Question about Gabapentin 50mg?!

[Pixie28]

Hi,

I'm new here. I have a very small Cavalier who weighs only 4.8kg (she was the runt of the litter) She has been diagnosed with SM and put on 50 mg Gabapentin as well as Metacam.

I have been ringing round the pet chemists online to see if I can get it cheaper, as it is £135 a month from the vet!

Everywhere that I have phoned, say there is no such thing as 50mg and the lowest dose is 100mg. I know there is a 50mg as she is on it. I can't seem to find anywhere who does it.

Does anyone know anything about this or has anybody had their dog on this dose?

Thank you in advance

Kate

[Nicki]

Welcome to the forum and sorry to hear about your wee one - you will find lots of help, advice and support on here as sadly many of us have either had or still have dogs with SM.

I'm presuming you are in the UK? according to the British National Formulary Gabapentin is only available in the following sizes 100 mg, net price 100-cap pack = £3.57; 300 mg, 100-cap pack = £8.83; 400 mg, 100-cap pack = £5.53 [the prices quoted are net of VAT and are usually correct, they show the huge markup there is on drugs, but remember that veterinary practices rely on income from drugs to support the practice, otherwise fees for consultations etc would have to rise considerably. They also have a legal responsibility for the dog for medication they prescribe.]

I suspect that the price you are paying is due to it being specially compounded to obtain this dose. You can compound it yourself, you can obtain empty capsules from a pharmacy or even on E-bay now! You can tip the contents of a 100mg capsule onto a piece of folded paper, and then carefully tip half into a new capsule and half into an old one, and reseal. It's a bit fiddly but doesn't take too long to do. [At one point one of my Cavaliers was on an epilepsy drug and there was a manufacturing problem, so we could only obtain very high dose capsules - I had to split each capsule into 6 doses ] Of course you will need to get the 100mg capsules or a prescription from your vet for which they may charge, ask them to put repeats on it too, and you can obtain the drug from pharmacies - I think Boots the chemist is one of the cheapest right now. Your vet may not be too happy about you splitting capsules, as it's impossible to be totally accurate, but if you are very careful it balances out over the course of a day or so.

I think Gabapentin is available in a liquid form in other countries, but not the UK - it is not recommended as it is very irritating to the gut lining, another reason why this drug should only be given in sealed capsules.

BTW anyone can register to access the BNF http://bnf.org/bnf/bnf/current/129255.htm#_129255

Have you seen a neurologist? Really they are the best people to see as they have experience with SM and are able to do a full consultation. Also have a look at http://sm.cavaliertalk.com/ and http://www.veterinary-neurologist.co.uk/ [from where you can download a treatment alogirthm - under Syringomyelia, downloadable PDFs] It is usually recommended for your dog to be given one of the CSF reducing drugs, Clare Rusbrdige recommends Zitac [cimetidine as being the gentlest for long term treatment]

Hope this helps

[BrooklynMom]

Have you tried calling the human pharmacies? Not the animal ones? I get Brooklyn's at a people's pharmacy. But she is on 100 mg...I have no idea about 50mg, sorry! I would just say try the people chemists and see how you go, they can sometimes break it down smaller for you if they are a compound chemist (if it does not exist).

There will be some good advice from other board members for you too I am sure

On a side note, what a tiny little cav I would love to see pics if you get around to it.

[Pixie28]

Hi, thanks for your reply. I have rung round loads of vet pharmacies but not tried human chemists. Is it exactly the same drug?
I rang the neurologist to ask and apparently where she went, they make it up themselves.
I shall keep trying. I found 100mg for £14 and I am paying £135!!!

Here are a couple of pics of little poppy! I also have a ruby and a jrtXcav

[Nicki]

She's very sweet


Yes it's exactly the same drug, it's a human drug that is not licensed for use in veterinary medicine like many other human drugs [they probably won't ever be licensed as there is not a large enough market for it to be profitable for the drug companies to do this] , however it has been used for some time now.

You are more likely to be able to obtain it from general pharmacies.

Can I ask who quoted you £14 that is a good price!

[Pixie28]

It was HyperDrug who said £14 or thereabouts. It was for the 100mg's.

Very good price!

[Pixie28]

Oh that's strange. I had a post with the photos on but it has disappeared!!

[Nicki]

Thanks for that - I think some people have had problems with them saying that they have it and not delivering

Just found your photos post and approved it so you should be ok now!!

[BrooklynMom]

Oh she is adorable!!!!

Yes, the drug is the same in a human pharmacy. My Cav gets hers from a human pharmacy And it will likely be cheaper and they will help you with how to make or get a 50mg tablet. If a regular human pharmacy can't help, call a compound pharmacy (still a people pharm)...they make blends and unique drug sizes. I have used compound pharmacies for my own weird medicine strengths

Good luck and welcome to the boards!!! Poppy is so adorable.

[Karlin]

There definitely isn't a 50 mg form manufactured, but as others said, you can either split a capsule (which is what I did back when one of my dogs was on that low a dose) or use a compounding pharmacy. I had never even heard of compounding pharmacies until I had Cavaliers with SM! I suppose one thing to keep in mind is that often that low a dose isn't adequate, or becomes inadequate over time, so I wouldn't buy massive amounts if it is costly to compound at that dose. I don't know of very many dogs that have remained on the dose that low, although it is the initial trial dose for dogs. Often it needs to be increased pretty quickly if it's not managing scratching and other symptoms, or more typically, the drug loses its effectiveness over time (at which point a related drug in the same family, Lyrica–the generic name is pregabalin– can be very effective and actually tends to work better as it is the more advanced version of the same kind of drug and can be given at a much lower dose).

I am really shocked at the amount your vet is charging though–I suppose they are ordering in themselves from a compounding pharmacy and then will charge so that they make some profit off of doing this on your behalf, which is fair enough, but those are extortionate prices. My vets don't even offer this particular drug, because it is the human drug–they just write me a prescription and I take it into my local pharmacy.