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Stop Deramaxx and call your vet the same day if your dog vomits (especially blood), has black or tarry stool, stops eating, seems unusually tired, has a painful or swollen belly, drinks or urinates much more or less than normal, or has yellow gums or eyes. Never give Deramaxx with another NSAID (Rimadyl, Metacam, Previcox, Galliprant, aspirin) or a steroid such as prednisone. Never keep giving the after-surgery dose for arthritis: it is double the arthritis dose. Do not use in cats.
The short answer: Deramaxx (deracoxib) is an FDA-approved, COX-2-selective NSAID for dogs with three different label doses: 1–2 mg/kg once daily for arthritis, 3–4 mg/kg once daily for up to 7 days after orthopaedic surgery, and 1–2 mg/kg for 3 days after dental surgery. It works: in placebo-controlled trials after dental extractions, only 14.8% of dogs on deracoxib needed rescue pain relief versus 66.7% on placebo, and a 209-dog arthritis trial found better weight-bearing on a force plate. Its biggest danger is dosing. When the manufacturer reviewed 29 dogs whose gut perforated on Deramaxx, 90% had been given more than the approved dose or had another NSAID or a steroid within 24 hours. Use the right dose for the condition, one NSAID at a time, and bloodwork before and during treatment.
By Marc Brannigan and Natalie Mondine, co-founders of HempMy Pet · Published November 7, 2026 · Last reviewed November 7, 2026. We have grown and bottled full-spectrum hemp for pets on our own Colorado farm since 2016. We are not veterinarians — everything below comes from the published veterinary studies, consensus guidelines and drug labels listed at the end.
What Deramaxx Is
Deramaxx is the brand name for deracoxib, a "coxib" NSAID now sold by Elanco. Like other NSAIDs it blocks the cyclo-oxygenase (COX) enzymes that make the prostaglandins behind pain and inflammation. It is selective for COX-2, the inflammation-driving enzyme, and largely spares COX-1, which protects the stomach lining, the kidneys and platelet function. At doses above about 8 mg/kg a day that selectivity breaks down, according to the label, which is one reason the dose matters so much.
It comes as beef-flavoured chewable tablets in 12 mg, 25 mg, 75 mg and 100 mg, half-scored. It is FDA-approved in dogs for three uses:
- Osteoarthritis pain and inflammation, once daily as needed, long term.
- Pain after orthopaedic surgery, such as cruciate repair, for no more than 7 days.
- Pain after dental surgery, for 3 days, starting about an hour before the procedure.
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Deramaxx Dose for Dogs: Three Conditions, Three Doses
| Dog weight | Arthritis (1–2 mg/kg/day, ongoing) | After orthopaedic surgery (3–4 mg/kg/day, max 7 days) |
|---|---|---|
| 15 lb (6.8 kg) | 7–14 mg | 21–27 mg |
| 25 lb (11.3 kg) | 11–23 mg | 35–45 mg |
| 40 lb (18.1 kg) | 18–36 mg | 56–72 mg |
| 60 lb (27.2 kg) | 27–55 mg | 84–108 mg |
| 80 lb (36.3 kg) | 36–73 mg | 112–144 mg |
| 100 lb (45.4 kg) | 45–91 mg | 140–180 mg |
Calculated from the label: 0.45–0.91 mg/lb/day for arthritis and dental surgery, 1.4–1.8 mg/lb/day after orthopaedic surgery. For illustration only: your vet picks the dose and tablet combination.
The table shows the trap. A dog sent home after cruciate surgery on 3–4 mg/kg can be on double the arthritis dose. If that bottle keeps being refilled once the dog's leg is healing and the problem is now arthritis, the dog is overdosed every day. The label caps the post-surgical dose at 7 days for a reason.
- Small dogs: any dog needing less than 12.5 mg must be dosed with the 12 mg tablet, which can be halved to 6 mg. The label warns against breaking larger tablets for small dogs.
- With food: absorption is best after a meal, though it works fed or fasted.
- Missed dose: give it when you remember unless the next dose is nearly due; never double up.
- Cats: the label says “Do not use in cats.”
How Fast Does Deramaxx Work?
