Caution shipping Compounded Pergolide - Avrio
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I’ve had at least two earlier phone calls with Avrio Pharmacy about shipping my horses’ CP. My directions are not being saved in the notes for my horse’s file. Today I received email notice that a prescription for CP was being mailed by priority mail with an estimated 3 day transit time. Temperatures here are in the 90’s and in the low 100’s in Phoenix, Arizona . When I asked how 3 day delivery was appropriate for a temperature-sensitive medication, I was told my prescription is not temperature-sensitive and further that Avrio receives its shipments of pergolide mesylate “out of the back of a truck.” I arranged overnight delivery with an ice pack. This isn’t the first time the shipping issue has come up with Avrio. ECIR members using this pharmacy need to take steps to protect the potency of CP and make sure shipments during hot weather include ice packs and spend minimum time in transit. Don’t agree to any shipments spanning a weekend. Based on my experience, I’d check each shipment on auto-renew. |
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Bobbie Day
Oh wow thank goodness I won’t need a refill until probably December, but I may have to think about someone else doing our medication. |
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Cass, I too had to arrange for expedited shipping and packaging with ice packs too when it was over 100 here in No Cal and they did accommodate with upgraded shipping fees. I was worried about the distance and time on hot trucks, warehouses etc.
I am considering a swap to a compounding pharmacy in Cali to mitigate. But have to do some research first since my dosges have changed again considerably. Thanks Nan -- Nancy and Vinnie and Summer Oakley, Ca Joined Nov 2018 https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie https://ecir.groups.io/g/CaseHistory/album?id=245855 Summer https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer https://ecir.groups.io/g/CaseHistory/album?id=249104 |
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Hi, Bobbie.
Sorry for the misunderstanding. I didn't mean to suggest Avrio gets the capsules somewhere else! The prescriptions are "compounded" in house at Avrio. The product the Avrio worker suggested is not temperature sensitive is bulk pergolide mesylate. That is the form of pergolide that is weighed into capsules by the compounding pharmacist at the prescribed dose, with or without added flavoring/coloring. -- Cass, Sonoma Co., CA 2012 ECIR Group Moderator Cayuse and Diamond Case History Folder Cayuse Photos Diamond Photos |
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let us know what pharmacy you choose.
-- LJ Friedman Nov 2014 Vista, Northern San Diego, CA Jesse( over the rainbow) and majestic ‘s Case History
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Starshine Ranch
Just a little FYI about Avrio and their Pergolide mesylate. I've been getting it from them since the switch from Pet Health. I too wondered if heat (we were in the upper 90's to 100's) or shipping time would affect the product but given that my horses' ACTH just tested 18.5 and 19.2 (from Cornell) respectively, after bumping them slightly to accommodate the seasonal rise, I would say that their product holds its effectiveness. Also, I considered switching to Precision Pharmacy in S. Cal because they made it sound like their Pergolide would be less expensive but then I found that they would charge considerably more. And since I have always gotten good service with Avrio, I'm staying with them... at least for now.
Linda in Grass Valley, CA 2020 Midnight and Ostara https://ecir.groups.io/g/CaseHistory/files/Linda%20Midnight%20OStara |
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Shawn Gould
Hi all,
Just thought I would weigh in. I am extremely happy with Precision. I found their pharmacist, Phu very nice and he wanted to help me price wise. I switched earlier this year when Avrio jacked up their prices. I get 2 month supply of liquid pergolide in oil apple flavor 5ml per 1ml for $150.85. And they ship with ice packs at no extra charge. I don’t have to ask, they are out of Bakersfield. It’s HOT there. They were interested in giving me a price that was closer to what I was paying before the prices jumped. I suppose it’s possible that the capsule form is more stable than liquid and less temp sensitive, I don’t know. I find the people at Precision to be very responsive and thoughtful. If they make a mistake they fix it. If you call ask to speak to Phu and tell him your pergolide story and see what they can do for you. BTW the vet that recommended this pharmacy is of the opinion that Wedgewood and Precision were the only compounding pharmacies in the country that she trusts. (Oh brother!) We all have our opinions. While Wedgwood has been at it a long time I think the way they treat their customers ie. Refusing to give prices for medications and the prices themselves are outrageous. I’ve dealt with a lot of compounding pharmacies for humans and pets and they have always quoted me prices before purchase or Rx. Shawn and Candy Dec 2020, Fallbrook, CA Candy Case History: https://ecir.groups.io/g/CaseHistory/files/Shawn%20and%20Candy Candy Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=258140 |
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Starshine Ranch
Shawn, l that is interesting news... I am paying $286 for 5mg/ml and getting a 90 ml bottle.
