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  1. #1
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    Default Compounded Drugs - Interesting Article

    "If you think nobody cares about you, try missing a couple payments..."



  2. #2
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    That's a joke, right? An article cautioning people on compounded drugs, entitled "consider the source", and brought to you by the makers of Adequan?

    Yeah, consider the source, indeed.

    Not that good caution re: compounded drugs isn't a fine thing and well worth talking about, but the blatant corporate relationship and the obvious benefit to Adequan to making this sort of information "front and center" and making compounded drugs sound downright scary made me smile.
    Click here before you buy.


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  3. #3
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    Yes, I did laugh when the first thing I read was:

    When you’re seeking horse health information, go to a reliable source.
    From AQHA Corporate Partner Adequan


    In any event, I agree that folks should research and ask questions regarding compounded drugs and not just assume they are the same as FDA approved drugs but just cost less.
    "If you think nobody cares about you, try missing a couple payments..."



  4. #4
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    Even compounded drugs need to be FDA approved.
    Click here before you buy.



  5. #5
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    Sounds like Pentosan is giving Adequan a run for it's money. Hey Adequan - maybe if you drop your price, people will come back.


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  6. #6
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    Quote Originally Posted by jm2 View Post
    Sounds like Pentosan is giving Adequan a run for it's money. Hey Adequan - maybe if you drop your price, people will come back.
    Yeh I think so...I posted a link on one of the Pentosan threads that I got in my e-mail. Something about there is no generic adequan and the evils of compounded drugs...put out by Adequan of course. So yep, they're feeling it!



  7. #7
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    Quote Originally Posted by deltawave View Post
    That's a joke, right? An article cautioning people on compounded drugs, entitled "consider the source", and brought to you by the makers of Adequan?

    Yeah, consider the source, indeed.

    Not that good caution re: compounded drugs isn't a fine thing and well worth talking about, but the blatant corporate relationship and the obvious benefit to Adequan to making this sort of information "front and center" and making compounded drugs sound downright scary made me smile.
    Pffffffttt! Yup, this is the stuff that makes me cynical.



  8. #8
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    Just so you don't keep insisting that the practitioners are on the same team as Big Pharma. Which, for all its less-than-altruistic behavior still has its place. It's entirely possible to use the products without succumbing to the shtick.
    Click here before you buy.



  9. #9
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    Quote Originally Posted by deltawave View Post
    Just so you don't keep insisting that the practitioners are on the same team as Big Pharma. Which, for all its less-than-altruistic behavior still has its place. It's entirely possible to use the products without succumbing to the shtick.
    Keep up the good work--around here, most of 'em have gone over to the Dark Side--and I don't mean Eventing!



  10. #10
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    I think it's a poorly written, in some cases misleading, and a bit "the sky is falling" article. But, there are some truths in it:
    This is true (bolding mine)-
    “Compounding pharmacies can import bulk grade pharmaceutical powders and compound the medications. You have to realize, they haven’t gone through the FDA approval process. There has been no testing, no validation or monitoring by the FDA.”

    Counter to DW's statement above, compounded drugs are NOT actually approved by the FDA- more that they are allowed (a subtle but important difference, from an industry perspective). Quite often, they are PREPARED from FDA-approved drugs, but the compounded medication in and of itself is NOT approved. Compounding pharmacies regularly make errors in dosage, formulation**, etc- get on FDA's website sometime and check out all the violations they issue to compounding pharmacies. Hopefully, it will only result in a medication that doesn't work (this is why so many people complain that compounded omeprazole paste doesn't work that well- because it's not being prepared correctly), but in bad cases, an error in dosage can lead to some pretty severe consequences, even death.

    My most enlightening encounter with a compounding pharmacy was the time one called me and over the phone asked me to teach them how to make an extended-release tablet for hypertension. I refused- because if an XR dosage that is prepared incorrectly "dose-dumps", a patient can receive 2 or 3x the amount of drug all at once that they were supposed to get over 8 or 12 or 24 hours. This is the kind of stuff that happens at compounding pharmacies.

    This is not entirely true-
    Compounds that are being sold as low cost options to FDA-approved products are not only illegal,

    Not true. FDA has specific guidance on when compounded drugs are illegal and when they are legal. This kind of statement in an article like this is misleading and speaks to the credibility of the whole article (which is also already in question, being funded by a drug manufacturer as others have already pointed out )

    This can be true-
    but they are also potentially dangerous.

    See my story above about fly-by-night places incorrectly preparing complex dosage forms!

    Havng said all of the above, I do think compounding pharmacies have their place. I've actually started using pentosan on my mare and I've been very pleased with it. I also have Abler omep granules on hand for stressful situations. I do consider myself a very educated consumer in this space and am more than comfortable with these products. I do find it misleading that articles such as these try to confuse people by crying that the sky is falling and they are doing illegal things by using compounded drugs- not true, and distasteful, IMNSVHO.

