ABSTRACT
The objective of this study was to compare serum concentrations of transdermal fluoxetine compounded in Lipoderm base versus commercially available oral fluoxetine tablets. Sixteen clinically healthy, client-owned cats that were at least one year of age were enrolled. Cats weighed between three and seven kilograms, had no comorbidities, and were behavior medication naïve. Cats were recruited from January 2016 through April 2016. Eight cats were assigned to each medication group based on owner preference. The cats received either oral (1 mg/kg) or transdermal (5 mg/kg; maximum 25 mg daily) fluoxetine compounded in a transdermal base (PCCA Lipoderm), administered daily for 60 days. Serum levels of fluoxetine and norfluoxetine were assessed as a surrogate for relative efficacy. Serum was collected and analyzed by high-performance liquid chromatography-mass spectrometry/mass spectrometry at baseline and days 5, 10, 30, 45, and 60 post-drug start. Adverse effects were monitored during physical exams, speaking with owners, and laboratory analysis of liver function tests at baseline and days 5, 30, and 60 post-drug start. Serum fluoxetine concentrations significantly differed between the treatment groups at days 45 and 60 post-drug start. Norfluoxetine concentrations significantly differed at days 30, 45, and 60 post-drug start. Blood concentrations of fluoxetine and norfluoxetine significantly differed between oral and transdermal routes after 30 days of treatment. Oral fluoxetine concentrations were consistently higher. Transdermal fluoxetine appeared to be well-tolerated, but a lack of knowledge regarding effective blood levels makes it unclear if a clinical effective response would be obtained at the blood concentrations achieved.
Subject(s)
Fluoxetine/administration & dosage , Fluoxetine/blood , Administration, Cutaneous , Administration, Oral , Animals , Cats , Fluoxetine/analogs & derivatives , Tablets/administration & dosageABSTRACT
Transdermal medications are a desirable route of administration for feline patients. However, before compounding, pharmacists and veterinarians should critically evaluate if the medication is appropriate for administration via the transdermal route. This article discusses points to consider regarding transdermal therapy. Tables summarizing the current literature and medications that should never be used transdermally are included.
Subject(s)
Cat Diseases/drug therapy , Pharmaceutical Services , Veterinary Drugs/administration & dosage , Veterinary Drugs/chemistry , Administration, Cutaneous , Animals , Cats , Drug Compounding , Humans , Interdisciplinary Communication , Pharmacists , Veterinarians , Veterinary Drugs/adverse effectsABSTRACT
Administering chronic medications to feline patients without the daily battle of oral and injectable medications is the holy grail of veterinary pharmacotherapy. For some medications, the transdermal route may be the solution. However, there are many considerations for determining if a medication will be safe for the patient and caregiver as well as effective when administered transdermally. A comprehensive checklist to assess the appropriateness of transdermal therapy is provided.
