Your questions answered
What dose should I use?
Reconcile® is given once daily, which is ideal for maximum compliance.¹²
It is given orally at a once daily dose of 1 to 2 mg/kg bodyweight according to the dosage table below:
Do I have to give the tablets with food?
Reconcile® tablets may be given with or without food. The tablets are flavoured and most dogs will consume the tablet when offered by the caregiver. ¹²
How soon should I expect to see a response?
Clinical improvement with the product is expected within 1 to 2 weeks. If no improvement is noted within 4 weeks, case management should be re-evaluated. ¹² ¹³
Are there any dogs I shouldn’t use Reconcile in?
Reconcile® is contraindicated for use in dogs with epilepsy or a history of seizures, nor should the drug be given to dogs with a known hypersensitivity to fluoxetine, other SSRIs or to any of the excipients. The safety of Reconcile® has not been established in dogs less than 6 months of age or weighing less than 4 kg. The safety of the veterinary medicinal product has not been established during pregnancy and lactation, thus its use is not recommended during pregnancy and lactation.
What side effects might I see with Reconcile?
The most common adverse events reported in decreasing order of reported frequency are: decreased appetite (including anorexia), lethargy, urinary tract disorders (cystitis, urinary incontinence, urinary retention, stranguria), incoordination or disorientation, weight loss/loss of condition or mydriasis, panting, seizures and vomiting. In order to minimise the risk of adverse effects the recommended dose should not be exceeded. ¹²
Can I use Reconcile® alongside other medications?
Reconcile® should not be given concomitantly with veterinary medicinal products that lower the seizure threshold (e.g. phenothiazines such as acepromazine or chlorpromazine). ¹²
Do not use the product in conjunction with other serotonergic agents (e.g. sertraline) and monoamine oxidase inhibitors (MAOIs) [e.g., selegiline hydrochloride (L-deprenyl), amitraz] or tricyclic amines (TCAs) (e.g. amitriptyline and clomipramine).
A 6-week washout interval should be observed following discontinuation of therapy with Reconcile® prior to the administration of any veterinary medicinal product that may adversely interact with fluoxetine or its metabolite, norfluoxetine. Additionally the SPC states ¹²: “Fluoxetine is largely metabolised by the P-450 enzyme system, although the precise isoform in dogs is unknown. Therefore, fluoxetine should be used with caution with other veterinary medicinal products.” Reconcile® chewable tablets have not been evaluated with drugs that affect the cytochrome P450 enzyme system. Reconcile® chewable tablets should be used with caution when co-administered with any drug that affects the cytochrome P450 enzyme system (for example, ketoconazole).
Do I need to regularly check bloods for a patient on Reconcile
There is no requirement on the Reconcile® SPC to regularly check any haematological or biochemical parameters for patients on Reconcile®. ¹² Reconcile® caused no marked or consistent effects on haematology, blood chemistries or urinalysis in a one year safety study in dogs. As for any patient receiving medication, professional judgment should be used in monitoring the patient for response to therapy and for adverse reactions. ¹¹
What dose should I use?
Reconcile® is given once daily, which is ideal for maximum compliance. ¹²
It is given orally at a once daily dose of 1 to 2 mg/kg bodyweight according to the dosage table below:
Do I have to give the tablets with food?
Reconcile® tablets may be given with or without food. The tablets are flavoured and most dogs will consume the tablet when offered by the caregiver. ¹²
How soon should I expect to see a response?
Clinical improvement with the product is expected within 1 to 2 weeks. If no improvement is noted within 4 weeks, case management should be re-evaluated. ¹² ¹³
Are there any dogs I shouldn’t use Reconcile in?
Reconcile® is contraindicated for use in dogs with epilepsy or a history of seizures, nor should the drug be given to dogs with a known hypersensitivity to fluoxetine, other SSRIs or to any of the excipients. The safety of Reconcile® has not been established in dogs less than 6 months of age or weighing less than 4 kg. The safety of the veterinary medicinal product has not been established during pregnancy and lactation, thus its use is not recommended during pregnancy and lactation.
What side effects might I see with Reconcile?
The most common adverse events reported in decreasing order of reported frequency are: decreased appetite (including anorexia), lethargy, urinary tract disorders (cystitis, urinary incontinence, urinary retention, stranguria), incoordination or disorientation, weight loss/loss of condition or mydriasis, panting, seizures and vomiting. In order to minimise the risk of adverse effects the recommended dose should not be exceeded. ¹²
Can I use Reconcile® alongside other medications?
Reconcile® should not be given concomitantly with veterinary medicinal products that lower the seizure threshold (e.g. phenothiazines such as acepromazine or chlorpromazine).¹²
Do not use the product in conjunction with other serotonergic agents (e.g. sertraline) and monoamine oxidase inhibitors (MAOIs) [e.g., selegiline hydrochloride (L-deprenyl), amitraz] or tricyclic amines (TCAs) (e.g. amitriptyline and clomipramine).
A 6-week washout interval should be observed following discontinuation of therapy with Reconcile® prior to the administration of any veterinary medicinal product that may adversely interact with fluoxetine or its metabolite, norfluoxetine. Additionally the SPC states¹²: “Fluoxetine is largely metabolised by the P-450 enzyme system, although the precise isoform in dogs is unknown. Therefore, fluoxetine should be used with caution with other veterinary medicinal products.” Reconcile® chewable tablets have not been evaluated with drugs that affect the cytochrome P450 enzyme system. Reconcile® chewable tablets should be used with caution when co-administered with any drug that affects the cytochrome P450 enzyme system (for example, ketoconazole).
Do I need to regularly check bloods for a patient on Reconcile
There is no requirement on the Reconcile® SPC to regularly check any haematological or biochemical parameters for patients on Reconcile®.¹² Reconcile® caused no marked or consistent effects on haematology, blood chemistries or urinalysis in a one year safety study in dogs.¹¹ As for any patient receiving medication, professional judgment should be used in monitoring the patient for response to therapy and for adverse reactions.
If you have any other technical questions on Reconcile please contact our veterinary team on vets@fortehealthcare.com
References:
11. Field study T8E420001. Efficacy Evaluation of Fluoxetine (fluoxetine hydrochloride) for the Control of Separation Anxiety in Dogs. Freedom of Information Summary NADA 141-272; Reconcile Fluoxetine Hydrochloride Chewable Tablets: Dogs. 2007: 3.
12. Reconcile Chewable Tablets for Dogs, Summary of Product Characteristics. 2021.
13. Reconcile European Public Assessment Record, accessed October 2021.
https://www.ema.europa.eu/en/documents/scientific-discussion/reconcile-epar-scientific-discussion_en.pdf