Compounded ulcer meds

[Lord_Helpus]

There is a new ulcer treatment going around town (Southern Pines, NC) and it is receiving high marks from people who have had horses on Gastroguard, Ulcerguard, or generic omeprasole

It is made by a compounding pharmacy and it is a powder containing sucralfate and omeprazole.

A friend’s GP dressage horse who has been on ulcer meds for years, has been able to go from a loading dose to 2x/day to 1x/day to every other day and has not exhibited ulcer symptoms in the 3+ months he has been on the med.

I recently has a horse with an injury and I think the pain was giving him an upset stomach. I was able to buy a tub of this powder and within 4 days, my horse was back to his happy self.

Yes, horses eat it with their food just fine.
Yes, it is MUCH cheaper than Gastroguard/Ulcerguard. A 30 day supply costs about $100.

I am not an expert on ulcers. And I am not saying that this stuff is the best thing in the world. But the people who have used this powder have had long experiences with ulcers and they are raving about it (which is how I heard about it and got some).

Just thought I would pass it on so anyone interested can check with their vet to see what he/she thinks of a compounded powder with these ingredients.

[scrbear11]

I think this is what my sister was telling me about last night! She manages a large show barn. Their vet swears by it! How do I get it? Do you know what it’s called?

[Sunflower]

Omeprazole-- in humans-- has some severe side effects. I do not know if those translate into the treatment of horses, but in humans one effect can be an increase in the production of stomach acid after its use is stopped. http://www.gastrojournal.org/article/S0016-5085(99)70118-6/abstract

I was not able to come up with information on this effect on its use in equines after a quick search, but I still wonder.

I personally would stay far far away from PPIs of any sort without more information on how they effect the equine system upon withdrawal.

[scrbear11]

[QUOTE=Sunflower;8143757]
Omeprazole-- in humans-- has some severe side effects. I do not know if those translate into the treatment of horses, but in humans one effect can be an increase in the production of stomach acid after its use is stopped. http://www.gastrojournal.org/article/S0016-5085(99)70118-6/abstract

I was not able to come up with information on this effect on its use in equines after a quick search, but I still wonder.

I personally would stay far far away from PPIs of any sort without more information on how they effect the equine system upon withdrawal.[/QUOTE]

Sunflower, this has already been researched. An equine, like a human, must be weaned from the medication. And unfortunately, there is not other way to treat ulcers in equines.

[sascha]

[QUOTE=scrbear11;8143777]
Sunflower, this has already been researched. An equine, like a human, must be weaned from the medication. And unfortunately, there is not other way to treat ulcers in equines.[/QUOTE]

Yes, to your first sentence.

No, to your second sentence. There are other ways. There are none so far that are quite as convenient. Folks didn’t start treating ulcers with the advent of Omeprazole. People were treating them successfully many years prior. But, it was a giant pain in the ass because of the frequency with which those other meds needed to be given.

[Sunflower]

There is also some research that NSAIDs and PPIs given in combination can result in damage to the human small intestine. http://www.optibacprobiotics.co.uk/blog/2015/01/new-research-on-effects-of-nsaids-ppis-gut-health

Again, I have no idea if this holds true if given in combination to horses. But it is worth a thought.

Also, there is some information that weaning people off PPIs is not always successful in preventing the hypersecretion of acid, which then sets up a vicious cycle of using PPIs to ease the problems that the withdrawal created. http://www.aboutlawsuits.com/heartburn-drug-warning-lawsuit-64265/

Given a choice I would run a country mile from PPIs for either myself or my horse.

[scrbear11]

[QUOTE=Sunflower;8144137]

Given a choice I would run a country mile from PPIs for either myself or my horse.[/QUOTE]

That being said, what is your recommendation for the treatment of ulcers? I’m honestly not being snarky, just curious.

[Bastile]

you can get compounded omeprazole at the same dosage that gastro/ulcer guard comes in at Wells Pharmacy in Ocala FL. you need a vet prescription.

[dungrulla]

You can get compounded omeprazole at just about any compounding pharmacy with a vet prescription.

Personally I’m hesitant to give it due to the withdrawal. I’ll stick with ranitidine, thanks.

[scrbear11]

[QUOTE=dungrulla;8144226]
You can get compounded omeprazole at just about any compounding pharmacy with a vet prescription.

