Commission Implementing Regulation (EU) 2025/901of 19 May 2025establishing a list of substances which are essential for the treatment of equine species, or which bring added clinical benefit compared to other treatment options available for equine species and for which the withdrawal period for equine species shall be six months and repealing Regulation (EC) No 1950/2006(Text with EEA relevance)

Commission Implementing Regulation (EU) 2025/901 of 19 May 2025 establishing a list of substances which are essential for the treatment of equine species, or which bring added clinical benefit compared to other treatment options available for equine species and for which the withdrawal period for equine species shall be six months and repealing Regulation (EC) No 1950/2006 (Text with EEA relevance) THE EUROPEAN COMMISSION, Having regard to the Treaty on the Functioning of the European Union, Having regard to Regulation (EU) 2019/6 of the European Parliament and of the Council of 11 December 2018 on veterinary medicinal products and repealing Directive 2001/82/EC OJ L 4, 7.1.2019, p. 43, ELI: http://data.europa.eu/eli/reg/2019/6/oj. , and in particular Article 115(5) thereof, Whereas: (1) Regulation (EU) 2019/6 lays down rules for use of veterinary medicinal products, including the requirement to use them in accordance with the terms of their marketing authorisations. Where there is no veterinary medicinal product authorised or available in a Member State for food-producing animals of the equine species or for an indication, veterinarians may, in particular to avoid causing unacceptable suffering and under their direct responsibility, use medicinal products outside the terms of their marketing authorisations, in accordance with the rules laid down in Articles 113 and 115 of that Regulation. (2) In order to increase the availability of medicinal products to food-producing animals of the equine species while ensuring a high level of consumer protection, and by way of derogation from Article 113(1) and (4) of Regulation (EU) 2019/6, Article 115(5) of Regulation (EU) 2019/6 provides for the establishment, by means of implementing acts, of a list of substances which are essential for the treatment of equine species, or which bring added clinical benefit compared to other treatment options available for equine species and for which the withdrawal period for equine species shall be six months. (3) Commission Regulation (EC) No 1950/2006 Commission Regulation (EC) No 1950/2006 of 13 December 2006 establishing, in accordance with Directive 2001/82/EC of the European Parliament and of the Council on the Community code relating to veterinary medicinal products, a list of substances essential for the treatment of equidae and of substances bringing added clinical benefit (OJ L 367, 22.12.2006, p. 33, ELI: http://data.europa.eu/eli/reg/2006/1950/oj). , as amended by Regulation (EU) No 122/2013 Commission Regulation (EU) No 122/2013 of 12 February 2013 amending Regulation (EC) No 1950/2006 establishing, in accordance with Directive 2001/82/EC of the European Parliament and of the Council on the Community code relating to veterinary medicinal products, a list of substances essential for the treatment of equidae (OJ L 42, 13.2.2013, p. 1, ELI: http://data.europa.eu/eli/reg/2013/122/oj). , had established a list of substances essential for the treatment of equidae and of substances bringing added clinical benefit.

(4) The Annex to Regulation (EC) No 1950/2006 was last updated in 2013 by means of Regulation (EU) No 122/2013. Therefore, the experience gained from using the substances listed in that Annex should serve as basis for establishing the list referred to in Article 115(5) of Regulation (EU) 2019/6, including the need to update the information on use of those substances, their advantages and alternatives. Furthermore, the need to add other substances as a result of newly available evidence should also be considered. (5) To ensure a high level of consumer protection, substances should only be included in the list set out in this Regulation where they do not pose an unacceptable risk to consumers when used in food-producing animals of the equine species and a six-month withdrawal period is respected. (6) A substance only qualifies as an essential substance where no satisfactory alternative for the treatment or diagnosis of an indication is available and where the condition would, if untreated, create unnecessary suffering for the animal. A substance only qualifies as bringing added clinical benefit where it provides a clinically relevant advantage based on improved efficacy or safety or a major contribution to treatment or diagnosis. This may be the result, inter alia, of different modes of action, different pharmacokinetic or pharmacodynamic profiles, different lengths of treatment or different routes of administration. (7) At the request of the Commission, the European Medicines Agency (the Agency) carried out a scientific evaluation of the substances listed in the Annex to Regulation (EC) No 1950/2006, as well as of the substances that were identified in a survey among the competent authorities and relevant stakeholders. In its scientific advice Scientific advice under Article 115(5) of Regulation (EU) 2019/6 for the establishment of a list of substances which are essential for the treatment of equine species, or which bring added clinical benefit compared to other treatment options available for equine species and for which the withdrawal period for equine species shall be six months (EMA/CVMP/159047/2023, 18 July 2024). , the Agency identifies some of those substances as essential or as bringing added clinical benefit and for which a withdrawal period of six months would not pose an unacceptable risk for consumers. (8) In line with the Agency’s advice, the substances recommended as essential or as bringing added clinical benefit should be used for the specific diseases or conditions, treatment or diagnostic needs specified in the Annex to this Regulation. In addition, the Agency advised that consideration should also be given to the alternatives listed in that Annex. (9) The substances listed in Tables 1 or 2 in the Annex to Commission Regulation (EU) No 37/2010 Commission Regulation (EU) No 37/2010 of 22 December 2009 on pharmacologically active substances and their classification regarding maximum residue limits in foodstuffs of animal origin (OJ L 15, 20.1.2010, p. 1, ELI: http://data.europa.eu/eli/reg/2010/37(1)/oj).

