What is compounding?
Drug compounding is often regarded as the process of combining or mixing drugs to create a medication tailored to the needs of an individual patient.
The generic form of Vetmedin is Pimobendan.
Vetmedin is in limited supply. Orders placed will be shipped as product continues to come off backorder.
Diroban 25 mg/ml sterile powder for injection is indicated for the treatment of stabilized Class 1a, 2b, and 3c heartworm disease caused by immature (4 month-old, stage L5) to mature adult infections of Dirofilaria immitis in dogs.
You Should Always Have Access to Your First Choice
How does the Diroban work?
Melarsomine dihydrochloride (the active ingredient in Diroban) is an organic arsenical chemotherapeutic agent. Melarsomine has a molecular weight of 501.34 and is chemically designated as 4 – [(4, 6-diamino-1, 3, 5- triazon-2-yl) amino] phenyldithioarsenite of di (2-aminoethyl), dihydrochloride. It is freely soluble in water. When injected intramuscularly, it is rapidly absorbed. The exact mode of action on D. immitis is unknown.
Dosage & Administration
Diroban should be administered by deep intramuscular injection only in the epaxial (lumbar) muscles in the third through fifth lumbar region (see graphic). Do not administer at any other site. Avoid superficial injection or leakage. Use a 23 gauge 1 inch needle for dogs equal to or less than 10 kg (22 lb) in weight. Use a 22 gauge 1 1/2 inch needle for dogs greater than 10 kg (22 lb). Use alternating sides with each adminsitration. If repeated administrations are warranted avoid injecting at the same lumbar location. Record the location of the first injection(s) in the patient's medical record for future reference.
Disease Classification: It is vital to classify the severity of heartworm disease to apply the appropriate dosage regime for DIROBAN (see INDICATIONS).
Class 1 and 2: If necessary, dogs should be stabilized prior to treatment. DIROBAN should be administered intramuscularly in the lumbar (L3-L5) muscles at a dose of 2.5 mg/kg twice, 24 hours apart (see Dosing Table) Four months following treatment, a second treatment series (2.5 mg/kg twice, 24 hours apart) can be elected taking into condiferation the response to the first DIROBAN treatment and the condition, age, and use of the dog. Worms that were too your to be killed by the first treatment series, i.e., < 4 months, may be killed by a second treatment series.
Class 3: Alternate Dosing Regime: Dogs with severe (Class 3) heartworm disease should be stabilized prior to treatment and then dosed intramuscularly in the lumbar (L3-L5) muscles with a single injection of 2.5 mg/kg then approximately 1 month later with 2.5 mg/kg administered twice 24 hours apart (see Dosing Table).
Dosing Table: Care must be taken to adminsiter the proper dose. Accurately weigh the dog and calculate the volume to be injected based on the dose of 2.5 mg/kg (1.1 mg/lb). This is equivalent to 0.1 mL/kg (0.045 mL/lb). The following table should be used as a guide to ensure that the proper volume has been calculated.
|Volume Per Injection (mL)||0.1||0.2||0.3||0.4||0.5||0.6||0.7||0.8||0.9||1.0||2.0||3.0||4.0||5.0*|
*Limited data were collected on the administration > 5.0 mL at a single injection site.
Preparation: DIROBAN should be aseptically reconstituted only with the provided 2.0 mL of Sterile Diluent (sterile water for injection). This provides 2.5 mg melarsomine dihydrochloride per 0.1 mL of injectable solution. Two 50 mg vials will be required for dogs weighing > 20 kg and 40 kg and 3 vials will be required for dogs > 40 kg and 60 kg. Use immediately. Reconstituted solution may be used within 36 hours if refrigerated and kept from light. Sterile water diluent is not suitable for intravascular injection.
Treatment Response: A baseline can be established pre-treatment by using commercially available in-office heartworm antigen test kits prior to treatment. Treatment response can be assessed best by heartworm antigen testing applied 4 months after treatmen. A successful treatment is determined to be conversion from an antigen positive to an antigen negative status. In dogs with signs of heartworm disease, gradual improvement shoul dbe observed as the long-term effects of the heartworm infection resolve. Some dogs may have chronic effects that will not totally resolve.
CONCOMITANT THERAPY: During the course of clinical field trials, DIROBAN was administered concurrently with anti-inflammatories, antibiotics, insecticides, heartworm prophylactics, and various other drugs commonly used to stabilize and support dogs with heartworm disease with no adverse drug interactions noted.
Routine Prophylaxis: If the dog is not currently receiving commercially available heartworm preventatives, they may be administered consistent withlabel recommendations and re-exposure risk.