Looking for a very specific prescription pill (dose, size, coating, etc)
April 23, 2015 5:59 PM   Subscribe

I have a very picky patient (cat...) and need to find a pharmacy that sells a very specific pill - 5mg Fluoxetine (Prozac) small in size, sugar coated (like Advil.)

Every local pharmacy can fill the prescription, but I need it filled in a specific pill type/shape. We have tried pill pockets, we have tried liquid Prozac, now we would like to try just finding the right pill. Is there a search tool out there where I can enter a fine-grained request to get exactly the type of pill I need and ideally a link to the pharmacy where it can be ordered?

Search: 5mg, small in shape, ideally sugar coated or otherwise easy to swallow, etc, etc.

Or alternatively, do you know of any source for what I'm looking for. I can get the prescription, I just need it filled and delivered to an address in California.
posted by pwb503 to Pets & Animals (6 answers total) 2 users marked this as a favorite
 
Try a compounding pharmacy for veterinarians.
posted by janey47 at 6:09 PM on April 23, 2015 [3 favorites]


Hm, I might see if my vet could ask their vet meds pharma rep, or possibly the manufacturer's regular customer service line, to see if there is some kind of distribution database. I mean, surely one exists, but idk how accessing it would work otherwise.

when you tried the liquid did you mix it in with the stinkiest wet food imaginable? if the kitty is able to eat wet food, of course.

on preview, yes, a pet meds compounding pharmacy may have other ideas on how to accomplish this will the pills you are actually able to acquire. maybe a special coating they can add? or compound a quick-dissolving sublingual? or the last ditch effort of desperate pet owners, the suppository.
posted by poffin boffin at 6:14 PM on April 23, 2015


So I used to be a veterinary pharmacy purchasing manager, so I can speak to this with some authority. This request is going to be difficult for a number of reasons. First, for a popular drug like fluoxetine, there are going to be a number of manufacturers, both on the human side and on the veterinary side. Some of those veterinary manufacturers will simply be repackaging human product with a veterinary label. So the first thing you need to do is identify the manufacturer or manufacturers that make the type of pill you are looking for. This will be a name you are probably unfamiliar with, like Mylan or Teva or Apotex. Once you have that, you will need to identify a pharmacy that stocks that particular brand of fluoxetine.

The second problem will be that brands of generic medications go on backorder all. The. Time. It was the bane of my existence. Sometimes just for a few days, sometimes for weeks or months. The pharmacy can't stop carrying the drug, so they will buy a different brand, even though it might be more expensive, or harder to split, or larger, or some other formulation that isn't as desirable. So each time you get the prescription filled you will need to verify with the pharmacy staff that they have the specific brand you want, and will fill it from that stock and only that stock.

Basically, you are going to want to find a friendly pharmacist - most likely a small independent pharmacist - who will seek out the brand you need and will remember that it is important to fill your prescriptions specifically from that brand. Even then, you will probably want to stock up as much as possible, so that you can weather an extended backorder of your preferred product.

Now, the pharmacy that I worked at are super nice, and would absolutely help a client with a request like this, but they can only fill scripts written by a vet with a North Carolina license. What they might be able to do is at least identify a brand that will meet your needs. I'll talk to them tomorrow and see what brands they have in stock.
posted by Rock Steady at 6:35 PM on April 23, 2015 [2 favorites]


If you can't find the exact pill you might have better luck finding a vet pharmacy that will make an emulsion you can put on the inside tips of cat's ears.

I had good luck with this exact thing on a cat who would not be pilled.
posted by fluffy battle kitten at 6:41 PM on April 23, 2015 [3 favorites]


You can definitely do the ear emulsion with this medicine, my cat is on that exact thing b/c he will not take pills and refuses the liquid, unless there's some reason you don't want to do that (it's like .1 ml for a dose, so a little squirt, and you just need to rub it on, nice and quick).
posted by leesh at 6:47 PM on April 23, 2015 [1 favorite]


With regards to medications compounded as emulsions to put on ears, it is great for cats who do not tolerate oral drugs, but it may not always result in a biologically active dose being given to the cat.

In the instance of fluoxetine (Prozac) specifically, a study was done where a compounded gel formulation was applied to cat ears. Although the medication was absorbed into systemic circulation through the ear, only 10% of the administered dose was actually available as an unchanged drug as compared to oral administration.

So, if your cat is getting a 5 mg dose of fluoxetine and it is compounded as an emulsion to be applied transdermally, he or she may only be receiving 0.5mg of the drug, which may not be a high enough concentration to be effective.

While compounding drugs specifically for veterinary patients is an attractive option, sometimes the vehicle in which the drug is prepared does not result in the same pharmacokinetics as the unadulterated drug. Even fluoxetine compounded as a delicious fish-flavored liquid may not be as bioavailable as a tablet from the manufacturer.
posted by Seppaku at 9:40 AM on April 25, 2015


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