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Tuesday, November 29, 2011

Compounded Drugs, What Does this Mean?

Drug compounding is a process to "produce a medication by combining or altering ingredients for the special needs of a patient". As stated in the AAEP Horse Health Article of June 2009, Your Horse's Life is Not Worth the Risk: What every horse owner should know about drug compounding; "Because there is a scarcity of approved medications for use in horses, there is a legitimate need for compounding in equine veterinary medicine. Some examples of legitimate compounding would include crushing a tablet and creating a paste or gel to aid in the administration to the patient or mixing two anesthetics in the same syringe for use in your horse."

Further this article states the American Association of Equine Practitioners (AAEP) position statement on this topic. "The AAEP acknowledges that reputable pharmacies produce legitimate compounded drugs to improve the health of horses when an FDA-approved option doesn't exist. However, when inappropriately compounded and used, these drugs may pose a serious threat to the health of your horse. Knowing the facts about legitimate and illegitimate compounded drugs will help you and your veterinarian decide on the best treatment option for your horse." For the full article refer to the reprint in the OWEC Newsletter, July 2009 issue or search for it on www.aaep.org.

The topic of compounded drugs often sparks much debate. From near conspiracy-theorists who feel that all drug companies are bad and are out to gouge consumers for profit only, to those who are trying to find cheaper or more palatable or easily administered drug options for their horse and everything in between. Bottom line, our horses depend on us to make the safest and best choices for their health and welfare. If a cheaper alternative does not work or is unsafe, have we saved any money? Have we done our best or even an "OK" job by our horse?

As many will remember, in April of 2009, 21 polo ponies were the tragic victims of inappropriately compounded medication given to them by their trainers or caretakers that resulted in sudden death. Several horses in Louisiana in 2006 suffered a similar fate. These are very dramatic examples of the worst consequence. The problem is, when do we know when a compounded product we have ordered (and sent payment) from a source we thought to be reputable is unsafe or ineffective?

Whenever possible, if an FDA-approved drug is available for medicating our horses, our horses depend on us to use them. The FDA-approval process assures the product is safe and effective for its intended use, but also the methods, facilities and controls used for the production of the drug meet FDA Standards to preserve it's identity, strength, quality, purity, and consistency from batch to batch. The FDA-approval process is a very expensive one and those manufacturers who have complied with this process and been granted approval have invested much time and expense to provide the product. As well, if problems are noted we have someone to go to seek solutions or recompense when adverse effects are noted. Compounders' products are unregulated by the government and not subject to the same standards for consumer protection or accountability.