Tilmicosin: veterinary dose and monograph

At a glance

Drug class

Antibiotic

Also known as

Micotil, Pulmotil

Species with doses

Cattle, Sheep, Pigs and Rabbits

General dose range

10 mg/kg SC q72h — check the species tables for the indication

Routes

SC, PO

Last reviewed

1 October 2026

Indications

• Bovine respiratory disease (BRD) — Mannheimia / Pasteurella haemolytica
• Ovine respiratory disease
• Swine respiratory infection (in-feed only, Pulmotil)

Tilmicosin 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 (label, single SC): Plumb’s p.1122 (Micotil 300 label): 10 mg/kg SC in the neck (or behind the shoulder over the ribs), max 15 mL per site; pneumonic pasteurellosis 10 mg/kg SC every 72 h (Shewen & Bateman). Papich 5e: 10–20 mg/kg SC single dose; avoid IV or IM. Plumb’s: 28-day slaughter withdrawal at labelled doses; not for lactating dairy cattle ≥20 months or veal calves. NEVER IV; fatal to people after accidental self-injection, and to pigs, goats and horses.

Horses

• CONTRAINDICATED in horses: Papich 5e: horses — do not use; safety not established. Tilmicosin is cardiotoxic.

Goats

• CONTRAINDICATED in goats: Papich 5e: goats — do not use. Tilmicosin injection is cardiotoxic and has been fatal in goats, pigs and horses (and in people after accidental self-injection).

Sheep

• Respiratory infection (label): Papich 5e and Plumb’s p.1122 (label): 10 mg/kg SC single dose, max 15 mL per site; not in lambs <15 kg or lactating ewes whose milk is used for food. Plumb’s: 28-day slaughter withdrawal.

Pigs

• Respiratory disease (Pulmotil in-feed only): Per label feed concentration. Injection of tilmicosin is FATAL in swine — feed route only.

Buffalo

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

• BRD (label, single SC): Plumb’s p.1122 (Micotil 300 label): 10 mg/kg SC in the neck (or behind the shoulder over the ribs), max 15 mL per site; pneumonic pasteurellosis 10 mg/kg SC every 72 h (Shewen & Bateman). Papich 5e: 10–20 mg/kg SC single dose; avoid IV or IM. Plumb’s: 28-day slaughter withdrawal at labelled doses; not for lactating dairy cattle ≥20 months or veal calves. NEVER IV; fatal to people after accidental self-injection, and to pigs, goats and horses.

Rabbits

• Pasteurellosis (extra-label): Plumb's p.1122 (Ivey & Morrisey 2000): rabbits — either 25 mg/kg SC once, repeat in 3 days if needed; OR 5 mg/kg SC day 0, then (if no reaction) 10 mg/kg SC on days 7 and 14. ⚠ Can cause weakness, pallor, tachypnoea and SUDDEN DEATH; acute death if given IV. SC only.

Contraindications

NEVER administer IV (fatal). FATAL in swine via injection, non-human primates and potentially horses. Severe reactions reported in camelids. Do not use automatically powered syringes. Avoid eye contact. Not for female dairy cattle ≥20 mo or veal calves. Do not use in lactating ewes producing milk for human consumption. Do not use in lambs <15 kg.

Species-specific warnings

Cattle: Label approved at 10 mg/kg SC for BRD. 28-d slaughter withdrawal. NEVER in dairy cattle at any lactation stage — no milk withdrawal exists.

Sheep: Label approved at 10 mg/kg SC. 35-d slaughter withdrawal. Tachycardia / pyrexia at high doses.

Goats: FATAL at therapeutic cattle doses. NEVER use in goats. Use tulathromycin instead.

Horses: FATAL even at low doses. NEVER use in horses.

Pigs: FATAL at injection doses. Use only the in-feed Pulmotil formulation (different pharmacokinetics) per label.

Dogs: NOT approved in dogs. Cardiotoxic. Use alternative macrolide (azithromycin) or other antibiotic class.

Adverse effects

• Local tissue reaction / trim loss (IM route)
• Edema at SC injection site
• Fatal in swine if injected (use feed only)
• Severe / fatal reactions in horses, primates, camelids

Drug interactions

• Other cardiotoxic drugs (digoxin, cardiac glycosides, calcium): additive cardiac toxicity in humans / animals — DO NOT mix
• Beta-blockers (propranolol, atenolol): can BLUNT tilmicosin cardiotoxicity if accidental human exposure — used in human poisoning protocols
• Other macrolides (erythromycin, tylosin, azithromycin): additive — do not combine
• Lincosamides (clindamycin): theoretical antagonism (same ribosomal site)

Pregnancy and lactation

Approved for use in pregnant cattle, sheep, lactating cattle (with strict withdrawal). Crosses placenta in low amounts. Use at label dose. No teratogenicity reported at therapeutic doses.

Monitoring

• Operator safety: NEVER point needle toward self; use a tip-protector; have someone trained nearby in case of accidental injection
• Withdrawal: cattle 28 d slaughter, NEVER in dairy at any lactation stage; sheep 35 d slaughter; swine label-prohibited
• Injection site for swelling — single dose only at each site
• Cattle: monitor for inflammatory response, intake, and respiratory recovery
• Withdrawal documentation rigorous for slaughterhouse compliance

Toxicity and overdose

FATAL TO HUMANS at accidental self-injection — cardiac arrest within minutes. Restricted to veterinary use only with handler safety training. FATAL TO HORSES, GOATS, SWINE at therapeutic cattle doses — restricted to labelled species. Cattle: injection-site swelling, occasional sterile abscess. Lameness if injected too close to vascular structures. Sheep: tachycardia, pyrexia at high doses.

Management: NO ANTIDOTE. Human accidental self-injection: IMMEDIATE 911 / emergency room. IV calcium chloride / calcium gluconate (limited evidence), epinephrine, beta-blocker (propranolol) for tachyarrhythmias. Outcomes are poor — fatalities reported even with prompt ICU care. Animal overdose: supportive — IV fluids, cardiac monitoring, beta-blocker for arrhythmia. Recovery rare from significant cattle overdose.

Clinical pearls

• Cattle BRD single-shot: 10 mg/kg SC base of ear / behind shoulder — one dose for 72-hour coverage
• Sheep enzootic pneumonia (Mannheimia, Pasteurella): 10 mg/kg SC — convenient single-dose
• FATAL self-injection risk — handle with extreme caution; many vets refuse to stock it for this reason
• NEVER use in horses (fatal), goats (fatal), swine (fatal at cattle dose). Use tulathromycin or tildipirosin alternatives instead
• No milk-discard data — DO NOT use in lactating dairy cattle at any stage
• Combine with NSAID (meloxicam, flunixin) for fever / inflammation control

Mechanism of action

Macrolide antibiotic (semi-synthetic, derived from tylosin). Reversibly binds the bacterial 50S ribosomal subunit, blocking peptidyl-tRNA translocation and inhibiting protein synthesis. Bacteriostatic (cidal at high concentrations against susceptible organisms). Concentrates inside macrophages and inflamed tissue — sustained-release pharmacokinetics give 72-hour activity from a single SC dose in cattle. Spectrum: Gram-positive cocci, Mannheimia, Pasteurella, Mycoplasma, Histophilus.

Formulations and products

• Micotil 300 injection 300 mg/mL
• Pulmotil 90 feed premix 90.7 g/lb

Storage

Injectable: 15–25 °C, do not refrigerate (can precipitate), do not freeze. Restricted-access cabinet — operator-safety requirement. Multidose vial: discard 28 days after broaching.

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

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

Frequently asked questions