Veterinarian FAQs

FOR PRESCRIBING VETERINARIANS.

Frequently asked questions about Adequan® Canine (polysulfated glycosaminoglycan or PSGAG)

ABOUT ADEQUAN® CANINE

What is Adequan® Canine? Arrow Up
Adequan® Canine (polysulfated glycosaminoglycan) is the only FDA-approved disease-modifying osteoarthritis drug (DMOAD) for dogs. It is recommended for intramuscular injection for the control of signs associated with non-infectious degenerative and/or traumatic arthritis of canine synovial joints.
How is Adequan® Canine different from a non-steroidal anti-inflammatory drug (NSAID)? Arrow Up
Adequan® Canine is a prescription formulation PSGAG. It is a disease-modifying osteoarthritis drug (DMOAD) which inhibits cartilage loss in a dog’s joints. The specific mechanism of action of Adequan® in canine joints is not known.1
How is Adequan® Canine packaged? Arrow Up
Adequan® Canine Solution is supplied as 100 mg/mL in a 5 mL preserved multiple dose vial; packaged 2 vials per box.
What is the dosage and administration? Arrow Up
2 mg/lb body weight (0.02 mL/lb or 1 mL/50 lb) by intramuscular (IM) injection only, twice weekly for up to 4 weeks (maximum of 8 injections). Do not exceed the recommended dose or therapeutic regimen.
How fast does Adequan® Canine work? Arrow Up
It begins to reach joint synovial fluid within 2 hours and detectable levels are maintained in the synovial fluid and articular cartilage for up to 3 days (72 hours).2
Are there age or breed restrictions for Adequan® Canine? Arrow Up
No age or breed restrictions.
Can Adequan® Canine be used in pregnant, breeding or lactating female dogs? Arrow Up
The use of Adequan® Canine in pregnant, breeding or lactating animals has not been evaluated.
What is the pharmacology of Adequan® Canine? Arrow Up
  • Low molecular weight allows the distribution of PSGAG from the bloodstream to the synovial fluid.
  • PSGAG reaches synovial fluid within 2 hours of injection.2
  • Distribution from the synovial fluid to the cartilage takes place by diffusion.
  • In the articular cartilage, the drug is deposited into the cartilage matrix.
  • Detectable levels are maintained in synovial fluid and articular cartilage for up to 72 hours.2
  • The specific mechanism of action of Adequan® in canine joints is not known.1




MODE OF ACTION & EFFICACY

What is the Mechanism of Action for Adequan® Canine? Arrow Up
The specific mechanism of action of Adequan® in canine joints is not known.1 In vitro research suggests PSGAG:1
  • Inhibits certain catabolic enzymes which have increased activity in inflamed joints.
  • Enhances the activity of anabolic enzymes.
  • Anabolic effects studied include the ability to stimulate the synthesis of protein, collagen and proteoglycans.
  • Potentiates hyaluronic acid synthesis by synovial membrane cells (synoviocytes)
  • In the articular cartilage the drug is deposited into cartilage matrix and may help shield against further degradation.
Why is Adequan® Canine classified as a Disease-Modifying Osteoarthritis Drug or DMOAD? Arrow Up
Unlike pharmaceuticals designed to treat the signs of osteoarthritis (OA) alone, a disease-modifying osteoarthritis drug or “DMOAD” is a pharmaceutical that’s capable of making a positive impact on altering or reducing the progression of OA. Adequan® Canine is a DMOAD because it is clinically proven to modify the disease in addition to treating the signs of OA.3
What is the proof of efficacy for Adequan® Canine? Arrow Up



HOW TO USE: PROTOCOL

Can I give Adequan® Canine to a dog already taking an NSAID? Arrow Up
American Regent Animal Health (ARAH) has not completed any trials or studies identifying the combination use of NSAIDs and Adequan® Canine (polysulfated glycosaminoglycan).
Does Adequan® Canine work well within a multimodal treatment regimen? Arrow Up
Adequan® Canine is a disease-modifying osteoarthritis drug (DMOAD).1 The combination of disease treatment with Adequan® Canine and supportive modalities can help slow progression of osteoarthritis (OA) and help promote mobility.4 Develop a personalized multi-modal plan that is specific to each patient that can include disease treatment with Adequan® Canine and supportive modalities such as pain management, exercise, weight control and physical therapy.
When is the optimal time in the disease cycle to use Adequan® Canine? Arrow Up
Working as a disease-modifying osteoarthritis drug (DMOAD), Adequan® Canine binds to key components of the cartilage matrix to help slow degradation of synovial joints. Adequan® Canine used early, at the first clinical signs of osteoarthritis can help slow the progression of the disease before cartilage is irreversibly damaged.1 This could have a profound positive impact on the speed and severity of the OA disease cycle over the patient’s lifetime.

