08/27/2026
The Overuse of Previcox / Equioxx in Horses
(And Why “Better Than Bute” Isn’t the Standard We Should Be Using)
Previcox and Equioxx are both forms of firocoxib, a COX‑2 selective NSAID commonly prescribed for pain and inflammation in horses. COX‑2 selective means the drug targets the inflammation‑producing COX‑2 enzyme while sparing more of the COX‑1 enzyme that protects the stomach and kidneys, however they still reduce the protective prostaglandins that keep the gut lining healthy- and are not "ulcer free".
These drugs are often described as “safer than bute.”
But here’s the truth: bute is well‑known to cause significant gastric and hindgut ulceration when used long‑term in a high percentage of horses, so being “better than bute” is not exactly a meaningful measure of safety.
The FDA‑approved Equioxx label clearly states: not for use beyond 14 days.
Yet in my practice, I see horses on it for months… even years.
NSAIDs are not preventative, they do not heal anything.
Long‑term use can come with real consequences.
In both human and vet medicine, it’s well‑established that chronic NSAID use can contribute to:
• gastric ulcers
• colitis
• kidney stress or damage
• reduced blood flow to the digestive tract
• hindgut irritation
• systemic inflammation over time
So while owners are trying to reduce mild to moderate MSK discomfort, they’re often doing it at the cost of the digestive system, which ultimately drives more inflammation long‑term.
Pain is communication.
Masking it without understanding the root cause often leads to bigger problems long term.
To be clear, this post is not stating that NSAIDS should not be used, medications absolutely have their place. However many owners are unaware of the long term side effects. Risks and benefits should always be considered. For those who take this post as denying seniors horses comfort- it is not that. Unfortunately I see many young and middle aged horses on long term NSAIDS. I like to ask "at what cost"?
And the answer will be different for everyone!
If you want to read more- head to my blog!
https://kcequinewellness.ca/blogs/equine-wellness/lets-stop-overusing-previcox-equioxx-for-horses
If long term medication is not for you, and you're looking for a holistic approach to help your horse heal naturally head to my website to book your consult now.
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