Regulation (EU) 2026/1810 – Deletion

Amendment to Implementing Regulation (EU) 2025/901

Article 1

The Annex to Implementing Regulation (EU) 2025/901 is replaced by the text in the Annex to this Regulation.

Amendment to Regulation (EC) No 1950/2006

Article 2

The entries for the substances digoxin, dorzolamide, griseofulvin, imipramine, ketoconazole, phenytoin and ticarcillin in the Annex to Regulation (EC) No 1950/2006 shall be deleted.

Entry into force

Article 3

This Regulation shall enter into force on the day following that of its publication in the Official Journal of the European Union .

Supplementary provisions

Groups of substances

ANNEXSupplementary provisions

ANNEX Groups of substances I. Anaesthetics Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages Oxybuprocaine a Local topical anaesthesia for use in eyes None identified Wide clinical experience Prilocaine b Local topical anaesthesia prior to intravenous injection or catheterisation Lidocaine In specific preparations (eutectic mixture of local anaesthetics), for topical application to skin; can be used to facilitate intravenous injection or catheterisation Sevoflurane b Mask induction of anaesthesia in foals Isoflurane Better suited for mask induction as less pungent than the alternative ( 1 ) Active substances identified with an ‘a’ are essential substances. Substances identified with a ‘b’ are substances which bring added clinical benefit. II. Analgesics Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages Bromfenac b Treatment of uveitis and ocular inflammation Systemic nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g. flunixin); topical (ocular) ketorolac Topical NSAIDs may result in less patient discomfort, reduced postoperative inflammation, prevention of miosis, and improvements in visual acuity in the early postoperative period Fentanyl b Multimodal approach for moderate to severe acute painful conditions Butorphanol, morphine Produces better analgesia than certain other opioids and can be used for very painful conditions; recognised value for use in multi-modal approaches Ketorolac b Treatment of eye pain and inflammation Systemic NSAID therapy (e.g. flunixin) Formulated for local application Methocarbamol b As part of treatment protocols in severe painful muscle spasms or severe muscle inflammation conditions Systemic NSAIDs (e.g. flunixin) Potent skeletal muscle relaxation; specific action on the internuncial neurons of the spinal cord to reduce acute skeletal muscle spasms without a concomitant alteration in muscle tone Morphine b Analgesia Butorphanol, fentanyl More potent than other analgesics Triamcinolone acetonide b Treatment of joint inflammation Methylprednisolone Less harmful effects on cartilage metabolism III. Antimicrobials Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages I. Antibiotics Amikacin b Treatment of septicemia in horses and foals Gentamicin, ceftiofur Better safety profile in the target animal Azithromycin b Treatment of Rhodococcus equi infections susceptible to azithromycin Clarithromycin, erythromycin, gamithromycin, tulathromycin, doxycycline Added clinical benefit in cases of Rhodococcus equi infections in foals that can be resolved as monotherapy or in combination with doxycycline Clarithromycin b Treatment of Rhodococcus equi infections susceptible to clarithromycin Azithromycin, erythromycin, gamithromycin, tulathromycin, doxycycline More active against Rhodococcus equi in vitro than erythromycin or azithromycin; achieves greater concentrations in pulmonary epithelial lining fluid and alveolar macrophages than either erythromycin or azithromycin, though the half-life is shorter Fusidic acid b Topical treatment of eye infections caused by gram-positive bacteria susceptible to fusidic acid Ofloxacin, moxifloxacin Broad spectrum for treatment of gram-positive infections; primary choice in superficial, uncomplicated corneal ulcers and acute conjunctivitis in horses Moxifloxacin b Topical treatment of external eye infections caused by gram-positive cocci, gram-negative, atypical and anaerobic bacteria, such as Pseudomonas aeruginosa, susceptible to moxifloxacin Ofloxacin Advantageous pharmacokinetic profile; spectrum of activity includes gram-positive cocci and anaerobic bacteria that may be resistant to other quinolones Ofloxacin b Treatment of external eye infections caused by gram-positive and gram-negative micro-organisms susceptible to ofloxacin Moxifloxacin Clinical experience; penetrates the entire cornea up to the anterior chamber of the eye Polymyxin B b Treatment of bacterial keratitis, topical use Ofloxacin, moxifloxacin Effective alternative to systemic treatments; different mechanism of action to other topical alternatives II. Antifungals Amphotericin B a Treatment of fungal pneumonia, systemic use None identified Treatment of choice Ketoconazole b Adjunctive therapy in the treatment of guttural pouch mycosis, topical use Enilconazole Less irritant compared to the alternative; formulated for