Bulk Drug Substances Reviewed and Not Listed

FDA reviewed these bulk drug substances and is not including them on either 1) The List of Bulk Drug Substances for Compounding Office Stock Drugs for Use in Nonfood-Producing Animals, or 2) The List of Bulk Drug Substances for Compounding Drugs for Use in Food-Producing Animals or Free-Ranging Wildlife Species. Therefore, these bulk drug substances are not covered by the enforcement discretion policy described in Guidance for Industry #256 Compounding Animal Drugs from Bulk Drug Substances. These substances may be nominated again for re-evaluation by FDA using the nomination procedure described in the appendix to GFI #256.

FDA will accept nominations of additional bulk drug substances at any time and will continue to review nominations and update lists. For information on how to submit a bulk drug substance nomination, see the appendix to Guidance for Industry #256 Compounding Animal Drugs from Bulk Drug Substances.

DOGS, CATS, HORSES

Bulk Drug Substance (BDS)	Species	Dosage form(s)	Strength/concentration	Reason
Altrenogest (11/15/2023)	horse	any	any	Altrenogest is not typically needed urgently and FDA- approved altrenogest products can be used as labeled, or in an extralabel manner under 21 CFR Part 530, until a patient-specific prescription can be filled, if needed.
Amikacin (3/8/2023)	dog, cat dog, cat, horse	otic ointment otic solutions injectable solution	0.67% - 5% 0.67% - 5% 200mg/mL	There are several FDA-approved otic products that could be used as labeled in an urgent situation. If a compounded preparation of amikacin is needed, a patient-specific prescription should suffice. If an injectable solution is needed for urgent treatment, Amiglyde-V® (NADA 127-892) or the amikacin injectable solutions FDA-approved for use in humans can be used in an extralabel manner under 21 CFR Part 530.
Amlodipine besylate (1/19/2023)	dog, cat	oral solution oral suspension capsule transdermal gel oral paste tablet soft chewable treat	any concentration other than 1.25 mg/ml any concentration other than 1.25 mg/ml any strength other than 0.625 mg any concentration any concentration any strength other than 0.625 mg any strength	Insufficient rationale was provided for the need for transdermal gel, oral paste, and soft chewable treat dosage forms on an urgent basis and specialty formulations can be obtained via patient-specific prescription and are not generally needed as office stock; insufficient rationale was provided for the needs of strengths other than 0.625 mg for capsules and tablets or for concentrations other than 1.25 mg/mL for oral solutions and oral suspensions as office stock to be used on an urgent basis.
Amoxicillin (10/10/23)	dog, cat	oral suspension	any	There are FDA-approved products that can be used as labeled or in an extralabel manner under 21 CFR Part 530 to treat cats and dogs in an urgent situation, until a patient-specific prescription can be filled, if needed.
Amoxicillin/ clavulanate (10/10/23)	dog, cat	oral suspension	any	There are marketed FDA-approved tablets, chewable tablets, and oral suspensions containing the same active ingredient that can be used as labeled or in an extralabel manner under 21 CFR Part 530 for urgent treatment in cats and dogs, until a patient-specific prescription can be obtained, if needed.
Apomorphine hydrochloride (8/11/2016)	dog	subconjunctival solution subconjunctival tablets	3.125-6.25 mg/mL 6.25 mg	Clevor (ropinirole ophthalmic solution) 30 mg/mL (NADA 141-534) is now FDA-approved for induction of emesis in dogs.
Azithromycin (4/20/2023)	dog, cat, horse dog, cat	capsule liquid tablet, flavored or unflavored otic ointment/solution oral paste oral powder mucoadhesive paste periodontal gel soft chew treat	10 – 500 mg 1 – 250 mg/ml 25 – 50 mg 225 mg 0.5 – 5% 20 – 360 mg/ml 1 gm/dose 100 mg/ml 8.5% 25 – 200 mg	There are many FDA-approved and marketed antibiotics that can be used in an urgent situation in dogs, cats, and horses. If a compounded preparation of azithromycin is needed, a patient specific prescription should suffice.
Betamethasone dipropionate (3/29/2023)	dog, cat, horse	otic ointment otic suspension	0.05% - 1% 0.05% - 1%	There are several FDA-approved and marketed steroid-containing otic products, with and without antibiotics and/or antifungals, labeled for use in dogs and cats, which can also be used in an extralabel manner in horses. If a compounded preparation of betamethasone is needed, a patient-specific prescription should suffice.
