|
|
Discussion on Dosages & Sources of Omeprazole
|
| Author |
Message |
Member:
Sjeys
|
Posted on Thursday, Mar 30, 2006 - 11:00 am:
My 12 yo very hot, very worried TB was diagnosed with ulcers (via scoping) and stretched out (like he had to pee) colic like behavior about six months ago. I put him first on Cimetidine and 3 days into it, he stopped the stretching out and then I switched him to Gastroguard at $30/day for a month. He was like a new horse. Completely great personality; but I didn't do the follow up dose of 1/2 a dose for a month due to money issues.
Of course, the ulcers appear to be back again a few months later with exactly the same symptoms. Besides wanting to kick myself for not just shelling out the extra $15 a day for 30 days; I am wondering about the following:
1. I tried him on Cimetidine again as a stop gap just to get rid of the symptoms and it doesn't appear to be working nearly as well now; I'd say there's been a 70% reduction based upon his behavior. I was surprised it didn't work as well this time.
2. I read that ranitidine is supposed to be more efficacious than Cimetidine anyway and so just started him this morning on the proper dosage but wondered if anyone had a good online source for cheap Ranitidine HCl. It looks like I need a human prescription for most online pharmacies to order the 300 mg version (which I'd like to do because its cheaper), but I'm hoping I can get away with a horse Rx.
3. I also wanted to try a cheaper version of Omeprazole (Gastro/Ulcergard) and was thinking about grinding up Prilosec (which is Omeprazole) or if anyone knew of a compounding pharmacy where I could get omeprazole.
I am facing the fact that I may have to come up with a lot of money to treat this again using Gastroguard and will do that as the horse is unrideable with the ulcers. Gastro (and Ulcer) Gard is running from $30 to $50 a day based upon my sources. I know that Ulcergard is cheaper, but only if you use it in the "preventative" doses as opposed to the treating dosage, in which case it costs the same.
This horse is turned out 24x7 on 1-2 acres of pasture; has excellent quality Bermuda 24 x 7, Beet Pulp and vitamins 2x per day (based on the hay analysis) and some alfalfa twice a day. He did get about 1/2 a pound of oats, but I have started backing off that considering their high starch content.
I do not work him when he has ulcers. otherwise, a lot of our work is at the walk (which sounds odd, but he is fit enough running around the pasture all the time). We do light trot work only if i can keep him quiet and listening. Otherwise, we have spent years working him long and low around our neighborhood which has a lot of wide open spaces. He has never been on the track.
Thanks for your help.
|
Member:
Dres
|
Posted on Thursday, Mar 30, 2006 - 5:25 pm:
Susan, I just started my mare on the generic RANITIDINE 300 mg twice a day.. She is starting to show signs of an ulcer coming back.. I used the Gastroguard the first time around and it worked wonders.. but like you , its expensive and it appears this mare is a nervous ninny and holds it in till her tummy hurts and behavioral problems start occurring.. I got mine at COSTCO warehouse... CHEAP... you might try there...
good luck..
On the first day God created horses, on the second day he painted them with spots..
|
Member:
Sjeys
|
Posted on Thursday, Mar 30, 2006 - 9:28 pm:
I am *so* glad you mentioned Costco. I bought the 150 mg Zantac there and was giving him that, but its only 95 tablets at basically $20. When you figure out the dose, its like almost a bottle a day for him based upon his weight. So, I did a google search on "costco ranitidine" and that came up with a Seniors site that talked about Costco's brand of ranitidine which is called Kirkland Signature™ Acid Reducer. It is 240 tablets for $5.99. This will definitely help! Thanks for the advice and I'm glad I checked their site again!! Now, if I could just find a cheap source of Omeprazole, my life would be complete!
|
Member:
Sjeys
|
Posted on Thursday, Mar 30, 2006 - 9:37 pm:
Oh wait, I just realized that this is the 75 mg one; I think I'm just going to call the vet tomrorow and see if he can write a Rx for the 300 mg version from Costco and get it over with  . I was a bit leery since they originally charged me $50/day for the Gastroguard but I talked them down to $30 since a big vet hospital here sold it for that. I really wish I didn't have to bargain for my horses meds...
|
Member:
Eoeo
|
Posted on Friday, Mar 31, 2006 - 12:27 am:
I believe the 14 day supply of omeprazole runs about $10? at Walmart. It would take the 14 day supply I believe to treat a horse, check with your vet on how many tablets,it would take. That would be cheaper the gastroguard. EO
|
Moderator:
DrO
|
Posted on Friday, Mar 31, 2006 - 7:53 am:
We are not sure why but the over the counter omeprazole may not be effective in horses. See the article on Ulcers for more on this.
