My mini mare with Cushings and Insulin resistance is doing well on 1 mg / day of Prascend. However, the tablets are expensive, 60 for $114, vs, $48 for the same number of compounded capsules fro Thrivingpets.com. Has anyone used the capsules and this compounder? Any other recommendations? My vet is skeptical that the capsules will be as good as the tablets. It is odd that they come in .95 mg and 1.05 mg strengths, but not 1 mg.
I work at a compounding pharmacy and not all compounded products are created equal.
Perhaps you can give the compounding pharmacy a call and see if they potency test their pergolide capsules. If they do test you can ask them if they follow USP as their regualtions for a pass is 90-110% which in my opinion is good (all manufactured products follow this as well). I would also ask if they test every batch, not just random batches.
I also know that pergolide is a tricky drug to compound. If it is not made a certain way, it can degrade really quickly and not be as effective as it should be.
If they don’t potency test, I would pass. Perhaps look into a different compounding pharmacy that does potency test - they are out there. I have not heard of this compounding pharmacy, but I only know of a few bigger names in the US. I’m not saying that they arent good, I would just personally ask a few questions before I ordered from them.
Compounding pharmacies are not able to compound any product that is the same form/strength as a manufactured product. So they cant make a 1mg capsule as there is a manufactured product that is already available in that strength (even though its a tablet, a capsule is a similar form and it could cause the compounding pharmacy issues).
A compounding pharmacy is there to fill the void of commercially available products so technically a 0.95mg or a 1.05mg strength is perfectly legal for a compounding pharmacy to make, while a 1mg strength is not.
I’m not trying to steer you away from compounding at all as I’m in the buisness and I would 100% give any of our compounded products to any of my animals. More so than any manufactured products out there as we have data/testing on every batch of our products.
Testing and data is really important and I know of a few smaller compounding pharmacies that charge less $ and do not have any data/testing to back up any of their products.
IMO, Prascend is better simply because the tablets are much, much smaller and it was easier to feed to the horse. With the big pills I got from the (very well thought of) compounding pharmacy, it was a struggle to get the horse to take them.
Pills. Easy to use, you know exactly how much is in each tablet.
Working great for our cushings 30 year old pony.
I’d go with the Prascend tabs. they come labeled with an NDC # something you won’t find in compounded drugs.
Yeah, I’m willing to go with compounded meds in certain cases (I’m trying compounded omezaprole on my mare right now) but I use the Prascend for my Cushing’s gelding. He’s had one bout of laminitis, and I don’t want it to happen again.
I vote Prascend, too. My Vet told me the shelf life on compounded omeprazole is about 2 weeks.
I vote Prascend, too. My Vet told me the shelf life on compounded Pergolide is about 2 weeks.
I also vote Prascend. . . Having known horses that have used the compounded pergolide and Prascend, the horses on Prascend seem to do better overall. Now the vet we use only recommends Prascend because it seems like the compounded versions just don’t seem to have the consistency.
I used compounded Pergolide for years. Now I use Prascend and am much happier. It’s much more stable and the pills are very small. My horse needed 7mg. of Pergolide but is now controlled with 1.5mg. of Prascend during the seasonal rise. The cost is the same, but I know he’s getting a full effective dose every day.
Thanks so much for this knowledgeable, detailed reply. I will call Thriving Pets and ask about potency testing of each batch.
I get my pergolide from Thriving Pets, compounded. He gets 1 mg, and I divide it between the am and pm feedings. I open the capsule and sprinkle half on each bucket. Easy, less costly, and my vet is fine with it.
Pergolide: compounded capsules or Prascend tablets?
Thanks for this detailed and knowledgable reply. I called Thriving Pets and was told that they get the pergolide from another pharmacy that does the compounding, most recently from Medisca; I gather they also use other suppliers. ThrivingPets just puts the powder into the capsules. They said the compounding pharmacy was required by FDA to do potency testing, so it comes to them already tested. I don’t know if this is a good story or not. Does it sound like it would produce a reliable product? It seems to me it would be preferable if the same pharmacy that did the compounding also did the encapsulating. If anyone knows of a reliable source of compounded pergolide capsules, I’d love to hear about it. However, I hear good things about Thriving Pets both from one respondent here and on the Equine Cushings and Insulin Resistance Yahoo forum. So, still in a bit of a quandary.