Buprenorphine HCl (4/24/2023)	dog, horse dog, cat, horse	injectable polymeric matrix solution injectable solution oral solution	any any any	FDA-approved injectable solution is available as labeled for administration or for extralabel use under 21 CFR Part 530 for injection or oral administration. Specialty formulations can be obtained via patient-specific prescription and are not generally needed as office stock.
Carprofen (12/19/2023)	dog	any	any	FDA-approved animal drugs (carprofen and other non-steroidal anti-inflammatory drugs) can be used as labeled or in an extralabel manner under 21 CFR Part 530 to treat the same conditions. Specialty formulations can be obtained via patient-specific prescription and are not generally needed as office stock.
Chloramphenicol (2/28/2023)	horse	powder for oral administration topical ointment ophthalmic solution or ointment	10 g 1% 1%	Oral suspension and paste are listed on the List of Bulk Drug Substances for Compounding Office Stock Drugs for Use in Nonfood-Producing Animals for use in horses. For topical and ophthalmic use, there are FDA-approved human and animal drug products available for initial empirical treatment, there are human health risks associated with administration of chloramphenicol, and in instances where chloramphenicol may be indicated based on culture and sensitivity results, this preparation can be compounded on an individual patient basis and is not needed for urgent or immediate treatment to prevent animal suffering or death.
Chloramphenicol (2/28/2023)	dog, cat	capsule oral suspension otic ointment/solution/suspension	30 - 1000 mg 125 - 500 mg/mL 1 - 2%	There are FDA-approved animal drug products available for initial empirical treatment. In instances where chloramphenicol may be indicated based on culture and sensitivity results, this preparation can be compounded on an individual patient basis and is not needed for urgent or immediate treatment to prevent animal suffering or death.
Clenbuterol (6/6/2023)	horse	oral solution	any	Ventipulmin Syrup, NADA 140-973, is FDA-approved and can be used as labeled, or in an extralabel manner under 21 CFR Part 530, in horses in an urgent situation, until a patient-specific prescription can be filled, if needed.
Clomipramine HCl (7/5/2023)	dog, cat	capsule oral suspension soft chew treat tablet (flavored or unflavored) transdermal gel	any	Clomipramine should not be needed for urgent treatment to avoid animal suffering or death. There are FDA-approved formulations of clomipramine that can be used as labeled or in an extralabel manner under 21 CFR Part 530. If clomipramine is needed in a formulation that is not FDA-approved, a patient-specific prescription for compounded clomipramine should be sufficient.
Clopidogrel (11/15/2023)	dog, cat horse	transdermal gel soft chewable treat oral suspension	any any any	Oral suspension, tablets, and capsules are on the List of Bulk Drug Substances for Compounding Office Stock Drugs for Use in Nonfood-Producing Animals and should be sufficient for urgent use. If a specialty formulation such as transdermal gel or soft chewable treat is deemed necessary by a veterinarian, it can be obtained via a patient-specific prescription. If clopidogrel is needed urgently in horses, tablets FDA-approved for use in humans could be used in an extralabel manner under 21 CFR Part 530 until a patient-specific prescription could be obtained, if needed.
Corticotropin (ACTH) (1/19/2023)	dog, cat, horse	injectable	40 & 80 units/ml	There are FDA-approved products that can be used in an extralabel manner under 21 CFR Part 530 in dogs, cats, and horses. There is lack of supporting information that this drug is needed on an urgent basis in these species.
Cyclosporine (11/30/2023)	dog, cat, horse	ophthalmic gel ophthalmic solution ophthalmic suspension	any any concentration other than 1 – 2% any	Compounded cyclosporine ophthalmic ointment and solution 1-2% for use in dogs, cats, and horses are on the List of Bulk Drug Substances for Compounding Office Stock for Use in Nonfood-Producing Animals. An FDA-approved cyclosporine ophthalmic ointment 0.2% is also available. These should be sufficient for urgent use until a patient-specific prescription for another dosage form or concentration can be filled, if needed.
Dexamethasone (9/21/2016)	horse	oral powder	10 mg/packet	FDA-approved human oral tablets can be used to compound 10 mg oral powder doses.