DrO
|
Member:
Sjeys
|
Posted on Friday, Mar 31, 2006 - 10:10 am:
Trust me, I read every line in that article...especially after I didn't do the follow up and am back at square one . I know its taking a chance, but figured that maybe someone ahead of me might have tried it. Sometimes things work and the original studies on it don't bear this out and vice versa. To save $30 to $50 per day I figured I could let my horse try it. He has that funny stance when he has ulcers so its very easy to tell if the meds are working or not.
I do have him on the OTC Prilosec 40 mg 2x per day and he's also finishing up his bottle of cimetidine until I can get the vet to hopefully write a Rx for Ranitidine. We'll see. I wonder what the magic of Omeprazole in the gastroguard is...maybe the suspension (or whatever they call how it comes in the tube).
|
Member:
Dres
|
Posted on Friday, Mar 31, 2006 - 10:14 am:
Susan, why ask the Doc for a perscrip for 300 mg ? I am giving my mare 4 tabs twice a day of the 75gm generic version... 4 pills / 1 pill either way you have to crush it and give it..
On the first day God created horses, on the second day he painted them with spots..
|
Member:
Oakfarm
|
Posted on Friday, Mar 31, 2006 - 10:41 am:
I will try to find the original data, but I remember an email to this or another based-in-reality list <g> that explained that patented GastroGard uses a specific method of keeping the omeprazole in suspension, that this is different from the human OTC versions..and that is supposed to be why GastroGard works better.
That said, why not get UlcerGard--which is the same exact thing as GastroGard in half strength, also made by the same company..and seems to work just as well..and is a lot cheaper (best part last!)
|
Member:
Sjeys
|
Posted on Friday, Mar 31, 2006 - 11:00 am:
I'd heard too that Ulcergard was cheaper but when I went out and looked the price per tube was actually more expensive in some cases than Gastroguard. I think Ulcergard prices their tubes at 1/2 doses (and in some cases I even saw quarter doses), so a tube will dose 2-4 times, but the tube still costs $36.00 per day or whatever the price du jour is. To get rid of the ulcers, you have to treat 1 tube per day for 30 days and 1/2 a tube per day for 30 days.
I'd be first in line since its the exact same product and just dose one tube of ulcergard per day, but I found the prices to be the same or higher than gastroguard. I got the impression that Ulcergard wised up finally on their pricing structure.
Please someone tell me I'm wrong as I'd order cases of it at this point if I could get some kind of break. Thanks for your help.
|
Member:
Sjeys
|
Posted on Friday, Mar 31, 2006 - 11:01 am:
I wanted to get the 300 so I could crush up a lot less pills and its quite a bit cheaper per day.
Ranitidine: 6.6 mg/kg orally every 8 hours at 1200 lbs this is 3,597 mg every 8 hours OR
10,791 mg every 24 hours.
75 mg per tablet = 48 tablets every 8 hours...that's a lot of pills to buy and keep track of .
|
Member:
Dres
|
Posted on Friday, Mar 31, 2006 - 11:25 am:
humm Susan i must have the amounts wrong then.. i understand that 300 mg twice a day is what i am to give of the Ranitidine.. thus only 4 tabs twice a day..
On the first day God created horse, on the second day he painted them with spots..
|
Member:
Sjeys
|
Posted on Friday, Mar 31, 2006 - 11:46 am:
Or I just OD'd my horse... Hopefully someone will chime in here. I knew I should have paid more attention in math.
|
Member:
Oakfarm
|
Posted on Friday, Mar 31, 2006 - 11:50 am:
Have you asked your vet how much s/he would charge you for UlcerGard?
I know I paid a lot less than the prices I have found online or in the above posts..
FWIW, I also have lots of Prilosec here, and in my one or two-rat study -- horses with ulcers -- what I have found is:
nothing works better than gastroGard to clear up BAD case.
as soon as everything is under control-- ie horse will drink and eat on his own without obvious discomfort, I switch to ranitidine, the generic Costco stuff--tiny pink pills I do not have to crush up. I start with 10 a day, lower the dosage over a month or so..So far, I have to admit, I am not finding much difference in recovery time between ranitidine and Prilosec.
I add aloe vera juice to the food--and if the horse will not eat food with this on it, I use a large syringe and get the 1/2 cup down him..I believe that aloe vera seems to restore the pH of the stomach..