local application Miconazole b Treatment of fungal infection of the eye Natamycin, nystatin, voriconazole Broad spectrum of activity; less irritant compared to other topical antifungals Nystatin b Treatment of fungal and yeast infections of the eye and genital tract Miconazole Treatment of choice for yeast infections Voriconazole b Treatment of fungal keratitis, topical use Miconazole Broad spectrum of activity III. Antivirals Aciclovir b Treatment of cases of equine herpes virus infection associated with complications, topical use only Ganciclovir Treatment of choice for ocular ulcers when the implication of a viral pathogen is suspected Ganciclovir b Treatment of cases of equine herpes virus infection associated with complications, topical use Aciclovir, valaciclovir Wealth of evidence for the treatment of different virus-types causing herpetic infections Valaciclovir b Treatment of cases of equine herpes virus infections, oral use Aciclovir Better pharmacokinetic profile and a different route of administration IV. Substances for respiratory disorders Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages Ambroxol b Stimulation of surfactant in premature foals Steroids, bromhexine, dembrexine, surfactant transfer from healthy donor Preferred clinical choice for premature foals Fluticasone b Control of allergic pulmonary disease including mild to moderate cases of equine asthma and subtypes via inhalation Beclomethasone Inhalation leads to less adreno-cortical suppression, quicker rebound after therapy ends and fewer systemic side effects than systemic corticosteroid therapy because of its limited systemic absorption; especially indicated for control of mild-moderate and refractory severe asthma as well as long-term maintenance therapy Ipratropium bromide b As a bronchodilator in horses with mild-moderate asthma Clenbuterol Anticholinergic action, as an alternative to beta-agonists Oxymetazoline b Treatment of nasal oedema Phenylephrine Alpha-adrenoceptor agonist with strong vasoconstrictive properties and longer acting effect Phenylephrine b Treatment of nasal oedema Oxymetazoline Reduces the need for insertion of nasal tubes during recovery V. Substances for cardiology Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages Amiodarone b Systemic and oral treatment of atrial fibrillation, supraventricular and ventricular tachycardias Quinidine sulphate/gluconate, sotalol, verapamil Different mode of action: class III anti-dysrhythmic Propafenone b Treatment of ventricular tachycardia and ventricular tachyarrhythmia Quinidine sulphate/gluconate Different mode of action: sodium channel antagonist that decreases heart excitability Quinapril a Treatment of heart failure; cardiovascular protection in horses with atrial fibrillation (AF) or mitral regurgitation (MR) None identified Different mode of action: angiotensin-converting-enzyme (ACE) inhibitor Quinidine sulphate/gluconate b Treatment of cardiac arrhythmias Amiodarone, sotalol, verapamil Treatment of choice for atrial fibrillation Sotalol b Long-term treatment of cardiac arrhythmias Amiodarone, quinidine sulphate/gluconate More suitable in horses requiring long-term anti-arrhythmic therapy; less adverse events than amiodarone Verapamil b Treatment of supraventricular arrhythmias Amiodarone, quinidine sulphate/gluconate, sotalol Different mode of action: calcium channel blocker VI. Substances for diagnostic procedures Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages Barium sulfate a Enhanced gastrointestinal tract visualisation during radiographic examinations None identified No satisfactory alternative treatment for enhanced gastrointestinal tract visualisation during radiographic examinations Fluorescein b Diagnosing corneal keratitis or ulceration, topical use Rose bengal Diagnostic tool of choice when a viral culture is needed afterwards Iohexol a Contrast agent for lower urinary tract radiography, arthrography, myelography, sino- or fistulography and dacryocystography None identified Non-ionic, water-soluble contrast agent Phenylephrine a Diagnosing grass sickness None identified Ancillary diagnostic approach to equine grass sickness polyneuropathy Rose bengal b Diagnosing corneal keratitis or ulceration, topical use Fluorescein Diagnostic tool of choice for diagnosing eye keratitis/ulcers Thyrotropin releasing hormone a Diagnosing pituitary pars intermedia dysfunction None identified No satisfactory alternatives for diagnosing pituitary pars intermedia dysfunction VII. Substances for gastrointestinal disorders Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages Metoclopramide b Treatment of post-operative ileus Intravenous fluid substitution, painkillers (e.g. flunixin), lidocaine Prokinetic drug Misoprostol b Treatment of gastric glandular disease and colitis Omeprazole, sucralfate Superior to omeprazole for the treatment of equine gastric glandular disease Phenylephrine a Treatment of nephrosplenic entrapment None identified Clinical value in the resolution of