When your horse becomes sick, the bills begin to pile up. The veterinary fees are bad enough, but you understand that there’s equipment to pay for and support staff to be paid.
But what about the drugs? What if your horse must take a drug for the rest of his life? Is there a way to save money? And can you use “old drugs”? Download this entire article as a PDF here.
I’ve had clients hand me a dusty old bottle of medicine and ask, “Is this any good?” Here’s the thing: An expired product might be ineffective, or worse, could be unsafe. Be wary of anything contaminated by hair, dirt or even your hand. Drugs and chemicals can become toxic with time, so if you’re not sure, ask your veterinarian and provide specific information as the name of the drug, how you stored it and its expiration date. Products not stored according to label instructions, such as “Store between 20° and 25° C (68° to 77° F). Protect from excessive moisture.” That means, if you’ve kept in your unheated tack room all winter long, you’ve probably ruined the medication.
A generic drug is the same chemical produced under the same rigorous FDA standards as the original drug. Generics are safe, and they can save you money.
A prime example is bute. There are hundreds of manufacturers, but all of the bute tablets are the same. We found prices ranging from $15.99 to $22.99 for 100 tablets.
However, not all drugs, i.e. Adequan, have generics. The patent remains in place long enough to allow the original manufacturer to recoup the costs of researching and marketing the original drug.
That’s one of the reasons you see advertising telling you, “There is no generic Adequan.” There is no FDA-approved generic Adequan. (Adequan is a Horse Journal recommended drug because it works. It may even save you money over oral nutraceuticals.)
Compounded drugs lack FDA approval and aren’t necessarily made under the same rigorous standards set forth for new and generic drugs.
Mixing two injectable drugs is compounding. Creating an oral liquid from crushed tablets is compounding. Even adding apple flavoring to a commercially available drug is compounding.
Usually, this is done to meet the needs of a particular patient, such as making a specific concentration to meet an individual animal’s needs. Because the regulations regarding compounding drugs allow for quite a bit of latitude, people assert that their use is dangerous.
Our chart shows you the risks associated with compounded medications vs. FDA-approved drugs. One of the biggest issues is that you can’t be certain that the drug you’re giving has in it what the label indicates because the FDA isn’t monitoring it.
Current federal law allows compounding pharmacies to mix drugs under certain circumstances, such as:
• There must be no other FDA-approved commercially available drug that is made to specifically treat the problem at hand.
• The compounded drug must be made from FDA-approved ingredient drugs.
• It must be safe and effective.
• All labeling must conform to federal regulations.
Be aware that, by adding other chemicals or flavorings or by interfering with protective coatings of tablets, a compounder may interfere with the drug stability, thereby decreasing its potency. This in turn compromises the drug’s ability to be absorbed into the body, which consequently reduces its efficacy. For example, research found compounded oral omeprazole (aka GastroGard and UlcerGard) wasn’t as effective for treating equine ulcers as the commercially available FDA-approved form of the drug from Pfizer. The study showed the systemic absorption of the compounded formulation was lower than for the real (FDA-approved) product. That would make you think something must be different.
Work with your veterinarian on drug costs. If you can find the same drug elsewhere at a lower cost, your veterinarian will likely give you the prescription you need.
Article by Contributing Veterinary Editor Grant Miller DVM.