Omeprazole/Misoprostol Paste

Paste medications are thick and sticky, usually given by mouth using a syringe or tube. They’re often used for dewormers or other oral meds in horses, dogs, and cats. The key is to aim for the back of the mouth so your pet swallows the paste instead of spitting it out.

For Horses:

1. Set the dose on the syringe if it has markings (usually based on weight).
2. Stand beside your horse, not in front, and have someone hold them if possible.
3. Gently insert your thumb into the side of the horse’s mouth (between the teeth) to open it.
4. Insert the syringe into that gap and squirt the paste toward the back of the tongue.
5. Lift the horse’s head slightly and encourage swallowing by stroking the throat or gently blowing on the nostrils.
6. Watch for licking or chewing—that means they swallowed. If paste spills out, check how much was lost and contact your vet if unsure.
7. You can offer a little water afterward and reward them with a treat like a carrot if allowed.

For Dogs & Cats:

1. Gently open your pet’s mouth or slip the syringe into the side of it.
2. Aim toward the back of the tongue and squirt the paste in.
3. Hold the mouth closed briefly, and rub the throat or blow gently on the nose to encourage swallowing.
4. Give praise or a treat afterward to make it a positive experience.

Aftercare:

1. Wipe your pet’s mouth if needed.
2. Clean or recap the syringe as instructed.
3. Store the tube according to label directions.

Tip: Paste can feel weird to pets at first. For horses, try giving applesauce by syringe ahead of time so they get used to the sensation.

This compounded formulation combines two active ingredients from different drug classes: omeprazole, a proton pump inhibitor and misoprostol, a prostaglandin analog. In compounding practice, clinicians may consider a combination like this to address the gastric environment through more than one mechanism. Your veterinarian determines whether it is appropriate based on your animal's history and diagnostic findings.

At a pharmacological level, omeprazole binds to the hydrogen-potassium ATPase enzyme system—the "proton pump"—within the gastric parietal cells, which suppresses the final step of acid secretion into the stomach lumen. Misoprostol is a synthetic prostaglandin analog that binds to prostaglandin receptors on parietal cells, further reducing acid secretion while supporting mucosal blood flow and the secretion of protective bicarbonate and mucus. Together, the two ingredients act on the gastric environment through complementary mechanisms.

This description reflects the general pharmacology of the active ingredient's drug class; your veterinarian determines whether this approach is appropriate for your animal.

Prescription only. Use only under the direction of a licensed veterinarian. This information is not a substitute for veterinary diagnosis, prescribing or monitoring. Compounded drugs are not approved by the FDA for safety or effectiveness.

Commonly observed effects of omeprazole/misoprostol may include mild gastrointestinal changes such as loose stools, flatulence or transient colic-like symptoms shortly after administration. Because misoprostol can influence uterine contractions, this medication is typically used with extra caution or avoided in pregnant mares, as it is associated with a risk of abortion. Owners who are pregnant or may become pregnant should exercise extreme care and wear non-porous protective gloves (such as chemical-resistant nitrile or neoprene) when handling this medication to avoid accidental skin absorption.

This medication is typically avoided in patients with a known hypersensitivity to either omeprazole or misoprostol. It is important to provide your veterinarian with a complete history of all other prescriptions and supplements your horse is receiving, as changes in gastric pH can influence the absorption of other oral medications. Your veterinarian will provide specific guidance on the timing of administration relative to feeding to ensure the protocol remains suitable for your horse's individual needs. Contact your veterinarian promptly if you observe significant behavioral changes, persistent diarrhea or any signs of physical discomfort during the administration period.