Adequan® Canine has shown to be beneficial for patients diagnosed at all stages of OA, but as noted above, it may be most effective in the early stages of the disease cycle.
What is the treatment protocol for a new patient starting with Adequan® Canine? Arrow Up
The approved label dose of Adequan® Canine is 2 mg/lb body weight (0.02 mL/lb or 1 mL/50 lb), by intramuscular injection only, twice weekly for up to 4 weeks (maximum of 8 injections). Repeat this treatment protocol as needed. Do not exceed the recommended dose or therapeutic regimen. Do not mix Adequan® Canine with other drugs or solvents. Be sure to practice aseptic techniques in withdrawing each dose to decrease the possibility of post-injection bacterial infections. Adequately clean and disinfect the stopper prior to entry with a sterile needle and syringe. Use only sterile needles, and use each needle only once. Use within 28 days of first puncture and puncture a maximum of 10 times. Dispose of spent needles in accordance with all federal, state and local environmental laws.
What is the treatment protocol after the first 8 injections? Arrow Up
The approved label dose of Adequan® Canine is 2 mg/lb body weight (0.02 mL/lb or 1 mL per 50 lb), by intramuscular injection only, twice weekly for up to 4 weeks (maximum of 8 injections). We have no further studies or technical data supporting a use protocol beyond the approved label dosing.
Where do I administer an injection? Arrow Up
Intramuscular (IM) administration should be in a major muscle group.
Can the 8 doses be withdrawn at one time for a full course of treatment into 8 syringes to have available for traveling? Arrow Up
No, there has been no stability testing of Adequan® Canine when stored in a syringe and this is not recommended. Each dose should be drawn into a syringe and used immediately.
Do I have to keep Adequan® Canine refrigerated? Arrow Up
No, Adequan® Canine needs to be stored at 68° to 77° F (20° to 25° C) with excursions permitted to 59° to 86° F (15° to 30° C). Avoid prolonged exposure to temperatures greater or equal to 104° F (40° C).
Is Adequan® Canine in a multiple-use vial? Arrow Up
Yes, Adequan® Canine contains a preservative, which allows for multiple punctures of an individual vial. Adequan® Canine must be used within 28 days of first puncture and is limited to a maximum puncture of 10 times. Please properly dispose of spent needles in accordance with all federal, state and local environmental laws.




HOW DOES ADEQUAN® CANINE COMPARE?

Why is it important to treat osteoarthritis as a disease and not just manage its signs? Arrow Up
According to canine osteoarthritis (OA) experts, the optimal management of OA focuses on strategies that slow down the clock.5 Adequan® Canine is a disease-modifying osteoarthritis drug (DMOAD) which is proven to bind to and help promote key components of the cartilage matrix and inhibit damaging enzymes to help slow OA degradation of synovial joints. By treating the disease early in its cycle, there may be a profound positive impact on the progression and severity of the OA disease cycle over the patient’s lifetime.

A treatment program which focuses only on managing the signs of OA will not address the underlying disease state responsible for causing disease progression.
What is the difference between FDA-approved prescription Adequan® Canine and other over-the-counter products? Arrow Up
There are many supplements and over-the-counter products making similar claims to Adequan® Canine. However, these products do not have the structured and qualified product testing and trials Adequan® Canine completed to obtain FDA-approval. Adequan® Canine (polysulfated glycosaminoglycan) is the only FDA-approved disease-modifying osteoarthritis drug for use in dogs and is recommended for intramuscular injection for the control of signs associated with non-infectious degenerative and/or traumatic arthritis of canine synovial joints.




