Is bromide safer than phenobarbital for long term use?
We don’t know. Phenobarbital has been used in dogs for decades and has always been considered a relatively safe drug. Only in the last five to ten years has it been recognized that some dogs develop hepatotoxicity when treated with phenobarbital alone. Neither the incidence nor the underlying mechanism of this adverse reaction is known, but it appears likely that hepatotoxicity is related to chronic and/or high doses of phenobarbital. However, other modulating risk factors are also likely to be present, since not all dogs on long-term phenobarbital therapy develop this syndrome. Although we don’t yet have decades of experience with the use of bromide in dogs with epilepsy, it does appear so far that bromide is relatively safe in dogs when used over months to years and monitored appropriately. SUMMARY For dogs treated with both bromide and phenobarbital, an estimated 53% will be able to have a reduction or discontinuation of phenobarbital even while showing an improvement in seizure con
