I often speak with veterinarians who have concerns about the safety of compounded flavored medication. They are concerned that the flavoring contains xylitol or sugar, in which some patients may react badly. I also receive questions about hypoallergenic flavoring, whether or not the flavoring contains harmful additives, and how flavor affects the shelf life of the medication.
The Affect of Xylitol or Sugar in Flavoring
Flavoring from compounding pharmacies may or may not contain xylitol. For sweet flavors, medications are typically sweetened with sugar, xylitol or stevia extract. There are xylitol and sugar-free medications available, but the only way to clarify which type of flavors are used in the medication is to ask your compounding pharmacy. Knowing whether or not your medications contain xylitol or sugar is crucial, especially when dealing with diabetic patients and dogs, respectively. Make sure your pharmacy understands the potential adverse effects of added sweeteners on your patients’ health.
Flavors may or may not contain animal protein, to which many of your patients may be allergic. Animal protein is commonly used in veterinary flavors like beef, chicken, and liver. The only way to know if the flavor in your medication contains protein is to ask your pharmacy team member. This information is accessible and should be readily available upon your request.
What Harmful Additives Could Be in the Medication?
Additives commonly found in compounding flavors that are safe for humans are not necessarily safe for use in animals. Sodium Benzoate and Potassium Sorbate are newer additives being used in compounding pharmacies to improve the solubility of medications. Improved solubility makes your medication dosing more accurate, but these two ingredients are toxic to cats when administered regularly over a 14 day period.
Flavors also may or may not contain gluten, corn, dairy and/or wheat, so, for your patients on food trials, clarify the contents and additives with your pharmacy to avoid adverse reactions.
Does Flavor Affect the Medication’s Shelf Life?
Flavors are available in three primary forms: powder, liquid oil, and water based. Flavors in the form of powder and liquid oil base do not typically affect the beyond-use-date (or shelf life) of your medication. However, water – based (aqueous) flavors can significantly affect the shelf life of your medication.
For example, when doxycycline is mixed with water based flavors, the medication is no longer recommended for use after 4-5 days.
Not all flavors used in compounding medication are created equally. Some flavors have xylitol, sugar, or other harmful additives mixed in which can negatively impact your patients. Using the wrong flavor for the wrong patient can result in ineffective dosing or increased risks of toxicity.
If you are mixing flavor into your medication yourself, be very careful and use highly accurate scales and high-quality flavoring. To avoid negative reactions and harmful additives, it’s best to work with a pharmacy team that specializes in veterinary compounding. Remember, you should never be afraid to ask your pharmacy team questions while you are picking flavors!
For more information about flavoring compounded medications, call EPC at 888-733-0300 FREE ext 3 and ask for our detailed list of safe, delicious flavors!