dispensing buprenorphine

[ajb92504]

How are you guys dispensing buprenorphine? The way we are currently doing it is a pita. We can only get it in ampules, so we draw up the 1cc in a syringe and then fill other tb syringes from the original syringe in the correct dosage for the animal and cap them off with syringe caps. We are sending multiple tb syringes home with the owners and

Comments

[wirenth]

We recently started using compounded oral solution to send home. It comes in a BOTTLE. No more ampules! (Well, except what's given injectably in the hospital.) And we even got oral dosing syringes that fit the bottle. Drawing it up is no longer painful and time-consuming! We still do the multiple single-dose syringes in a baggie with a label stuck to it though.

[ladyamalthea123]

Technically it's illegal to dispense compounded medication. It's ok to use in hospital though. We have the same PITA protocol, though with tiny doses I use BD insulin syringes where I can pry off the needle (making that an even more PITA proposition). That way we don't loose so much in the hub. With the ampules you may want to invest in filter needles to withdraw the sample from the ampule, that way any tiny glass flecks don't end up in the drug. You can also empty 5 vials at a time and inject them into a sterile 10mL vial for easier dosing with less hassle of breaking ampules all the time, you can just do it in spurts.

[meig]

Technically, yeah. But it happens allllll the time.

[ladyamalthea123]

Yep, I know, hence why I said technically ;-). My hospital only recently put a ban on sending home compounded meds. We have a list of compounding pharmacies that we send home with the paper Rx's.

[sarahfer]

Is this for oral use? What I do for my own cat is draw up from 5 amps at a time and put it into a small glass bottle. We have a client for whom we dispense it this way too.

[ajb92504]

Yes, usually we send a few days' worth home after declaws or for other painful situations with instructions to apply contents of 1 syringe under the tongue or on the gums. So it's usually only maybe 10 doses at a time per patient.

[meig]

That's how we do it.

[cherylkat]

That's generally how we do it, save without the ampules. We get large 120ml bottles from a compounding pharmacy and draw syringes up from that to put into baggies (or dispense into smaller bottles). As far as I know we wouldn't be doing it if it were against the rules, they did a lot of checking before this particular system - prior, about a year or so ago we were cursed with the ampules (which we broke apart 10 at a time and transferred into a 10 ml sterile vial ...) but then they became hard to get so we went to this system. The drug comes from a pharmacy called Roadrunner Pharmacy in AZ (yes the 0.3 mg/ml concentration), and is the only way we can get it in that concentration. We have to get the 0.15 mg/ml concentration for injectable as well

[ladyamalthea123]

Yes, the laws can vary from state to state, so check your statutes.
This is from the AVMA website: Q:

Is it OK if I purchase a large quantity of compounded products from a compounding pharmacy to sell at a later date?

A:

No. When you need to have a drug compounded, the drug should be compounded only for a patient's individual needs. Some states allow veterinarians to prescribe and keep a small quantity for administration within the clinic, but states generally do not allow veterinarians to dispense and send patients home with drugs previously compounded by a compounding pharmacy. Also, be suspicious of (and report) any pharmacy that offers to sell you large quantities of compounded drugs for a much cheaper price than what you would normally pay for an FDA-approved drug - some pharmacies illegally manufacture drugs, and the FDA (and for controlled substances, the DEA) is cracking down on these illegal activities.

Original Link http://www.avma.org/issues/prescribing/prescribing_faq.asp