PepcidAC or PrevAcid24 for horses?

[wbhorseusa]

One of my horses is showing very small signs of stomach discomfort. For example, before I get on for a ride and walk him to the mounting block he starts breathing heavy from what seems like anxiety. He never loosens up throughout the ride. I am suspecting ulcers. The vet will be coming out to scope him.

I have used Zantac and Tagamet in the past for heatburn for horses, but I suffer from heartburn myself and the products that I find work the best are PepcidAC and Prevacid. Has anyone used either of those products? I am thinking one Prevacid caplet in the morning should do it even though he is a horse (that stuff works for like three days on me!)

[Dazednconfused]

The only thing proven to cure ulcers in horses is Ulcergard/Gastroguard. I certainly wouldn't assume that one little pill made for a human of average height/weight would work on a 1200lb horse. If I suspected my horse had ulcers, I wouldn't be messing around with a human-form of OTC meds. I would go straight to what has proven to work - which is the Merial product (NOT the generic omeprazole from India/elsewhere) combined with changes in management (less stress, more turnout, more alfalfa, less grain, spread out meals/lots of forage). If I couldn't afford Gastroguard I guess I would go with the management changes + Ranitidine if I could be assured it would be given often enough.

Isn't Pepcid for heartburn? Or acid reflux...that's not the same thing as ulcers, as far as I know. Seems like that would be treating a fungus with an antibiotic - ie, not useful or relevant to addressing the problem...JMO.

[LarissaL]

The three drugs usually prescribed for horsey ulcers are omeprazole, ranitidine and cimetidine. Zantac and Tagamet are the brand names of the latter two and should be dosed multiple times a day. I would try Prilosec or the generic human omeprazole (try CVS, Costco, etc) over using a drug less commonly given to horses. None are especially cheap though.. I have my horse on 7 omeprazole pills daily and it costs over $3/day.

[Melyni]

as LarissaL said, omeprazol, rantinidine & cimetidine.

Omeprazol is the only one with research behind it for horses. dosage should be 1mg/kg BW given once per day.

You can use the human versions but you need to read the label and give enough pills to supply the correct dosage.

The other two rantinidine and cimetidine need to be given twice or three times daily.

BTW no horse (or human) should stay on proton inhibitors for longer than 90 days. Then they need a break for 90 days.
Excessive use of proton inhibitors in humans has shown to result in interference with the calcium metabolism and may exacerbate osteoporosis.

It would be best to buy the horse version, ulcergard is not that expensive.
MW

[rcloisonne]

Omeprazol is the only one with research behind it for horses. dosage should be 1mg/kg BW given once per day.
Actually, the recommended dosage is 4mg/kg.

from Merial:

Dosage Regimen

- For treatment of gastric ulcers, GastroGard Paste should be administered orally once-a-day for 4 weeks at the recommended dosage of 1.8 mg omeprazole/lb body weight (4 mg/kg). For the prevention of recurrence of ulcers, continue treatment for at least an additional 4 weeks by administering GastroGard Paste at the recommended daily maintenance dose of 0.9 mg/lb (2 mg/kg).

http://valleyvet.naccvp.com/view_label.php?u=country&p=msds&prodnum=1111020


You can use the human versions but you need to read the label and give enough pills to supply the correct dosage.
You would need 113 OTC Prilosec tablets (20mg) to equal a single syringe of Gastrogard or Ulcergard (contains 2.26g/syringe). Then you have the pesky problem of how to get that many tablets down a horse's throat without the horse chewing them. Chewing or breaking the tablets in any way exposes the drug to stomach acid with renders it ineffective.

The other two rantinidine and cimetidine need to be given twice or three times daily.
And neither has ever been shown to be effective for equine ulcers.

It would be best to buy the horse version, ulcergard is not that expensive.
MW
Most people wouldn't consider $30.00+dollars/day for 30 days plus another 30 days at 1/2 dose, inexpensive. The biggest drawback of these products is cost.

[Melyni]

my bad,
The dosage to heal an ulcer once it has been diagnosed by a vet, is 4mg/kg. This is the dosage on the GastroGard tube (meant for treating existing ulcers) and a prescribed drug which should be given to horses who are under veterinary supervision.

The dosage for preventing an ulcer is 1mg/kg, as described on the tubes of UlcerGard, sold over the counter for general use.

The higher dose rate will of course have more side effects which is why it should be prescribed by a vet.


MW

[wbhorseusa]

Well, I have given him some PepcidAC Complete as treats about 3 hours before working him and it does seem to help. I started out giving him human doeses and have gotten up to three, and three seem to be the magic number. I don't plan on doing it unless I feel he needs it, but its a little hassle because I won't really know until we start walking to the mounting block.

So.... it seems safe to me to give him three pepcidac completes and it seems to be helping a bit. He is not as nervous and is dealing with the workout better.

Hopefully this helps someone else googling it.

[Dazednconfused]

Yes, people can google your one single anecdote. He could improve from a variety of other factors besides three Pepcids.

To me this seems kind of ridiculous. Nobody should be reading this post and thinking three human-sized Pepcid are going to make a difference in their horse with ulcers. "I *think* I noticed a difference, even though this has never proven to work in horses and the horse weighs 7 or 8 times as much as a human. That makes perfect sense!":no: There is a very simple (though not cheap) solution and that is omeprazole.:no:

[jn4jenny]

Well, I have given him some PepcidAC Complete as treats about 3 hours before working him and it does seem to help. I started out giving him human doeses and have gotten up to three, and three seem to be the magic number. I don't plan on doing it unless I feel he needs it, but its a little hassle because I won't really know until we start walking to the mounting block.

So.... it seems safe to me to give him three pepcidac completes and it seems to be helping a bit. He is not as nervous and is dealing with the workout better.

Hopefully this helps someone else googling it.

The reason you're perhaps seeing improvement is because famotidine (PepcidAC) is a close cousin to ranitidine, a drug that used to be the veterinary standard of care for ulcers before GastroGard came along. As I understand it, famotidine is about 7x more potent than ranitidine but has worse bioavailability in horses compared to ranitidine. In very rough terms, 3 Pepcid AC's is like feeding 210 mg of ranitidine. That's not even close to the recommended daily ranitidine dosage of 2-3 mg per pound (so ideally 700-1000 mg of ranitidine 3x daily), but I can see how it would take the edge off on a WICKED case of ulcers. For a few hours, anyway.

If the horse is in so much pain that he's responding to a measly dose of ranitidine, I'd stop riding him immediately. He's in serious pain, and every time you ride him you're churning up that stomach acid and exacerbating the condition. The good news is that your horse appears to respond to famotidine to at least some degree, so maybe ranitidine is an option for you. Ranitidine was the standard of care for equine ulcers before GG came along; it requires a much more diligent and consistent administration schedule, and it doesn't work for every single horse, but it's significantly cheaper than GG.

As you suggested, Google is your friend.
http://www.horseadvice.com/horse/messages/4/195873.html