Pets on medication vet vs people version

Natt on 20/07/2016 - 21:20

This is part rant, part being astonished. And can someone check my logic?

We are looking after a dog at the moment, and it's been prescribed clomicalm 20mg a day by the Vet. The first time we got a supply was part of a consult, so did not really realise the price.

Turns out its $90 for a MONTH.

I have found the human equivalent Anafranil 25mg, or the generic. Price for generic 30 days $6.

The dog is about 9 kilos. At 10kg-20kg the dosage goes up to 40mg so it's a big dosage range.

Can anyone see a problem in giving the dog the people version, I can't. 5 mg extra a day seems like it would not be an issue.

Active ingredient is Clomipramine Hydrochloride

It's insane what the difference in price is. How can a vet sell something at 15X the price!

Am I missing something? To be honest it's seems ethically questionable to me. There must be so many people buying this stuff for dogs and paying way too much!?

General Discussion

Comments

  • PVA on 20/07/2016 - 21:24
    +1

    someone posted a site here with animl drugs that are super cheap compared to vets, search for it.

    i have no idea about using a human equiv.

    —- Found it.. https://www.ozbargain.com.au/node/244719

  • Natt on 20/07/2016 - 21:40

    thanks that might be useful for the cat.

    But even at that site at 20mg it's $49 a month. So the 25 mg human equivalent is still much cheaper at $6.

  • [Deactivated] on 20/07/2016 - 21:47
    +1

    There could be alergy issues with the human version.

    The active drug might be the same but the coatings might be different. The dog might be allergic or have other reactions to the other ingredients in the human version. I'm just speculating here. I don't work in the area of drugs or animals.

    If the human drug is safe for the dog, the cost difference could be caused by the size of the market. There's a larger market for the human drug and therefore the prices are lower per unit. It's similar to the idea of school uniforms being much more expensive than the equivalent generic clothing item as the production run for uniforms is much smaller than the production runs for mainstream clothing.

  • altomic on 20/07/2016 - 22:08

    rambling story about animal drugs

    my old cat was prescribed uppers by the vet.

    after taking the meds she just wanted to eat and eat and eat. and she'd meow and meow and meow. and sometimes she'd eat so quickly that she'd vomit and then,<stop reading here> being hungry due to the medication, she'd eat her vomit.

    poor kitty. she was abandoned by her mum when she was super small. my wife and I took her in but she was always crazy. we got her in Tokyo and then when we left Japan we brought her back here.

    • robertbruce on 21/07/2016 - 08:08
      +2

      yep, dogs have owners, cats have staff

  • cjhfield on 20/07/2016 - 22:09

    Yes you can use the human version. Its the same drug. The dose difference is insignificant. The dose range is 2-4mg/kg so is well within the range.

    To buy the generic you will need a script however. Your GP may be willing to provide a private script. You can't just buy it over the counter.

    $90/month for such a cheap (old) drug is daylight robbery.

    • Natt on 20/07/2016 - 22:19

      thanks cjhfield

      I'll try and hunt that 2-4mg/kg figure up now so I have it for the vet.

  • Natt on 20/07/2016 - 22:11

    I'll ask the vet. To be honest I expect them to say it's fine.

    Our cat is on the people version of a drug for hyperactive thyroid and it's fine. Costs less than 20% of the pet equivalent.

    They were very reluctant to write a prescription until I told them the price difference.

    II was very happy with how my vet did a home visit to euthanise my very old dog. But it really makes me think about getting a list together of pet vs human drugs so people can ask for them.

  • Natt on 20/07/2016 - 22:53

    Done some hunting. It looks like Anafranil is not registered for animal usage. That might be why the reluctance.

    I'll be sure to tell the vet if the dog keels over we won't hold them responsible,

    It's a sad story, we are looking after the dog it while the owner is overseas. No one else can, or will because of behavioural problems, and not even the owner seems to really want it.

    Adoption is out of the question, it's that badly behaved. We are just trying to keep it alive, give it quality of life and try and unravel some of its behaviours.

