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Reptigirl
17th November 2010, 03:19 AM
Hey everyone! I'm sorry if this question has already been asked before but I could not find anything on it.

Flash is currently on Lyrica 3 times a day. The vet has it compounded into a liquid form. It has been working great as long as I am always on time. I only see very mild symptoms occasionally throughout the day.

It is time for a refill and I checked with the local pharmacies. No one will compound Lyrica here :confused: Texas A&M is compounding it for us and is shipping it down overnight. Flash loves the compound and takes it down with ease.

I hate to change it but is there any difference between the compound and the pill form? That is besides a liquid compound that he will easily lick up and trying to hide a pill in food? Right now we are looking around $40 a month and he is only getting 25 mg 3 X a day. I'm worried if we ever have to up the dosage it will start to get expensive .... fast! I'm thinking the pill form from a local pharmacy will be cheaper....

Just wondering. I'm not going to change anything right now but in the near future I may want to.

Thanks!

Cathy Moon
17th November 2010, 04:58 AM
$40 per month is a very good price!

We get 50 mg Lyrica capsules (2 times per day), and it costs us $163.05 per month at Walgreens. 25 mg capsules are nearly as expensive as 50mg at Walgreens.

I will definitely look into compounding if we can save money that way.

Cavaliers2kiss
5th January 2011, 02:59 AM
I want to thank you Reptigirl for starting this thread.

My little girl's gabapentin was being compounded into a 60 mg capsule for $100 a month in the city. We live in Texas. So today we traveled two hours to Texas A&M. We switched to the generic form of Lyrica for only $30. That's quite a savings and the medication can be shipped in the future.

Thank you! Thank you!

anniemac
5th January 2011, 03:07 AM
Wow. Ella is getting 50 mg 2x a day and it costs almost $100 every two weeks. Seeing neurologist Thursday and must ask!

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anniemac
5th January 2011, 03:09 AM
I want to thank you Reptigirl for starting this thread.

My little girl's gabapentin was being compounded into a 60 mg capsule for $100 a month in the city. We live in Texas. So today we traveled two hours to Texas A&M. We switched to the generic form of Lyrica for only $30. That's quite a savings and the medication can be shipped in the future.

Thank you! Thank you!

I could fly to Texas and back for how much it would save. Please let us know when they can ship. Wonder if they do this at other vet schools like nc state

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Karlin
5th January 2011, 03:58 AM
OK, am confused here -- because Lyrica is not available yet in generic form and won't be for a couple of years, as far as I know? The only place I can find generic pregabalin listed is on lots of very suspicious cheap drug sites. Maybe a research hospital can dispense in some different format?

Cathy Moon
5th January 2011, 04:06 AM
I don't think Lyrica/Pregabalin will be available in a generic form for several years... at which time I will be having a champagne party. :)

I'm thinking the compounded 60mg gabapentin might have been changed to a standard 100mg gabapentin capsule for that low price of $30. Gabapentin has been available in generic form for quite awhile.

Cavaliers2kiss
5th January 2011, 04:06 AM
Anniemac wrote:
I could fly to Texas and back for how much it would save.

I wonder if other universities do the same thing, too. Unfortunately the MRIs are still very expensive in Texas. I must clarify that Lacey is on a small dosage of .7 ml twice a day. The pregabalin is in a tasty liquid form.

Cavaliers2kiss
5th January 2011, 04:14 AM
I'm sorry Cathy and Karlin. I didn't realize pregablin was the true name for Lyrica.

I'm just pleased to get it at such a nice price and I'm anxious to see if it works better than the gabapentin. She was still scratching on the 60 mg dose.

Cathy Moon
5th January 2011, 04:15 AM
Wow that's great! The neurologist at OSU didn't have anything like that available for us. Do you know how many mg pregabalin per kg of body weight your Lacey is getting?

Reptigirl
5th January 2011, 04:33 AM
I want to thank you Reptigirl for starting this thread.

My little girl's gabapentin was being compounded into a 60 mg capsule for $100 a month in the city. We live in Texas. So today we traveled two hours to Texas A&M. We switched to the generic form of Lyrica for only $30. That's quite a savings and the medication can be shipped in the future.

Thank you! Thank you!

WOW! I'm so happy you are saving money!!!

Well I found a better way to save :D

I have spent a while calling different places trying to find a cheaper pharmacy that will compound lyrica for us. Most local pharmacies wont compound Lyrica for some reason but I found 2 here in town that will. Flash's dosage was raised and we are now paying $65 a month. The local pharmacy will compound the same medication for $45. So next time we need a refill I'm going to have them send the prescription down.