(Dr. O-- am I fooling myself?)
Once horse is REALLY drinking water , I add a tiny bit of electrolytes or salt to the food, as I am a firm believer in the idea that most horse problems can be helped if not cured if the horse will stay hydrated/drink enough water..
I NEVER add salt until the horse is definitely better, drinking on its own, as this can be dangerous..
And, I make sure that the horse gets turnout and small feeds of hay during the day, to keep the digestive tract stable...
so far, this has worked...
good luck with your horses and here's hoping for a speedy recovery!
|
New Member:
Docs25
|
Posted on Sunday, Apr 2, 2006 - 3:31 pm:
I have a 25y old quarter horse gelding who had never been sick a day in his life.[I bought him as a 4y/o] Jan 10th 05 I noticed he was standing in the middle of his paddock panting like crazy. 68-70 per minute. I took his temp....106.4 yikes! called the vet and other than treating the fever, he took some blood is hct was 17....tapped his belly got blood returns on two sticks. Vet said he was bleeding fm somewhere. At first he thought he had eaten some type of toxic leaves cuz he noticed a "fake cherry" tree that had been blown down by all of our hurricanes. The tree was leaning over the fence into the paddock. He is an extremely easy keeper and doesn't want for anything in the feed and hay dept. So this confused the vet as to why he would eat enough of these leaves to be toxic. Our next guess was that he was kicked in the belly by one of my other horses. He is in with 1 other gelding and my paint stallion. They have been paddock mates since my stallion was 9 mos old [he is 9 now]But...I know anything is possible. My stallion is well behaved but.... he can be a brat. The 3rd was ulcers/cancer. I tried all the meds mentioned. Gastrogard, ulcergard,Milk Of Mag. Because of his age I could not use Tagamet. All seemed to help but the fevers have continued on/off for the last year every 2 to three weeks, fm 102 to 105. [I have bought enough banamine and bute paste/injetable for 100 horses!]
He had maintained his weight ><50 lbs until this last bout of fever. He started a fever of 104 on 2/16/06. All last year he would only go off his feed until the fever came down [a couple of hrs]. Nothing would bring it down under 102. He was off his feed/little water and would pick at the hay. It seemed he DrOpped 200 lbs in a matter of days. Then I noticed the ventral swelling just behind his front legs on his belly. Called the vet and even though his hct had gone up over the past year[not by much] it crashed to 13. Vet said the ventral swelling was caused frm 1. another bleed(non injury, he's been stalled all year)2. he was breaking down the protein in his blood but his blood work showed his protein at 8.1% 3. his ulcer had returned or it is cancer. He would not have survived trailering [or anesthesia] to Gainesville which is 4 hrs away.
Believe it or not there is a bright side to all of this. I decided to go back to ranitidine at 6.6mg/kg so we started 3,000 mg twice a day and after the 2nd dose he was back on his feed,eating everything he can get his lips on. Only a slight temp increase to date, 100.8 [knock wood]Body clipping helped! I bought 2 tubes of bute & banimine at the last vet visit and still have a lot left.
I have my boy back. He has gained most of his wt back but unfortunately lost some muscle tone. But he is talking to me again and back to his old antics! OTC ranitidine at Wally World for 120 tabs is $10.28 but I get funny looks when I buy 7 bottles at a time!! I am looking for larger bottles! And have a call in for the vet to rx 300mg.
I don't think there are any problems with keeping him on ranitidine long term. All I have read says no but I wonder about how it effects the kidney's. Have there been any reported problems? I have read both human and equine articles and even higher doses don't seem to have any problems. He is doing so great now, I hope not.
Thanks for the rant time its been a long year!
|
Member:
Dres
|
Posted on Sunday, Apr 2, 2006 - 3:55 pm:
L.Smith.. it has been a long year for you.. thanks for sharing..
Susan, i went back over my notes.. i read the units wrong.. its 3,000 mg twice a day.. not 300 mg.. so i am crushing away.. 
On the first day God created horses, on the second day he painted them with spots..
|
Member:
Hwood
|
Posted on Sunday, Apr 2, 2006 - 3:58 pm:
L.Smith, welcome to the HA "Club." If you are like me, you will find that it is filled with a most wonderful group of caring people who show their love toward people and horses.