    **I should add that pharmaceutical manufacturing facilities often make mistakes as well- but the level of self-oversight and governing body (ie, FDA, EMEA) oversight is so much higher to large GMP facilities than individual pharmacies, that there is more chance these types of errors will be discovered. Of course, large pharma are also making and distributing medicines to much larger numbers of people, so these types of errors can be vastly more widespread (such as the extensive issues J&J has been having with Tylenol products at their McNeil facility in Fort Washington PA, very close to my old stomping grounds)
    Last edited by hey101; Sep. 28, 2012 at 12:16 AM. Reason: ** add a footnote
    ~Living the life I imagined~



  11. #11
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    Quote Originally Posted by deltawave View Post
    That's a joke, right? An article cautioning people on compounded drugs, entitled "consider the source", and brought to you by the makers of Adequan?

    Yeah, consider the source, indeed.


    It's true that compounded drugs are not FDA approved, but I suspect the main gripe of Luitpold, Merial, etc. is that compounding pharmacies are cutting into their profits by making similar cheaper alternatives or in some cases circumventing the rules by compounding large quantities of drugs that are basically copies of FDA-approved drugs. The latter may actually be illegal, but the drug makers can't appeal to the public by saying "they're making illegal copies of our drug and selling them cheaper to you" so they use other arguments.

    Thanks for the balanced explanation, hey101. I'm happy with the compounded drugs I use. I gave Luitpold my money for 17 years - to use their product in a unapproved way that hasn't even been proven to work (the monthly Adequan shot) - and that's quite enough



  12. #12
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    Thanks, disco and Hey101, for the clarification of the fine points.
    Click here before you buy.



  13. #13
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    A very unfortunate and real example of the risks one takes when using compounded drugs.
    http://www.cnn.com/2012/10/06/health...ure/index.html

    I have to admit, examples like this do give me significant pause when using sterile products for injection (like Pentosan). Aside from the effect of the drug itself, oral medications have a lot less of risk of contamination.
    ~Living the life I imagined~



  14. #14
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    Quote Originally Posted by hey101 View Post
    A very unfortunate and real example of the risks one takes when using compounded drugs.
    http://www.cnn.com/2012/10/06/health...ure/index.html

    I have to admit, examples like this do give me significant pause when using sterile products for injection (like Pentosan). Aside from the effect of the drug itself, oral medications have a lot less of risk of contamination.
    hey101 - I thought the same thing as you when I heard of the many deaths in this meningitis case. There is just a higher risk purchasing an injectable from a compounding pharmacy vs big pharma manufacturing with it's additional levels of oversight and QC.
    “You'll always miss 100% of the shots you don't take.” - Wayne Gretsky



  15. #15
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    Especially with injectable drugs, there are so MANY places where risk can enter: manufacture, improper dosing (because the drugs are available to basically anyone with a credit card), improper selection of drugs, poor technique for injection and storage, sloppy handling of the drug, using drugs past their expiration date, having no knowledge of potential drug interactions, etc. etc.

    It's awful that any contamination takes place, and it's probably somewhat more likely to take place in places where fewer quality control measures are in place. But the riskiest part of giving injectable drugs is still the injection itself, when proper technique is not followed assiduously.
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    Quote Originally Posted by ET's Home View Post
    hey101 - I thought the same thing as you when I heard of the many deaths in this meningitis case. There is just a higher risk purchasing an injectable from a compounding pharmacy vs big pharma manufacturing with it's additional levels of oversight and QC.
    my thoughts also
    Free bar.ka and tidy rabbit.



  17. #17
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    Do you think the people who got the contaminated spinal injections knew they were getting compounded drugs? I doubt it. They were given in a clinical setting. Hospitals use compounded drugs all the time. Most have their own compounding pharmacy. I understand why it feels risky (and I guess it is) but I don't want to live my life in a constant state of paranoia. Big pharma makes mistakes too; they are very good at making settlements.



  18. #18
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    Pentosan user here. I have no qualms about using it. I'm a registered nurse so am able to give an IM injection competently. If I had to use Adequan (which I have in the past) I could not afford it at this point. My vet prescribed Pentosan and I get it from her. I trust her opinion and judgement. She also uses it on her own horse. I think Adequan is losing customers to this product and is trying to do damage control. There are still many people out there who will continue to use Adequan who can also afford it.
    "You post all your drama on Facebook and get mad when people judge you? You're a special kind of stupid, aren't you?"



  19. #19
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    I'm a registered nurse so am able to give an IM injection competently.
    Just curious, and I've been meaning to make this a poll question--how do you, as a medical person, prep the skin of a horse to whom you're giving an IM injection? I have gone back and forth between "no prep", "alcohol soak-and-dry" and "scrub with chlorhexidine and wipe". Still haven't made up my mind.
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  20. #20
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    Quote Originally Posted by hey101 View Post
    A very unfortunate and real example of the risks one takes when using compounded drugs.
    http://www.cnn.com/2012/10/06/health...ure/index.html

    I have to admit, examples like this do give me significant pause when using sterile products for injection (like Pentosan). Aside from the effect of the drug itself, oral medications have a lot less of risk of contamination.
    And this event is hitting even closer to home......

    http://www.chronofhorse.com/article/...erious-illness



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