Telmitraxx

Important safety and use flags

• This score covers only reduction of persistent renal proteinuria in a stable, adequately hydrated cat with confirmed CKD. It does not cover unselected CKD, acute kidney injury, nonspecific renal support, dogs or systemic hypertension.
• Do not substitute Semintra 10 mg/ml or its hypertension regimen. US NADA 141-501 is a different 10 mg/ml product dosed initially twice daily; Telmitraxx is 4 mg/ml and this assessment uses 1 mg/kg = 0.25 ml/kg once daily for CKD proteinuria.
• Confirm persistent renal proteinuria and address pre-renal/post-renal causes, urinary sediment/infection and hypertension before attributing protein loss to CKD. Borderline UPC 0.2–0.4 usually requires monitoring rather than automatic treatment; current guidance treats persistent UPC >0.4.
• Do not initiate in a clinically dehydrated or hypovolaemic cat. Correct volume status first because RAAS inhibition can precipitate a marked fall in glomerular filtration; acute or rapidly changing kidney disease is outside this rating.
• Measure blood pressure, creatinine/renal markers, electrolytes, UPC and haematology at baseline and early after initiation, then serially. A small stable creatinine rise can occur; marked or progressive azotaemia, hypotension, weakness, anorexia or dehydration requires prompt reassessment.
• Do not combine with another ACE inhibitor or angiotensin-receptor blocker as routine therapy. Other antihypertensive or diuretic treatment can amplify hypotension or renal effects; document the combination rationale and monitor closely.
• Do not use during pregnancy or lactation. Safety is not established in breeding cats or kittens under six months; pregnant people should avoid exposure to RAAS-active solutions and wash skin immediately after accidental contact.
• Stop and reassess for persistent vomiting/regurgitation, diarrhoea, reduced appetite, weight loss, lethargy, hypersensitivity or liver-enzyme elevation. Reduced erythrocyte indices are a known class/product monitoring issue rather than a reason to omit baseline haematology.
• Use the supplied syringe and current body weight. Give directly into the mouth or with only a small amount of food and confirm the whole dose is consumed; do not hide it in a full meal. Avoid contaminating the syringe or bottle opening.
• Store below 30°C in the original container and use within six months after opening. Record the opening date. Georgian registration and current local availability are absent, so procurement and replacement continuity must be confirmed before starting long-term therapy.