Dipyrone (10/5/2016)	Shar-Pei and Shar-Pei mixed breed dogs	solution for injection	250 and 500 mg/ml	The FDA-approved drug product Zimeta (dipyrone 500 mg/mL) (NADA 141-513) can be used in an extralabel manner under 21 CFR part 530.
Edetate disodium (12/14/2023)	dog, cat, horse	any ophthalmic dosage form	any	Insufficient information was submitted to support the need for urgent use in these species for the conditions nominated. There is a lack of supporting information in the scientific literature that this drug is needed as office stock for urgent or immediate treatment of these species. If a compounded preparation of ophthalmic edetate disodium is needed, a patient-specific prescription should suffice.
Enrofloxacin (9/21/2016)	horse	oral paste and suspension	100-200 mg/ml	There are FDA-approved enrofloxacin products that can be used in an extralabel manner or used to compound enrofloxacin paste and suspension.
Famciclovir (6/6/2023)	cat	capsules oral paste oral powder soft chew treats unflavored tablets flavored quadrisected tablet oral suspension	any any, other than 25-325 mg/ml	Famciclovir in an oral suspension (25 - 325 mg/ml) for cats is on the List of Bulk Drug Substances for Compounding Office Stock Drugs for Use in Nonfood-Producing Animals. In addition, FDA-approved famciclovir tablets can be used in an extralabel manner under 21 CFR Part 530 to treat the same conditions in cats.
Fenbendazole (11/20/2023)	dog, cat, horse	any	any	There are a number of FDA-approved fenbendazole products that could be used as labeled or in an extralabel manner under 21 CFR Part 530. Additionally, there are several FDA-approved products with different active ingredients labeled for the same indications that could be used in place of fenbendazole if deemed appropriate by a veterinarian. If a different dosage form and/or strength/concentration of fenbendazole is deemed necessary by a veterinarian, a patient-specific prescription should suffice.
Fenbendazole/praziquantel/pyrantel pamoate (11/20/2023)	dog, cat	any	any	There are a number of FDA-approved fenbendazole, praziquantel, and pyrantel pamoate products that could be used as labeled or in an extralabel manner under 21 CFR Part 530 for urgent treatment in cats and dogs. Additionally, there are several FDA-approved products with different active ingredients labeled for the same indications that could be used if deemed appropriate by a veterinarian. If a combination fenbendazole/praziquantel/pyrantel pamoate product is deemed necessary by a veterinarian, a patient-specific prescription should suffice.
Flumethasone (4/18/2023)	horse	injectable solution	any	FDA-approved Bimasone (ANADA 200-612) can be used in horses in an urgent situation until a patient-specific prescription for another dosage form can be filled, if needed.
Flunixin (10/31/2023)	horse	any	any	FDA-approved flunixin meglumine products can be used as labeled or in an extralabel manner under 21 CFR Part 530 to treat the same conditions in horses in an urgent situation, until a patient-specific prescription can be filled, if needed.
Fluoxetine (12/21/2022)	dog, cat, horse	capsule, tablet, soft chew treat, suspension, paste, transdermal gel	all strengths and concentrations	Fluoxetine may take several weeks to achieve a therapeutic effect and is not needed for urgent treatment to avoid animal suffering or death. Reconcile^® (fluoxetine), NADA 141-272, is approved for use in dogs and there are alternative medications FDA-approved for use in animals that could be used to treat some of the nominated conditions. Additionally, fluoxetine products FDA-approved for use in humans can be used in an extralabel manner if deemed appropriate by a veterinarian as could several other alternative drugs FDA-approved for use in humans. If fluoxetine is needed in a formulation that is not FDA-approved, a patient-specific prescription for compounded fluoxetine should be sufficient.
Flurbiprofen (3/29/2023)	dog, cat	ophthalmic suspension	0.04%	FDA-approved flurbiprofen ophthalmic products for humans can be used in an extralabel manner under 21 CFR Part 530 to treat dogs and cats in an urgent situation, until a patient-specific prescription can be filled, if needed.
Gentamicin (3/29/2023)	dog, cat	otic ointment otic solution anal sac ointment topical gel topical ointment otic ointment otic suspension ophthalmic ointment	0.3-1% 0.3-1% 0.3-1% 0.3% 0.3% 0.3% 0.3% 0.3%	FDA-approved and marketed combination drug products containing gentamicin or other drugs can be used as labeled in an urgent situation in dogs and cats. Drugs containing gentamicin approved for other animal species and humans that be used in an extralabel manner under 21 CFR Part 530. If a compounded preparation of gentamicin is needed, a patient-specific prescription should suffice.