, or substances prohibited for use in stockfarming by Council Directive 96/22/EC Council Directive 96/22/EC of 29 April 1996 concerning the prohibition on the use in stockfarming of certain substances having a hormonal or thyrostatic action and of ß-agonists, and repealing Directives 81/602/EEC, 88/146/EEC and 88/299/EEC (OJ L 125, 23.5.1996, p. 3, ELI: http://data.europa.eu/eli/dir/1996/22/oj). , do not qualify as essential or bringing added clinical benefit. Therefore, in the event that substances listed in the Annex to this Regulation are also included in Tables 1 or 2 in the Annex to Regulation (EU) No 37/2010, or their use in food-producing animals of the equine species is prohibited by Union legislation, these substances should no longer be used for the purposes of this Regulation. (10) The list of substances set out in the Annex to this Regulation should replace the list provided for under Regulation (EC) No 1950/2006. Regulation (EC) No 1950/2006 should be repealed. In order to allow the competent authorities, veterinarians, and animal keepers concerned to adapt to the changes resulting from the non-inclusion in the Annex to this Regulation of some substances or indications listed in the Annex to Regulation (EC) No 1950/2006, a sufficient transitional period should be allowed. (11) In order to increase the availability of medicinal products to food-producing animals of the equine species and avoid unacceptable suffering, this Regulation should enter into force on the day following that of its publication in the Official Journal of the European Union. This Regulation should also apply as from the date of its entry into force. (12) The measures provided for in this Regulation are in accordance with the opinion of the Standing Committee on Veterinary Medicinal Products, HAS ADOPTED THIS REGULATION:

Article 1

Scope The list of substances referred to in Article 115(5) of Regulation (EU) 2019/6 is set out in the Annex to this Regulation.

Article 2

Rules on use of substances listed in the Annex

1. Substances which are essential for the treatment of equine species may be used for the indications specified in the Annex to this Regulation, where no veterinary medicinal product authorised for food-producing animals of the equine species or no medicinal product referred to in Article 113 of Regulation (EU) 2019/6 would yield equally satisfactory results in terms of successfully treating the animal or avoiding unnecessary suffering for the animal.
2. Substances which bring added clinical benefit compared to other treatment options may be used for the indications specified in the Annex to this Regulation and taking into account the alternatives listed in that Annex, where they provide a clinically relevant advantage based on improved efficacy or safety or a major contribution to treatment compared to veterinary medicinal products authorised for food-producing animals of the equine species or to medicinal products referred to in Article 113 of Regulation (EU) 2019/6.

1. Where any of the substances listed in the Annex to this Regulation are entered in Tables 1 or 2 of the Annex to Regulation (EU) No 37/2010, or their use in food-producing animals of the equine species is prohibited by Union legislation, such substances shall no longer be used for the purposes of this Regulation.

Article 3

Repeal

1. Regulation (EC) No 1950/2006 is repealed with effect from 21 May 2027.
2. References to the repealed Regulation (EC) No 1950/2006 shall be construed as references to this Regulation.