From the FDA label, blood levels peak about 2 hours after a dose and more than 90% of the drug is absorbed. At normal doses the half-life is short, about 3 hours, but the label notes that the pain-relieving effect lasts longer than that, which is why it is given once a day. At an overdose of 20 mg/kg the half-life stretches to 19 hours, because the body's clearance gets saturated.
After surgery, it is given before the procedure so it is working when the dog wakes up. For arthritis, the 209-dog field trial ran for 43 days, and owners and force-plate measurements favoured deracoxib over placebo. Give it a couple of weeks before judging, and ask your vet rather than raising the dose.
Does Deramaxx Work? What the Dog Trials Show
- Arthritis (209 dogs, label field study): placebo-controlled, 43 days at 1–2 mg/kg. Deracoxib dogs did significantly better on force-plate weight-bearing and on owner scores for quality of life, lameness and activity. Side effects were about as common as on placebo.
- Soft-tissue surgery (2012): 2 of 16 deracoxib dogs needed rescue pain relief, versus 9 of 16 on placebo.
- Dental extractions (2011): 4 of 27 deracoxib dogs needed rescue, versus 20 of 30 on placebo.
- A trial where it did not help: in 30 dogs doing intense rehab after TPLO knee surgery, adding deracoxib made no difference to lameness, range of motion or muscle recovery (Gordon-Evans 2010).
- Off-label in bladder cancer: vets sometimes use COX-2 inhibitors for transitional cell carcinoma. In 26 dogs given deracoxib alone, 17% had partial remission and 71% stable disease, with a median survival of 323 days (McMillan 2011). That is your oncologist's decision, not an arthritis dose.
Deramaxx Side Effects in Dogs
| Side effect | How common | What to do |
|---|---|---|
| Vomiting, diarrhea, poor appetite | The most common; similar to placebo in the 209-dog field study | Call your vet if it lasts more than a day or two |
| Vomiting blood, black or tarry stool, belly pain | Uncommon but serious: possible ulcer or perforation | Stop and go to your vet the same day |
| Lethargy, weakness | Listed in post-approval reports | Call your vet |
| More or less drinking and urinating | Uncommon: possible kidney effect | Stop and call your vet |
| Yellow gums or eyes, raised liver values | Rare: possible liver effect | Stop and call your vet |
Source: DERAMAXX FDA label, including post-approval reports listing GI ulceration and perforation, peritonitis, liver and kidney effects, seizures and other events. The label adds that some serious GI events were preceded by loss of appetite, fast heart rate, fast breathing and fever.
Will deracoxib make my dog sleepy? It is not a sedative. Lethargy appears in post-approval reports, so a dog that is suddenly dull or weak on it should be checked, especially if it is also off its food.
The Perforation Problem, and Why It Is Mostly Avoidable
Soon after Deramaxx launched, a team including the manufacturer reviewed every report of gut perforation in its safety database. Of 29 dogs, 16 had been given more than the approved dose for their condition, 17 had received another NSAID or a corticosteroid within 24 hours, and 26 (90%) had one or both. Twenty of the 29 died or were euthanised. These are reports, not a rate, but the pattern is clear: most of these perforations followed a dosing or combination error.
Not all of them. In a separate report, three dogs developed perforations just past the stomach after starting deracoxib at 2–3 mg/kg, and two of the three were on the approved dose (Case 2010). And in a 2022 hospital review of 18 dogs whose stomach or gut perforated on a single NSAID at the label dose, 3 were on deracoxib, versus none on the far more widely prescribed carprofen (see our Previcox guide for the full breakdown). The practical rules are the same for every NSAID: the right dose for the condition, never two NSAIDs, never with a steroid, a washout gap when switching, and bloodwork.
Kidneys and Long-Term Use
In the label's six-month safety study in healthy dogs, urea (BUN) drifted up with dose but stayed in the normal range at label doses. Microscopic kidney changes appeared only at 6 mg/kg a day or more, and papillary necrosis, a serious kidney injury, appeared in one dog at 8 mg/kg and three at 10 mg/kg (Roberts 2009). Those are three to five times the arthritis dose, but they show what happens when dosing creeps up.
How long can a dog stay on Deramaxx? For arthritis, the label allows it once daily "as needed," long term. That is reasonable with baseline bloodwork and urinalysis, a recheck after the first few weeks, and regular rechecks after that; many vets check every 6 to 12 months. After orthopaedic surgery, the higher dose stops at 7 days; after dental surgery, at 3 days.