You might want to do a local google maps search for "Compounding pharmacies" and then call around.

Reptigirl
5th January 2011, 04:38 AM
Anniemac wrote:
I could fly to Texas and back for how much it would save.

I wonder if other universities do the same thing, too. Unfortunately the MRIs are still very expensive in Texas. I must clarify that Lacey is on a small dosage of .7 ml twice a day. The pregabalin is in a tasty liquid form.

Flash is getting .8 ml 3 X daily (which I believe works out to 20mg 3 X Daily)

Flash LOVES his medication. He will do tricks for it.


Agreed the MRI's are very expensive.. the total for our ONE visit was over $1800. That included the MRI & care required, spinal tap (was only $25! LOL), and 1 month of medication.

Cavaliers2kiss
5th January 2011, 05:00 AM
Cathy, I assume Lacey is on a small dose. She scratches and pulls out her hair, but she has very few neurological deficits. In fact she still trains in canine freestyle...no jumping though.

Lacey weighed 6.9 kg today and as mentioned before she takes .7 mL of Pregabalin twice a day. The medication in this form must be kept in the refridgerator.

anniemac
5th January 2011, 05:30 AM
So glad Ella is having long visit with neurologist Thursday. I get such good info here. Cathy I will do a champagne toast when it's generic. Hey but it helps her

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anniemac
6th January 2011, 04:49 PM
I talked to ellas neurologist about this information and he said he would call Texas a & m. I mentioned the expense so when we were going over medication options he mentioned not taking lyrica! No way....

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Karen and Ruby
7th January 2011, 11:45 PM
Gosh

I pay 153.00 for 42 days worth which is approx $239!!!

Ive never heard of compound Lyrica/Pregabalin and Im with Karlin being confused!!

As far as I knew it isn't a trialed drug (on animals) and wasn't available to the masses at that cheap of price!

Cavaliers2kiss
8th January 2011, 12:51 AM
I made a mistake calling Pregabalin a generic for Lyrica. However, Lyrica is being compounded in a liquid form at Texas A&M. It is sitting in my refridgerator right now. This is no hoax.

*Pauline*
8th January 2011, 01:39 AM
How do you administer the liquid? Does it have sugar in it? I'm just thinking of teeth here, I'd prefer to give capsules. I know that means dividing capsules, I did this for years with Dylan's Gabapentin.

I pay 310 for 180x50mg Pregabalin at Boots Chemist, that lasts him 3 months.

Reptigirl
8th January 2011, 01:57 AM
Here is a great link that talks about compounding medications:

http://www.choicehealthservices.com/whats_compounding.pdf

It came be made without sugars and preservatives.

And flavored for pets. Flash gets the tutti fruity listed on the bottom of the page and really likes it. Its nice not to have to worry about getting a pill down him.

Cathy Moon
8th January 2011, 02:34 AM
I made a mistake calling Pregabalin a generic for Lyrica. However, Lyrica is being compounded in a liquid form at Texas A&M. It is sitting in my refridgerator right now. This is no hoax.

I think it's exciting that you have found this affordable option. :D

I hope that Anne can get some of this for Ella; then I'm next in line... :)

Karlin
26th January 2011, 05:27 PM
I made a mistake calling Pregabalin a generic for Lyrica. However, Lyrica is being compounded in a liquid form at Texas A&M.

Oh don't worry, that isn't an issue. Every brand name also has a 'common' or generic name regardless of whether it is actually available AS a generic :thmbsup: --but I am still really confused as pregabalin is as far as I know, NOT available as a generic and won't be for a couple of years -- it is still under patent restrictions. So I cannot understand how it is possible to get it at a cost that is less than gabapentin costs many of us. I am wondering if this is under some study being done through Texas A&M.

Are you saying your cavalier was on only 60mg doses of gabapentin? That would be extremely low -- my fellow is now on 200mg 3x.

I was quoted €148 for 56 25mg capsules for Lyrica/pregabalin in Ireland -- meds here tend to cost more. If I switched to this I'd probably have my partner get it in N. Ireland.

*Pauline*
26th January 2011, 06:28 PM
pregabalin is as far as I know, NOT available as a generic and won't be for a couple of years

Yes, this is what the pharmacist told me.

Charlifarley
26th January 2011, 07:37 PM
-- my fellow is now on 200mg 3x.
I was quoted 148 for 56 25mg capsules for Lyrica/pregabalin in Ireland --.

Karlin, can I understand from the above that if you switched your dog over to Lyrica, he would be on a lower dosage than he currently is with gabapentin? I ask because Bosco changed to Lyrica a month or so ago, and he is on the same original dosage. I have a feeling I need to speak to my vet about this because I think someone else mentioned previously about their dog being on a lower dosage of Lyrica vs gabapentin.