    • Hiroko on 20/07/2016 - 23:04
      +3

      good on ya for taking up such a big responsibility on top of your own personal life.
      i hope the dog will return the favour and provide you with much deserved joy and affection for its remaining years.

    • [Deactivated] on 21/07/2016 - 02:59

      I like to watch "It's Me Or The Dog".
      Basically, the lady comes in and with certain strategies, completely changes out of control dog behaviour.
      I love to watch it for the change that happens, and the changes in the people's lives - but she might have some strategies for things you're dealing with.
      Maybe google the problems and "It's Me Or The Dog".
      She also has a lovely attitude towards dogs, gentle, caring, considerate, vs being a c*** ie. control/domination/hitting.

  • cjhfield on 20/07/2016 - 23:29

    Clomipramine has an indication for separation anxiety in dogs. It does not matter if the label says Anafranil or Clomicalm. Its still clomipramine. They are just brand names of the same thing. If the vet has assessed the dog and thinks its appropriate then buy the cheapest version you can find and see if it helps. It would be fraud to try and get your doc to write a PBS script but a private script is not. As long as the doc accepts your need for it for the dog and does not believe you are going to abuse it in some way they likely will write the script. If you saw the doc just for this private script it would also be fraud to claim the cost from Medicare but if you see the doc for something else and ask for a script while you are there it would not.

  • Natt on 20/07/2016 - 23:41

    Cool. With our cat's medication we make sure to tell the pharmacist it's not PBS.

    Interestingly the cat has a brand preference. One he spits out, the other he will eat whole with gusto and go looking for more.

    His love of the medication is actually one of the reasons he has lived so long with his condition. Cats are notoriously hard to medicate it's easy to fall into bad habits and not dose them.

    Odd cat. Should post his video no one believes that he eats it from your hand.

    • endotherm on 21/07/2016 - 03:03
      +9

      How To Give A Cat A Pill :

      Pick cat up and cradle it in the crook of your left arm as if holding a baby. Position right forefinger and thumb on either side of cat's mouth and gently apply pressure to cheeks while holding pill in right hand. As cat opens its mouth, pop pill into mouth. Allow cat to close mouth and swallow.

      Retrieve pill from floor and cat from behind sofa. Cradle cat in left arm and repeat process.

      Retrieve cat from bedroom, and throw soggy pill away. Take new pill from foil wrap, cradle cat in left arm, holding rear paws tightly with left hand. Force jaws open and push pill to back of mouth with right forefinger. Hold mouth shut for a count of ten.

      Retrieve pill from goldfish bowl and cat from top of wardrobe. Call spouse from garden.

      Kneel on floor with cat wedged firmly between knees, hold front and rear paws. Ignore low growls emitted by cat. Get spouse to hold head down with a ruler and rub cat's throat vigorously.

      Retrieve cat from curtain rail, get another pill from foil wrap. Make note to buy new ruler and repair curtains. Carefully sweep shattered figurines and vases from fireplace and set to one side for gluing later. Wrap cat in large towel and get spouse to lie on cat with head just visible below armpit. Put pill in end of drinking straw, force mouth open with pencil and blow down drinking straw.

      Check label to make sure pill not harmful to humans. Drink one beer to take taste away. Apply Band-Aid to spouse's forearm and remove blood from carpet with cold water and soap.

      Retrieve cat from neighbour's shed. Get another pill. Open another beer. Place cat in cupboard and close door onto neck to leave head showing. Force mouth open with dessert spoon. Flick pill down throat with elastic band. Fetch screwdriver from garage and put cupboard door back on hinges.

      Drink beer. Fetch bottle of Scotch. Pour shot, drink. Apply cold compress to cheek and check records for date of last tetanus shot. Apply whiskey compress to cheek to disinfect. Toss down another shot. Throw tee-shirt away and fetch new one from bedroom.

      Call fire department to retrieve the cat from tree across the road. Apologize to neighbour who crashed into fence while swerving to avoid cat.

      Take last pill from foil-wrap. Tie the little bastard's front paws to rear paws with garden twine and bind tightly to leg of dining table. Find heavy duty pruning gloves from shed. Push pill into mouth followed by large piece of fillet steak. Be rough about it. Hold head vertically and pour 2 pints of water down throat to wash pill down.

