Pentosan question

[Spartacus]

Hello all,

One of my horses has been on compounded Pentosan 250 mg/ml 6 cc IM every 3 weeks for years. I mean, years. He was off of it last year due to my own injury–he wasn’t doing much, either, so no reason to do it. Recently, I asked my vet to renew the prescription, and they now refuse to do so, saying that IM Pentosan is off-label use, and it can only be used as a joint lavage in an already incised joint. I was stunned. In checking this with the pharmacy, the reason I was given made no sense to them. IM Pentosan is used all over the country and the world, including the state in which I reside. The veterinary practice told me to switch to Adequan instead. We established that Adequan did very little for this horse approximately 10 years ago, and the compounded Pentosan works like magic, so I see no good reason to do that. We are in California. Is anyone aware of any licensing or other legal or medical reason that a vet would decide to no longer rx this out? Thanks very much!

[arabiansrock]

my understanding is some vets are having trouble getting it.

[jawa]

I haven’t ordered a new batch in 4-5 months, but my vet in VA had no problem getting me a compounded version from Wedgewood. I understand that the no -compounded version is in short supply.

[sandsarita]

Huh - my vet is getting pentosan without any issue. Actually recommends it over adequan in general. He is most worried about a banamine shortage right now. Am not sure if mine is compounded or not. Will need to look when I give injections next week

[Spartacus]

I called Wedgewood, and they couldn’t think of any reason why the vet wouldn’t rx it out, legally or for any other reason like that. I don’t know whether the veterinary practice has decided that, because they don’t make money this way, it’s not worth it to them, or if there is truly some other legality type reason. Will be checking with other local vets to see if they have any objection to ordering it. I’m not happy about this, but if the practice wants to cut me loose (as a 20 year client) because I don’t make them a lot of money, I totally understand. I’m not offended by that. I’m in an expensive, high-end show horse area, and I don’t have any high-end show horses anymore. But if that is the reason, it would be nice to be told.

[LadyB]

I’m in Canada, so relying on Adequan is near impossible lately, as it’s getting harder to get it across the boarder.

I ordered my first 2 bottles of Pentosan Platinum last week and received it yesterday with no issues. I don’t think it’s a problem to get at the moment and haven’t heard anything about it being a problem.

Your vet sounds like they want you to pay more money for something they sell. Also if you’ve tried Adequan with no success in the past, then why the heck would you waste the money on that again. Either you need a new vet or you need to sit your vet down and explain to them how stupid they sound by asking you to go to adequan which you KNOW didn’t work 10 years ago.

[shamrock]

Hey LadyB - are you ordering your Pentosan from the states or Canada? I was getting mine through Horseprerace, but was hoping to find somewhere here in Canada to order from. Our crappy dollar makes it really expensive to order anything from the states right now.

[Tiffani_B]

I get mine from horseprerace.com without a prescription and without any issues. It’s much cheaper, too.

[LadyB]

@shamrock

Hey LadyB - are you ordering your Pentosan from the states or Canada? I was getting mine through Horseprerace, but was hoping to find somewhere here in Canada to order from. Our crappy dollar makes it really expensive to order anything from the states right now.

Currently ordering from Horseprerace, honestly, even with the exchange, it’s cheaper for me to buy from them then to buy the Triacta HA every month at $130

I bought 2 bottles of Pentosan Platinum for $49.99 (currently 25% off all Pentosan products!) and even with the exchange and $39 shipping it is still going to be cheaper for me. Those bottles are going to last me 4 loading doses (one month) plus an monthly dose for another 6 months. So even with the exchange its soooo much cheaper than Triacta HA a month. Which is going to help my pocket a lot. BUT I have never had him on it before, so we’ll see how he goes with it, he did well with the Triacta, but the cost is hurting.

[shamrock]

@LadyB

Currently ordering from Horseprerace…,

Okay thanks. Good to know there are still no issues receiving from them. I want my boy back on it. Good luck with yours too!

[LadyB]

I’m hoping there won’t be issues!