Hydroxyzine HCl (11/27/2023)	dog, cat, horse	any	any	Hydroxyzine is not typically needed urgently to avoid animal suffering or death. FDA-approved animal drugs can be used as labeled to treat the same conditions, and Hydroxyzine HCl FDA-approved for use in humans can be used in an extralabel manner under 21 CFR Part 530, until a patient-specific prescription can be obtained, if deemed necessary by the veterinarian.
Imatinib (10/13/2023)	dog, cat	any	any	Imatinib is not typically needed urgently. If treatment with compounded imatinib is deemed necessary by a veterinarian, a patient-specific prescription should suffice. The FDA-approved drugs Palladia (NADA 141-295) and Stelfonta (NADA 141-541) can be used as labeled or in an extralabel manner. FDA-approved imatinib products (for humans) can be used in an extralabel manner under 21 CFR Part 530 in dogs and cats.
Isoflupredone acetate (12/6/2022)	horse	suspension for injection	2 mg/ml	FDA-approved drugs are available for urgent use in horses for the same or similar indications.
Itraconazole (11/27/2023)	cat, dog, horse	any oral formulation	any	Itrafungol (NADA 141-474) is FDA-approved for use in cats. Itraconazole capsules and oral solutions are FDA-approved for use in humans and could be used in an extralabel manner under 21 CFR Part 530 if deemed appropriate by a veterinarian. Peer-reviewed studies indicate that oral itraconazole products compounded from BDS are poorly absorbed and likely to be ineffective, potentially leading to treatment failure and fatality if used in life-threatening infections. If a veterinarian deems a compounded oral itraconazole product necessary, a patient-specific prescription should suffice.
Ketoconazole/chloramphenicol/triamcinolone acetonide (2/28/2023) Ketoconazole/gentamicin/triamcinolone acetonide (2/28/2023) Ketoconazole/mupirocin/triamcinolone acetonide (2/28/2023) Ketoconazole/ofloxacin/triamcinolone acetonide (2/28/2023)	dog, cat	otic gel otic suspension otic solution otic ointment	any	There are many FDA-approved and marketed otic combination drug products that can be used as labeled in an urgent situation in dogs and cats. If a compounded preparation of this otic combination is needed, a patient-specific prescription should suffice.
Levamisole (12/19/2023)	dog, cat horse	any	any	Levamisole is not needed urgently for the nominated conditions in dogs and cats and a patient-specific prescription should suffice. FDA-approved animal drugs can be used to treat the nominated condition in horses in an urgent situation. Levamisole can be obtained via a patient-specific prescription if deemed necessary by the veterinarian.
Marbofloxacin (11/15/2023)	dog, cat	any oral dosage form any otic dosage form	any any	There are marketed FDA-approved drugs containing the same active ingredient, in the same or similar dosage form that can be used as labeled for dogs and cats, and FDA-approved products that can be used in an extralabel manner under 21 CFR Part 530. If the veterinarian determines that a different dosage form is needed the FDA-approved formulations can be used until a patient-specific prescription is filled.
Maropitant citrate (1/20/2023)	dog, cat	capsules oral paste oral suspension soft chew treat tablet, flavored, quadrisected transdermal gel nasal solution	2 – 120 mg 20 – 40 mg/ml 1.8 – 60 mg/ml 2 – 60 mg 8 – 32 mg 25 – 200 mg/ml 0.1%	Cerenia (maropitant citrate) injectable solution 10 mg/mL (NADA 141-263) is FDA-approved for the treatment of vomiting in dogs and cats. Cerenia^® is also FDA-approved in tablet form (NADA 141-262) for the treatment of vomiting in dogs and may be used in an extralabel manner in cats. These formulations should be sufficient for urgent use. If longer term treatment is deemed necessary by the veterinarian, compounded formulations may be obtained pursuant to a patient-specific prescription.
Mebendazole (11/20/2023)	dog	any	any	Mebendazole should not be needed for urgent treatment as there are many FDA-approved medications that could be used as labeled or in an extralabel manner under 21 CFR Part 530 for the same indications. If a veterinarian determines that mebendazole specifically is needed, a patient-specific prescription should suffice.