Personally I’m hesitant to give it due to the withdrawal. I’ll stick with ranitidine, thanks.[/QUOTE]

I thought ranitidine just eased the symptoms, rather than cured the problem. Someone educate me please… Ranitidine would be MUCH less expensive than omeprazole

[dungrulla]

Ranitidine also reduces acid, via a different method than omeprazole. Neither actually has any healing effect on ulcers–they simply reduce stomach acid.

The reason that ranitidine is not approved as an ulcer cure is because Merial did not pay the however much it costs to do clinical trials proving the efficacy of ranitidine. There is, however, no logical reason to think that one drug works any better or worse than the other when given appropriately.

There is nothing intrinsically “healing” about omeprazole, it’s just a stomach acid reducer.

Ranitidine does not cause the same rebound effect on humans, and although they are different species, I would assume the same is true of horses. Ranitidine, when given effectively, does just as good a job reducing stomach acid levels.

I myself got no benefit from omeprazole but get benefit from ranitidine 2-3x/day. The issue is you must take ranitidine 2-3x/day instead of just once…as must your horse, so compliance tends to be lower.

[Lord_Helpus]

I had never heard of sucralfate before, so I Googled it before starting my horse on the powder. Has it been given to horses in the past? It seems that the combination of the 2 drugs might be what has given this powder the raves it has received.

I know it is a small sample, but the 2 vets who are prescribing it must have had prior knowledge of the 2 products when used together.

http://www.medicinenet.com/sucralfate/article.htm

PS Another horse has slowly gone from loading dose —> 2x/week without any reoccurance of symptoms. The horse’s vet says that 2x/week is a good maintenance dose and the horse can stay on it indefinitely.

[sascha]

[QUOTE=Lord Helpus;8144326]
I had never heard of sucralfate before, so I Googled it before starting my horse on the powder. Has it been given to horses in the past? It seems that the combination of the 2 drugs might be what has given this powder the raves it has received.[/QUOTE]

Up here in The Great White North, we’ve been using the 2 drugs together for ages. Just picked up a bottle of each from my vet today. Knock on wood, when my horse isn’t trailering out I can wean her off both (for the winter), and then start her up again in the spring before heading out on trailer rides longer than 10 minutes.

The 2 drugs together can also be bought in tubes, but it’s a fair bit cheaper to buy separately.

[IPEsq]

Yes, sucralfate is commonly given for hindgut issues.

[Halter_Horse1]

When my yearling filly had both hind and foregut issues, along with very loose stool she was prescribed Sucralfate and Omeprazole. I used the Sucralfate alone for about 10 days waiting for my abler order to come, then moved her over to Omeprazole and Sucralfate. the loose stool was starting to get better after the 10 days, After 40 days her stool was mostly normal and the major ulcer symptoms had subsided.

[mroades]

Yes we have been giving those two meds in conjunction for years

[cy89]

What is this new stuff called?

[whbar158]

Not sure that powder is that “new”. Back in '07 (maybe '08?) I know people were giving it, it was a purple powder if I remember correctly and I swear it was that combination. I know it was Omeprazole and something and I think it was that. Oh and this was in NC before I moved.

[PNWjumper]

[QUOTE=Lord Helpus;8144326]
I had never heard of sucralfate before, so I Googled it before starting my horse on the powder. Has it been given to horses in the past? It seems that the combination of the 2 drugs might be what has given this powder the raves it has received.[/QUOTE]

Sucralfate, as others have mentioned, is often given to ease fore and hind gut ulcers. IIRC, it coats ulcers in fore and hind gut. It is far less expensive than omeprazole. If I had my say, I would never give omeprazole to my horses without sucralfate being added in.

I’ve posted many times about my guy colicking badly twice with what we now suspect to be a reaction to being on omeprazole long term (5ish months) with what we assumed to be hind gut ulcers. Sucralfate was a big help in getting him back to normal - particularly the transition from vet clinic to his normal diet, and I’ve said many times that I will no longer give omeprazole without something for the hindgut (Succeed, sucralfate, or SmartDigest Ultra - those, of course, not all being equal). I also won’t put a horse on omeprazole for more than a week or two at a time because of those past issues.

As for other things to help with ulcers, they’ve been detailed greatly here over the years - aloe vera juice, apple cider vinegar, Uguard, ranitidine, along with many, many other supplements and additives.

[mles55]

Some people say that omeprazole is better than any antacid or coating agent. However, one product that contains a combination of antacid and sulcralfate can be a good adjuvant to Ulcergard in helping prevent ulcers. It is used as a short-term protectant, just before exercise, which gives a buffering effect against acids during exercise.
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