Deramaxx vs Rimadyl, Metacam and Previcox
| Drug | What it is | How it compares with Deramaxx |
|---|---|---|
| Rimadyl (carprofen) | COX-2-preferential NSAID, once or twice daily | The most prescribed dog NSAID; reduces platelet function more than deracoxib, which matters around surgery |
| Metacam (meloxicam) | COX-2-preferential NSAID, once-daily liquid | Liquid makes small-dog dosing simpler; one dose for arthritis |
| Previcox (firocoxib) | Coxib like Deramaxx, once daily | One dose (5 mg/kg) for both arthritis and surgery; similar evidence base |
| Galliprant (grapiprant) | Blocks one prostaglandin receptor, not the COX enzymes | Often chosen for dogs with higher stomach or kidney risk |
| Gabapentin | Nerve-pain drug | Not anti-inflammatory; often given alongside an NSAID |
Platelet finding: Brainard 2007, PMID 17331013. Your vet picks based on your dog's kidneys, liver, stomach history and other medicines.
Is Deramaxx the same as ibuprofen? No. Both are NSAIDs, but ibuprofen is a human drug that dogs are very sensitive to; it can cause stomach ulcers and kidney failure at doses people would consider small. Never give a dog ibuprofen, naproxen or other human painkillers. See what you can safely give a dog for pain.
Drugs Not to Combine With Deramaxx
- Any other NSAID, including aspirin, and any corticosteroid such as prednisone or dexamethasone. In the perforation review, 59% of dogs had one of these within 24 hours.
- With caution: diuretics such as furosemide, ACE inhibitors and other drugs that affect the kidneys or are highly protein-bound.
- Usually fine alongside: gabapentin, amantadine and trazodone. Tell your vet about every supplement too. See our hemp and dog medications guide.
Where Hemp Fits
We make hemp oil, so here is the honest version. The best canine evidence for CBD is in osteoarthritis pain, the same condition Deramaxx is approved for, but nothing supports stopping a prescribed NSAID and swapping in hemp. It fits alongside your vet's plan:
- In our own 90-day study overseen by veterinary pain specialist Dr. Robin Downing, dogs stayed on their existing prescriptions while our oil was added, and every medication change was made by the supervising vet.
- Both NSAIDs and CBD can raise liver values, so a dog on both needs bloodwork. Every published figure is in hemp side effects in dogs, and the doses used in dog trials are on one page.
Full-spectrum extract in cold-pressed hemp seed oil, grown and bottled on our own Colorado farm: the oil used in our 90-day joint study, where dogs stayed on their prescriptions. Not a replacement for Deramaxx. Tell your vet before adding it to an NSAID plan. Third-party tested every batch. $99
Shop 1,000mg Hemp Seed Oil → See the StudyWhat Is the Safest Anti-Inflammatory for Dogs?
No single NSAID is safest for every dog. What makes any of them safer is the same list: the right drug for your dog's kidneys, liver and stomach history, the right dose for the condition, one NSAID at a time, no steroid alongside, and bloodwork. For dogs who cannot take NSAIDs, Librela is an option, and weight loss, controlled exercise, rehab and non-slip floors help every arthritic dog. Our guide to arthritis in dogs covers what helps at each stage.
Questions to Ask Your Vet
- Is this the arthritis dose or the after-surgery dose, and when does it change?
- What is the dose in mg/kg, and which tablets should I use?
- Do we need bloodwork and a urine test before starting, and when is the recheck?
- If we switch NSAIDs, how many days of washout?
- What signs mean stop and come in?
Frequently Asked Questions
How long can a dog be on Deramaxx?
For arthritis, the label allows Deramaxx once daily as needed, long term, at 1 to 2 mg/kg. Long-term use needs baseline bloodwork and urinalysis, a recheck after the first few weeks and regular rechecks after that. After orthopaedic surgery, the higher 3 to 4 mg/kg dose is limited to 7 days, and after dental surgery the course is 3 days.
How fast does Deramaxx work?
Blood levels peak about 2 hours after a dose, according to the FDA label. After surgery it is given beforehand so it is already working. In placebo-controlled trials after dental extractions, only 14.8% of dogs on deracoxib needed rescue pain relief, versus 66.7% on placebo. For arthritis, judge it over a couple of weeks with your vet.