Article 4

Entry into force and application This Regulation shall enter into force on the day following that of its publication in the Official Journal of the European Union. It shall apply from 21 May 2025. This Regulation shall be binding in its entirety and directly applicable in all Member States. Done at Brussels, 19 May 2025. For the Commission The President Ursula von der Leyen

Annex

ANNEX Groups of substances I. Anaesthetics Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantagesOxybuprocaineaLocal topical anaesthesia for use in eyesNone identifiedWide clinical experiencePrilocainebLocal topical anaesthesia prior to intravenous injection or catheterisationLidocaineIn specific preparations (eutectic mixture of local anaesthetics), for topical application to skin; can be used to facilitate intravenous injection or catheterisation II. Analgesics Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantagesBromfenacbTreatment of uveitis and ocular inflammationSystemic nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g. flunixin); topical (ocular) ketorolacTopical NSAIDs may result in less patient discomfort, reduced postoperative inflammation, prevention of miosis, and improvements in visual acuity in the early postoperative periodFentanylbMultimodal approach for moderate to severe acute painful conditionsButorphanol, morphineProduces better analgesia than certain other opioids and can be used for very painful conditions; recognized value for use in multi-modal approachesKetorolacbTreatment of eye pain and inflammationSystemic NSAID therapy (e.g. flunixin)Formulated for local applicationMethocarbamolbAs part of treatment protocols in severe painful muscle spasms or severe muscle inflammation conditionsSystemic NSAIDs (e.g. flunixin)Potent skeletal muscle relaxation; specific action on the internuncial neurons of the spinal cord to reduce acute skeletal muscle spasms without a concomitant alteration in muscle toneMorphinebAnalgesiaButorphanol, fentanylMore potent than other analgesicsTriamcinolone acetonidebTreatment of joint inflammationMethylprednisoloneLess harmful effects on cartilage metabolism

III. Antimicrobials Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantages I. Antibiotics AmikacinbTreatment of septicemia in horses and foalsGentamicin, ceftiofurBetter safety profile in the target animalAzithromycinbTreatment of Rhodococcus equi infections susceptible to azithromycinClarithromycin, erythromycin, gamithromycin, tulathromycin, doxycyclineAdded clinical benefit in cases of Rhodococcus equi infections in foals that can be resolved as monotherapy or in combination with doxycyclineClarithromycinbTreatment of Rhodococcus equi infections susceptible to clarithromycinAzithromycin, erythromycin, gamithromycin, tulathromycin, doxycyclineMore active against Rhodococcus equi in vitro than erythromycin or azithromycin; achieves greater concentrations in pulmonary epithelial lining fluid and alveolar macrophages than either erythromycin or azithromycin, though the half-life is shorterFusidic acidbTopical treatment of eye infections caused by gram-positive bacteria susceptible to fusidic acidOfloxacin, moxifloxacinBroad spectrum for treatment of gram-positive infections; primary choice in superficial, uncomplicated corneal ulcers and acute conjunctivitis in horsesMoxifloxacinbTopical treatment of external eye infections caused by gram-positive cocci, gram-negative, atypical and anaerobic bacteria, such as Pseudomonas aeruginosa, susceptible to moxifloxacinOfloxacinAdvantageous pharmacokinetic profile; spectrum of activity includes gram-positive cocci and anaerobic bacteria that may be resistant to other quinolonesOfloxacinbTreatment of external eye infections caused by gram-positive and gram-negative micro-organisms susceptible to ofloxacinMoxifloxacinClinical experience; penetrates the entire cornea up to the anterior chamber of the eyePolymyxin BbTreatment of bacterial keratitis, topical useOfloxacin, moxifloxacinEffective alternative to systemic treatments; different mechanism of action to other topical alternatives II. Antifungals Amphotericin BaTreatment of fungal pneumonia, systemic useNone identifiedTreatment of choiceMiconazolebTreatment of fungal infection of the eyeNatamycin, nystatin, voriconazoleBroad spectrum of activity; less irritant compared to other topical antifungals NystatinbTreatment of fungal and yeast infections of the eye and genital tractMiconazoleTreatment of choice for yeast infectionsVoriconazolebTreatment of fungal keratitis, topical useMiconazoleBroad spectrum of activity III. Antivirals AciclovirbTreatment of cases of equine herpes virus infection associated with complications, topical use onlyGanciclovirTreatment of choice for ocular ulcers when the implication of a viral pathogen is suspectedGanciclovirbTreatment of cases of equine herpes virus infection associated with complications, topical useAciclovir, valaciclovirWealth of evidence for the treatment of different virus-types causing herpetic infectionsValaciclovirbTreatment of cases of equine herpes virus infections, oral useAciclovirBetter pharmacokinetic profile and a different route of administration

