Pardale V

RE: Pardale V

Bob Russell — Mon, 22 May 2017 11:22:11 GMT

"SQP's are 'professionally qualified' persons entitled to prescribe certain veterinary medicines".

They are not professionally qualified any more than anyone else that has done a short course with an exam at the end. The term prescribe is a disgrace as they are not qualified to make a diagnosis.

Glorified shop keepers and a legal fudge to allow merchants to continue to sell wormers etc. As far as I am aware this is the only EU country where they exist.

Sales of Pardale should be based on reasonable quantities. A full pot or more would not be reasonable IMO but how often do internet suppliers give a monkeys about what is reasonable? A sale is a sale!

Perhaps things would change if someone shovels a handful of tablets and go into liver failure. I bet the authorities would come gunning at whoever supplied the tablets. That said antibiotics, thyroid medication and numerous other drugs can be bought on-line being prescribed by doctors completely unaware of the persons medical history!

RE: Pardale V

bob lehner — Sun, 21 May 2017 10:00:27 GMT

[quote user="Joyce Whitehead"] So my question really is, should a prescription be needed for a VPS drug used off licence?[/quote]

VMD Guidance Notes on the Cascade say : ' Only a vet registered with the RCVS can prescribe medicines under the cascade'. So a pharmacist or SQP cannot do so.

[quote user="Michael Woodhouse"]There is nothing, anywhere, that says the quantity must be reasonable[/quote]

I would not agree with this - in general the guiding principle should be to prescribe the minimum amount of medicine needed for that condition.

VMD Guidance notes on Retailing Medicines say:

Retail supply

When prescribing a medicine classified as POM-V or POM-VPS or supplying a medicine classified as NFA-VPS, the RQP:

must be satisfied that the person who will use the medicine is competent to do so safely and intends to use it for an authorised purpose
must advise on its safe administration and on any necessary warnings or contra-indications on the label or package leaflet
must not prescribe (or, in the case of a NFA-VPS product, supply) more than the minimum amount required for the immediate treatment. However, it is a defence to show that:
- the veterinary medicine prescribed or supplied was in a container specified in the marketing authorisation (MA)
- the marketing authorisation does not permit smaller containers
- the RQP is not a person authorised to break open the package before supply
  Pardale V is available in a 100 tablet pack and so I think dishing out 500 tabs would not be acceptable under normal circumstances.
- Having said that,the data sheet for Pardale is a bit woolly - 'Max of five days' - but no suggestion as to how long before starting another course - and the dose rate given is much higher than the BSAVA Formulary recommendation - which also doesn't mention the five day thing.

RE: Pardale V

Bob Russell — Thu, 18 May 2017 11:03:13 GMT

I suspect it is something that falls between the cracks!

Such a large quantity of human paracetamol makes it POM. I cannot see how it is safer than human paracetamol for someone looking to top themselves in one of the least pleasant ways possible!

The classification is a bit dodgy especially as many dose rates are off-licence. This should really convert it to a POM-V under cascade.

It is also a drug where controls on availability (pack size) has been introduced to reduce suicide risks. Perhaps this is something that human medication regulators should be made aware of!

RE: Pardale V

Michael Woodhouse — Thu, 18 May 2017 00:42:56 GMT

[quote user="Laurence Webb"]The issue isn't that they are NFA-VPS, but the quantity that is being supplied and whether it is reasonable. [/quote]

There is nothing, anywhere, that says the quantity must be reasonable. Try the RCVS definition:

NFA-VPS medicines may be supplied in circumstances where the veterinary surgeon or SQP is satisfied that the person who will use the product is competent to do so safely, and intends to use it for the purpose for which it is authorised. https://www.rcvs.org.uk/advice-and-guidance/code-of-professional-conduct-for-veterinary-surgeons/supporting-guidance/veterinary-medicines/

They are using it as a dog painkiller. Very easy to say 5 days on 1 day off.

