I am getting ready to start Adequan and have recently heard of 2 different methods and am curious as everyone’s thoughts.
If you do option 1, will you continue with a monthly shot or repeat the loading dose in 6 months/1 year
Thanks
Adequan only recommends Option #1 (https://www.adequan.com/Dosing-and-Administration). They do not recommend continuing monthly injections thereafter, only repeating the process as directed by your veterinarian. I repeat every 6 months.
Ditto ridernc. Use it as directed on the label, which is 1x4x7. That’s what’s studied and what it’s approved for, for “reliable” results.
If AFTER that you want to try monthly to try to extend the time before you need the full dose again, that’s your decision, but honestly, I wouldn’t jump to doing that. See how the full dose does, keep a journal of your rides and see if you start noticing a downward trend in his comfort, and go from there.
I have read the study by Adequan. They recommend every 4 days on the loading dose because that was about how long the medication stayed in circulation. However … there is really no reason why they chose 7 doses and there’s no discussion point of this in the study.
So… if money were no object, you should give your horse Adequan every 4 days forever.
Seriously.
But who can afford that? (not me)
I could never find an actual scientific-supported reason on where they come up with the loading dose twice a year. Yes, research, on the 4-day dosing. But why only 7 days and why twice a year?
@ridernc or @JB have either of you seen research that I have not on WHY is it 2 loading doses a year and WHY a 7-shot series? I couldn’t find it and my vet had told me it doesn’t exist.
When I had my horse on Adequan, I did what my vet directed me to do, which is the loading dose, and then given a “maintenance” shot once per month aft that. If you ever stop those monthly shots, then you restart with the loading dose again… By happenstance, my horse reponded better to Pentosan than Adequan, so I switched him to that and give it every 2 weeks as he does the best on that schedule (and pentosan is super cheap).
Did you do a loading dose for the Pentosan?
I can dig a little deeper tonight, but if memory serves, the protocol is the way it is because that was the protocol that received FDA-approval for Adequan as a DJD treatment. Adequan makes no claims that it can or should be used for maintenance as it was not FDA-approved for such. However, they do allow for veterinarians to make those calls based on their own observations and specific horse-client relationships.
Yes. It was a long time ago but I believe it was 5-shots on the loading dose, every 4 days.
This particular horse, when I had him on Adequan, he felt the best for about that one week after the shot. He didn’t have stiffness on warmup. We tried the pentosan on a whim. Since it was so cheap, I chose to do a shot every 2 weeks after the loading dose. It took a couple months until it dawned on me his stiffness was completely gone. Always. That was almost 2 1/2 years ago and he’s never missed a dose since. It’s been a life changer for him, literally.
I don’t know that Adequan labeling says 2 doses a year? It’s really not a loading dose, as that implies “the highest dose now” followed by regular use of a lower dose. The dosing protocol is 1x4x7
The website says
After the initial series, veterinarians and owners alike should keep monitoring the horse’s joint health and mobility. Veterinarians may repeat the 1•4•7 series as needed upon recurrence of the clinical signs of DJD.
Many people do this twice a year to stay on top of things, or because they feel it’s losing effectiveness in the 6 month range.
The 4 day spacing is based on peak HA at the 96 hour mark
FOI Summary for Supplemental Approval of NADA 140-901 September 12, 1996 (fda.gov)
I’ve seen the reasoning behind 7 total doses, but I don’t remember it, can’t find it right now, so I don’t want to make a guess beyond "that’s probably as many doses as joint health is seen to improve and then likely stays improved long enough to not need to do that again for a while (6 months, year whatever)
Right. They did the 7 shots every 4 days in their study, so that would be what the FDA approves. My point was that their study didn’t really say WHY they chose 7 shots in the series (Why not 10? Why not 5?)
Of course, vets and human doctors prescribe things “off label” all the time, when indicated for the specific situation.
Sorry, I call it a loading dose, but correct they do not!
Hmm, I thought I read before that Adequan recommended doing the series twice a year but I could be mistaken on that or their wording could have changed as well.
I asked a friend of mine who I knew had been involved in some discussion on this. She had emailed Luitpold, who told her that an in-house, unpublished study showed that max efficacy was seen at 7 doses, at a dose every 4 days.
So, how often a given horse needs that max efficacy is variable because arthritis is just complicated.
My chiro has me doing the monthly doses of Adequan and loading dose if needed. I wanted to just do the loading dose as needed (for logical scientific reasons), but this approach seems to be working.
Maybe there’s something that’s not fully understood about the function of this drug.
are you getting good results with doing a monthly shot without the loading dose?
How is pentosan dosed? Method of administration?
I’d say so. When he gets adjusted the chiropractor will tell me if we need to do another loading dose. He was adjusted yesterday (done every 12 wks followed by massage therapy) and she said he’s good, keep doing what we’re doing.
I’ve done the monthly series, pre-show for years before the current protocol came out (because I is old), then switched to the 4x7 and usually did pre show Legend.
With my most recent horse (pony) I did the seven shots every 4 days sequence, then I was late on a few shots (again, because I is old) and just gave up and started doing it weekly because every Monday was something my feeble brain could handle. Since then I’ve done it every 7 days for 7 to 10 shots, depending on which size of adequan I have.
Honestly, the every 7 days has worked every bit as well for this particular horse and has the added benefit of carrying me through a good chunk of peak show season in the winter when adequan is at close to max efficacy, and just like the 4x7 regimen, it feels like it has a lasting effect for 6-8 months from the start of dosing. Plus with this approach I can time a shot for Monday or Tuesday before an FEI event starts, whereas the 4x7 could put the next dose right in the middle of competition, which would be no bueno.
I thought adequate was fine for competition?
I don’t think the adequan itself is the problem it’s the giving an injection of anything mid FEI competition that’s a problem.
Exactly!
It is given intramuscular, just like Adequan. I give 5 mL per the direction of my vet.
Dosing for Pentosan is 1 shot every week for 4 weeks. Like adequan it can be done yearly or every 6 months depending on the horse’s needs
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