IV. Substances for respiratory disorders Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantagesAmbroxolbStimulation of surfactant in premature foalsSteroids, bromhexine, dembrexine, surfactant transfer from healthy donorPreferred clinical choice for premature foalsFluticasonebControl of allergic pulmonary disease including mild to moderate cases of equine asthma and subtypes via inhalationBeclomethasoneInhalation leads to less adreno-cortical suppression, quicker rebound after therapy ends and fewer systemic side effects than systemic corticosteroid therapy because of its limited systemic absorption; especially indicated for control of mild-moderate and refractory severe asthma as well as long-term maintenance therapyIpratropium bromidebAs a bronchodilator in horses with mild-moderate asthmaClenbuterolAnticholinergic action, as an alternative to beta-agonistsOxymetazolinebTreatment of nasal oedemaPhenylephrineAlpha-adrenoceptor agonist with strong vasoconstrictive properties and longer acting effectPhenylephrinebTreatment of nasal oedemaOxymetazolineReduces the need for insertion of nasal tubes during recovery V. Substances for cardiology Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantagesAmiodaronebSystemic and oral treatment of atrial fibrillation, supraventricular and ventricular tachycardiasQuinidine sulphate/gluconate, sotalol, verapamilDifferent mode of action: class III anti-dysrhythmicPropafenonebTreatment of ventricular tachycardia and ventricular tachyarrhythmiaQuinidine sulphate/gluconateDifferent mode of action: sodium channel antagonist that decreases heart excitabilityQuinaprilaTreatment of heart failure; cardiovascular protection in horses with atrial fibrillation (AF) or mitral regurgitation (MR)None identifiedDifferent mode of action: angiotensin-converting-enzyme (ACE) inhibitorQuinidine sulphate/gluconatebTreatment of cardiac arrhythmiasAmiodarone, sotalol, verapamilTreatment of choice for atrial fibrillationSotalolbLong-term treatment of cardiac arrhythmiasAmiodarone, quinidine sulphate/gluconateMore suitable in horses requiring long-term anti-arrhythmic therapy; less adverse events than amiodaroneVerapamilbTreatment of supraventricular arrhythmiasAmiodarone, quinidine sulphate/gluconate, sotalolDifferent mode of action: calcium channel blocker VI. Substances for diagnostic procedures Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantagesBarium sulfateaEnhanced gastrointestinal tract visualization during radiographic examinationsNone identifiedNo satisfactory alternative treatment for enhanced gastrointestinal tract visualisation during radiographic examinationsFluoresceinbDiagnosing corneal keratitis or ulceration, topical useRose bengalDiagnostic tool of choice when a viral culture is needed afterwards