[quote user="Laurence Webb"]In the human field I would be surprised to find a pharmacist that is willing to sell a year's worth paracetemol to someone for safety reasons and I would be concerned about the risk of overdosage to both animals and humans if this amount of paracetemol can be sold at one time.[/quote]

200mg/kg is often quoted as toxic level of paracetamol. 100kg adult, 32X500mg tablets = 160mg/kg. 2 boxes will do you just fine and supermarkets will happily sell you that in 2 consecutive transactions. If you really want to kill yourself with paracetamol then you easily can. You really think this limit makes a difference? It's also ridiculous suggesting having 500 tablets means your dog is more likely to OD than dispensing 100, or 200.

[quote user="Laurence Webb"]something that you may wish to discuss with the VMD

The VMD looking at their dispensing behaviour with a view to reviewing their SQP status may more effective[/quote]

AMTRA regulate SQPs not VMD. if you ring the VMD they can do nothing as this is operating within the law and it would just make the caller look like they didn't understand medicine categories. There really is nothing to be done.

Lets stay off our high horses on this.

RE: Pardale V

Laurence Webb — Thu, 18 May 2017 00:22:57 GMT

As an aside, the dosage instructions on the data sheet are a bit vague for members of the public to follow.

It does state 1 tablet per 12kg (equal to 33mg/kg paracetemol, compared to the 10mg/kg recommended in the BSAVA formulary) but also shows the vaguer dose of "6-18 kg body weight): ½-1½ tablets every 8 hours" which could lead to the owner of a 6kg dog mistakenly giving it 1.5 tablets, equating to 100mg/kg per dose

The pet could therefore get 300mg/kg in a day. From memory, VPIS advise toxicity starts at 150mg/kg.

RE: Pardale V

Laurence Webb — Thu, 18 May 2017 00:11:51 GMT

The issue isn't that they are NFA-VPS, but the quantity that is being supplied and whether it is reasonable.

Given that a large dog could get 3 tablets tid for 5 days, then supplying anything over 45 tablets raises a question - are they being used long term or is the dog being given 5 day treatments on an ad-hoc basis?

The latter is within the licence, but it would need to be done 11 times per year to get through the supply of 500 tablets in that time. The example of a 7kg dog getting half a tablet tid stretches it to over 67 lots of 5 day treatments per year, which isn't possible even with a one day break between treatments.

It is definitely pushing the boundaries and something that you may wish to discuss with the VMD. In the human field I would be surprised to find a pharmacist that is willing to sell a year's worth paracetemol to someone for safety reasons and I would be concerned about the risk of overdosage to both animals and humans if this amount of paracetemol can be sold at one time.

Sadly, having a quiet word with the online site about your concerns is unlikely to have any positive result! The VMD looking at their dispensing behaviour with a view to reviewing their SQP status may more effective.

RE: Pardale V

Michael Woodhouse — Wed, 17 May 2017 21:26:30 GMT

I knew it was NFA-VPS.

My understanding was a POM-VPS needs 'prescribing' whereas a NFA-VPS is supplied by vet, SQP or pharmacist. Seems to confirm looking at the definitions on NOAH site:

POM-VPS A veterinary medicines classified as POM-VPS may be prescribed by any Registered Qualified Person (RQP - a veterinarian, a pharmacist or an appropriately qualified SQP (). A clinical assessment of the animal(s) is not required when prescribing this category of veterinary medicine and the animal does not have to be seen by the prescriber. However sufficient information about the animal and the way it is kept must be known to the prescriber in order to prescribe and supply appropriately.

NFA-VPS A veterinary medicine classified as NFA-VPS may be supplied by an RQP (a veterinarian, a pharmacist or an appropriately qualified SQP) provided the requirements for supply are met. These medicines do not require a prescription.

http://www.noahcompendium.co.uk/?id=-312921

I don't much like it, but it is only paracetamol with a tiny bit of codeine. We can all buy co-codamol OTC for personal use. I don't think they are doing anything wrong in the eyes of the law (but would be if this was a POM-VPS).

It's actually very easy to get hold of lots of human paracetamol if you want to