Horse Health

Compounding 101

October 28, 2010

Why drug compounding can be risky and why horse owners need to educate themselves.

Drug compounding can be risky if not done by a veterinarian or trusted pharmacist.

From America’s Horse

When 21 polo ponies died suddenly – and very publicly – after collapsing in April 2009 at the International Polo Club in Palm Beach, Florida, the horse world was abuzz. Was it sabotage? Tainted feed? What?

And then when the answer came – an incorrectly compounded medication – it might have been the most startling revelation of all, because unlike an international conspiracy, compounding is something much more ordinary and something that many horse owners don’t scrutinize as much as, perhaps, they should.

But it wasn’t the first time compounding had been in the news. In early 2007, The American Quarter Horse Racing Journal reported on two racehorses in Louisiana who had recently died from clenbuterol-associated toxicity from drugs that had been obtained from Central America. The American Association of Equine Practitioners reports that because compounded drugs are not regulated, other incidents have likely gone unreported.

So, with that much – literally, your horse’s life – hanging in the balance, AAEP teamed with America’s Horse to offer some facts to help educate horse owners about the finer points of compounding.

First, a Definition:
Compounded drugs are unregulated drugs produced by altering or combining drugs to serve a patient’s particular need. An example would be combining two drugs together, or crushing pills and creating a paste with them. By combining drugs, in essence, a new drug is created, and it can vary greatly in potency, stability, purity and effectiveness. The term “compounding” also encompasses something as simple as adding flavoring to make a medication more palatable or mixing two anesthetics in the same syringe.

You’ve tried joint injections, and while that might have worked for a while, your horse is in pain again. So now what? In AQHA’s FREE Horse Arthritis Treatment report, you’ll learn about a new treatment option – IRAP – that is gaining results in horses with osteoarthritis.

AAEP acknowledges that reputable pharmacies can produce legitimate compounded drugs that improve the health of horses when FDA-approved options don’t exist. And, because there is a scarcity of approved medications for use in horses, there is a legitimate need for compounding in equine veterinary medicine, AAEP says.

But, first and foremost, compounding must be done by a veterinarian or by a pharmacist acting on the order of a veterinarian. And there must be an existing relationship between the vet and his client/patient. Always, extreme caution is advised.

Apples and Oranges
Although we might equate compounded drugs, which are generally cheaper than FDA-approved medications, with generics, the two aren’t really comparable.

According to AAEP, generic drugs are the bio-equivalents of brand-name drugs – meaning that they contain exactly the same ingredients – and they must be approved by the FDA and manufactured in an FDA-approved facility.

Compounded drugs are not FDA-approved or tested.

Don’t Skimp
AAEP recommends that compounded drugs never be requested, used or prescribed as a cost-saving measure. These knockoff drugs could end up costing your horse’s life. Instead, legal, FDA-approved medications, when they exist, are a much safer route. FDA-approved medications undergo years of testing and are closely monitored by the government to ensure a consistent, safe performance.

“As a horse owner, your primary concern is the health and welfare of your horse. Because compounded products have no regulatory requirements for potency, safety, stability or production testing, they are to be used only as a last resort when there are no approved products available,” says Dr. Kenton Morgan, chairman of the AAEP Biological and Therapeutic Agents Committee.

Make sure you have an open dialogue with your veterinarian about compounded medications. If he or she feels a compounded drug is the best treatment option, ask plenty of questions. As AAEP reminds us, understanding the potential risks and benefits of our horse’s medication is part of our role as responsible horse owners.

Making a decision about your horse’s arthritis? In AQHA’s FREE Horse Arthritis Treatment report, you’ll learn about a new treatment option – IRAP – that is gaining results in horses with osteoarthritis.

To learn more about AAEP’s position statement on compounding, or to get information on many other horse health issues, visit www.aaep.org

Roll It!

Cutting originated in America but has universal appeal. Watch AQHA Professional Horsemen Teddy Johnson and Boyd Rice help Youth World Cup competitors learn how to work the cow from the best seat in the house.

Merial Announces Introduction of Equioxx (firocoxib) Injection Providing Horse Owners Added Flexibility, Convenience

With a long-standing commitment to providing horse owners and veterinarians the highest quality products, Merial is pleased to introduce Equioxx (firocoxib) Injection. With the addition of Equioxx Injection to Equioxx (firocoxib) oral paste, competitors now have a solid “one-two pain management punch” available to relieve the pain and inflammation associated with equine osteoarthritis (OA), also known as degenerative joint disease.

“Committed to supporting equine health and performance, Merial is proud to offer the flexibility of two Equioxx formulations to better meet the pain management needs of horses,” says Frank Hurtig, DVM, MBA, Merial’s Director of Large Animal Veterinary Services. “Both forms of Equioxx provide 24 hours of prescription OA pain relief  in just one daily dose. While Equioxx Injection is labeled for up to five days’ use, Equioxx Oral Paste can be used to help control the pain and inflammation associated with OA for an additional nine days. This means up to 14 days of once daily dosing OA pain management, providing added convenience and the freedom to treat during longer events without skipping days.”

Equioxx is also the only NSAID approved for use for up to 14 consecutive days by the American Quarter Horse Association and the United States Equestrian Federation, when given at the recommended dose with a 12 hour withdrawal time prior to competing. Traditional NSAIDs are only approved for a maximum of five days in these events. In addition, it is important for horse owners to note AQHA allows only one active NSAID in the system of a horse during competition and a similar USEF rule goes into full effect December 1, 2011.

For more information about Equioxx Injection or Equioxx Oral Paste, horse owners should talk to their veterinarian, visit www.equioxx.com or call 1-888-MERIAL-1.