Essential to logical therapeutic drug use is the knowledge of the quality, strength (concentration), purity and availability of the molecule in the formulation that we propose to administer. Further, it is the veterinarian’s responsibility to practice medicine scientifically as well as ethically.

If we believe these statements to be true and valid, then we can understand that various levels of scientific or empirical evidence regarding the nature of a particular drug formulation provide us with different levels of assurance that patients will respond positively to the administration of a drug. The highest assurance for safe and effective use of a drug comes when the available drug formulation that includes the dosage form, excipients, and concentration, etc. which was associated with a sought-after response, without troublesome adverse effects, as evidenced in controlled clinical tests that evaluated safety and efficacy.

When well-controlled clinical studies are missing, we must use more questionable supportive information which includes pharmacokinetic data, case series and/or anecdotal reports, and data collected from other species. As the specificity and balanced nature of the supporting data weakens, our confidence in the drug’s effect should lessen. We must keep the value of the available facts for safety and effectiveness in mind when applying any therapeutic. Equine veterinarians are somewhat familiar, and to some degree comfortable with the use of drugs when the scientific evidence is lacking.

The literature is full of case series, case reports, pharmacokinetic and in vitro data (microbiology) information, but controlled prospective clinical studies are exceptional

With all of this ambiguity, the least we must be on familiar terms with is that we are actually administering the drug that we intend to administer. This is natural for drugs approved by many government regulatory agencies (e.g., Health Canada, United States Food and Drug Administration). Regulatory agency approved formulations have to pass a high quality of manufacturing controls and support a high level of confidence regarding product content.

The problem with equine veterinary medicine is that practitioners find themselves attending to conditions for which there are practically no clinical data to support therapeutic choices. Equine practitioners should time and again treat animals where no approved formulation exists, or where approved formulations are impossible to administer.

In situations like these, equine veterinarians often use compounded medications.

Drugs are administered in the anticipation of achieving a desirable effect. Veterinarians often find themselves in situations where the only alternative for treatment is a compounded medication. However, use of compounded medications is restricted ethically and scientifically by several stipulations that but are not limited to, but include the development of a veterinarian-client-patient relationship, prescription drug dispensing restrictions, and the formulation’s use in the treatment of disease or to progress in terms of welfare, but not to improve performance.

Besides, there should be no government regulatory agency (e.g., Health Canada, United States Food and Drug Administration) approved product in an appropriate dosage form to treat the condition.

Something that is basic to achieving a positive effect when administering drugs is in knowing that the drug is administered in the required strength and that the drug is accessible to the patient.

If practitioners choose to compound, or to prescribe compounded medications, they assume the responsibility for the effectiveness of formulation, its safety and composition. Accepted drugs are consistentl0079 formulated to specification. Guarantee of a formulation’s composition or its availability to the patient is uncertain when veterinarians advise compounded medications.
For that reason, the veterinarian must ask some explicit questions prior to hiring a firm to compound a prescribed formulation.