Not all pain relievers work the same way so it’s important to have more than one drug on hand. Knowing which painkillers are best suited for specific situations can help you stock a first aid kid that gives your horse the relief he needs.

Store medications in a dark environment that is not hot or too cold to maximizes storage longevity. And keep all medications in a locked cabinet that is out of reach for children, pets, and people other than yourself. 

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Flunixin Meglumine 

Until generic forms became available, this medication has been commonly referred to as Banamine. It is a useful drug to have on hand for colic, intestinal dysfunction, eye inflammation, laminitis, and many other instances of pain, swelling, and lameness.

Some precautions should be considered when using it for colic pain:

  • Oral administration is associated with a lag time of 4-6 hours to achieve peak effects, and longer if intestinal motility is diminished.
  • Given to a dehydrated horse, it has the potential to elicit gastric or colonic ulcer disease or kidney damage.
  • Although labeled for intramuscular use, that route of administration has the potential to precipitate a life-threatening infection from Clostridial bacteria.
  • Given at the recommended therapeutic dose, it can mask a surgical colic. Instead, the most given at one time should be one-quarter of the maximum recommended musculoskeletal dose.

Other NSAIDs

Phenylbutazone, ketoprofen, and meloxicam are also excellent non-steroidal anti-inflammatory medications that have similar therapeutic properties as flunixin. The precautions mentioned above for flunixin should also be considered for these medications.

Firocoxib is a powerful analgesic that is commonly used for chronic pain and osteoarthritis. Until recently, horse owners have been using the canine tablet form (Previcox) of firocoxib off label, but now the equine formulation of the oral tablet is available, called Equioxx, labeled specifically for horses. The benefits of firocoxib are that it is primarily a COX-2 inhibitor in the prostaglandin cycle so it tends to be more protective of the beneficial prostaglandins (PGE2, for example) than the other NSAIDs. PGE2 is responsible for many protective functions of the intestinal lining.


While not considered strictly as an analgesic, corticosteroids do exert pain-relieving properties. Examples include dexamethasone and prednisolone. These should be used under veterinarian advisement due to the potential for unwanted side effects.


Sedatives work also as excellent painkillers. Detomidine, one of these alpha-2 agonists is now formulated in an oral paste called Dormosedan gel. It is administered under a horse’s tongue to achieve sedation and pain-relieving effects within 20-30 minutes. This makes it easy to give and relatively safe to use. Many sedatives, including detomidine, should not be used in horses with heart problems, respiratory, vascular, or kidney disease. Follow manufacturer and your veterinarian’s instructions on the dosing amount.


Butorphanol is a non-narcotic opioid that is administered intravenously (IV) or intramuscularly (IM) to relieve pain. This drug must be used under veterinary supervision. It should be noted that as an opioid it has the potential to diminish intestinal motility.

Topical Surpass

A topical non-steroidal cream, diclofenac sodium, is labeled as Surpass specifically for horses. It is applied to an area of inflammation, such as over a joint or tendon, to relieve pain and inflammation. Gloves should be worn when applying this drug.

The Bottom Line

In all cases, even though you may have some of these medications on hand, contact your veterinarian before administering any analgesic drugs to your horse. Your vet can provide the best suggestion of which product to use for the particular problem you want to address as well as how much to give and for how long. These decisions are best individualized for every horse.

By Nancy S. Loving, DVM