Can I Get Some Bute?
Why some common medications require a prescription
R. Paul Schwab, DVM
Veterinarians get many requests each week for medications such as phenylbutazone (“bute”), trimethoprim/sulfa (TMS) pills, and others that require a doctor’s prescription. Many of these are used routinely for horses with minor and major ailments including injuries, wounds, respiratory infections, etc. A large percentage of horse owners and trainers are very familiar with their uses and side effects, but are frustrated when the veterinary office may not sell it to them without first seeing their horses.
Veterinary drugs are classified in different categories that determine how a particular product can be dispensed:
1. Over the Counter (OTC) drugs do not need a prescription from a veterinarian; products may be sold through catalogs, feed stores, and veterinary hospitals.
2. Prescription (Rx, Legend) drugs have the following statement: “Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian.” Prescription drugs may be distributed only by persons or firms authorized by state and local laws.
The FDA is the responsible party who puts individual medications into one of these categories. Usually they are classified based on the amount of information required so a product can safely be used in an individual animal.
Veterinarians usually dispense prescription drugs based on the need of an animal or group of animals that they are treating for a specific problem. There are times when we can dispense medications to owners or trainers for animals that we have not seen. We may recommend and dispense a prescription medication to an animal for a simple problem handled over the phone or for an ongoing issue on an animal treated previously. Veterinarians can only do this if they have a veterinarian-client-patient relationship (VCPR) with the person they are selling the medication to.
A VCPR exists if*:
1. The veterinarian has assumed the responsibility for making clinical judgments regarding the health of the animal and the need for medical treatment, and the client has agreed to follow the veterinarian’s instructions.
2. The veterinarian has sufficient knowledge of the animal to initiate at least a general or preliminary diagnosis of the medical condition of the animal. This means that the veterinarian has recently seen and is personally acquainted with the keeping and care of the animal by virtue of an examination of the animal or by medically appropriate and timely visits to the premises where the animal is kept.
3. The veterinarian is readily available for follow-up evaluation, or has arranged for emergency coverage in the event of adverse reactions or failure of the treatment regimen.
What Does All This Mean?
Basically, in order for a veterinarian to sell or prescribe a medication for an animal(s), he or she needs to have seen that animal or group of animals recently and know the client well enough to know the medication will be used properly and for those animals only. The actual time frame may vary between states or clinics, but realistically, an animal needs to have been seen within one year.
Online Pharmacies
How do online pharmacies fit into this picture? You can buy medications from online pharmacies if your veterinarian has faxed or called in a prescription to that pharmacy and as long as that pharmacy is certified through the National Association of Boards of Pharmacy. The pharmacy staff veterinarian cannot authorize a prescription without consent of a licensed attending veterinarian.
These rules and laws are meant to help protect the animal from misuse or misunderstanding of use of a particular medication. So on your next visit to the vet, if the receptionist or veterinarian doesn’t freely give out the bute or TMS tablets you wanted to pick up, there is a reason.
---
*Taken from AVMA’s Guideline for Veterinary Prescription Drugs
R. Paul Schwab, DVM
Veterinarians get many requests each week for medications such as phenylbutazone (“bute”), trimethoprim/sulfa (TMS) pills, and others that require a doctor’s prescription. Many of these are used routinely for horses with minor and major ailments including injuries, wounds, respiratory infections, etc. A large percentage of horse owners and trainers are very familiar with their uses and side effects, but are frustrated when the veterinary office may not sell it to them without first seeing their horses.
Veterinary drugs are classified in different categories that determine how a particular product can be dispensed:
1. Over the Counter (OTC) drugs do not need a prescription from a veterinarian; products may be sold through catalogs, feed stores, and veterinary hospitals.
2. Prescription (Rx, Legend) drugs have the following statement: “Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian.” Prescription drugs may be distributed only by persons or firms authorized by state and local laws.
The FDA is the responsible party who puts individual medications into one of these categories. Usually they are classified based on the amount of information required so a product can safely be used in an individual animal.
Veterinarians usually dispense prescription drugs based on the need of an animal or group of animals that they are treating for a specific problem. There are times when we can dispense medications to owners or trainers for animals that we have not seen. We may recommend and dispense a prescription medication to an animal for a simple problem handled over the phone or for an ongoing issue on an animal treated previously. Veterinarians can only do this if they have a veterinarian-client-patient relationship (VCPR) with the person they are selling the medication to.
A VCPR exists if*:
1. The veterinarian has assumed the responsibility for making clinical judgments regarding the health of the animal and the need for medical treatment, and the client has agreed to follow the veterinarian’s instructions.
2. The veterinarian has sufficient knowledge of the animal to initiate at least a general or preliminary diagnosis of the medical condition of the animal. This means that the veterinarian has recently seen and is personally acquainted with the keeping and care of the animal by virtue of an examination of the animal or by medically appropriate and timely visits to the premises where the animal is kept.
3. The veterinarian is readily available for follow-up evaluation, or has arranged for emergency coverage in the event of adverse reactions or failure of the treatment regimen.
What Does All This Mean?
Basically, in order for a veterinarian to sell or prescribe a medication for an animal(s), he or she needs to have seen that animal or group of animals recently and know the client well enough to know the medication will be used properly and for those animals only. The actual time frame may vary between states or clinics, but realistically, an animal needs to have been seen within one year.
Online Pharmacies
How do online pharmacies fit into this picture? You can buy medications from online pharmacies if your veterinarian has faxed or called in a prescription to that pharmacy and as long as that pharmacy is certified through the National Association of Boards of Pharmacy. The pharmacy staff veterinarian cannot authorize a prescription without consent of a licensed attending veterinarian.
These rules and laws are meant to help protect the animal from misuse or misunderstanding of use of a particular medication. So on your next visit to the vet, if the receptionist or veterinarian doesn’t freely give out the bute or TMS tablets you wanted to pick up, there is a reason.
---
*Taken from AVMA’s Guideline for Veterinary Prescription Drugs
Labels: dave sauter, Doctors Corner, horse health, horse medication, November 2009
posted by NWHS at
6:03 AM
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