Has it ever happened to you how competitive pricing, counterfeit drugs, untrustworthy sources for drugs and the honesty that our profession must maintain present an everyday dilemma? How can veterinarians avoid being affected by gossips of adulterated and contaminated food and drugs and still maintain the public’s trust?

Dawn Merton Boothe, DVM, Ph.D., Dipl. ACVIM and ACVCP, director of pharmacology at Auburn University, asked veterinarians to contest the adulteration of products in her letter to the editor in the Dec. 1 Journal of the American Veterinary Medical Assn.
Compounded drugs aren’t approved by the Food and Drug Administration. When approved drugs are not available, or are not suitable because of the way they are packaged by the manufacturer for a doctor’s intended use in a particular patient, compounding of that drug is allowed. Though the compounding industry is growing fast, it is not well regulated yet.

Veterinary compounding is regulated by 50 state boards of pharmacy that use unclear federal laws that are inferred inconsistently. Most compounding pharmacies are run by pharmacists of undependable expertise who keep an eye on the preparation of the ingredients.

Veterinarians must understand that compounded drugs offer no guarantee of potency, stability, bioavailability, safety, or effectiveness. We have become relaxed using FDA-approved products, with guaranteed analysis, efficiency and warnings regarding unfavorable events while using that particular drug as a single agent or in combinations with other drugs.

The hundreds of compounding pharmacies all over the country do not use uniform methods or bases for their compounded products. Only a small number of pharmacies run tests on the stability of their acquired and outsourced compounds.

Some are unlawfully manufacturing medications under the disguise of pharmacy compounding. The field has spread out into a confusing crossover situation for veterinarians. We have human pharmacists formulating products for animals. If they do not respect and know the human-animal bond, they may purchase “bargain” bulk or raw chemical formulations made in China and other untrustworthy sources to save money. Without testing these bargain agents for consistency, stability, and impurities, our patients are at risk.

For instance, potassium bromide, cisapride, diethylstilbestrol, and other discontinued or no-longer-approved human drugs can be formulated only from bulk chemicals for veterinary medicine, and they are slackly supervised. We need to protect our veterinary patients from being maltreated by this potential danger.