POM-V Prescription Required

Apotil 300 mg/ml Solution for Injection

Active ingredient: Tilmicosin

Form

Injection

Species

Cattle Sheep

Manufacturer

Nimrod Nederland B.V.

VMD MA No.

61571/5000

What it's used for

Treatment of interdigital necrobacillosis (bovine pododermatitis, foul in the foot). Sheep Treatment of respiratory tract infections caused by Pasterurella...

Full indications, dosage and side effects ↓

View official SPC (PDF)

The prescription itself has a price. See what practices near you charge for a consultation and the written prescription fee.

Paying less for Tilmicosin

1

Ask your vet for a written prescription

They must provide one on request. Under the CMA Order the fee is capped at £21 from 2027.
2

Fill it at a registered online retailer

The CMA found online pharmacies 50–60% cheaper than practice dispensing on common medicines — typically £200–£300 a year.

Your prescription rights → VMD register of retailers →

Prescription required

Your vet must provide a written prescription on request. You can then purchase from any licensed online retailer.

Clinical information

Apotil 300 mg/ml Solution for Injection — SPC Details

Source: VMD Summary of Product Characteristics (SPC). Last updated 27 Mar 2026.

Treatment of interdigital necrobacillosis (bovine pododermatitis, foul in the foot).
Sheep
Treatment of respiratory tract infections caused by
Pasterurella multocida.
Treatment of foot rot caused by
necrophorum..
Treatment of ovine mastitis associated with
agalactiae.

Do not administer intravenously.
Do not administer intramuscularly.
Do not administer to lambs weighing less than 15 kg.
Do not administer to pigs.
Do not administer to horses or donkeys.
Do not administer to goats.
Do not administer to primates.
Do not use in cases of known hypersensitivity to the active substance or any of the
excipients.

Occasionally, a soft diffuse swelling may occur at the injection site, but this
disappears within five to eight days.
Deaths of cattle have been observed following a single intravenous dose of 5 mg/kg,
and following the subcutaneous injection of doses of 150 mg/kg at 72 hour intervals.
In pigs, intramuscular injection at 20 mg/kg has caused deaths. Sheep have died
following a single intravenous injection of 7.5 mg/kg.

Do not administer to lambs weighing less than 15 kg, since there is a real risk of
overdosage toxicity. Accurate weighing of lambs is important to avoid overdosage.
The use of a 2 ml or smaller syringe will facilitate accurate dosing.
A bacteriological cure of acute ovine mastitis caused by and
Mycoplasma agalactiae has not been demonstrated by a clinical trial.

i) Special precautions for use in animals
Use of the product should be based on susceptibility testing of the bacteria
isolated from the animal. If this is not possible, therapy should be based
on local (regional, farm level) epidemiological information about
susceptibility of the target bacteria.
ii) Special precautions to be taken by the person administering the veterinary
medicinal product to animals
Operator Safety Warnings:
INJECTION OF TILMICOSIN IN HUMANS CAN BE FATAL – EXERCISE
EXTREME CAUTION TO AVOID ACCIDENTAL SELF-INJECTION AND
FOLLOW THE ADMINISTRATION INSTRUCTIONS AND THE
GUIDANCE BELOW, PRECISELY
•
•
FOR INJECTION with the needle attached. The needle should be
connected to the syringe only when filling the syringe or
administering the injection. Keep the syringe and needle separate at
all other times.
•
•
vicinity.
•
INJECTION.
•
and take the vial or the package leaflet with you. Apply a cold pack
(not ice directly) to the injection site.
Additional operator safety warnings:
•
•
NOTE TO THE PHYSICIAN
INJECTION OF TILMICOSIN IN HUMANS HAS BEEN ASSOCIATED
WITH FATALITIES.
The cardiovascular system is the target of toxicity, and this toxicity may be
due to calcium-channel blockade. Administration of intravenous calcium
chloride should only be considered if there is positive confirmation of
exposure to tilmicosin.
In dog studies, tilmicosin induced a negative inotropic effect with
consequent tachycardia, and a reduction in systemic arterial blood
pressure and arterial pulse pressure.
DO NOT GIVE ADRENALIN OR BETA-ADRENERGIC ANTAGONISTS
SUCH AS PROPRANOLOL.
In pigs, tilmicosin-induced lethality is potentiated by adrenalin.
In dogs, treatment with intravenous calcium chloride showed a positive
effect on the left ventricular inotropic state and some improvements in
vascular blood pressure and tachycardia.
Pre-clinical data and an isolated clinical report suggest that calcium
chloride infusion may help to reverse tilmicosin induced changes in blood
pressure and heart rate in humans.
Administration of dobutamine should also be considered due to its positive
inotropic effects although it does not influence tachycardia.
As tilmicosin persists in tissues for several days, the cardiovascular
system should be closely monitored and supportive treatment provided.
Physicians treating patients exposed to this compound are advised to
discuss clinical management with the National Poison Information Service
on:0844 892 0111.

Interactions between macrolides and ionophores have been observed in some
species.

Do not store above 30 C.
Protect from light.

i) Special precautions for use in animals
Use of the product should be based on susceptibility testing of the bacteria
isolated from the animal. If this is not possible, therapy should be based
on local (regional, farm level) epidemiological information about
susceptibility of the target bacteria.
ii) Special precautions to be taken by the person administering the veterinary
medicinal product to animals
Operator Safety Warnings:
INJECTION OF TILMICOSIN IN HUMANS CAN BE FATAL – EXERCISE
EXTREME CAUTION TO AVOID ACCIDENTAL SELF-INJECTION AND
FOLLOW THE ADMINISTRATION INSTRUCTIONS AND THE
GUIDANCE BELOW, PRECISELY
•
•
FOR INJECTION with the needle attached. The needle should be
connected to the syringe only when filling the syringe or
administering the injection. Keep the syringe and needle separate at
all other times.
•
•
vicinity.
•
INJECTION.
•
and take the vial or the package leaflet with you. Apply a cold pack
(not ice directly) to the injection site.
Additional operator safety warnings:
•
•
NOTE TO THE PHYSICIAN
INJECTION OF TILMICOSIN IN HUMANS HAS BEEN ASSOCIATED
WITH FATALITIES.
The cardiovascular system is the target of toxicity, and this toxicity may be
due to calcium-channel blockade. Administration of intravenous calcium
chloride should only be considered if there is positive confirmation of
exposure to tilmicosin.
In dog studies, tilmicosin induced a negative inotropic effect with
consequent tachycardia, and a reduction in systemic arterial blood
pressure and arterial pulse pressure.
DO NOT GIVE ADRENALIN OR BETA-ADRENERGIC ANTAGONISTS
SUCH AS PROPRANOLOL.
In pigs, tilmicosin-induced lethality is potentiated by adrenalin.
In dogs, treatment with intravenous calcium chloride showed a positive
effect on the left ventricular inotropic state and some improvements in
vascular blood pressure and tachycardia.
Pre-clinical data and an isolated clinical report suggest that calcium
chloride infusion may help to reverse tilmicosin induced changes in blood
pressure and heart rate in humans.
Administration of dobutamine should also be considered due to its positive
inotropic effects although it does not influence tachycardia.
As tilmicosin persists in tissues for several days, the cardiovascular
system should be closely monitored and supportive treatment provided.
Physicians treating patients exposed to this compound are advised to
discuss clinical management with the National Poison Information Service
on:0844 892 0111.
4.

This information is sourced from the official Summary of Product Characteristics (SPC) published by the Veterinary Medicines Directorate (VMD). It is provided for informational purposes only and does not replace professional veterinary advice. Always consult your vet before administering any medication.