Heather Zorn, P.A.S
In case you haven't heard, the FDA has approved a new drug for equine use in treating Cushing's/PPID. It is called Prascend and comes in 1mg tablets.
Due to the 1mg tablets being made available commercially, if you are currently prescribed 1mg capsules of Pergolide, pharmacies are no longer compounding that particular dose.

You have 2 options, and will very much depend on your vet's opinion on the matter:
1. You can have your prescription rewritten and resubmit to your compounding pharmacy in .95mg or 1.05mg capsules, or according to your compounding pharmacy's instructions.
2. You can switch over to Prascend.
As of right now, the legality issue is very much up in the air. In the FDA's opinion (which is not a law), compounding 1mg Pergolide is not permitted. However, the actual laws (passed by Congress) do not address compounding from bulk for animals. In order to compromise, reputable compounding pharmacies have stopped making 1mg capsules until it can be sorted out.
Unfortunately, I don't know of any other horses that have actually been ACTH tested after making the switch to be able to tell you which is a better option for your horses. There is almost no research available at this early time, other than what has been released by the manufacturer (which I remain skeptical about until it can be duplicated and reviewed.)
Only time and ACTH testing will tell if Prascend at a lower dose is better across the board. There are indeed potency issues with compounded drugs and these will vary from pharmacy to pharmacy, depending on how old their bulk drug is and how they handled it. Call your compounding pharmacy and ask if they do potency checks and have Certificates of Analysis on their compounded drugs. Some do and are happy to supply you with these items if you ask.
My main issue with Prascend is that the dose is based on weight, not on actual blood work/ACTH values, which could create some confusion between horse owners and vets regarding proper dose.
One thing that is a pretty safe bet at this point is that Prascend is more stable for a longer period of time. How that translates into your costs and results remains to be seen. Boehringer Ingleheim (the manufacturers of Prascend) are doing some very aggressive marketing, so we can expect to hear more of the "Prascend is more effective than…." hype. If you haven't heard of it yet and read any equine publications, you soon will!
It is more expensive, however, especially when purchased through your vet's office. A local NM vet sells a 60 tablet box for $149.00, and online at ThrivingPets.com, it is $99.95 for the same amount. Compare that to 60 capsules of the compounded Pergolide 1.05mg at $42.00
You may want to discuss your options with your vet regarding remaining with pergolide if it is effectively treating your horses vs a switch over to Prascend. Since both are available by prescription only, your decision will be heavily based on your vet's opinion.
Choosing a reputable compounding pharmacy should be a major determination in your decision. I personally use, and refer my clients to ThrivingPets.com, as their customer service is wonderful, prices are great and competitive, as well as having a consistent and analyzed product. You'll want to choose a company with good estimates of expiration dates, good storage methods, as well as a good customer base to ensure new inventory. It is important to note that a compounding pharmacy can compound ANY strength, other than 1mg, at this time.
Happy reading! There is plenty of info out there, but read it with an "educated consumer" view…
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