*Pauline*
26th January 2011, 07:46 PM
Karlin, can I understand from the above that if you switched your dog over to Lyrica, he would be on a lower dosage than he currently is with gabapentin?

It's a completely different drug so you can't compare. Dylan was on 150mg gabapentin 3 times a day and is now on 50mg Pregabalin twice a day.

Reptigirl
26th January 2011, 07:47 PM
Are you saying your cavalier was on only 60mg doses of gabapentin? That would be extremely low -- my fellow is now on 200mg 3x.


Flash is getting 60 mg of Pregabalin (Lyrica) 3X a day.

Our bottle reads 25mg/ml
Flash gets .08ml every 8 hours... If I figured it right that make it 60mg of Pregabalin every 8 hours. That's odd it is "low". Last time I called the neuro because his symptoms were worse she said she hated to up it to .08 because it can start to make them really groggy and start sedating him. (It hasn't) She recommended we start thinking of surgery if his symptoms continue to get worse rather then keep raising the dosage of his meds. I'm confused if his dosage is "low" why our neuro doesn't seem interested in raising it much more. Maybe because he is a puppy? He is still only 9 months old.

Karlin
26th January 2011, 07:57 PM
If I figured it right that make it 60mg of Pregabalin every 8 hours.

That is actually very high if 60mg 3x. Note I was talking of 200mg *gabapentin* (Neurontin), not Lyrica (pregabalin). Most dogs start on 25 mg 2x, maybe going up to 50mg 2x. I had thought I understood from Clare that it doesn't benefit them to get this drug more than twice daily? I don't know how much higher you could go safely for his size or without having serious side effects. But I am not sure if you are calculating that correctly -- it would be worth checking what the actual individual dose of Lyrica is.

To be honest: if you are on very high doses of Lyrica -- which is really the last option except for introducing additional serious painkillers on top -- and he is only 9 months -- I'd opt for the surgery. The prognosis for medication treatment for early onset dogs, especially if early onset before one year, is very poor according to Clare's figures and research.

There are many reasons to opt for medications and not surgery but I think you are probably looking at a limited time of palliative care for Flash if you choose to continue on meds alone. He is very young to already be on at the maximum of what he can be treated with and not much works after Lyrica except perhaps adding in steroids for whatever time might be possible. I don't know how familiar your neurologist or you are with Clare's papers on this and the overall statistics that comeback, but Flash would by any measure I know of, be considered a very serious early onset case.

Karlin
26th January 2011, 08:17 PM
Karlin, can I understand from the above that if you switched your dog over to Lyrica, he would be on a lower dosage than he currently is with gabapentin?

Oh goodness yes -- should generally start on only 25mg 2x and some are on lower than that I think. It is a much stronger drug.

For Flash and Bosco: this is Clare's treatment diagram:

http://www.veterinary-neurologist.co.uk/syringomyelia/docs/treatalgo.pdf

But she doesn't give suggested doses for Lyrica. I have spoken to her about it for Leo though and one advantage is that it is a much lower dosage and know the general starting point is around 25mg 2x.

Note that after Lyrica the option is steroids or surgery. For a young dog seriously affected dog who keeps declining (eg keeps needing medications increased), there are not many medication options left. Most neurologists I know of would recommend surgery for an early onset severely affected dog.

Reptigirl
26th January 2011, 08:26 PM
That is actually very high if 60mg 3x. Most dogs start on 25 mg 2x, maybe going up to 50mg 2x. I had thought I understood from Clare that it doesn't benefit them to get this drug more than twice daily? I don't know how much higher you could go safely for his size or without having serious side effects. But I am not sure if you are calculating that correctly -- it would be worth checking what the actual individual dose of Lyrica is.

To be honest: if you are on very high doses of Lyrica -- which is really the last option except for introducing additional serious painkillers on top -- and he is only 9 months -- I'd opt for the surgery. The prognosis for medication treatment for early onset dogs, especially if early onset before one year, is very poor according to Clare's figures and research.

There are many reasons to opt for medications and not surgery but I think you are probably looking at a limited time of palliative care for Flash if you choose to continue on meds alone. He is very young to already be on at the maximum of what he can be treated with and not much works after Lyrica except perhaps adding in steroids for whatever time might be possible. I don't know how familiar your neurologist or you are with Clare's papers on this and the overall statistics that comeback, but Flash would by any measure I know of, be considered a very serious early onset case.