Congratulations for finding something that helps your gelding. I was expecting to read that you had put the horse down after the second paragraph, but am so happy that he is more comfortable and showing it by his actions.
|
Member:
Sjeys
|
Posted on Sunday, Apr 2, 2006 - 4:39 pm:
I'm going to try the Ranitidine; it comes out to like $3.60 per day; which is cheaper than $30 per day for Gastro/UlcerGard. Though for those that are looking I *did* find UlcerGard online for $30 and Ulcergard.com is also offering some $$ back per tube purchased up to X number of tubes. can't remember exactly how much, but its something like $2 off for up to 7 tubes, so that comes out to only $28 per day.
I'm glad I'm not the only one with ulcer issues. Looking back on past behavior that trainers thought was 'tying up' or colic (due to his stretched out position) I now realize it was ulcers. So glad to hear that Ranitidine worked for you...it gives up hope. I'm also only going to work him 4 days a week with three days off in a row. Its not what I want but to keep him healthy its what he needs. Thanks for your information, everyone!
|
Moderator:
DrO
|
Posted on Sunday, Apr 2, 2006 - 8:43 pm:
Sorry to be late here the last 4 days I have been on the road.
Lita, I have heard the suspension theory and that the OTC formulation allows the omeprazole to be degraded in the stomach but I remember the work looked pretty good. I agree with the above however that this is not the final word.
There are 2 questions here Lita. One is what is causing your horses to go off feed and then the next is what are the effects of the medications you are giving doing. The current work on these OTC products and what I know about aloe and ulcers suggest that if this is the problem, these medications are unlikely to be helping.
Concerning the ranitidine, my worry is the work that shows that while horses do get more comfortable the ulcers do not heal as they do with omeprazole. Now this population of horses were one's whose management predisposed them to ulcers. Perhaps if you also correct the management problem along with 60 days of ranitidine...
DrO
|
Member:
Oakfarm
|
Posted on Sunday, Apr 2, 2006 - 9:12 pm:
Thanks for answering Dr,O.
I agree that ranitidine probably does not heal the ulcers as well as omeprazole--I think that's why GastroGard gets the big promotion, and I do think this product or UlcerGard works better for horses than OTC omeprazole.
It is not my horses who are off their feed etc..I was just saying what system I followed in the two cases of (unrelated) ulcers that cropped up here.
I agree with you that management is key. In fact, I'll go further, and say that I really believe that so long as the horses stay hydrated, drink enough clean water, this goes far to eliminate a lot of problems, like ulcers..
|
New Member:
Docs25
|
Posted on Sunday, Apr 2, 2006 - 10:59 pm:
Thanks, everyone!
Holly Wood, My horse Doc turns his nose up if there is a slight hint of anything different in the bucket other than feed. He is such a sweet heart, after all I have had to get into him he just takes it all in stride. I have a large plastic syringe I use for dosing everything. I was crushing too then I DrOpped one in some water by accident,..it dissolved in just a few minutes so now that is what we do. He pouts after bute though:o)He seems to know the taste of the ranitidine and that it helps so he doesn't try to spit it out. He also learned how to burp himself. Typical man....:o)
|
Member:
Redalert
|
Posted on Monday, Apr 3, 2006 - 9:59 am:
... from one owner of a horse with chronic gastric ulcers to another, I first send my condolences, as now you have to manage them! After the meds, I found the most important management factor is good quality ROUGHAGE, turnout, and splitting up of meals into three or four a day, instead of the usual two. On the upside of the "extra" meals, my guy now actually eats less grain, is as fat as before, and very much healthier! I really believe, from my personal experience, that roughage always being available, is a really key factor. I also had to turn his stall into one with a private paddock so that he could move about at will. I know, a lot of trouble, but what's a girl to do? Good luck with your horses, Lita, Susan, and L.Smith.
Nancy
|
Member:
Paul303
|
Posted on Monday, Apr 3, 2006 - 10:15 pm:
Hey, Nancy, your kind words to me were welcome a couple of weeks ago. I'm in the equine ulcer club also ( soon to be followed by a case of my own, probably ). My gal is down to 1/2 Gastroguard dose and is hating every minute of it. And what REALLY makes me nuts is that my horses are out 24/7. Their outside stall doors open to large woodlot pasture that connects to their huge grass pasture. Their inside stall doors are open to their indoor paddock. The stall doors are always open except at feeding times - when they get Safe Choice or Kwik ( just enough for medications and supplements ). They have hay in their stalls, outside and inside at all times. Automatic waterers in stalls and pastures. Oh....we don't show or trailer anywhere. We do little arena work and ride the State Park right out our back door. The clinic she spent 6 days at last month, didn't bother scoping her 'til the 3rd day - they didn't think she was a candidate for ulcers.Aaarrgh!!!
