Recently, there have been several headlines regarding compounded medications and the associated risks to horse health and welfare. In some cases, using an improperly compounded medication can lead to death. Any death of a horse is difficult. Those that are preventable – as in the case of an improperly prepared compounded medication – are unacceptable. Writing off the use of all compounded medications, however, would be a rash decision. Compounded medications, when used responsibly, may have a place in horse racing.
The question is how do we know when compounded medications should be used and what medications are appropriately compounded? As horsemen/women, we may lack a degree in chemistry or be unfamiliar with the nearly unpronounceable names of drugs prescribed veterinarians prescribe. But that should not relieve us of having a basic understanding of certain terms and practices, like compounding. A basic grasp of pharmaceutical processes, together with open communication with experts (e.g., veterinarians) regarding this issue helps facilitate a safe and responsible environment for acquiring and using compounded drugs.
What is a compounding? Compounding basically occurs when a pharmacist or a veterinarian combines one or more FDA approved medications, adds flavorings to medications, or creates an alternative formulation (e.g., paste form versus powdered form) from an existing FDA approved medication. Compounding, in the strictest sense, occurs when a veterinarian mixes hyaluronic acid and a corticosteroid prior to a joint injection. It can also include adding flavoring to powdered bute and combining it with inactive ingredients into paste form. The key words here are FDA approved medications which provide some reassurance that the drugs used in compounding are safe and meet strict guidelines for production and labelling.
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