Cascade and Off-Label Veterinary Prescriptions
When no suitable licensed veterinary medicine is available, UK veterinary surgeons may prescribe medication under the prescribing cascade. This allows human medicines or alternative veterinary medicines to be used where clinically appropriate.
Many medications used in cardiology, neurology, behavioural medicine, gastroenterology and pain management are prescribed under this system.
How the Cascade Prescription Process Works
- Your vet issues a valid written prescription.
- You complete our cascade medication enquiry form.
- Upload your prescription directly within the form.
- We review the prescription and source the medication.
- You receive a secure invoice.
- If you are happy with the price, create an account and checkout as normal.
- Your medication is dispensed under VMD and RCVS standards.
Submit a Cascade Medication Request
Examples of Common Off-Label Medications and Their Uses in the UK
Below are examples of medications frequently prescribed under the UK veterinary cascade. These medicines are used when no suitable licensed veterinary alternative is available for the specific condition being treated.
This list is not exhaustive, but reflects some of the most commonly requested human medicines prescribed for dogs and cats in UK veterinary practice.
Neurology & Pain Management
| Medication | Common Veterinary Use |
|---|---|
| Zonisamide | Refractory epilepsy |
| Levetiracetam | Adjunct seizure control |
| Pregabalin | Neuropathic pain |
| Gabapentin (CD Sch 3) | Neuropathic pain, chronic pain |
| Amantadine | Chronic pain modulation |
| Amitriptyline | Neuropathic pain, behavioural cases |
Cardiology & Circulation
| Medication | Common Veterinary Use |
|---|---|
| Clopidogrel 75mg | Anti-platelet therapy |
| Rivaroxaban | Anticoagulant therapy |
| Sildenafil | Pulmonary hypertension |
| Tranexamic Acid | Bleeding control |
Gastrointestinal & Appetite Support
| Medication | Common Veterinary Use |
|---|---|
| Metoclopramide | Prokinetic, anti-emetic |
| Ondansetron | Anti-emetic |
| Omeprazole | Gastric acid suppression |
| Mirtazapine | Appetite stimulation |
| Ursodeoxycholic Acid | Liver disease support |
Urology & Behaviour
| Medication | Common Veterinary Use |
|---|---|
| Hypovase (Prazosin) | Urethral relaxation |
| Desmopressin | Diabetes insipidus |
| Trazodone | Behavioural calming |
| Robaxin (Methocarbamol) | Muscle relaxation |
Regulated Supply & Prescription Requirements
All cascade medications are supplied strictly against a valid veterinary prescription. We operate under Veterinary Medicines Directorate (VMD) regulation and Royal College of Veterinary Surgeons (RCVS) standards. All medications are obtained from authorised UK pharmaceutical wholesalers, maintaining secure, regulated supply chains with full traceability and compliance with Veterinary Medicines Directorate (VMD) requirements.
