AVRIO Pharmacy - Change in capsules


Natalie Washburn
 

Hello,
I just received my first RX refill from AVRIO (after the switch over from PetHealth).  The capsules are TINY in comparison to what I've been receiving from PetHealth for the past 3-4 years.  I'm worried.  Has anyone else experienced this?  Are they using a different form of the drug or a different process that allows them to fit more inside a capsule?  
Please advise.
Thank you,
~Natalie & Jay in TX

Nov 2002

NRC & NAT 2008

Jay - https://ecir.groups.io/g/CaseHistory/files/Natalie%20and%20Jay

Photos - https://ecir.groups.io/g/CaseHistory/album?id=1902&p=Name,,,20,2,0,0

 


Sherry Morse
 

Hi Natalie,

The easiest way to answer your question would be to call customer service and ask them about it.




V F
 

Hi Natalie,
I experienced the same - smaller capsule & not tinted light blue. I emailed my inquiry since the phone lines take forever (I was number 2 & it took close to half an hour to actually talk to someone). I got a response from the pharmacist who said it is the same RX, they are just using different capsules now & do not add any coloring. So far my horse seems to be doing fine, so I believe she is correct. But if you have any questions, I would ask, just to be sure this time of year.
--
Virginia F, Lily, Jasuur, Cache, Haat & Spiritt in the sky, in South Central Oregon
ECIR 2010
Jasuur case history and bloodwork folder:  https://ecir.groups.io/g/CaseHistory/files/VirginiaF%20and%20Jasuur
https://ecir.groups.io/g/CaseHistory/album?id=147028


 

I have had the same experience and called them about it.  They told me it has the equivalent amount of Pergolide.  Will start on it soon.
--
Jackie Decker and Tori
June 2016
White City, Oregon


Laura Risley
 

Hi all,

No worries, your capsules contain the same amount of medication.  At Pet Health in Youngtown we only had 2 sizes of capsules 3 and 0.  At Avrio we have several additional sizes available, including a size 4 capsule (the higher the number, the smaller size) there is less filler in the smaller capsules.  I’m happy to help if there are additional questions. 

--
Laura Risley, PharmD
Pharmacist at Avrio Pharmacy (Pet Health division)
Owner of Bo and Sid
Phoenix, AZ 
Joined 2021


Joy V
 

FYI:  There is also a change in the liquid compounded pergolide now.  The suspension oil is milky and very watery (I thought it was water) and there are visible particles that settle and separate very quickly.  I'm pretty stressed out about this because 1) this change was not mentioned when I called in for my refill, 2) it is extremely concerning how quickly the particles in this settle/separate because what if too many or too little of them end up in each dose?? and mostly 3) this is the rise right now and I REALLY don't want any changes to anything in his routine, let alone the formulation of his medication.  

I called and spoke to a pharmacist and was told it's the exact same RX, which I believe, and that the suspension oil is just different.  This does nothing to diminish my concern about those particles.  It would have been nice to know that they were going to change the suspension oil w/ the change in location. 

I guess I will be testing his ACTH earlier than I had planned to make sure this works.   I am uploading a photo that shows what I mean about the particles in the RX.  

sigh

--
Joy and Willie (EC/IR)
Nevada County, CA - 2019

Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526


Laura Risley
 

Hi Joy!

I'm sorry that I did not update earlier on the change in oil-base and that you weren't told when you placed your order.  I want to reassure you, and the others, that we are indeed using an oil base - MCT (medium-chain trigylceride) oil.  it is the preferred oil here.  The suspension will be white rather than cloudy.  If the particles you are seeing are darkish in color, that is actually the powdered molasses flavoring.  We have ordered an oil-based liquid flavor for the future that will mix better. I took a look at a couple orders in lab and they are mixing well - except for the flavoring settling out - the liquid does appear milky and thinner.   

I hope this helps!  Please let me know if you have other questions!

--
Laura Risley, PharmD
Pharmacist at Avrio Pharmacy (Pet Health division)
Owner of Bo and Sid
Phoenix, AZ 
Joined 2021


Joy V
 

Thanks for your reply Laura.  I'm just nervous to change *anything* because it's taken almost 2 years to get my horse at his current condition.  

Also, the adaptor sent for the bottle to syringe the dose out is too big for the bottle.  There's no way it will fit.  This is frustrating.