Now what?? Vivaldi in the barn all day?
|
Member:
Redalert
|
Posted on Tuesday, Apr 4, 2006 - 9:10 am:
Really, Lee ... I feel your pain! My guy has chronic gastric ulcers. And, even tho he had plenty of reasons to develop ulcers three years ago, NOW, he has the "perfect life", and he still has episodes. Well, maybe it is the Grateful Dead I play in the barn while doing chores. Should I try Vivaldi?
Nancy
|
Member:
Stevens
|
Posted on Tuesday, Apr 4, 2006 - 3:58 pm:
Susan,
I have a 12 yr old, 1250lb DWB who was diagnosed with an ulcer (scoped) about 5 years ago. The lady who owned him at the time did the full Gastroguard treatment and the follow up. Since then he's gotten alfalfa twice a day, free choice Bermuda, and pelletized rice bran twice a day mixed with 16 of the CostCo generic ranitidine pills for a total of 32 pills a day. Absolutely no recurrence. When he acted a bit unhappy, she increased his rice bran.
It was a hard decision for me to buy him 6 months ago given the full disclosure of this history. But together with my vet and trainer I decided that I was willing to keep up this program for this horse. It's been 6 months and he continues to do great! I feel really fortunate after reading this thread.
Good Luck!
Chris
|
Member:
Sjeys
|
Posted on Tuesday, Apr 4, 2006 - 4:41 pm:
Chris, so glad to hear that this is working for you. I'll try him at this does of Ranitidine, which looks like its about 2/3 of the given dose. How much rice bran do you give? I give mine rice bran but just a few ounces (maybe 1/3 of a cup). Is there a benefit to the pelleted vs. the regular rice bran?
Based upon the feedback here and common sense, it makes sense that there's something else going on with these horses...since its not the obvious issues of feed and turnout and exercise, since those have all been ruled out. Who knows, like humans, we may one day find out its a virus that causes ulcers in horses...
And while I'm dreaming, maybe one day the drug companies will stop ripping me off with $30 to $50 tubes of Gastroguard ...I bet they cost pennies to make...
|
Member:
Stevens
|
Posted on Tuesday, Apr 4, 2006 - 5:07 pm:
Susan,
I use the pelleted rice bran simply because I think it's not as messy to store as the regular. As long as it's stabilized I doubt there's any difference regarding shelf life. A 40 pound bag lasts me about 2 weeks so he's getting close to 3lbs a day (split into 2 feedings). He's a big boy and works hard, although I admit he's put on some weight which is OK with me and actually convinced the previous owner that he was happy with me.
I agree that there is something else going on with these horses. My boy is not at all nervous and never was according to the previous owner. He's been hauled and shown and is pretty much the best thing since sliced bread in my opinion.
Keep dreaming, the patent on Gastroguard is going to run out eventually and you can bet it will be available in a generic form sooner or later 
|
Member:
Martina
|
Posted on Tuesday, Apr 4, 2006 - 6:15 pm:
Hi everyone, if you search under Omeprazole on Ebay there's Ulcer Gard available at $31.99/tube. I've also found that if you call the various Vet Supply houses that carry Ulcer Gard (Valley Vet, etc.) they will sometimes give you a better price if you purchase >25 tubes at a time. Rebates are also available from the manufacturer.
This treatment is proven. Anything else is just prolonging the inevitable (and the problem).
Since treatment, my gelding gets about 2 lbs of soaked alfalfa cubes after each grain meal. He's been doing great (knock wood)!
|
Member:
Stevens
|
Posted on Tuesday, Apr 4, 2006 - 6:35 pm:
Hi Tina,
I agree that omeprazole is the only "proven" in a study treatment. I do not agree that it is inevitable that ulcers will recur.
Another horse at my barn was scoped and diagnosed with a gastric ulcer. The vet prescribed Cimetidine, bought via the Sam's Club pharmacy. The owner, teenage girl, pretty much did every thing wrong according to the literature I've read. The horse did get the cimetidine, but was kept out of work for 5 days only, after which the kid started riding him (walk, trot and canter). He was being jumped soon thereafter. They did start giving him lunch of Timothy but no increase in turn out. He was re-scoped after about a month and was given a totally clean bill of health and the ulcer pronounced totally healed.
Omeprazole never entered his system.
Withholding feed and turnout has been shown to consistently induce ulcers. That's not the same as saying it's the ONLY way to induce ulcers. Omeprazole has been definitively shown to cure ulcers but it may not be the ONLY treatment that works.
|
|
|
