Restarting pergolide after 10 days without it


Bonnie
 

Due to a clerical error, my pergolide order did not get filled and mailed as usual. It just arrived after 10 days of no capsules. Lad is on 24 mg compounded capsules. He has had no symptoms of any disturbance from lack of it.
Can I just give the regular dose, or must it be titrated up?
Thanks to smart people on this list I learned how to divide a capsule into smaller doses using blank capsules from the drugstore, if necessary.
--
Bonnie and Lad
North Ontario
Dec 2008
 


 

Bonnie, I would probably titrate up, not by quarter mgs, perhaps.  Maybe by 5 mg and, of no adverse reactions, another 5.  I switched my horse from a high dose of pergolide to cabergoline some years ago, resulting in an intense veil.  The situations are quite different but my experience encouraged me to be a bit more cautious in that regard.
--
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


 
 


Bonnie
 

Thank you for sharing your experience, Martha. I will goo the cautious route.
--
Bonnie and Lad
North Ontario
Dec 2008
 


hdavis
 

I’m curious about how u split your compounded pill capsules. I’m looking at increasing my pergolide mesylate but my pills are 2.5 mgs of mesylate powder in a capsule.  Any tricks u can share for titrating up?  
--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa 
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

https://ecir.groups.io/g/CaseHistory/album?id=8819 


Storm

Case History


 




 

Heather, I think the easiest way, and probably the most reliable, is to dissolve the contents of your pergolide capsule in a known amount of water and then portioning that solution out into oral syringes.  For instance, if you have a 2.5 mg capsule and want 1.25 mg, you might dissolve it in 10 ml of water and make each dose 5 ml.  If you wanted 0.5 mg, you would dissolve in 10 ml water and draw up 2 ml.  Pergolide is not stable in water or any sort of moisture but it loses effectiveness over a period of several weeks, rather that days.  I would probably toss the empty capsule into her feed.  The capsules will also dissolve but it takes longer.
--
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


 
 


Bonnie
 

Heather, here is the method someone from the list taught me. You need a sewing needle or pin thick enough to make a hole in the end of the pergolide capsule. You also need "blank" capsules from your pharmacy. These are empty shells. The job is easier if the blank has a larger diameter than the original. Have a small light handy, and a container you can close to keep your pierced capsule in.
Open a blank capsule. Pierce the compounded pergolide capsule at the small end. Remove the needle and insert the pierced end into half the blank capsule. Gently pinch the pergolide capsule to "puff" the powdered medication into the blank. Use your light to help you see the amount that has gone in.

Note this is only an approximate split of your dosage. You will have to use an estimate e.g. a quarter of the original dose has been transferred.

When you are satisfied with the amount transferred into the blank, cap it. Then re-insert the needle into the hole you made in the original capsule, and leave it in place to keep it airtight. Place it carefully in your sealed container to be used again next day. 
This method allows you to work your way up to your intended dose over the course of a few days. You will need several of the original capsules to make your gradual increase to the level you want.
Work carefully and wear a mask, with care the job can be done neatly and safely.
--
Bonnie and Lad
North Ontario
Dec 2008
 


Lorna Cane
 

When I needed half doses,I used to open capsule, tip half of powder onto a folded memo card (a sheet of paper would work ,but I like the stiffness of the card),tip powder from card into syringe, with a little water already added, and use that right away. I was usually adding this to capsules already being fed,in order to bump dose.
I put capsule with remaining powder back together and use it for next day.

--

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


Lorna Cane
 

Oh,Bonnie, thanks. You reminded me of the pin prick method!
I used to do that,too.Easier than opening capsule.


--

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


hdavis