nephrosplenic entrapment; causes a dose-dependent splenic contraction Ranitidine b Treatment of gastric ulcers in critically ill neonates, intravenous use Omeprazole The intravenous route of administration brings added clinical benefit over other oral antiulcer medications Sucralfate b Treatment and prevention of gastric ulcers in horses Omeprazole Different mode of action than omeprazole (mucosal adherent), which provides physical lesion stabilisation VIII. Substances for metabolic disorders Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages Insulin b As an aid in the treatment of hyperlipidaemia unresponsive to glucose therapy or severe hyperlipidaemia, used in combination with glucose and other therapies Diagnosing metabolic disorders (e.g. insulin resistance associated with equine metabolic syndrome or pituitary pars intermedia dysfunction) Low-molecular weight heparin can be used for cases of hyperlipidaemia Insulin is the preferred clinical choice IX. Substances for musculoskeletal disorders Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages Atracurium b Inducing muscle paralysis under general anaesthesia Cisatracurium, guaifenesin Brings added clinical benefit in horses under general anaesthesia in cases where increased muscle relaxation is necessary such as ophthalmic surgeries, certain orthopaedic repairs and when deep access to the abdominal cavity is needed. Cisatracurium b Inducing muscle paralysis under general anaesthesia Atracurium, guaifenesin Brings added clinical benefit in horses under general anaesthesia in cases where increased muscle relaxation is necessary such as ophthalmic surgeries, certain orthopaedic repairs and when deep access to the abdominal cavity is needed. Dantrolene sodium b Prevention of rhabdomyolysis Prevention of malignant hyperthermia during anaesthesia NSAIDs, intravenous fluids, vitamin E/selenium Efficacious as preventative, inhibiting the release of calcium from the sarcoplasmic reticulum and thus causing dissociation of excitation-contraction coupling Edrophonium a Reversing the effects of atracurium muscle paralysis None identified Cholinesterase inhibitor, essential for reversal of neuromuscular blockade; least side effects of the cholinesterase inhibitors in horses Guaifenesin b Induction and maintenance of general anaesthesia in field conditions Atracurium, cisatracurium Particularly indicated in field (non-hospital) conditions where anaesthesia may be necessary; the reduced cardiopulmonary depressive effects facilitate safe anaesthesia without advanced monitoring equipment or mechanical ventilation X. Substances for nervous system disorders Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages Diazepam a Short-term anti-convulsant for treatment of seizures None identified Second-generation antiseizure Midazolam a Short-term anti-convulsant for treatment of seizures None identified Second-generation antiseizure XI. Substances for ophthalmology Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages Acetazolamide b Treatment of glaucoma, oral use Phenylephrine Its mechanism of action as carbonic anhydrase inhibitor Cyclopentolate b Mydriatic agent Atropine, phenylephrine Induces significant mydriasis without affecting tear production, intraocular pressure, digestive function (i.e. gut motility and faeces production), or heart rate Cyclosporine A b Treatment of autoimmune diseases of the eye Topical steroids Immunosuppressive effect by inhibiting T-lymphocyte proliferation and reducing cytokine gene expression Phenylephrine b Treatment of glaucoma and epiphora Atropine and tropicamide It does not (or only slightly) increase intra ocular pressure Synephrine b Treatment of the mucous membranes of the eye as a decongestant Phenylephrine, tetryzoline Fast local effect; enhances penetration of local therapy, providing synergistic effects with e.g. local antimicrobial therapy Tetryzoline b Treatment of the mucous membranes of the eye as a decongestant Phenylephrine, synephrine Fast local effect Timolol maleate b Treatment of glaucoma, topical use Acetazolamide Its specific mode of action as a non-selective beta-adrenergic receptor blocking agent, provides for an important therapeutic choice in the treatment of glaucoma Triamcinolone acetonide b Treatment of recurrent uveitis in cases that are refractory to other treatments Atropine, tropicamide Effective, low-morbidity treatment in cases that are refractory to other treatments Tropicamide b Treatment of recurrent uveitis Atropine, cyclopentolate, triamcinolone acetonide Rapid onset of action XII. Substances for sedation and premedication (and antagonism) Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages Acepromazine b For a multimodal approach for tranquilisation and premedication in combination with other sedatives Detomidine, romifidine, xylazine, diazepam The mode of action of acepromazine and its unique quality of sedation cannot be produced by alpha-2 agonist sedatives or benzodiazepines Atipamezole a Reversing the effects