SAFETY INFORMATION

Are there any Contraindications? Arrow Up
Do not use in dogs showing a hypersensitivity to PSGAG. PSGAG is a synthetic heparinoid; do not use in dogs with known or suspected bleeding disorders.
Any Precautions? Arrow Up
The safe use of Adequan® Canine used in breeding, pregnant, or lactating dogs has not been evaluated. Use with caution in dogs with renal or hepatic impairment.
What is the current Important Safety Information (ISI)? Arrow Up



ABOUT AMERICAN REGENT ANIMAL HEALTH (ARAH)

Who is American Regent Animal Health? Arrow Up
American Regent Animal Health is committed to advancing animal health with proven FDA-approved products like Adequan® branded products. The company’s portfolio is anchored by the only FDA-approved polysulfated glycosaminoglycan products for horses and dogs. For more than 20 years, Adequan® Canine (polysulfated glycosaminoglycan) has been prescribed by veterinarians across the country and helped thousands of dogs lead more active lives.
Where can I find out more about American Regent Animal Health? Arrow Up



HOW TO PURCHASE

How can I order Adequan® Canine? Arrow Up
Your Adequan® Canine needs can be serviced through a wide network of authorized veterinary distributors. Please visit Ordering Information or call ARAH at 800-458-0163.
Can veterinarians or pet owners purchase Adequan® Canine directly from American Regent Animal Health? Arrow Up
We have established a wide network of distributors that make purchase easy. Veterinarians that want to buy directly from ARAH should contact our National Key Accounts Manager to discuss available options. As this is a prescription-only product, pet owners must purchase through a licensed, practicing veterinarian.
Product was shipped in a method differing from the recommended storage, what should I do? Arrow Up
Contact your distributor.
How do I return expired product? Arrow Up
Short-dated or expired Adequan® Canine product should be returned to the distributor that originally supplied the product, per their established return policies. Contact your distributor or American Regent Animal Health at 800-458-0163.
Do I have an ARAH sales representative I can call? Arrow Up Which distributors currently carry Adequan® Canine? Arrow Up




FOR MORE INFORMATION

Where can I get marketing and in-clinic material? Arrow Up Who can I call with questions about Adequan® Canine? Arrow Up
To speak to a customer service representative, please call 800-458-0163 Monday-Thursday from 8:30 a.m. to 6:00 p.m. ET and Friday from 8:30 a.m. to 5:00 p.m. ET or email cs@americanregent.com. For technical questions, please call Medical Affairs at 888-354-4855 Monday-Friday, 9 a.m. to 5 p.m. ET. To report an adverse event, call 800-734-9236 or email pv@americanregent.com.
Adequan® Canine brand of polysulfated glycosaminoglycan (PSGAG)
INDICATIONS Adequan® Canine is recommended for intramuscular injection for the control of signs associated with non-infectious degenerative and/or traumatic arthritis of canine synovial joints.
IMPORTANT SAFETY INFORMATION Adequan® Canine should not be used in dogs who are hypersensitive to PSGAG or who have a known or suspected bleeding disorder. It should be used with caution in dogs with renal or hepatic impairment. Adverse reactions in clinical studies (transient pain at injection site, transient diarrhea, and abnormal bleeding) were mild and self-limiting. In post approval experience, death has been reported in some cases; vomiting, anorexia, depression/lethargy and diarrhea have also been reported. The safe use of PSGAG in breeding, pregnant or lactating dogs has not been evaluated. Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian. For additional safety information, please see Full Prescribing Information.
1. Adequan® Canine Package Insert, Rev. 1/19.
2. Adequan® Canine (polysulfated glycosaminoglycan) NADA 141-038 FOI Summary, 1997.
3. Disease modification in osteoarthritis: are we there yet?” W.M. Oo, D.J. Hunger, Clin Exp Rheumatol 2019; 37 (Suppl. 12): S135-S140.
4. 2015 AAHA-AAFP Pain Mgt. Guidelines for Dogs and Cats; J Am Anim Hosp Assoc 2015; 51_67-87. DOI: 10.5326JAAHA- MS-7331.
5. Face validity of a proposed tool for staging canine osteoarthritis: Canine OsteoArthritis Staging Tool (COAST), T. Cachon, O. Frykman, J.F. Innes, B.D.X. Lascelles, M. Okumura, P. Sousa, F. Staffieri, P.V. Steagall, B. Van Ryssen, COAST Development Group, The Veterinary Journal, 235 (2018) 1-8.

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