Okay, that makes more since as to what our neurologist was saying. We are going to be forced to do the surgery this year. I'm thinking once we get our tax return back (another month or two). This is because A & M requires at least 1/2 payment upfront and our insurance takes a good week to process the claim and get the check back in the mail.

I am VERY scared of the surgery. I know that is our only option but that will be a completely different thread really soon.

*Pauline*
26th January 2011, 08:28 PM
Our bottle reads 25mg/ml
Flash gets .08ml every 8 hours... If I figured it right that make it 60mg of Pregabalin every 8 hours.

No! You've got your maths wrong.

25mg/ml means there is 25mg of pregabalin per ml.

You are giving only 0.08ml. (eight hundredths of 25mg)

So divide 25ml by 100 then multiply by 8.

Your answer is 2mg. No wonder it's not working.

Karlin
27th January 2011, 01:14 AM
I am not sure that that is the case with compounded liquid Pauline... I was confused over such measurements on Metacam. I cannot believe a dog would be given 2mg -- that would be pointless.

It would be best to call the vet and find out what dosage you are giving.

I checked and stand corrected on dosages: am told some dogs are on pregabalin 3 or 4x and many are on over 50mg each time so there is a wide variation depending on symptoms and weight of the dog.

I was given this link too:

http://www.vet.cornell.edu/news/articles/09pregabalin.cfm

Hope that helps.

Surgery is a hard decision but if I had a dog under 5 showing the symptoms you have I'd opt for surgery. I wouldn't even hesitate with a 9 month old and would move asap to limit damage that cannot be remedied, unless there were indications that the dog was a poor candidate. Now that is *my own* perspective but I think a neurologist will tell you the prognosis is very poor for a dog that is severely symptomatic and worsening at under one year. Many however would feel that palliative care was what they wished to offer and that is a valid choice too. I am just giving my own perspective.

Reptigirl
27th January 2011, 01:17 AM
No! You've got your maths wrong.

25mg/ml means there is 25mg of pregabalin per ml.

You are giving only 0.08ml. (eight hundredths of 25mg)

So divide 25ml by 100 then multiply by 8.

Your answer is 2mg. No wonder it's not working.



Sorry, that was supposed to be .8 ml

Typing too fast for my own good.

sins
27th January 2011, 02:03 AM
I think check again with your vet?
At 0.8 ml,he's getting 20 mg in that amount.
If he's supposed to get three doses in 24 hours,that's a total of 60 mg.
If he's supposed to get 60 mg, three times in 24 hours,then he needs a total of 180 mg,so your dosage should be 2.4 mls instead of 0.8mls?
But please check your dosage and formulation with your vet before making any adjustments.
Sins

Reptigirl
27th January 2011, 02:36 AM
He is supposed to get .8ml every 8 hours.

Per the instructions of the neurologist

*Pauline*
27th January 2011, 08:51 AM
Thanks for doing the maths this time Sinead ;)

Yes, then that dose is still very low. Certainly he could be on a lot more before I would even consider surgery.

Dylan gets 50mg twice a day and it was a miracle drug for him. Over night he transformed xx

Tania
27th January 2011, 11:05 PM
From what I have read, the patent for Lyrica does not expire until October 2013, until then be aware that any medicine sold claiming to be generic Lyrica may be fake, therefore substandard and potentially dangerous.

http://epilepsy.emedtv.com/lyrica/generic-lyrica.htmlimproved

I also understood, Lyrica works in a similar way to Gabapentin. Lyrica is the improved version and is more potent, therefore the dose will be lower. I have found this article, if you read from "A Successor to Gabapentin"

www.drugdevelopment-technology.com/projects/pregabalin/ (http://www.drugdevelopment-technology.com/projects/pregabalin/)

lovecavaliers
28th January 2011, 12:45 AM
Wow that is great that A & M is giving out pregablin at such a low cost. Jack isn't on Lyrica but may need it in the future.
I too thought it was under patent until 2013. Anne did your vet get a hold of the vets at A & M and ask if it is offered at other vet schools at such a low rate? I know Dr. Dewy at Cornell did a study with A & M a couple of years ago (think 2009) looking at the effects of pregablin on epilepsy in dogs. So maybe Cornell might have access too?

anniemac
28th January 2011, 01:38 AM
My neurologist has not gotten back to me on a couple of things :( her vet said its illegal to cross state lines but I don't have much faith in some things he says.

I am upset b/c I really wanted to discuss more about some things. I will call to set up another acupuncture apt, maybe then I can ask him

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*Pauline*
28th January 2011, 09:00 AM
Wow, can't believe you haven't gotten answers yet. I'd press the neuro to talk to you over the phone. The dose of those meds is all wrong, therefore your dog is in pain!