IohexolaContrast agent for lower urinary tract radiography, arthrography, myelography, sino- or fistulography and dacryocystographyNone identifiedNon-ionic, water-soluble contrast agentPhenylephrineaDiagnosing grass sicknessNone identifiedAncillary diagnostic approach to equine grass sickness polyneuropathyRose bengalbDiagnosing corneal keratitis or ulceration, topical useFluoresceinDiagnostic tool of choice for diagnosing eye keratitis/ulcersThyrotropin releasing hormoneaDiagnosing pituitary pars intermedia dysfunctionNone identifiedNo satisfactory alternatives for diagnosing pituitary pars intermedia dysfunction VII. Substances for gastrointestinal disorders Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantagesMetoclopramidebTreatment of post-operative ileusIntravenous fluid substitution, painkillers (e.g. flunixin), lidocaineProkinetic drugMisoprostolbTreatment of gastric glandular disease and colitisOmeprazole, sucralfateSuperior to omeprazole for the treatment of equine gastric glandular diseasePhenylephrineaTreatment of nephrosplenic entrapmentNone identifiedClinical value in the resolution of nephrosplenic entrapment; causes a dose-dependent splenic contractionRanitidinebTreatment of gastric ulcers in critically ill neonates, intravenous useOmeprazoleThe intravenous route of administration brings added clinical benefit over other oral antiulcer medicationsSucralfatebTreatment and prevention of gastric ulcers in horsesOmeprazoleDifferent mode of action than omeprazole (mucosal adherent), which provides physical lesion stabilisation VIII. Substances for metabolic disorders Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantagesInsulinb As an aid in the treatment of hyperlipidaemia unresponsive to glucose therapy or severe hyperlipidaemia, used in combination with glucose and other therapies Diagnosing metabolic disorders (e.g. insulin resistance associated with equine metabolic syndrome or pituitary pars intermedia dysfunction) Low-molecular weight heparin can be used for cases of hyperlipidaemiaInsulin is the preferred clinical choice IX. Substances for musculoskeletal disorders Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantagesAtracuriumbInducing muscle paralysis under general anaesthesiaCisatracurium, guaifenesinBrings added clinical benefit in horses under general anaesthesia in cases where increased muscle relaxation is necessary such as ophthalmic surgeries, certain orthopaedic repairs and when deep access to the abdominal cavity is needed.CisatracuriumbInducing muscle paralysis under general anaesthesiaAtracurium, guaifenesinBrings added clinical benefit in horses under general anaesthesia in cases where increased muscle relaxation is necessary such as ophthalmic surgeries, certain orthopaedic repairs and when deep access to the abdominal cavity is needed.Dantrolene sodiumb

Prevention of rhabdomyolysis Prevention of malignant hyperthermia during anaesthesia NSAIDs, intravenous fluids, vitamin E/seleniumEfficacious as preventative, inhibiting the release of calcium from the sarcoplasmic reticulum and thus causing dissociation of excitation-contraction couplingEdrophoniumaReversing the effects of atracurium muscle paralysisNone identifiedCholinesterase inhibitor, essential for reversal of neuromuscular blockade; least side effects of the cholinesterase inhibitors in horses GuaifenesinbInduction and maintenance of general anaesthesia in field conditionsAtracurium, cisatracuriumParticularly indicated in field (non-hospital) conditions where anaesthesia may be necessary; the reduced cardiopulmonary depressive effects facilitate safe anaesthesia without advanced monitoring equipment or mechanical ventilation X. Substances for nervous system disorders Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantagesDiazepamaShort-term anti-convulsant for treatment of seizuresNone identifiedSecond-generation antiseizure XI. Substances for ophthalmology Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantagesAcetazolamidebTreatment of glaucoma, oral usePhenylephrineIts mechanism of action as carbonic anhydrase inhibitorCyclopentolatebMydriatic agentAtropine, phenylephrineInduces significant mydriasis without affecting tear production, intraocular pressure, digestive function (i.e. gut motility and faeces production), or heart rateCyclosporine AbTreatment of autoimmune diseases of the eyeTopical steroidsImmunosuppressive effect by inhibiting T-lymphocyte proliferation and reducing cytokine gene expressionPhenylephrinebTreatment of glaucoma and epiphoraAtropine and tropicamideIt does not (or only slightly) increase intraocular pressureSynephrinebTreatment of the mucous membranes of the eye as a decongestantPhenylephrine, tetryzolineFast local effect; enhances penetration of local therapy, providing synergistic effects with e.g. local antimicrobial therapyTetryzolinebTreatment of the mucous membranes of the eye as a decongestantPhenylephrine, synephrineFast local effect Timolol maleatebTreatment of glaucoma, topical useAcetazolamideIts specific mode of action as a non-selective beta-adrenergic receptor blocking agent, provides for an important therapeutic choice in the treatment of glaucomaTriamcinolone acetonidebTreatment of recurrent uveitis in cases that are refractory to other treatmentsAtropine, tropicamideEffective, low-morbidity treatment in cases that are refractory to other treatmentsTropicamidebTreatment of recurrent uveitisAtropine, cyclopentolate, triamcinolone acetonideRapid onset of action