I can tell you that my horse was diagnosed 3 years ago, and I bought him last year in May. He came out of a show barn, and had been on Prascend for two years. While his coat wasn’t dull, it was longish and seemed rough. After a year of being with me and on the compounded stuff, he has a very slick, shiny coat…and that’s living outside 24/7. Don’t know if that really makes any difference, but if the compounded stuff was less potent, I’d think his coat would look worse instead of better.
Thanks, Unff. I’d like to give Thriving Pets a try, if I can get my vet to go along.
At this time we currently live with more than a dozen PPID positive horses. Without question I would go with the Prascend over compounded pergolide. We have seen FAR more consistent results with prascend than we ever did on the compounded pergolide. It is more expensive but, in our experience, the price difference is well worth it.
That is an interesting reply from the pharmacy. Our rules are slightly different in Canada, but I’m fairly aware of US rules/regulations as well.
Medisca is not a compounding pharmacy or a pharmacy at all but they are a bulk supplier (they supply raw chemicals to pharmacies). They are a very good reputable company and are well trusted in the industry. Medica would have a C of A (certificate of analysis) for their products and it would have been tested for potency - in the pure drug form only. A compounding pharmacy then purchases the pure drug from Medisca and compounds using this tested chemical (usually a USP grade).
FDA has nothing to do with vet compounding pharmacies (human, yes) so I don’t know why they would say that. Medica would be under FDA rules though as they supply for human use as well as vet use.
Thriving pets do not have to potency test, but of course its always good practise. Even if the raw chemical is potency tested (as the Medisca raw chemical would be) once the compounding pharmacy mixes the product, as they would have to when making the capsule, potency would be altered. When making a capsule at 1.05mg or 0.95mg they would not directly weigh that amount into an empty capsule shell - they have to mix it with a placebo and then make the capsule. Who’s to say there is 1.05mg or 0.95mg in each capsule once its mixed and encapsulated? One capsule could potentially contain 100mg while another can contain 0.05mg if the product was not mixed properly or if they use the wrong base, the product can test at 50% potency. Theres no way to know unless its tested. This is why potency testing is so important once an item is compounded.
It sounds like I’m against compounding pharmacies, but I’m really not. As I said before, I would take any generic or compounded product myself or give it to any of my animals. But I would be picky where I got it from, especially being in the buisness as long as I have been. There are just some places out there that skip corners and give good compounding pharmacies a bad name.
double post
When it comes to Cushings I didn’t want to risk getting an inferior product and went with the Prascend. My mare foundered prior to being diagnosed with a cushings and I never wanted that to happen again.
ThrivingPets uses the +/- 10% DiamondJubilee mentioned above. Rondar misquoted us when she said we have our Pergolide compounded by Medisca. Medisca is, as DiamondJubilee pointed out, a compounding wholesaler. ThrivingPets only purchases chemicals from FDA-regulated wholesalers, such as Medisca. Every lot of Pergolide Mesylate we purchase comes with an Assay Test that indicates the drug name, chemical name, potency, presence of impurities etc. and that it passes the FDA guidelines to be USP (Pharmaceutical) grade.
ThrivingPets purchases our bulk chemicals from a compounding wholesaler and measure the chemicals, mix the powders, and encapsulate the powders here in our pharmacy. We also log each measurement, as required by pharmacy law, and keeps these records for 7 years in case there are any questions about a specific lot number. As mentioned above, each batch is tested to ensure that the strength of each capsules is between 90% and 110% of the stated strength. In most instances, our capsules are between 98% and 102% of their stated strength.
Pergolide Mesylate is a very touchy chemical. It is sensitive to light, air, moisture and temperature. ThrivingPets does a number of things to ensure our Pergolide is as stable and potent as possible. We store our Pergolide in the refrigerator, we recommend our clients also store their Pergolide in the refrigertor. We also recommend our clients purchase Pergolide capsules because they protect the medicine from air and moisture. We recommend a maximum of 100 days supply of Pergolide capsules (the USP gives this product a 6 month expiration). If our clients want the liquid (compounded in oil) or loose powder, we only dispense 30 days supply at a time due to it’s shorter shelf life.
If you have any questions or concerns, please feel free to contact us at 303-333-1899 or thrivingpets@gmail.com.
Thank you,
ThrivingPets