      Consume remainder of Scotch. Get spouse to drive you to the emergency room. Sit quietly while doctor stitches fingers and forearm and removes pill remnants from right eye. Call furniture shop on way home to order new table.

      Arrange for RSPCA to collect cat and call local pet shop to see if they have any hamsters.

      How To Give A Dog A Pill :

      Wrap it in bacon.
      Done.

      • QW3RTY on 21/07/2016 - 10:02

        Incredible.

      • [Deactivated] on 21/07/2016 - 13:54

        FUNNY :-)

        and just doing the math at $90/mo normally but with that wastage it's now about 7x$90 = $560 per month !

  • jennkei on 21/07/2016 - 03:19

    I always expect vet medications to be more expensive. If it's a large difference, always see if you can ask for a prescription instead (there may be a prescription fee)/ask if there are cheaper alternatives. And scrutinise the care plan before it happens! You have the right to ask how much things are. Understandably tough if it's an emergency situation, though.

    Clomicalm itself is probably more expensive for them to purchase than the generic to begin with, having to keep stock and all the associated costs, not being able to buy in bulk like bigger pharmacy chains are able to, all of the factors lead to an increase in price. I don't work at that particular vet and can't tell you if the markup is ridiculous or not. :P

  • GOFYS on 21/07/2016 - 07:34

    I don't mean to be rude abut this but you asked for someone to check your logic.

    I have never heard of "this stuff", how does anyone know about it? I looked it up. What the….?

    Clomipramine, sold under the brand name Anafranil among others, is a tricyclic antidepressant (TCA). It is used for the treatment of obsessive compulsive disorder, panic disorder, major depressive disorder, and chronic pain. It may decrease the risk of suicide in those over the age of 65. It is taken by mouth.
    Common side effects include dry mouth, constipation, loss of appetite, sleepiness, weight gain, sexual dysfunction, and trouble urinating. Serious side effects include an increased risk of suicidal behavior in those under the age of 25, seizures, mania, and liver problems. If stopped suddenly a withdrawal syndrome may occur with headaches, sweating, and dizziness. It is unclear if it is safe for use in pregnancy. Its mechanism of action is not entirely clear but is believed to involve increased levels of serotonin.

    Common side effects of Anafranil include: nausea, insomnia, dizziness, headache, drowsiness, tremor, fatigue, myoclonus, constipation, urination disorder, ejaculatory disorder, dyspepsia, weight gain, paresthesia, visual disturbance, nervousness, xerostomia, anorexia, and diaphoresis. Other side effects include: orthostatic hypotension, vomiting, sleep disorder, anxiety, muscle twitching, memory impairment, hypertonia, tachycardia, hot flash, pruritus, tinnitus, skin rash, fever, non-puerperal lactation, taste disorder, and flushing. See below for a comprehensive list of adverse effects.

    Right now, i think I'm the one who needs it.

  • voiletmay on 21/07/2016 - 08:00
    +1

    I have a diabetic cat and quite often people use human insulin (lantus) on their cats. It is cheaper. Was cheaper to research and act on that research (ie. change the cats died away from what the vet said) and have the cat go into remission and not need insulin anymore.

    So maybe research and find if there is an an alternative and if the medication is really necessary.

    I've quite often being given human medications for my pets from the vet. Maxolon (an anti-nausea tablet) is a common one you get given by vets and by doctors.

  • Fake News on 21/07/2016 - 08:39
    +1

    Most human drugs are subsidised by the PBS, they are cheaper as taxpayers' money is going towards the majority of the cost. And, Vets have a huge mark up on things- we just paid $80 for 8.5ml of ear antibiotics for our dog!!!

