Update on Illegal Compounding of Clenbuterol Veterinary Drug Products

Background information at  http://www.TheHorse.com/ViewArticle.aspx?ID=947 

From the Food and Drug Administration (FDA)

In 1998, the FDA approved a new animal drug application (NADA) for Boehringer-Ingelheim Vetmedica's Ventipulmin Syrup, which contains a small amount of clenbuterol, as a restricted use prescription-only drug for treating horses affected with airway obstruction. When FDA approved the NADA for Ventipulmin, several controls were put in place to ensure that this drug would not be misused in food-producing animals.

Ventipulmin is the only clenbuterol drug product approved for use in the United States. Ventipulmin may only be used in horses not intended for food. FDA has special concern with clenbuterol, a beta-agonist drug that has been used illegally in the U.S. to enhance production of food animals. The use of clenbuterol in other countries has resulted in documented adverse reactions in humans who ingested meat-containing residues of clenbuterol.

In recent years, availability of illegal clenbuterol formulations, produced as "compounded" drug product has increased steadily. (See The Animal Medical Drug Use Clarification Act (AMDUCA) permits compounding under very limited circumstances. Compounding must be done only on the order of a licensed veterinarian, based upon a valid veterinarian/client/patient relationship from approved human or veterinary drugs. In addition, other criteria must be met including establishing the need for a compounded product, and prohibitions against use of some drug products in food-producing animals. AMDUCA does not permit compounding from bulk drugs. Bulk clenbuterol should only be available for use by Boehringer Ingelheim Vetmedica, Inc. in the production of the approved clenbuterol product.

When an approved product is available, a compounded product is not permitted to be used unless it meets the criteria in AMDUCA. Since there is an approved clenbuterol product available, only limited compounding from approved Ventipulmin is permitted. Clenbuterol products that mimic the approved product are unapproved new animal drugs and are not legal for preparation, sale, and use.

Veterinarians and animal owners should be aware that these unapproved clenbuterol products have not been shown to be safe and effective and may not be prepared under conditions that are controlled to produce a consistent, quality product. Prescribing, purchasing, or distributing "compounded" clenbuterol is in violation of Federal law. Veterinarians ultimately assume responsibility for the efficacy, safety, and composition of drugs prescribed in this manner.

During the past two years Boehringer Ingelheim Vetmedica, Inc., working cooperatively with the FDA, has been investigating this activity and has provided information demonstrating the existence of compounded clenbuterol products are merely copies of the safe and effective FDA approved veterinary drug product readily available to veterinarians. FDA will consider enforcement action for any preparation, advertising, sale, and use of unapproved clenbuterol.

Responsible compounding pharmacies have the potential to provide a necessary service to veterinarians and their clients by providing useful drug formulations in the absence of FDA-approved pharmaceuticals that meet the specific therapeutic needs of the patient. While some compounded drugs may have a place in veterinary practice, compounded clenbuterol, except in very limited circumstances, does not. A FDA-approved clenbuterol hydrochloride product is available.

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