Mebendazole/praziquantel/pyrantel pamoate (11/20/2023)	dog	any	any	There are many FDA-approved formulations of praziquantel and pyrantel pamoate that can be used as labeled or in an extralabel manner under 21 CFR Part 530. Mebendazole should not be needed for urgent treatment to prevent animal suffering or death as there are many FDA-approved medications that could be used as labeled or in an extralabel manner under 21 CFR Part 530 for the same indications. If a veterinarian determines that a compounded mebendazole/praziquantel/pyrantel pamoate product is needed, a patient-specific prescription should suffice.
Methimazole (7/10/2023)	cat	capsules soft chew treat oral solution oral suspension tablets oral paste oral suspension oral solution transdermal gel	any	The nominations did not support the need for compounded methimazole for urgent use in cats. There are FDA-approved methimazole products that can be used as labeled or in an extralabel manner under 21 CFR Part 530 until a patient-specific prescription can be filled, if needed.
Methocarbamol (3/29/2023)	dog, cat horse dog, cat, horse	capsules oral paste oral powder oral suspension soft chew treat flavored and quadrisected tablet	15 -250 mg 500 mg/mL 0.5 gm -12 gm/dose 30 – 300 mg/mL 50 -125 mg 500 mg	Methocarbamol in an oral suspension (30-300 mg/ml) for dogs and cats is on the List of Bulk Drug Substances for Compounding Office Stock Drugs for Use in Nonfood-Producing Animals. In addition, there are FDA-approved drugs that can be used as labeled, and FDA-approved methocarbamol products that can be used in an extralabel manner under 21 CFR Part 530 to treat the nominated conditions in dogs, cats, and horses in an urgent situation, until a patient-specific prescription can be filled, if needed.
Mirtazapine (12/6/2023)	dog, cat	soft chewable treats oral suspension oral paste transdermal gel	1 – 3.75 mg 0.5 – 37.7 mg/ml 1.875 mg/ml 5 – 150 mg/ml	Mirtazapine BDS for compounding tablets (1 – 3.75 mg) and capsules (0.5 – 3.75 mg) is on the List of Bulk Drug Substances for Compounding Office Stock Drugs for Use in Nonfood-Producing Animals. FDA-approved tablets for humans (7.5/15/30/45 mg) can be used in an extralabel manner for dogs. Mirataz (mirtazapine transdermal ointment, 20 mg/g), NADA 141-481, is FDA-approved for use in cats and may be used in an extralabel manner in dogs, although FDA is not aware of evidence of adequate transdermal absorption of mirtazapine in dogs. These dosage forms may be administered to dogs and cats for urgent treatment until a patient-specific prescription for another dosage form can be filled.
Mitotane (2/28/2023)	dog	capsules oral suspension soft chew treat	any any any	Mitotane should not be needed for urgent treatment to avoid animal suffering or death. If a compounded mitotane product is deemed necessary by a veterinarian, a patient-specific prescription should suffice.
Neomycin sulfate/tetracaine HCl/triamcinolone acetonide (4/20/2023)	dog, cat, horse	otic ointment topical ointment topical powder	any any any	There are several FDA-approved and marketed drugs that can be used as labeled or in an extralabel manner for dogs, cats, and horses on an urgent basis. If a compounded preparation with neomycin, tetracaine HCl, and triamcinolone acetonide is needed, a patientspecific prescription should suffice.
Nitenpyram (2/28/2023)	dog, cat	oral solution rectal gel	22.7 mg/mL 11.4 and 57 mg	FDA-approved Capstar (nitenpyram), NADA 141-175, can be used as labeled, or in an extralabel manner under 21 CFR Part 530, to treat the same conditions in dogs or cats in an urgent situation, until a patient-specific prescription can be filled, if needed.
Ondansetron (2/8/2023)	dog, cat	capsules oral solution soft chew treat transdermal gel	0.5 - 24 mg 0.7 - 40 mg/ml 2 mg 20 – 70 mg/ml	There are FDA-approved products that can be used as labeled, or in an extralabel manner under 21 CFR Part 530, to treat the nominated conditions in dogs and cats in an urgent situation, until a patient-specific prescription can be filled, if needed.
