Update (June 19, 2026): Imepitoin Single Oral Dose Reduces Cortisol and Heart Rate in Cats During Veterinary Visits - Pilot RCT

TL;DR. A 2026 open-label pilot found a single oral imepitoin dose reduced salivary cortisol and heart rate to a greater extent than placebo in cats undergoing veterinary visits, though interpretability is limited by small size and open-label design.

What just dropped

• Agan et al. 2026 (Vet Sci, open access) enrolled 32 cats randomly assigned to imepitoin or placebo and evaluated physiological and behavioural stress parameters during veterinary visits. (https://europepmc.org/articles/PMC13211725)
• Salivary cortisol showed a differential pre-to-post change between groups, with a significant decrease in the imepitoin group.
• Heart rate: despite higher baseline HR in the imepitoin group, a greater reduction from pre- to post-treatment was observed compared to placebo.
• Behavioural scores (Cat Stress Score and Cat Examination Response Scale) improved in the imepitoin-treated group; however, the open-label design and single-investigator assessment limit interpretability of these findings.
• Authors concluded that confirmation in larger, well-controlled, blinded, methodologically robust studies is required before clinical application can be considered.

Context

Imepitoin (Pexion, Boehringer Ingelheim) is an EMA-approved partial benzodiazepine receptor agonist and low-affinity calcium channel blocker licensed for canine idiopathic epilepsy and noise aversion. It is not approved for use in cats and this pilot study is the first to explore its potential for veterinary-visit-associated stress in the species.

The concept follows from the drug's partial agonism at benzodiazepine receptors (GABA-A potentiation), which is the same receptor target as many anxiolytic drugs. The pilot was conducted by Ondokuz Mayis University (Turkey) in collaboration with IRSEA. The cortisol and HR findings are biologically plausible, but with n=16 per group and an open-label design, effect size confidence intervals are wide and observer bias is an acknowledged limitation.

What this changes in imepitoin-canine-idiopathic-epilepsy (https://www.thevoyage.ai/forvets/knowledge/imepitoin-canine-idiopathic-epilepsy)

This study does not change existing canine use of imepitoin, but it opens a novel candidate indication in feline behaviour medicine. Clinicians asking about off-label feline anxiolytic options should note this as a very early-stage signal only; gabapentin remains the most studied pre-visit anxiolytic in cats with a controlled crossover trial supporting its use. Await confirmatory blinded trials before considering imepitoin for this indication in cats.

References

1. Agan UB, Descout E, Meral Y. Effects of a Single Oral Dose of Imepitoin on Veterinary Visit-Related Stress in Cats: An Open-Label Pilot Study. Vet Sci. 2026;13(5):431. https://europepmc.org/articles/PMC13211725
2. Charalambous M, Tipold A, Volk HA, et al. Antiseizure monotherapy with imepitoin or phenobarbital in feline idiopathic epilepsy: a multicenter, single-blinded, randomized and placebo-controlled study. Front Vet Sci. 2026;13:1770972. https://europepmc.org/articles/PMC12921493

Related reads

• Imepitoin Canine Idiopathic Epilepsy
• Gabapentin for Pre-Visit Feline Anxiety: Evidence and Clinical Use