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Compounded Pergolide instead of Prascend


Kirsten Rasmussen
 

Yes, thank you Ferne!!

--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History  
Shaku's Photo Album   


ferne fedeli
 

Kirsten, don't you mean to say to get the Pergolide in CAPSULE form, not tablet.  I don't even think Compounded comes in tablet form...
--

Ferne Fedeli  Magic & Jack   2007

No. California
Case History

 

 


Kirsten Rasmussen
 

Renee, you need to chose a compounding pharmacy (ideally one that other members recommend here) or ask your vet to chose one, and have a prescription sent to that pharmacy written out as detailed above.  Although your vet cannot legally prescribe compounded pergolide because Prascend is getting too expensive for you, you can tell your vet that your horses are difficult to get pills in to and it would be easier for you or barn staff to dose them reliably if you only had to give 1 higher strength (compounded) pill instead of multiple Prascend pills.  Make sure you get the pergolide in tablet form.  The liquid or chewable forms are not as stable and we do not recommend them.  It's also handy to keep some unexpired Prascend pills on hand for small dose increases, like prior to the seasonal rise or if you see worsening symptoms or elevated ACTH.

--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History  
Shaku's Photo Album   


renee lefthand
 


-- yes I need to look into.thua as well 3 with it and using 4 pills per day and it is getting very expensive for me ....and 2 are severe have to recheck maybe 3 or 4 months before spring thank u for the information 
Renee SD 2020


Eleanor Kellon, VMD
 

On Thu, Oct 15, 2020 at 06:19 PM, Cheryl Oickle wrote:
I deal with Island Pharmacy and they are awesome. It took time to wrap my head around the strength difference after we discussed it three ways between vet and pharmacy and me. Basically 1 mg of compounded pergolide mesylate delivers 0.7 mg of the prascend equivalent due to the compounding ingredient. 
At the risk of confusing things, both Prascend and compounded pergolide are pergolide mesylate.  Both are also in a base of some sort because 1 mg is the equivalent of less than 2 grains of salt, virtually an invisibly small amount.  Compounding ingredients have nothing to do with it. It's the amount of pergolide mesylate and therefore of pergolide activity that is different in some compounded products vs Prascend.
 
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Cheryl Oickle
 

EXACTLY! So here my vet prescribes CP 1mg pergolide which hence only delivers 0.7 mg of actual pergolide + the mesylate part .
So crazy

--
Cheryl and Jewel
Oct 2018
Port Alberni BC Canada
https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel
https://ecir.groups.io/g/CaseHistory/album?id=81063


Cheryl Oickle
 

Yes that is the OTHER way of looking at it providing it is written out as that in the script from the vet.
Here, it is dispensed as 1 mg CP capsules hence the 0.3 mg difference accounting for the weight in the additive so inessence is ONLY delivering 0.7 mg of pergolide

--
Cheryl and Jewel
Oct 2018
Port Alberni BC Canada
https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel
https://ecir.groups.io/g/CaseHistory/album?id=81063


Eleanor Kellon, VMD
 

The confusion arises from a USP monograph on how to prepare liquid pergolide suspensions which calls for 1mg of pergolide mesylate instead of 1 mg pergolide activity.  1 mg of pergolide mesylate is equivalent to about 2/3 mg of pergolide (the rest is the mesylate). Prascend tablets = 1 mg pergolide activity = 1.33 mg of pergolide mesylate.

Compounders use the information in USP monographs to prepare their products so the above recommendation got carried over to the dry formulations as well.

To guarantee your tablets are equivalent to the dosage in a Prascend tablet the prescription should read:

                                   1 mg of pergolide from pergolide mesylate
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


LJ Friedman
 

The way I remember it is 1 prascend tablet should be compounded as 1.33 mg of compounded pergolide. So that means 2 pracend should be compounded as 2.66 mg.  ie then go up to 3.0 cp   Am I correct on that?
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Cheryl Oickle
 

I deal with Island Pharmacy and they are awesome. It took time to wrap my head around the strength difference after we discussed it three ways between vet and pharmacy and me. Basically 1 mg of compounded pergolide mesylate delivers 0.7 mg of the prascend equivalent due to the compounding ingredient. 
I increased Jewel to 2mg of prascend and when i transitioned to compounded it scripted out at 3mg of compounded which is actually the same as 2.1 mg of prascend. Hope this makes sense.
Jewel and Cheryl

--
Cheryl and Jewel
Oct 2018
Port Alberni BC Canada
https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel
https://ecir.groups.io/g/CaseHistory/album?id=81063


Eleanor Kellon, VMD
 


Lorna Cane
 

Hi Teresa,

Here's Island Pharmacy. I've lost all my PPID boys now, but Island Pharmacy (Kathryn) was so helpful to me for almost 20 years. 
More information in our Files. They do product testing.