Oxantel pamoate (11/20/2023)	dog	any	any	Oxantel pamoate should not be needed for urgent treatment to prevent animal suffering or death as there are many FDA-approved medications that could be used as labeled or in an extralabel manner under 21 CFR Part 530 for the same indications. If a veterinarian determines that oxantel pamoate specifically is needed, a patient-specific prescription should suffice.
Oxantel pamoate/praziquantel/pyrantel pamoate (11/20/2023)	dog, cat	any	any	There are many FDA-approved formulations of praziquantel and pyrantel pamoate that can be used as labeled or in an extralabel manner under 21 CFR Part 530. Oxantel pamoate should not be needed for urgent treatment to prevent animal suffering or death as there are many FDA-approved medications that could be used as labeled or in an extralabel manner under 21 CFR Part 530 for the same indications. If a veterinarian determines that a compounded oxantel pamoate/praziquantel/pyrantel pamoate product is needed, a patient-specific prescription should suffice.
Pentosan polysulfate sodium (12/20/2022)	dog, cat, horse	capsules oral suspension injectable solution	10-800 mg 75-400 mg/ml 100-250 mg/ml	Zycosan (NADA 141-599) (pentosan polysulfate sodium 250 mg/ml) solution for injection is FDA-approved for use in horses for the control of clinical signs associated with osteoarthritis. There are numerous FDA-approved products that can be used as labeled or in an extralabel manner under 21 CFR part 530 in dogs, cats, and horses.
Pergolide mesylate (4/21/2023)	horse	capsule oral granules oral suspension oral paste oral powder packet tablets, flavored transdermal gel	any	There is a marketed FDA-approved animal drug containing the same active ingredient, in the same or similar dosage form, that can be used as labeled in horses, and the drug is not typically needed urgently. If the veterinarian determines a different drug formulation is needed, a patient-specific prescription can be filled.
Phenylbutazone (11/3/2023)	horse	any	any	There are marketed FDA-approved drugs containing the same active ingredient, in the same or similar dosage forms that can be used as labeled in horses, and FDA-approved products that can be used in an extralabel manner under 21 CFR Part 530. If the veterinarian determines that a different dosage form is needed the FDA-approved formulations can be used until a patient-specific prescription is filled.
Phenylpropanolamine (11/27/2023)	dog, cat	any	any	Phenylpropanolamine should not be needed urgently to prevent animal suffering or death. FDA-approved phenylpropanolamine products can be used as labeled or in an extralabel manner under 21 CFR Part 530. If an alternative formulation is needed, this could be achieved with a patient-specific prescription.
Pimobendan (11/17/2023)	dog cat	any any, other than oral suspension and solution	any any, other than 2 – 2.5 mg/ml	FDA-approved VETMEDIN (NADA 141- 273) can be used as labeled in dogs, or in an extralabel manner under 21 CFR Part 530 in cats. Pimobendan BDS for compounding an oral suspension and solution (2 – 2.5 mg/ml) for cats is currently on the List of Bulk Drug Substances for Compounding Office Stock Drugs for Use in Nonfood-Producing Animals and can be used in an urgent situation until a patient-specific prescription for another dosage form can be filled, if needed.
Praziquantel (11/20/2023)	dog, cat, horse	any	any	Praziquantel is FDA-approved as an injectable solution (NADA 111-607) and as oral tablets (NADA 111-798) for use in cats and dogs. Praziquantel is FDA-approved for use in horses as part of a combination product with ivermectin (NADA 141-214 and NADA 141-215) and with moxidectin (NADA 141-216). These FDA-approved formulations should provide sufficient options for urgent use in cats, dogs, and horses. If a veterinarian deems an alternative formulation of praziquantel is necessary, a patient-specific prescription should suffice.
Praziquantel/pyrantel pamoate (11/20/2023)	dog, cat	any	any	There are several FDA-approved formulations of praziquantel and pyrantel pamoate that can be used as labeled or in an extralabel manner under 21 CFR Part 530 for urgent treatment. If a veterinarian deems an alternative formulation of this combination is necessary, a patient-specific prescription should suffice.
Prazosin (2/28/2023)	dog, cat	soft chewable treat transdermal gel capsule	0.5 - 1 mg 2.5 - 10 mg/ml 1 - 20 mg	FDA-approved prazosin drug products for humans can be used in an extralabel manner under 21 CFR Part 530 in most dogs and cats. Prazosin is on the List of Bulk Drug Substances for Compounding Office Stock Drugs for Use in Nonfood-Producing Animals in several concentrations and dosage forms that can be used in small dogs and cats. The need for specialized drug formulations beyond these can be addressed using patient-specific prescriptions.