of alpha-2 agonists None identified Reverses sedative and analgesic effects and adverse cardiovascular reactions Dexmedetomidine b Sedation or general anaesthesia as part of partial or total intravenous anaesthesia protocols Detomidine, romifidine, xylazine, diazepam The most selective alpha-2 agonist; short half-life and rapid redistribution, which particularly favour its use as a continuous-rate infusion Diazepam b Premedication and induction of anaesthesia, mild tranquilisation with minimal cardiovascular and respiratory side effects Acepromazine, detomidine, romifidine, xylazine The mode of action (at gamma-aminobutyric acid (GABA) receptor) provides unique tranquilisation without cardiorespiratory depression that cannot be produced by alpha-2 agonist sedatives (detomidine, romifidine and xylazine) or acepromazine Midazolam b Premedication and induction of anaesthesia, mild tranquilisation with minimal cardiovascular and respiratory side effects Acepromazine, detomidine, romifidine, xylazine The mode of action (at GABA receptor) provides unique tranquilisation without cardiorespiratory depression that cannot be produced by alpha-2 agonist sedatives (detomidine, romifidine and xylazine) or acepromazine Flumazenil a Intravenous reversal agent for benzodiazepine effect during recovery from Total Intravenous Anaesthesia (TIVA) techniques None identified Antagonist that competitively inhibits the benzodiazepine binding site at the GABA receptor Naloxone a Reversal of opioid effects during emergencies None identified No alternatives available Propofol b Induction of anaesthesia in foals via intravenous administration Isoflurane Improvement in cardiovascular stability and quality of recovery over inhalation anaesthesia in foals XIII. Substances for systemic disorders Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages Allopurinol b Neonatal ischaemia reperfusion injury Vitamin E Different mode of action in inhibiting the formation of reactive oxygen species (ROS) than vitamin E Dalteparin b Anticoagulant Heparin Reduction in molecular size is associated with a loss of thrombin inhibitory activity, but conversely an increase in factor Xa (FXa) inhibition compared to unfractionated heparin Dobutamine b Management of hypotension under general anaesthesia Ephedrine First-line medication for the treatment of hypotension in adult equines under general anaesthesia Dopamine a As part of a treatment protocol for acute kidney injury/renal failure only None identified Low doses have been shown to cause renal vasodilation, increased renal blood flow, and increased urine production without systemic cardiovascular effects in conscious healthy horses Ephedrine b Treatment of hypotension under general anaesthesia Dobutamine Used to treat hypotension in adult equines under general anaesthesia where dobutamine is ineffective. Different mode of action to dobutamine with a more direct effect on cardiac contractility Gelatinpolysuccinate b Addressing long-term hypovolaemia resulting from conditions like e.g. low albumin Crystalloids Colloids are larger molecules compared to crystalloids, thus stay longer in the intravascular space, which is an advantage for correcting hypovolemia from e.g. hypoalbuminemia Glycopyrrolate b Treatment and prevention of bradycardia Atropine Minimal central effect; suitable in conscious horses, before and after anaesthesia Noradrenaline / norepinephrine b Treatment of early septic shock Supporting cardiovascular function in critically ill foals Dobutamine, dopamine In compromised (sick) foals it is generally the only catecholamine effective in treatment of hypotension Vasopressin b Treatment of circulatory collapse in foals and adult horses Epinephrine, dopamine, dobutamine Alternative in cases where standard catecholamine therapies like dopamine, dobutamine, epinephrine are ineffective or require potentiation to restore vascular tone in refractory vasodilatory shock states XIV. Substances for tumours Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages Imiquimod a Treatment of sarcoids None identified Current research suggests that equine sarcoids likely result from a complex interaction including host immune system dysfunction XV. Miscellaneous Active substance ( 1 ) Indications Identification of alternatives Explanation of use / specific advantages Cetirizine b Treatment of conditions where an antihistamine is deemed necessary Chlorphenamine Second-generation histamine-1 (H1) receptor inverse agonists are alternatives with fewer central nervous system (CNS) (sedative) side effects Domperidone b Treatment of agalactia/dysgalactia in mares Sulpiride Its ability to stimulate prolactin secretion in situations of dopaminergic inhibition Sulpiride b Treatment of agalactia/dysgalactia in mares Domperidone Its ability to stimulate prolactin secretion in situations of dopaminergic inhibition

Article 1

Article 2

Article 3

Supplementary provisions

ANNEXSupplementary provisions

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