Shawnigan Lake, B.C.,

TOLL FREE: 1-877-743-6944 

Ask for Kathryn



--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


 

Teresa, compounded pergolide is allowed to be supplied by a compounding pharmacy with a vet’s prescription.  The vet can prescribe it if Prascend is unsuitable, which generally will not include cost.  Prascend is identical to compounded pergolide; the difference is in the packaging.  Prascend is supplied in foil packets which contain an inert gas and is stable for long periods of time.  Pergolide is susceptible to moisture and deteriorates rapidly so it needs special care, from choosing a pharmacy to purchasing in small quantities and storing carefully.  Those using 1-3 mg of pergolide might be happier using Prascend for the convenience.  I generally use a combination of both.
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


celestinefarm
 

Compounded pergolide is legal and is available in the states and in Canada at licensed compounding pharmacies.  Compounded pergolide is not inferior to Prascend as it is the same ingredient, pergolide mesylate. Forms of pergolide have been shown to have different rates of stability. The ECIR group has recommended compounded pergolide in capsule form as the capsules help to protect the pergolide from heat, light and moisture, the environmental effects that increase instability in pergolide. The most stable form of the drug is Prascend's form, tablets, wrapped in foil and opaque plastic blister paks. However, tablets are difficult to get into horses, and the cost ( which the AAEP says is not a valid reason to Rx compounded, because apparently they don't live in the real world) makes Prascend prohibitive to many owners when the horse needs more than 1-2mgs per day to control ACTH. 

Two of the most used compounding pharmacies here in the states  by members that compound pergolide are Wedgewood Pharmacy and Pet Health Pharmacy. Canadian members can provide info on Island Pharmacy. Both Wedgewood and Pet Health are accredited by the Association of Compounding Pharmacies and are licensed to dispense to almost all the states in the USA.

https://www.wedgewoodpharmacy.com/about-us/
https://www.pethealthpharmacy.com/what-is-compounding/

--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .


tosborne@...
 

I'm really confused.  I thought that compounded pergolide was illegal for a pharmacy to produce once the FDA approved Prascend?  I also thought that compounded pergolide was supposed to be inferior to Prascend with faster deterioration?
--
Teresa O in Ontario, Canada 2020
https://ecir.groups.io/g/CaseHistory/files/Teresa%20and%20Snickers


renee lefthand
 

so that is suppose to be just as good ? 
that is interesting 
thank you 

--
Renee SD 2020


Candice
 

Hi Cynthia!

I started out on Prascend like you as well for both of my horses until I found ECIR- because let me tell you it got expensive QUICK! LOL mine both get 2.75mg! 

I utilize Pet Health and have been very pleased with them. I have an autoship and don't need to worry about a thing! They work with my vet for refills and do all the calculations necessary when I switched over from Prascend, which was great!

Here is their website: https://www.pethealthpharmacy.com

Super affordable now for me, where as Prascend was not for 2 horses on that dose. 

Your vet will need to write you a prescription though- which is generally the sticky part! I hope everything works out in your favor and that you have a smooth transition!
--

Candice 

Primary Response Team

September 2018, Summerfield, FL

Shark's Case History: https://ecir.groups.io/g/CaseHistory/files/Candice%20and%20Shark

Shark's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=71507 

PHCP Barefoot Trimmer @ www.arkhavenfarm.com

 


Cynthia F
 

I started my mare on Prascend on July 24th, and slowly increased the dosage to 1 mg without any side effects. In the files it mentions using compounded pergolide as it's cheaper but I haven't been able to find any available at the sites listed. Does anyone have a pergolide supplier that I can contact? If I can get it cheaper than Prascend I would definitely like to go that route!
TIA
--
Cynthia F & Chicky
Cedar Rapids, IA
2019