What is the Deramaxx dose for dogs?
It depends on the condition. For arthritis it is 1 to 2 mg/kg (0.45 to 0.91 mg/lb) once daily. After orthopaedic surgery it is 3 to 4 mg/kg (1.4 to 1.8 mg/lb) once daily for no more than 7 days. After dental surgery it is 1 to 2 mg/kg once daily for 3 days. Dogs needing under 12.5 mg must use the 12 mg tablet.
What are the side effects of deracoxib?
The most common are vomiting, diarrhea and poor appetite, about as often as with placebo in the 209-dog arthritis trial. Serious but uncommon effects include stomach or intestinal ulcers and perforation, kidney injury and liver injury. In 29 reported perforation cases, 90% involved a higher-than-approved dose or another NSAID or steroid within 24 hours.
Is Deramaxx the same as ibuprofen?
No. Both are NSAIDs, but Deramaxx (deracoxib) is a COX-2-selective drug approved for dogs, and ibuprofen is a human drug that is toxic to dogs even at small doses, causing stomach ulcers and kidney failure. Never give a dog ibuprofen, naproxen or other human pain relievers.
Will deracoxib make my dog sleepy?
It is not a sedative, and most dogs are simply more comfortable on it. Lethargy and weakness do appear in post-approval adverse event reports, sometimes alongside early signs of a serious stomach problem, so a dog that becomes dull, weak or stops eating on deracoxib should be seen by a vet.
Is Deramaxx better than Rimadyl?
Neither is clearly better overall. Both are FDA-approved NSAIDs for arthritis and post-surgical pain. Deramaxx is more COX-2 selective and affected platelet function less than carprofen in one study, which can matter around surgery. Carprofen is the most prescribed and had no single-drug perforation cases in a 2022 hospital review. Your vet chooses based on your dog.
What is the strongest pain medicine for dogs?
It depends on the pain. NSAIDs such as deracoxib, carprofen, meloxicam and firocoxib are the mainstay for arthritis and post-surgical inflammation. For severe acute pain, vets use opioids, and for nerve pain, gabapentin or amantadine, often combined with an NSAID. There is no over-the-counter human painkiller that is safe to give a dog without a vet.
Can I give Deramaxx with gabapentin?
Usually yes, if your vet prescribes both. Gabapentin is not an NSAID and is commonly given alongside Deramaxx for arthritic dogs. Gabapentin can cause sleepiness, so watch your dog for the first few days. Never combine Deramaxx with another NSAID or a steroid.
Can cats take Deramaxx?
No. The Deramaxx label says “Do not use in cats.” Cats handle NSAIDs very differently from dogs, and only specific products are approved for them. Never give a cat a dog's NSAID.
The Short Version
Deramaxx (deracoxib) is an effective, FDA-approved NSAID with three label doses: 1–2 mg/kg daily for arthritis, 3–4 mg/kg for up to 7 days after orthopaedic surgery, and 1–2 mg/kg for 3 days after dental surgery. Most of its serious gut perforations in the manufacturer's own review followed too high a dose or another NSAID or steroid within 24 hours. Confirm which dose your dog is on, never carry the surgery dose into long-term use, give one NSAID at a time, and keep up with bloodwork.
Full-spectrum hemp from our own Colorado farm: alongside your vet's plan, not instead of it
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Previcox for Dogs · Meloxicam for Dogs · Carprofen for Dogs · Galliprant · Librela · Gabapentin · Arthritis in Dogs · Hemp & Dog Medications
Marc co-founded HempMy Pet in 2016 with his business partner Natalie Mondine, the company's COO. HempMy Pet breeds its own hemp genetics, grows them on its own Colorado farm, and formulates every batch in-house under human-grade standards — seed to sale, nothing sourced overseas. Every batch is third-party tested and the certificates of analysis are published. More about us.
HempMy Pet ran its own 90-day study of 37 dogs with chronic joint discomfort. Of the 32 that completed it, 30 (93%) showed a benefit, and 94% of owners reported their dog's quality of life had improved. It was overseen by Dr. Robin Downing, DVM, MS of the Downing Center for Animal Pain Management, with Lori Kogan, Ph.D. and Peter W. Hellyer, DVM of Colorado State University's College of Veterinary Medicine & Biomedical Sciences, and published in the Journal of the American Holistic Veterinary Medical Association. Read the methodology.
