10% / 80% premix (in-feed)
• Tiamulin 162.5 mg/mL injection
• Denagard (Elanco) — 12.5 % solution; 10 % / 80 % premix; 162.5 mg/mL injection, Water / feed medication / injection

Storage

Store premix / soluble powder dry, ≤25 °C; protect injectable from light.

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 antibiotics

• Streptomycin (Dihydrostreptomycin)
• Sulfadiazine
• Sulfadimethoxine
• Sulphadimidine (Sulfamethazine)
• Tildipirosin
• Tilmicosin
• Tinidazole
• Tobramycin

Frequently asked questions