Prascend Tablet 1mg (Single tablet)

Directions for Use

Administer orally, once daily, at an average starting dose of 2 µg/kg bodyweight. Studies from the published literature cite the most common, average dose as 2 µg /kg with a range from 0.25 mg - 5 mg total daily dose per horse (0.6 – 10 µg/kg). The starting dose (2 µg/kg) should then be titrated according to the individual response as determined by monitoring (see below). Practical starting doses are recommended as follows:

Tablets may be administered orally by dissolving the tablet with a small amount of water and/or mixing with molasses or other sweetener; taking care to rinse the dosing apparatus with water to ensure entire dose is administered; use immediately. Most horses respond to therapy and are stabilised at an average dose of 2 µg/kg. Clinical improvement with pergolide is expected within 6 to 12 weeks. Some horses may respond clinically at lower or varying doses, and it is recommended to titrate to the lowest effective dose per individual based on response to therapy, whether it is effectiveness or signs of intolerance. A small number of horses may require doses as high as 10 µg/kg per day. In these rare situations, appropriate additional monitoring should be implemented.

Monitoring and dose titration

Pre-treatment samples should be taken for appropriate diagnostic endocrinologic laboratory tests (e.g., serum or plasma ACTH or serum cortisol response to the low-dose dexamethasone suppression test) to diagnosis disease, monitor treatment, and for dose titration. Following initial diagnosis, repeat samples should be taken for endocrinologic testing for dose titration and monitoring of treatment at intervals of 6 weeks until stabilisation of clinical signs and/or diagnostic testing occurs. The approach to treatment is to titrate to the lowest effective dose per individual based on response to therapy, whether it is effectiveness or signs of intolerance. Dose titration is based on clinical sign improvement (e.g., hirsutism, polyuria, polydipsia, muscle wasting, abnormal fat distribution, chronic infections, etc.), and/or diagnostic testing improvement/normalisation (e.g., serum ACTH or serum cortisol response to the low-dose dexamethasone suppression test). Depending on the severity of the disease, time to treatment response may vary among individuals. For example, if clinical signs are not improving or if the diagnostic testing has not yet normalised at the first 6 week interval, the total daily dose may be increased by 0.5 mg. Some individuals may be improving but not yet normalised/stabilised and their dose may or may not need to be titrated based on the veterinarian’s discretion and the individual’s response/tolerance to the drug dose.Should clinical signs not be adequately controlled (based on clinical evaluation and/or diagnostic testing) consideration should be given to increasing the total daily dose by 0.5 mg increments every 6 weeks until stabilisation occurs and if the drug is tolerated at that dose. If signs of dose intolerance develop, treatment should be stopped for 2-3 days and reinstituted at one-half the previous dose. The total daily dose may be then be titrated back up to the desired clinical effect by 0.5 mg increments every 2-4 weeks. If a dose is missed, the next scheduled dose should be administered as prescribed. Following stabilisation, regular clinical assessment and diagnostic testing should occur every 6 months to monitor treatment and dose.