XII. Substances for sedation and premedication (and antagonism) Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantagesAcepromazinebFor a multimodal approach for tranquilisation and premedication in combination with other sedativesDetomidine, romifidine, xylazine, diazepamThe mode of action of acepromazine and its unique quality of sedation cannot be produced by alpha-2 agonist sedatives or benzodiazepinesAtipamezoleaReversing the effects of alpha-2 agonistsNone identifiedReverses sedative and analgesic effects and adverse cardiovascular reactionsDexmedetomidinebSedation or general anaesthesia as part of partial or total intravenous anaesthesia protocolsDetomidine, romifidine, xylazine, diazepamThe most selective alpha-2 agonist; short half-life and rapid redistribution, which particularly favour its use as a continuous-rate infusionDiazepambPremedication and induction of anaesthesia, mild tranquilisation with minimal cardiovascular and respiratory side effectsAcepromazine, detomidine, romifidine, xylazineThe mode of action (at gamma-aminobutyric acid (GABA) receptor) provides unique tranquilisation without cardiorespiratory depression that cannot be produced by alpha-2 agonist sedatives (detomidine, romifidine and xylazine) or acepromazineFlumazenilaIntravenous reversal agent for benzodiazepine effect during recovery from Total Intravenous Anaesthesia (TIVA) techniquesNone identifiedAntagonist that competitively inhibits the benzodiazepine binding site at the GABA receptor NaloxoneaReversal of opioid effects during emergenciesNone identifiedNo alternatives availablePropofolbInduction of anaesthesia in foals via intravenous administrationIsofluraneImprovement in cardiovascular stability and quality of recovery over inhalation anaesthesia in foals XIII. Substances for systemic disorders Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantagesAllopurinolbNeonatal ischaemia reperfusion injuryVitamin EDifferent mode of action in inhibiting the formation of reactive oxygen species (ROS) than vitamin EDalteparinbAnticoagulantHeparinReduction in molecular size is associated with a loss of thrombin inhibitory activity, but conversely an increase in factor Xa (FXa) inhibition compared to unfractionated heparinDobutaminebManagement of hypotension under general anaesthesiaEphedrineFirst-line medication for the treatment of hypotension in adult equines under general anaesthesiaDopamineaAs part of a treatment protocol for acute kidney injury /renal failure onlyNone identifiedLow doses have been shown to cause renal vasodilation, increased renal blood flow, and increased urine production without systemic cardiovascular effects in conscious healthy horsesEphedrinebTreatment of hypotension under general anaesthesiaDobutamineUsed to treat hypotension in adult equines under general anaesthesia where dobutamine is ineffective. Different mode of action to dobutamine with a more direct effect on cardiac contractilityGelatinpolysuccinatebAddressing long-term hypovolaemia resulting from conditions like e.g. low albuminCrystalloidsColloids are larger molecules compared to crystalloids, thus stay longer in the intravascular space, which is an advantage for correcting hypovolemia from e.g. hypoalbuminemiaGlycopyrrolatebTreatment and prevention of bradycardiaAtropineMinimal central effect; suitable in conscious horses, before and after anaesthesia

Noradrenaline/ norepinephrineb Treatment of early septic shock Supporting cardiovascular function in critically ill foals Dobutamine, dopamineIn compromised (sick) foals it is generally the only catecholamine effective in treatment of hypotensionVasopressinbTreatment of circulatory collapse in foals and adult horsesEpinephrine, dopamine, dobutamineAlternative in cases where standard catecholamine therapies like dopamine, dobutamine, epinephrine are ineffective or require potentiation to restore vascular tone in refractory vasodilatory shock states XIV. Substances for tumours Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantagesImiquimodaTreatment of sarcoidsNone identifiedCurrent research suggests that equine sarcoids likely result from a complex interaction including host immune system dysfunction XV. Miscellaneous Active substances identified with an a are essential substances. Substances identified with a b are substances which bring added clinical benefit. Active substanceIndicationsIdentification of alternativesExplanation of use / specific advantagesCetirizinebTreatment of conditions where an antihistamine is deemed necessaryChlorphenamineSecond-generation histamine-1 (H1) receptor inverse agonists are alternatives with fewer central nervous system (CNS) (sedative) side effectsDomperidonebTreatment of agalactia/dysgalactia in maresSulpirideIts ability to stimulate prolactin secretion in situations of dopaminergic inhibitionSulpiridebTreatment of agalactia/dysgalactia in maresDomperidoneIts ability to stimulate prolactin secretion in situations of dopaminergic inhibition