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[gunner]

Any time I am going to be spending thousands of dollars on a product, you can bet I will be researching it.  So I found some really interesting facts that you might like to know about. 

On this forum, some people have been advised only to use name brand Sporanox, others have used generic and still others have used the compounded form.  Either way, most have been sent home with one type of the drug or the other without proper instructions on how it works, or how best to give it to their pet.  I hope to dispell some of the confusion. 

Sporanox:  This product is one of the most expensive drugs used in vetrinary practice.  The making of Sporanox is complicated and requires expensive equipment and processes to manufacture; thus making the price reflect the difficulty in manufacture.  Sporanox is made with a tiny core bead of sugars or starches which is then coated with a mixture of Itraconazole and hydrophilic polymer, and then coated again with the hydrophilic polymer.  The hydrophilic polymer helps to make the itraconazole more water soluable so it can be absorbed into the system better.  Itraconazole on its own has a very low water solution rate.  The resulting tiny beads are then capsulated by weight, bottled and sold for consumption.

Generic:  Many of the drug companies also manufacture the generic version of their drugs.  They are completely the same in every way, only the packaging is different.  (To be your own competition makes good business sense.)  So, given the complicated and expensive manufacturing process of making Sporanox, I cannot be totally certain at this point but I am almost positive that the generic version of Sporanox is made by the same company.  Either way, there are strict government guidelines governing the manufacturing of generic brands and by law they truly have to perform in exactly the same manner and give the exact same results as name brand products.   For more information on generic v/s name brand see: http://www.4rx.com/brand-vs-generic.html

Compounded:  Itraconazole in the compounded form comes as a powder in a capsule.  This has powdered Itraconazole and fillers.  The Itraconazole in the compounded form comes without the hydrophilic polymer to make it more water soluable for better absorbtion into the system.  It is important to note that Itraconazole is fat soluable so it is important to give the compounded form of Itraconazole with fat, ie.: butter or with acid, fruit juice, etc. 

A new manufacturer on the market, a company in India is making competition for Sporanox under the name brand Fungitrace, suggests, for the better absorbtion of Itraconazole, to give the pill with either fatty food or putting more acid in the diet.  Making a more acidic system better at absorbing and using the itraconazole in the fungal fight.  Another company has just applied for a pattent which will blend the Itraconazole with fat and make it in a tablet form. 

In conclusion:  No matter what form of Itraconazole you get, for best results, give it with fatty food, and try to add some acid into their system.  (I have been adding apple cider vinegar to Gunner's water: 1tsp ACV and 1/8 tsp. baking soda to cut the zing, to 2 qts of water.)

I hope that helps to clear things up.  Any questions?  

[luvmyjacks]

For someone with limited computer skills I seem to beat the drum a lot about getting this fabulous information into a place/form where people new to blasto can find it easily.  That is THE most comprehensive piece on drugs ever posted on this forum and if Lisa could create a place for RESEARCH it would be really helpful.  We are all stumbling along and learning as we go so a lot of what we have been offering is tips on what helped, support when you just can't believe your dog is going to survive and cyber hugs.  A newcomer has to read through post after post while the clock is ticking on their dog.  There has been a lot added in the last few months as this site has attracted new members committed to research and involvement so how can we sort through all the good stuff and get a category for facts?  I would love to see your post kept at the top of the page at the very least, but we now need somewhere to go to look at research like this that has been discovered through hard work and persisitence.  Thank you for doing so much. 
FYI, based on posted stories of successes, I have always given Will his Itra in juicy meat and chunks of cheese, but I am going to up the ante now and as well add some acid - especially since your research indicates we are officially on the right track.

[GSP_Mom]

Again Thanks Bunches,  It seems that this is what I say every time I post & I can't say it enough.  This site was were I first learned that Bodi needed fat w/ the Intra.  He loves cheese & now I have started to give him a lob of margarine (also like very much) My vet only mentioned it after a few f/u visit which we have had a lot and will still probably have plenty more.  He has yet to mention a more acidic diet, which I will bring to his attention for other dogs he may treat.  Also, I had no idea about Sporanox, the Generic or the Compounded Intra.  In fact I thought Intra was the Generic.  Thanks to your research and the research done by others on this site I truly feel that I as well as many other dog parents who are lucky enough to stumble across this site, are far better educated and therefore can make better choices when it comes to the care of our beloved pets.  Not to mention the support, you guys are great!

