Compound Meds may not be the best choice for your cat. Paws for Reflection found this out first hand when we went to renew Little Yellow’s Theophylline, a bronchodilator used to treat his asthma, last spring, and found it was no longer available in pill form. He’s been taking a half, 100 mg. theophylline once a day since he was diagnosed with asthma some three years ago.

To read about Little Yellow’s journey with asthma, check out these posts:

• Feline Asthma often overlooked as vets look for more serious diseases
• Persistent coughing is a tell-tale sign of asthma
• Friday, the 13th, Paws hopes Dec. 13 is a good day; Friday, Sept. 13, an asthma attack and fears of death

Compound Meds may not be the best choice for your cat

Compounds is combining, mixing, or altering a drug’s ingredients to tailor it to a pet’s specific needs. Done by a licensed pharmacist, veterinarian,or person supervised by a licensed pharmacist, it may include mixing two injectable drugs into the same syringe or creating a skin-penetrating gel for a drug typically given other ways.

In our case, there was a higher dose available, but nothing that could be cut into a dose similar to what he’d been taking. At first, we thought there was just an issue restocking the drug, but as the bottle got emptier, we didn’t find any available. We started looking at options. We did stumble across the drug available in a compound form.

This blog post is for informational and educational purposes. If you are considering using compounded medications for your pet, consult with your veterinarian.

However, when we checked our options with our veterinarian, we found it would have to be given three-times a day because the compounded medication releases immediately into the kitty’s system. As I have to work to support my five felines, three times a day was unreasonable. Two, we could deal with, but not three.
As we looked for other alternatives, we did a lot of research on compound meds. What we found were some positives, and a lot of negatives.

Some of the positives include:

• Diluting the strength of a medication which may be necessary to adapt it to the cat’s weight.
• Drugs can be formulated with pet approved flavors such as chicken, beef, cheese, or liver.
• The drugs can be made into a form, such as chew-able treats or liquids, that are ore palatable to our pets.
• It can be useful if the drug is not commercially available because of drug shortages or a product that has been discontinued, as in our case.
• Allows two active ingredients to be combined into one product.

Some serious drawbacks to compounding

Here’s why compound meds may or may not be good for your cat. While compounding ingredients must be prepared from animal and human drugs approved by the Federal Drug Administration through the Federal Food, Drug and Cosmetic Act, they are governed by state boards of pharmacy and veterinary medicine.

What that means is that compound medications are not governed by the Federal Drug Administration (FDA). There is no guarantee the drug is safe or effective for your cat. Turns out the drugs and compounds may act differently in animals than in humans. Additionally, compounding may complicate the situation as changing how the drug is delivered into the system may affect how the drug works in the body.

Therefore, there is no guarantee, the drugs are pure, and there could be something mixed else mixed in. We learned the FDA approval process is intended for mass-produced drugs made by manufacturers. Because compounded medications are personalized for individual patients, the federal government has approved the use of compounded medications for those individuals who have received a prescription for that specific compounded medication.

Compound Meds may not be the best choice for your cat

Little Yellow had gotten quite used to his daily pill regimen, and we had drawn a truce that this was a part of the daily routine before breakfast.

Cats are notorious for refusing to swallow pills

We all know cats are notorious for refusing to swallow pills, and usually will eat right around one hidden in the food bowl. The pet who refuses to take medication because of the taste could be a prime candidate for compounding. Cats don’t like pills, but they do like tuna or chicken or beef. In this situation, your veterinarian can prescribe a flavored liquid, treat, or other dosage that is exactly right for your pet’s size and condition.

From time to time, a manufacturer may discontinue a veterinary medication, as was in our case. This may be because the large quantities necessary to make mass production cost-effective are no longer viable. Some pets, however, may still need that medication. When it has worked well for animals, a compounding pharmacist can prepare a prescription, and tailor the strength, dosage form, and flavor to that pet’s specific needs.

Drawbacks to compounding

Compound Meds may not be the best choice for your cat. Another strong drawback we found to compounded medications is they do not tested for safety like FDA-approved drugs which can take years. During research and development of a medication, drug manufacturers conduct FDA-required tests to demonstrate that their product is effective and safe. FDA evaluates the data before approving the drug and allowing it to be put on the market. This is not the case with compounded medications as they have not undergone FDA’s rigorous approval process.

Think twice about going with compounded medications

Therefore, the use of compounded medications is only recommended when an FDA-approved medication is not available in the appropriate formulation. When using compounded preparations, the best way to ensure your pet’s safety is to discuss with your veterinarian signs and symptoms of an adverse reaction. Also, if the appearance of the compounded medication changes (color change, odor change, consistency change) while you are using it, you should stop using it and call your veterinarian immediately.

Compounding needed when no other option available

According to American Veterinary Medical Association (AVMA), a not-for-profit association representing more than 89,000 veterinarians working in private and corporate practice, government, industry, academia, and uniformed services, compounding is usually necessary when there is no FDA-approved human or veterinary product available and medically appropriate to treat the patient.

Using compounded medications should be a joint decision between the owner and their veterinarian. For example, if a cat needs medication only available in a pill form, and the owner is unable to administer the pill at home, the veterinarian might have the drug compounded into a flavored liquid that the cat will accept.

Although compounds might be necessary in some medical situations, there are benefits and risks to their use. Because compounded preparations are not approved by the FDA, there is no assurance of how well they can be expected to work (safety, potency, stability, efficacy). That’s why it’s best to use an approved drug, but that is not always possible and compounded medications play an important role in animal health.

If you are going to use compounded medications

If you are going to use compounded medications, do the following:

• Check with your veterinarian, and make sure the pharmacy is accredit by a board like the Pharmacy Accreditation Board (PCAB).
• Find out where the raw ingredients for the compounding come from.

The bottom line is to make sure you are not putting our cat’s heath at risk, and the chosen medication is indeed safe for your cat.

Have you ever used compound medications? Have you thought about using them? Has the changed manufacturer’s guidelines forced you into making a decision? Please weigh in on this discussion, and share your thoughts.