You said 5mg/ml but what size bottle are you getting because that is quite a difference from what they told me. They said it would be more than the $286. -- Linda in Grass Valley, CA 2020 Midnight and Ostara https://ecir.groups.io/g/CaseHistory/files/Linda%20Midnight%20OStara |
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Not correct that bulk pergolide mesylate is not temperature sensitive. It must be stored at room temperature and protected from light, just like anything compounded from it https://www.spectrumchemical.com/media/sds/P3682_AGHS.pdf .
Pergolide is not weighed out straight from the bulk material into a capsule. It has to be mixed into some sort of carrier. For example, a pinch of salt weighs about 65 mg and a single grain of sand about 11 mg so you can imagine how much dilution must be done with the 100% pure pergolide mesylate -- Eleanor in PA www.drkellon.com |
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millionairess1989
Dr. Kellon,
I thought that the recommendation was to keep Pergolide capsules in the door of the refrigerator? Why is that the case if bulk Pergolide is kept a room temperature? -- Jennifer in Middle TN 2010 Mill 33 1/3 yrs Arabian-PPID, IR & Pacemaker Dependent; 2-13-89 to 6-11-22 Jack 23 yrs TN Walker- IR & RAO https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Millionairess https://ecir.groups.io/g/CaseHistory/album?id=831 https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Jack-TN%20Walker |
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Hi Jennifer, I’ve followed the refrigerator door recommendation as well but all my containers say room temperature. I feel it is safest on the door as it is protected from the wild swings in temperature that my barn might experience compared to my house. I’m not trying to chill it, just to keep the temperature stable, the door being the warmest part of the fridge. My little fridge sits in my heated tack room which I maintain at 50°F through the winter and who knows what during summer but at least I know where to find it.
-- 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 |
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Shawn Gould
Hi Linda,
It is a 60ml bottle. When I called in the early spring the pharmacist was motivated to keep my price down. He tried to match the old prices before Avrio took over. Maybe you can negotiate a better price by speaking to the pharmacist directly? -- Shawn and Candy Dec 2020, Fallbrook, CA Candy Case History: https://ecir.groups.io/g/CaseHistory/files/Shawn%20and%20Candy Candy Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=258140 |
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Hi Jennifer,
Same reasons as Martha. If I kept it in my house at room temp, I'd forget to take it out to the barn every night. So I use the fridge door in my feed room because a stable, cooler temp is probably better than the big daily fluctuations my feed room can experience. I have a high-low thermometer in my feed room so I know how much it changes in a day in all seasons. Of course, you're not supposed to store perishable goods in the door of the fridge because the temps change every time the door is opened, but my feed room fridge doesn't get that kind of frequent use so I assume it's ok. I am interested in doing a stability test though....Cass, if you can dig up that info and share it, I would be grateful. -- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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Just as a precaution here, when you call with a question about a prescription you should ALWAYS be directed to speak to the pharmacist. Only the pharmacist can legally answer your questions. Not dealing directly with the pharmacist is a red flag.
-- Eleanor in PA www.drkellon.com |
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Starshine Ranch
Thank you, Shawn... I will call them and see if I can negotiate a better price.
-- Linda in Grass Valley, CA 2020 Midnight and Ostara https://ecir.groups.io/g/CaseHistory/files/Linda%20Midnight%20OStara |
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