[shamrock]

Thanks for the heads up on that sale, btw! Just snagged a 50ml Pentosan Gold for only $104 ++

[PiasaBird]

I’ve been using Pentosan I buy through my vet. Horseprerace.com has a really good price!
–Now for my dumb question - Would this come with the needles to inject the Pentosan? If not, do you buy the needles from your vet?

I want to order, but I will await your rely.

[atr]

I can buy needles and syringes at the feed store.

[Cowgirl]

Regarding Horseprerace, how do you know that what is in the bottle is pentosan and not just saline solution? I used to get my pentosan compounded from Wedgwood on a vet prescription but my horse several times had swelling at the injection site. I tried horseprerace and it didn’t give me the same result as the Wedgewood. They stopped putting lot numbers on their bottles and of course, there are no controls. Are those of you who are using it seeing results?

[SecondInCommand]

I’m sorry, but if the person you talked to at Wedgewood had no idea what you were talking about when you mentioned your vet was protesting Extra Label Drug Use, then they have no business working at a pharmacy.

From the AVMA:
Guidelines for extralabel use in nonfood-producing animals:
…
Extralabel use of a drug labeled for another animal species can be used only if there is no approved, appropriate drug that is labeled for use in the patient’s species or if an approved drug exists for the patient’s species but is found by the veterinarian to be clinically ineffective.

https://www.avma.org/KB/Policies/Pages/Guidelines-for-Veterinary-Prescription-Drugs.aspx

The latter portion of that rule is where you have your wiggle room, so perhaps it’s time to have a discussion with your vet about Adequan’s efficacy with your horse.

[Danier]

@LadyB

Currently ordering from Horseprerace, honestly, even with the exchange, it’s cheaper for me to buy from them then to buy the Triacta HA every month at $130

I bought 2 bottles of Pentosan Platinum for $49.99 (currently 25% off all Pentosan products!) and even with the exchange and $39 shipping it is still going to be cheaper for me. Those bottles are going to last me 4 loading doses (one month) plus an monthly dose for another 6 months. So even with the exchange its soooo much cheaper than Triacta HA a month. Which is going to help my pocket a lot. BUT I have never had him on it before, so we’ll see how he goes with it, he did well with the Triacta, but the cost is hurting.

How many mL of Platinum are you giving per dose? I thought it was only two doses per bottle?

Horseprerace is still the best place I can find to get Pentosan. Its painful to pay $50 for shipping a tiny box, but you do what you have to.
I’m also afraid to order more than one bottle at a time, because I know a couple people who got their’s seized at the border when they ordered two bottles at once. I stick with plain old Pentosan now, and order the large bottle when it goes on sale, prerace has pretty regular sales on.

[LadyB]

1 bottle is 18ml, which with the Pentosan Platinum you only give 3mg per dose, not the 5-6 like the Gold. So that should last a few doses. This also depends on the weight of your horse, mine being a TB… I will be doing the 3mg per dose. Which one bottle will last more than 2 doses.

Administer through IV at a rate of 3 mg per kilogram of body weight (1.5 g per 500 kg horse) for 5 - 7 day intervals for four repetitions. Pentosan Platinum is equally effective when given by IV or intra-articular injection. If intra-articular use is required, administer 1 mL by sterile injection.

I did order 2 bottles, with no issues, but these are the 18ml bottles. @Danier There is a sale on at the moment 25% off Pentosan.

I personally wanted the HA, so I went with the Platinum, if I didn’t want the HA, I would’ve easily chose the Gold.

[Danier]

@LadyB

The dosage I’ve seen for Pentosan is 3mg/kg of body weight. So 1500mg for a 500kg horse.
The concentration of Pentosan (and Pentosan Gold) is 250mg/mL, so a 6mL dose contains 1500mg of Pentosan.

The concentration of Pentosan in Pentosan Platinum is 183mg/mL, so an 18mL bottle contains 3294mg of Pentosan, or just over two doses.

I doubt two smaller bottles would cause a problem, the people I know were ordering two of the 50mL bottles.

I just opened a new bottle, so I’m holding out for a 30% sale lol

[LadyB]

Thanks @Danier

You had me second guessing it all, so I started reading more into it. Appreciate the break down.