  • Onysius on 21/07/2016 - 10:43
    +1

    I remember that about 20+ years ago one of my previous dogs was bitten by a snake.
    When we took it to the vet, we were told that the anti-venom was the stuff that was beyond the use by date for human use.
    Therefore I suspect that it may be the same for the other medications too.
    My parents took their dog to the vet because of its arthritis, and were charged ~$50 for a 1 weeks supply of glucosamine, and they were to take it back every week for a recheck/refill. After the 1st week, I put it on a daily glucosamine (same dosage) bought from a pharmacy at a much cheaper price; and since then it hasn't had the arthritis problems, and you really wouldn't know that the dog was 17 years old.

    • keiragoble on 21/07/2016 - 11:23

      Some other medication is the same for human use. But I wasn't trying my dog bitten by a snake. I think that anti-venom have the same us by a human.

      • Onysius on 21/07/2016 - 13:15

        It was the same anti-venom for humans, but it was no longer suitable for human use.

    • snook on 21/07/2016 - 11:30

      what's the dose:size of dog?

      • Onysius on 21/07/2016 - 13:14

        Their dog is ~12kg, and have been giving it 500mg of glucosamine (or 1/2 a 1000mg tablet) every day.
        I found a table on the net drawn up by European vets, which which listed the dosage:weight for dogs (I just can't re-find it at the moment.
        The funny thing is the dog waits for the tablet every day, but still puts up a fight when they try to give it to her.

  • Natt on 21/07/2016 - 12:50

    Hi all

    Thought I would get back with my research.

    This is the drug:
    https://en.m.wikipedia.org/wiki/Clomipramine

    Dosage information was in the packet leaflet (from the vet). It's exactly as cjhfield stated 2-4 mg/kg

    Vet has the dogs weight at 7.8 kilos - it's currently on 20 mg. Maximum dosage would then be 31 mg.

    Human version is sold at 25 mg, so right in the middle.

    Currently the human generic is tough to get according to my local pharmacy, but a 50 day supply is $15. That's not subsidised. The cheapest pet equivalent is $83 for 50 days.

    Had a chat to the vet surgery. They sound willing to write a prescription for a $15 fee, although they need a couple of days notice apparently.

    Dog is tolerating the 20 mg dosage very well. It seems to take the "edge" off the really extreme behaviours, but he's not even slightly "zombie". Still happily demands his first walk at 5:45 am ( yes you read that time right).

    I am getting a letter together for the vet, so they can prescribe it by drug name at 25 mg, not the trade name. Going to ask for a 1-2 repeats. It's a "drug of addiction" apparently, so they will probably be reluctant to do more repeats.

    Anyway to cut a long story short. Dog gets the drugs, at 1/5th price. Which is awesome, because we would probably have ended up paying for it rather than the owner (long term dogsitter).

    So yeah. I think the lesson here is its worth asking your pharmacists about your pets medication!

  • retiredfeline on 21/07/2016 - 13:02
    +1

    I asked a relative who is a vet and they confirmed what you found out, including the fact that there's a shortage of Climipramine at the moment. They mentioned that in some cases the disparity narrows when you compare with the non-PBS price, and of course it's not meant to be subsidised for pets.

  • Natt on 21/07/2016 - 13:51

    Thanks for that greenpossum. I think we got lucky with the dogs weight.

    Cats for instance seem to be much more sensitive and 5 mg is the dosage.Dividing a tablet in 5 would not work.

    The $15 is the "private" price, and I would feel so guilty about trying to get it subsidised anyway.

    http://www.chemistwarehouse.com.au/buy/431/Anafranil-25mg-Ta…

    For dogs the dosage seems to go right up to 80mg. So theoretically it might be possible to give larger dogs multiple human tablets.

    After some thought, I do get its easier for the vet to give them the pet version at the time of consult so they know the animal has what it needs. On many drugs it seems like blood tests are needed to check there is no negative organ effect. So less chance of patient "disappearing" if the owner has to keep coming back.

    Some people will be able to do the pharmacy option though, and I am happy if they cater for that.

  • ms_caz on 22/07/2016 - 08:12

    I don't have the link at the moment but I believe that on the website for Ingleburn vets there is a human medication for animals dosage table. Try google … There are a few but most seem to be US based. I've given my dog Telfast for itching based on online research. And also Meloxicam for anti inflammatory medication.

Login or Join to leave a comment
Login Join