Vetnuus | August 2024 21 Why is compounding of medicine necessary for wildlife? • In the case where a medicine cannot be compounded the off-label use allows veterinarians to treat animals with available human medical drugs at an economic price. An example is the use of Trilafon instead of perphenazine. When a registered product or a product to use off-label is not available then a medicine can be compounded with a script from a veterinarian. • It makes it possible to capture wildlife with dart “cocktails” tailored to the species. • In small animals, it allows for easier dosing with a dilution of a concentrated product, which otherwise not be possible. • It enables the use of medicines that are currently not available in South Africa by compounding them with active pharmaceutical ingredients that are legally available. Few game capture drugs (not more than 6) are registered for wildlife in South Africa. • Only a small volume of a concentrated product is necessary to fill a dart. For example, 5 mg of etorphine and 150 mg azaperone will fill a 2cc dart. • Compounding is necessary where a herd must be treated with tranquillizers. The packaging of medicine products such as Serenace in 1 cc ampules makes it time-consuming to load syringes to inject a large herd of captured animals, while the compounded product Haloperidol is available in 20 cc bottles. • Wildlife veterinarians are using compounded medicines daily. The drug dosages are well established in the industry and veterinarians obtain their compounded medicine from a specific pharmacy with which they have a long-standing relationship. Problems associated with compounding medicine in wildlife. • Compounded drugs have a legal shelf life of only 30 days. Game capture operations depend on environmental factors such as high temperatures, cold fronts, rain, etc. This leads to the problem that the product has expired on paper but is still effective. Compounding a new batch will take time and is counterproductive. • Compounding is patient-specific and therefore compounding products should not be kept for routine dispensing. The use of game capture products is exclusive for healthy animals and to reduce stress and mortalities in wildlife. • Recently the product Yohimbine was confiscated at the Oliver Thambo airport without any publication of the reason in the Government Gazette. The reason from the South African Health Products Regulatory Authority (SAHPRA) stated that the product can be used as an aphrodisiac. This is a legal human problem that prevents a compounding pharmacy from compounding a medicine legally for veterinary use. Yohimbine and Atipamezole are used as antagonists (acting at the α-1 and α-2-adrenoreceptors found both in the central nervous system and peripherally) to Xylazine and Medetomidine. The problem is that Atipamezole reverses the alfa-2-receptors hundred per cent but not the α-1adrenoreceptors. Yohimbine reacts slower than Atipamezole but binds to the α-1-adrenoreceptors. The combination is preferred by experienced wildlife veterinarians to prevent the recycling in animals. Solutions • Veterinarians must respect their privilege to dispense products to their clients, However, during the chemical poaching of rhinos, some stated that a veterinarian sold immobilising products to the private sector for more than R1 million. Such actions may lead to veterinarians losing their privilege to dispense drugs for their clients. • To create an emergency body to react when a case such as Yohimbine happens. The body consists of; a. Member of SAPHRA (Act 101) - permanent b. Member of Department of Agriculture (Act 36) - permanent c. Member of SA Veterinary Association – permanent d. Member of Industry in dispute – not permanent e. Representative of the private sector appointed by the industry in dispute – not permanent. This body could then be making recommendations to the minister. v Opinion Piece
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