Capromorelin (Elura, 2 mg/kg PO q24h) produces a +5.2% mean body weight gain in cats with CKD-associated weight loss by Day 55, compared to −1.6% in vehicle-treated controls — a difference of +6.8%. FDA DailyMed An…
Weight gain begins early and is sustained throughout treatment. By Day 15, capromorelin-treated cats had gained +3.3% body weight versus 0.0% in controls; by Day 27, +3.8% versus −0.9%.FDA DailyMed An… The labeled dose is 2 mg/kg PO once daily for 56 days in cats with ≥5% unintended weight loss and a history of chronic kidney disease (CKD).FDA DailyMed An…
Capromorelin is the only ghrelin receptor agonist (GRA) authorized for weight loss management in cats, and its orexigenic and anabolic activity is not expected to be limited to CKD — comorbidities including hyperthyroidism, congestive heart failure, cancer, and arthritis were represented in the clinical population.Journal of Feli… The 2026 AAHA Oncology Guidelines also endorse capromorelin alongside mirtazapine as a first-line appetite stimulant in cats with cancer-related hyporexia.AAHA Clinical G…
The safety profile at the labeled dose is acceptable. In safety evaluations using doses of 6–60 mg/kg/day in healthy cats, adverse observations were limited to emesis, hypersalivation, lethargy/depression, head shaking, and lip smacking, all occurring more frequently in capromorelin-treated groups than placebo; no clinically relevant clinical pathology differences were identified.Journal of Vete… Transient reductions in blood pressure and heart rate have been reported after administration, though the clinical significance of this in CKD patients has not been fully characterized.Journal of Feli…
Capromorelin is the preferred first-line appetite stimulant for weight gain in feline CKD — mirtazapine (1.88 mg PO q48h) is an established alternative with demonstrated weight gain and reduced vomiting in CKD catsJournal of Feli…, while maropitant reduces vomiting but does not improve appetite scores or body weightJournal of Feli…, and omeprazole produces only a 2.7% increase in food consumption with no significant effect on appetite score or body weight.Journal of Vete…
| Drug | Dose & Route | Efficacy in Feline CKD | Key Caveat |
|---|---|---|---|
| Capromorelin (Elura) | 2 mg/kg PO q24h × 56 days | +5.2% body weight vs −1.6% control at Day 55 | Transient BP/HR reduction reported |
| Mirtazapine | 1.88 mg PO q48h | Significant improvement in appetite score, body weight, and vomiting frequency | Compounded transdermal formulations may not meet USP standards |
| Maropitant | 4 mg PO q24h × 14 days | Significant reduction in vomiting; no significant effect on appetite score or body weight | Not an appetite stimulant; antiemetic only |
| Omeprazole | 1 mg/kg PO q24h × 14 days | +2.7% food consumption only; no significant effect on appetite score or body weight | Tertiary option only; not first-line |
Would you like guidance on combining capromorelin with mirtazapine or maropitant in cats with concurrent vomiting and weight loss?