--
Joy and Willie (EC/IR)
Nevada County, CA - 2019

Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526


Joy V
 

Aaaand  now I can't get a call to go through to Avrio.  One ring and then nothing or a straight busy signal.  This is definitely not a great first impression all around.



--
Joy and Willie (EC/IR)
Nevada County, CA - 2019

Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526


Laura Risley
 

I’m sorry Joy.  Unfortunately there are some issues with the phones, it’s not just us, but all around.  I’ll call you soon here and if I can’t get through I’ll call with my cell.


On Sep 27, 2021, at 12:23 PM, Joy V <jvenham@...> wrote:

Aaaand  now I can't get a call to go through to Avrio.  One ring and then nothing or a straight busy signal.  This is definitely not a great first impression all around.



--
Joy and Willie (EC/IR)
Nevada County, CA - 2019

Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526

--
Laura Risley, PharmD
Pharmacist at Avrio Pharmacy (Pet Health division)
Owner of Bo and Sid
Phoenix, AZ 
Joined 2021


Joy V
 

It's ok, I sent an email to see if I can get the correct size adaptor.  Thank you though Laura.

Just want to confirm, the molasses flavoring is not actually molasses, correct?  

Thank you again,
Joy


--
Joy and Willie (EC/IR)
Nevada County, CA - 2019

Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526


Laura Risley
 

The molasses flavor is artificial :)

--
Laura Risley, PharmD
Pharmacist at Avrio Pharmacy (Pet Health division)
Owner of Bo and Sid
Phoenix, AZ 
Joined 2021


Joy V
 

Thank you again Laura, for your replies and the information, I really appreciate it.  You have helped allay some of my fears with this change.  


--
Joy and Willie (EC/IR)
Nevada County, CA - 2019

Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526


Laura Risley
 

Hi Joy,

Thank you!  Happy to help in any way I can.  Also, we are sending you a couple adapters.  

--
Laura Risley, PharmD
Pharmacist at Avrio Pharmacy (Pet Health division)
Owner of Bo and Sid
Phoenix, AZ 
Joined 2021


Deb Walker
 

For Laura/AVRIO - I hope this is appropriate to post this here but it is on the same subject. I have been following your threads, as it is likely Scotty's med will be increased after lab results are back. Even though I printed out your very complete description, when I read other people's questions, I end up confused again. I'm sure this change has been difficult for staff. I guess what I want to know is how to compare apples to apples...compounded pergolyde mesylate to Prascend.

Scotty has been on 5 mg. compounded and I was told it was equal to 5 mg. Prascend. However, based on your instructions, I must divide the compounded by 1.305 mg. to equal comparison to Prascend. So, that would mean his current 5 mg would only be 3.83 mg Prascend...correct?

The confusion comes in because I have read so many accounts of members of ECIR medicating with very high dosages safely, but the dosages aren't actually as high as being reported if it is compounded...correct?

I appreciate knowing that the capsules will come smaller either way...like everyone else here, we try to be hyper vigilant. Thank you.
--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619


Laura Risley
 

Hi Deb!

You are correct - the 5mg pergolide mesylate that Scotty is getting is equal to 3.83mg pergolide itself (ie - 3.83 tabs Prascend).  Prascend uses 1.305mg of pergolide mesylate to make their 1mg tablet (they just represent the pergolide part).  Clinics can get confused on this too - that's one of the benefits of changing to how we will now represent the drug - the label will now have the pergolide strength itself (like Prascend). 

So, the higher doses seen in some horses would be slightly less (divide by 1.305mg) than what is written - BUT, this is only true for our pharmacy, I cannot speak for other compounding pharmacies.  They may represent the base strength like we will be doing in the future.  We certainly see a wide variety of doses.

Hope this helps!

PS - I updated "Scottie" to "Scotty" in the system :)
--
Laura Risley, PharmD
Pharmacist at Avrio Pharmacy (Pet Health division)
Owner of Bo and Sid
Phoenix, AZ 
Joined 2021


Deb Walker
 

Thank you so much Laura for clarifying. Your customer service help is invaluable and I'm sure I speak for all of us here in thanking you. With such excellent service you make me feel very confident in Avrio.

I'm sure my vet probably sent the prescription through with the *ie* but thanks for updating to Scotty :)
--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619