Adequan I.A. (Canada)

This page contains information on Adequan I.A. for veterinary use.
The information provided typically includes the following:
  • Adequan I.A. Indications
  • Warnings and cautions for Adequan I.A.
  • Direction and dosage information for Adequan I.A.

Adequan I.A.

This treatment applies to the following species:
Manufacturer: Novartis

Polysulfated Glycosaminoglycan Injection

250 mg/mL

FOR VETERINARY USE ONLY

FOR INTRA-ARTICULAR USE IN HORSES

DIN 00670936

Description

Each mL of Adequan contains 250 mg of Polysulfated Glycosaminoglycan (PSGAG) and Water for Injection q.s.; sodium hydroxide and/or hydrochloric acid added as necessary to adjust pH.

Pharmacology

Polysulfated Glycosaminoglycan is chemically similar to the mucopolysaccharides of cartilaginous tissue. It is a potent proteolytic enzyme inhibitor and diminishes or reverses the processes which result in the loss of cartilaginous mucopolysaccharides. PSGAG improves joint function by stimulating synovial membrane activity, reducing synovial protein levels and increasing synovial fluid viscosity in traumatized equine joints.

Toxicity: Toxicity studies were conducted in horses. Doses as high as 1250 mg were administered intracarpally to 6 horses once a week for 18 weeks. This dosage is 5 times the recommended dosage and 3.6 times the maximum recommended therapeutic regimen. Clinical observations revealed a soreness and swelling in 1.8% of the animals (2/109 animals) at the injection site which was mild, self-limiting and lasted less than one day. No animal had any clinical illness during the trial and none showed clinical evidence of toxicity except for transient swelling at the injection site, possibly due to mechanical invasion of the joint.

Indication: Adequan is recommended for the treatment of non-infectious degenerative and/or traumatic joint dysfunction and associated lameness in horses.

Contraindications

Do not use in horses showing hypersensitivity to PSGAG.

Warnings

This drug is not to be administered to horses that are to be slaughtered for use in food. Keep out of the reach of children.

Dosage and Administration

The recommended dose of Adequan in horses is 250 mg once a week for up to five weeks, intra-articularly. The joint area must be shaved, cleansed and sterilized as in a surgical procedure prior to injection. Do not mix Adequan with other drugs and do not exceed the recommended dose, frequency and duration of treatment.

Adverse Reactions

The rate of adverse reactions based on the first four years of sales experience in the United States is 0.02%. Adverse reactions fall into two distinct categories with equal incidence: joint inflammation and septic arthritis. Post-injection inflammation or “joint flare” may result from sensitivity to Adequan, traumatic injection technique, exceeding the recommended dose, frequency, and number of Adequan injections, and from combining Adequan with other drugs. Joint inflammations are characterized by rapid onset (8-48 hrs after injection) and tenderness, swelling and warmth over the injected joint. Inflammatory joint reactions are successfully treated by systemic anti-inflammatories, cold water therapy and rest.

Joint sepsis is a rare but potentially life-threatening complication of intra-articular injection. It usually results from the deposition of skin organisms into the joint space by the needle tip. Gustafson et al. (1989) have demonstrated that Adequan may potentiate a subinfective dose of contaminant bacteria. Hence, strict aseptic technique is of utmost importance.

Successful resolution of joint sepsis depends upon prompt recognition and rigorous antimicrobial treatment. Early diagnosis of septic arthritis may be complicated by the similar appearance of joint inflammation. Excessive inflammation accompanied by lameness, and swelling and edema extending beyond the joint limits, should alert the practitioner to the possibility of sepsis. Synovial fluid analysis and culture are valuable diagnostic aids, but upon suspicion of joint sepsis broad-spectrum antimicrobial therapy should be instituted without delay.

Veterinarians are referred to the following references for a comprehensive review of septic arthritis and its treatment.

1. Bertone, AL; McIlwraith, CW, et al: Comparison of various treatments for experimentally induced equine infectious arthritis. Am. J. Vet. Res. (48): 519, 1987.

2. Gustafson, SB; McIlwraith, CW, et al: Comparison of the effect of polysulfated glycosaminoglycan, corticosteroids and sodium hyaluronate in the potentiation of a subinfective dose of Staphylococcus aureus in the midcarpal joint of horses. Am. J. Vet. Res. (50): 2014-2017, 1989.

3. Gustafson, SB; McIlwraith, CW, et al: Further investigations into the potentiation of infection by intra-articular injection of polysulfated glycosaminoglycan and the effect of filtration and intra-articular injection of amikacin in horses. Am. J. Vet. Res. (50): 2018-2022, 1989.

4. Hawkins, DL: Bacterial arthritis in Roundtable on Sodium Hyaluronate Therapy in the horse, Riviera Beach, FL. Mar. 1985, J. Eq. Vet. Sci. (5): 231, 1985.

5. Koch, DB: Management of infectious arthritis in the horse. Comp. Cont. Educ. (1): 546, 1979.

6. McIlwraith, CW: Treatment of infectious arthritis. Vet. Clin. N. Am., Lg. Anim. Pract. (5): 363, 1983.

7. Morris, PG: The clinical management of septic arthritis in the horse. Comp. Cont. Educ. (2): 5207, 1980.

8. Von Essen, R. and Holtta, A: Improved method of isolating bacteria from joint fluids by the use of blood culture bottles. Ann. Rheum. Dis. (45): 454, 1986.

Precautions

The concomitant use of Adequan with steroidal and/or non-steroidal anti-inflammatory agents may mask the symptoms of joint sepsis, thereby delaying the diagnosis and reducing the likelihood of satisfactory resolution. Joint injections should not be performed when the overlying skin is scurfed or blistered, as this precludes adherence to aseptic technique.

Adequan I.A. Caution

Not intended for use in breeding animals as effects on fertility and reproductive function in mares and stallions have not been studied.

How Supplied

Adequan® I.A., PSGAG 250 mg/mL, is available in 1 mL single dose vials packaged in boxes of 6.

Storage Conditions: Store at controlled room temperature up to 25°C (77°F).

Discard unused portion.

LUITPOLD PHARMACEUTICALS, INC., Animal Health Division, Shirley, N.Y. 11967

(1-800-458-0163)

Distributed by: Novartis Animal Health Canada Inc., 2000 Argentia Rd. Suite 400 Plaza 3, Mississauga, Ontario L5N 1V9

IN99171C

Rev. 4/09C

MG #15650

NAC No.: 12311010

NOVARTIS ANIMAL HEALTH CANADA INC.
2000 ARGENTIA RD., SUITE 400, PLAZA 3, MISSISSAUGA, ON, L5N 1V9
Telephone:   800-387-6325
Order Desk:   800-387-6325
Fax:   905-567-0221
Fax Orders:   800-827-5782
Website:   www.ah.novartis.ca
Email:   ah.questions@novartis.com
Every effort has been made to ensure the accuracy of the Adequan I.A. information published above. However, it remains the responsibility of the readers to familiarize themselves with the product information contained on the Canadian product label or package insert.

Copyright © 2014 North American Compendiums. Updated: 2014-12-03

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