Why Dr. Downing: in 2005 she became only the third veterinarian in the world credentialed as a Diplomate of the American Academy of Pain Management. She founded the International Veterinary Academy of Pain Management, is a Diplomate of the ACVSMR, a Certified Veterinary Pain Practitioner and a Certified Canine Rehabilitation Practitioner, and was the AVMA's 2020 Bustad Companion Animal Veterinarian of the Year. Read the published paper (PDF).
This article is general information for dog owners, not veterinary advice. It is reviewed and updated as new peer-reviewed evidence is published, and where the evidence is thin or negative we say so.
How We Sourced This Article
Every claim above traces to one of these.
- US Food and Drug Administration / Elanco. DERAMAXX (deracoxib) Chewable Tablets, label, NADA 141-203: indications and doses for arthritis, orthopaedic and dental surgery; 12 mg tablet rule; pharmacokinetics (2-hour peak, over 90% bioavailability, 3-hour half-life, non-linear above 8 mg/kg); 209-dog field study; post-approval adverse events; cat warning.
- Lascelles BD, Blikslager AT, Fox SM, Reece D. Gastrointestinal tract perforation in dogs treated with a selective cyclooxygenase-2 inhibitor: 29 cases (2002–2003). J Am Vet Med Assoc. 2005;227:1112–1117. PubMed.
- Case JB, Fick JL, Rooney MB. Proximal duodenal perforation in three dogs following deracoxib administration. J Am Anim Hosp Assoc. 2010;46:255–258. PubMed.
- Pfeifer JM, Levy NA, Carter DL, Beal MW. Gastric or duodenal perforation and secondary septic peritonitis following therapeutic NSAID administration. J Vet Emerg Crit Care. 2022;32:764–768. PubMed.
- Bienhoff SE, Smith ES, Roycroft LM, Roberts ES. Efficacy and safety of deracoxib for control of postoperative pain and inflammation associated with soft tissue surgery in dogs. Vet Surg. 2012;41:336–344. PubMed. Dental surgery: ISRN Vet Sci 2011, PubMed.
- Roberts ES, Van Lare KA, Marable BR, Salminen WF. Safety and tolerability of 3-week and 6-month dosing of Deramaxx (deracoxib) chewable tablets in dogs. J Vet Pharmacol Ther. 2009;32:329–337. PubMed.
- Gordon-Evans WJ, Dunning D, Johnson AL, Knap KE. Randomised controlled clinical trial for the use of deracoxib during intense rehabilitation exercises after tibial plateau levelling osteotomy. Vet Comp Orthop Traumatol. 2010;23:332–335. PubMed.
- McMillan SK, Boria P, Moore GE, et al. Antitumor effects of deracoxib treatment in 26 dogs with transitional cell carcinoma of the urinary bladder. J Am Vet Med Assoc. 2011;239:1084–1089. PubMed.
- Brainard BM, Meredith CP, Callan MB, Budsberg SC. Changes in platelet function, hemostasis, and prostaglandin expression after treatment with NSAIDs with various cyclooxygenase selectivities in dogs. Am J Vet Res. 2007;68:251–257. PubMed.
- Veterinary references. FDA, Get the facts about pain relievers for pets · PetMD, Deracoxib. Safety review: Monteiro-Steagall BP, et al. J Vet Intern Med 2013, PubMed.
- Kogan L, Hellyer P, Downing R. The Use of Cannabidiol-Rich Hemp Oil Extract to Treat Canine Osteoarthritis-Related Pain: A Pilot Study. J Am Holist Vet Med Assoc. 2020;58:35–45. Our disclosure: HempMy Pet supplied the hemp extract and reimbursed clinic costs; we had no involvement in any other study cited here.
Spot something that conflicts with your veterinarian's advice? Email support@hempmypet.com and we will correct it.
These statements have not been evaluated by the Food and Drug Administration. Our products are not intended to diagnose, treat, cure, or prevent any disease. This article is general information, not veterinary advice. Never start, stop or change your dog's medication without your veterinarian.
