Tildipirosin: veterinary dose and monograph

At a glance

Drug class

Antibiotic

Also known as

Zuprevo

Species with doses

Cattle and Pigs

General dose range

4 mg/kg SC single dose — check the species tables for the indication

Routes

SC, IM

Last reviewed

1 October 2026

Indications

• Bovine respiratory disease (BRD) — treatment and control/metaphylaxis (single dose)
• Swine respiratory disease (Actinobacillus, Pasteurella, etc.)
• Single-dose respiratory therapy in group/feedlot settings

Tildipirosin 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.

Cattle

• BRD (treatment / metaphylaxis): Papich 5e: 4 mg/kg (1 mL per 100 lb of 180 mg/mL) SC in the neck as a single injection. US label slaughter withdrawal 21 days; not for female dairy cattle 20 months or older, or veal calves. Other countries set longer withdrawals — follow the local label.

Pigs

• Swine respiratory disease: Papich 5e: 4 mg/kg (1 mL per 10 kg of 40 mg/mL) IM as a single injection. Not approved in the USA — check local approval and follow the local label withdrawal.

Buffalo

No buffalo-specific doses are on file, so buffalo are dosed as cattle.

• BRD (treatment / metaphylaxis): Papich 5e: 4 mg/kg (1 mL per 100 lb of 180 mg/mL) SC in the neck as a single injection. US label slaughter withdrawal 21 days; not for female dairy cattle 20 months or older, or veal calves. Other countries set longer withdrawals — follow the local label.

Contraindications

Adult horses / hindgut fermenters (fatal colitis — macrolide class). INTRAVENOUS administration in cattle (cardiotoxic — give SC only). Using the cattle (180 mg/mL) product in pigs or vice-versa. Macrolide hypersensitivity. Lactating dairy producing human milk (not approved). Observe meat withdrawal.

Species-specific warnings

Cattle: Give SC ONLY — IV administration is cardiotoxic and can be fatal. Not for lactating dairy; observe meat withdrawal (~21 days, verify).

Horses: Macrolide — fatal colitis in adult horses; strictly a cattle/pig product.

Adverse effects

• Injection-site swelling/pain (transient, can be marked at the SC site)
• Cardiovascular effects if given by the wrong route/IV (cardiotoxic)
• Fatal colitis in adult horses/hindgut fermenters

Drug interactions

• Other macrolides/lincosamides: cross-resistance
• No major small-molecule pharmacokinetic interactions

Pregnancy and lactation

Considered usable in pregnant cattle/pigs at label dose; verify product.

Monitoring

• Respiratory clinical response
• Injection-site reaction
• Meat withdrawal compliance
• Correct product/route for species (SC cattle, IM swine — never IV)

Toxicity and overdose

Wide margin SC in target species; the notable hazards are (1) CARDIOTOXICITY if given IV/intravascularly (can be fatal), (2) marked injection-site reactions, and (3) fatal colitis in horses/rabbits. Accidental human self-injection requires medical attention (cardiovascular risk).

Management: Supportive; no specific antidote. For inadvertent IV/cardiotoxicity, provide cardiovascular support/monitoring. Manage injection-site reactions and (in equids) colitis. Human exposure: seek medical care, show the product label.

Clinical pearls

• A one-shot long-acting macrolide for BRD — single SC injection covers the key pathogens for days; ideal for feedlot treatment/metaphylaxis
• NEVER give IV in cattle (cardiotoxic) — SC only; use the species-correct concentration (cattle 180 vs swine 40 mg/mL)
• Handle carefully — accidental human self-injection can be cardiotoxic; seek medical advice if it happens
• Avoid in horses/rabbits (fatal colitis); observe meat withdrawal and use macrolides prudently

Mechanism of action

A semi-synthetic macrolide that binds the 50S ribosomal subunit (23S rRNA), inhibiting bacterial protein synthesis against respiratory pathogens. It is extensively concentrated in lung tissue and phagocytes with a long terminal half-life, so a single injection sustains therapeutic pulmonary levels — the basis of one-dose BRD therapy. Its physicochemical properties also underlie potential cardiovascular effects if given intravascularly.

Formulations and products

• Injection 180 mg/mL (Zuprevo, cattle)
• Injection 40 mg/mL (Zuprevo, swine)
• Zuprevo (MSD Animal Health) — 180 mg/mL (cattle) / 40 mg/mL (swine), SC (cattle) / IM (swine) injection

Storage

Injection: 15–30 °C, protect from light; do not freeze. Keep cattle and swine formulations clearly separated.

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

• Sulfadiazine
• Sulfadimethoxine
• Sulphadimidine (Sulfamethazine)
• Tiamulin
• Tilmicosin
• Tinidazole
• Tobramycin
• Trimethoprim / Sulfadiazine (TMP-Sulfa)

Frequently asked questions