[gunner]

I just want to point out that anyone considering upping the level of the acid in their dog's diet, might not want to go too far with it, especially right at the start.  Suddenly drastically changing a dog's diet or p/h balance can bring on a whole set of troubles of it's own.  Fungi doesn't like an acidic environment so adding a LITTLE more acid to the diet is helpful either way.  The addition of natural yogurt is always a good choice.     Actually, as we girls know, yogurt is a GREAT product when fighting a yeast infection so it should be great to feed to our dogs as well!  Why didn't I think of this before?  I am off to the store!

[GSP_Mom]

ooh, yes yogurt!  That normally helps me with my instestinal trac too!  Bodi and I went to the vet today & she said if he'll eat it, give it!  Yogurt can only help she said. 

[Wilson3]

acidophilus good stuff in yogurt does wonders on yeast infections i buy them in the capsules and take them as needed this is also in the plant emzymes and probotics i give wilson as needed and my other dogs.
 great info gunner


wilson3

[Jen]

Very good topic, thanks!
I've never understood the reluctance of doctors to keep a generic away from the consumer. At times the attitude suggests that they depend on a consumer to be ignorant about the product or the regulations (FDA) in place, in order to boost sales. Dirtbike was treated with generic compounded Itra from Pet Health Pharmacy (along w/margarine), and we couldn't be happier with the price or the results.

I do understand the reluctance of some physicians to use a compounding pharmacy, as they have legitimate reason to consider some of the product suspect. They certainly can't afford to be burned by recommending a faulty product, but...

Dr. Barrett explains in this article, which is several yrs. old, but still relevant. I sometimes take Barrett with a grain of salt because he's a vendetta-type.
His site, however, is of great help when necessary. (Quackwatch.com)

http://www.quackwatch.org/01QuackeryRelatedTopics/compounding.html
Misuse of Compounding by Pharmacists

This is a list of compounding pharmacies gone wild with bioidenticals, causing further mistrust amongst physicians.
http://www.pharmwatch.org/strategy/bioidentical.shtml

Excerpt:
"In January 2008, the FDA ordered seven compounding pharmacies listd to the right to stop making illegal claims about "bio-identical hormone replacement therapy (BHRT)" products. The companies were told that the FDA regards "bio-identical" as a marketing term that implies a benefit for which there is no medical or scientific basis [6]. Some were also making unsupportable claims that their drugs are better than FDA-approved menopausal hormone therapy drugs and can be used to prevent and treat serious diseases such as Alzheimer's disease, stroke, and various forms of cancer.
Murray Avenue Apothecary
Pacifica Pharmacy
Panorama Compounding Pharmacy
Pharmacy Compounding Specialties
Reed's Compounding Pharmacy
Saint John's Medical Plaza Pharmacy
Village Compounding Pharmacy"

There will always be renegades. All in all, bless the compounders that saved our dog. Amen.
jen

[gunner]

Just wanted to move this one up too.  There must be an easier way???

[luvmyjacks]

Lisa has added a lot of new categories to the home page so perhaps she/we could earmark some items that could be extracted from the forum.  I would like to see all these last new people add their dogs to the case database and see if Lisa would add province/state and possibly cities instead of just Canada or US
Re this topic Larry I believe referred to a performance difference (according to his brother-in-law) between the different forms of Itraconazole whereas your research suggests the opposite.

[gunner]

According to my research, talking to as many pharmasists as I could, and hours on the internet, I came to the conclusions I did because:

Almost all vetrinarians know symptoms and diseases and the drugs used to fight them but they don't know the in's and outs of the drugs they use.  It is the pharmasist business to know how the drug works, how it is made and all the details about the drugs.  So, unless a vetrinarian has taken the time to research the drugs used on a "rare" disease like Blasto, I deffer to the pharmasist's expertise.  Vetrinarian's ears are also bent by drug salesmen.  Experts and researchers may be funded by pharmesutical companies for name brand research.  So again, the pharmasist who doesn't pick what pill to give a patient seems to have a less biased view, in my oppinion, has a bit more weight.   

The name brand Sporanox and generic equivelants are designed to be absorbed by being taken with just water.  They are, after all, designed for human consumption first.  The special process in manufacturing of these drugs allow them to be absorbed without taking fat to get them to metabolise in the system.  (Humans seem to have a problem taking a pill with a spoon full of butter, but dogs on the other hand kind of see a spoon full of butter as a treat) 

Compounded Itraconazole on it's own, taken only with water or nothing at all, will not be nearly as effective as the "Sporanox" varieties because there is no aid to help it become more water soluable.  However, Itraconazole is fat soluable.  So if you give the compounded form with fat, it is about equivelant in effectiveness to the name brand or generic.  The main problem in treating this disease with what ever drug you choose to use, is the instructions, or lack there of, on how to give them to your dog.  Along with the drug there are things you can do, and in the case of the compounded version, things you must do, to ensure the effectiveness of the drug. 

At this point, I would have no problem using the compounded form for my dog, I would just ensure that she got a quantity of fat to take the pill with.  There are dogs on this forum that are living proof that the compounded form works too.  I guess it is all a matter of prefference and pocket book.     

[luvmyjacks]

You are the best! And Will is a survivor who has used all three versions as I slowly went bankrupt and searched for less and less expensive versions.  Thanks to you and the other great researchers out there, including Jen who seems to find great tidbits all over the place.  Kudos to you.  Now we need to get these facts into a place of their own as well as on the forum. I emailed Lisa to see if she would make some additions or changes.

[Wilson3]

I found this site
http://www.avma.org/issues/drugs/compounding/faq_compounding.asp
talks about compounding drugs (this link http://www.avma.org/issues/drugs/compounding/veterinary_compounding_brochure.asp from the past one talks about vets and compound a bit more search around the site a bit)
the understanding i have from my vet and from the hospital sometimes they have to compound drugs because like sporanox it comes only in 100 mg and like wilson started on 125mg and ended on 175 mg so if they did not compound wilson would be dead the dose would not work for him and blasto would have won
wilson3
this site also
http://www.veterinarypartner.com/Content.plx?P=A&A=520&S=2&EVetID=900000012
their is a small bit on compounding not much

[Wilson3]

okay i am still a bit confused i asked thsi question in my last post here right above this one

my question is

sporanox comes only in 100mg http://www.veterinarypartner.com/Content.plx?P=A&A=520&S=2&EVetID=900000012

http://www.petplace.com/drug-library/itraconazole-sporanox/page1.aspx


and is the brand name got that much

but i have noticed their are ones on different doses then 100mg how are they getting the brand name? if it is not truely compound form but told it is brand name and paying the full price

the only way for wilson to be treated was with the compound form because their is a "safe" zone for his weight and if he took only 100 mg it would have never worked and if I gave him 2   100mg a day it would have did a ton of damage or even worse killed him

any answers

(I think i need a lfe to be still thinking about this one, but i hope the ones getting more or less then 100mg are not getting riped off)
wilson3

[gunner]

Hi Wilson3,

When I spoke to the pharmasist a while back, he told me that the only way he could compound name brand Sporanox for me was if I needed something other than the 100mg that they manufacture.  He would order the little Sporanox beads from the company and then carefully weigh and capsulate the correct ammount  ie: 125mg or 175mg or what ever.  He told me that for him to do it and to get the name brand and all that, there likely would be no cost savings at all. 

HOWEVER:  he could order Itraconazole and compound it like Road Runner Pharmacy and others, but if my dog needed 100mg and it is manufactured by a drug company then in Texas that is what he must sell, generic or name brand.  However if my dog needed 125mg of Itraconazole and the drug manufacturers don't make it in that ammount, then he could do that for me.  He still felt that it would not be a very cost effective measure for me. 

I hope that helps,
Joyce

[Wilson3]

yes it does thanks
wilson3