Pregabalin (2/8/2023)	dog, cat	capsules	10 - 55 mg	There are FDA-approved products that can be used in an extralabel manner under 21 CFR Part 530 to treat the same conditions in dogs and cats in an urgent situation, until a patient-specific prescription can be filled, if needed.
Pyrantel pamoate (11/20/2023)	dog, cat, horse	any	any	There are several FDA-approved formulations of pyrantel pamoate that can be used as labeled or in an extralabel manner under 21 CFR Part 530 for urgent treatment. Additionally, there are several FDA-approved medications containing different active ingredients that could be used as alternatives to pyrantel pamoate for the same indications if deemed appropriate by the veterinarian. If a veterinarian deems an alternative formulation of pyrantel pamoate is necessary, a patient-specific prescription should suffice.
Reserpine (10/11/23)	horse	any	any	FDA-approved drugs could be used as labeled or in an extralabel manner under 21 CFR Part 530 in the short-term, until a patient-specific prescription for reserpine can be filled for longer-term use, if needed.
Selegiline (10/26/2023)	dog, cat	any	any	There are FDA-approved animal and human drug products containing selegiline that can be used as labeled, or in an extralabel manner under 21 CFR Part 530, to treat the nominated conditions in dogs and cats. Selegiline is not typically needed urgently; a patient-specific prescription can be filled, if needed.
Sodium bromide (7/6/2023)	dog	capsules oral solution	any any	KBroVet-CA1 (potassium bromide, NADA 141-544) is conditionally approved for use in dogs. If a compounded preparation of sodium bromide is needed, a patient-specific prescription should suffice.
Sucralfate (2/28/2023)	dog, cat, horse dog, horse horse	capsules oral paste oral suspension oral powder oral powder (packet)	500 - 1,100 mg 250 - 500 mg/mL 2.5 - 500 mg/mL 250 mg/dose to 12 g/dose 10 g/packet	There are marketed FDA-approved human drugs containing sucralfate, in the same or similar dosage forms, that can be used in an extralabel manner under 21 CFR Part 530 to treat the same conditions in dogs, cats, and horses in an urgent situation. The FDA-approved human drugs can be used until a patient-specific prescription for a different dosage form is filled, if needed.
Telmisartan (2/22/2023)	dog, cat	capsules oral suspension soft chew treats flavored tablets	0.5-47 mg 1-180 mg/mL 2-20 mg 10 mg	There are FDA-approved products that can be used as labeled, or in an extralabel manner under 21 CFR Part 530, to treat the same conditions in dogs and cats in an urgent situation, until a patient-specific prescription can be filled, if needed.
Toceranib phosphate (2/8/2023)	dog, cat	capsules oral suspension soft chew treat	2 - 180 mg 5 - 115 mg/ml 7 - 65 mg	Toceranib phosphate is FDA-approved for dogs (Palladia®, NADA 141-295) and can be used in an extralabel manner under 21 CFR Part 530 in cats. If a different dosage form is needed for longer term treatment of a specific patient, a patient-specific prescription can be filled.
Trilostane (7/6/2023)	dog, cat	any	any	Trilostane should not be needed for urgent treatment to avoid animal suffering or death. Additionally, FDA-approved products can be used as labeled, or in an extralabel manner under 21 CFR Part 530, in an urgent situation, until a patient-specific prescription can be filled, if needed.
Vinblastine (11/15/2023)	dog, cat	any	any	Vinblastine is not typically needed urgently, and FDA-approved products can be used as labeled, or in an extralabel manner under 21 CFR Part 530 until a patient-specific prescription can be filled, if needed.
Xylazine (3/28/2023)	any	any	any	FDA-approved xylazine products, can be used as labeled, or in an extralabel manner under 21 CFR Part 530, as a single agent or in combined drug protocols for sedation or immobilization of the nominated species.

NONFOOD-PRODUCING MINOR SPECIES

Bulk Drug Substance (BDS)	Species	Dosage form(s)	Strength/concentration	Reason
Amikacin (2/8/2023)	birds, guinea pigs, chinchillas, hamsters, rats, mice, fish, and reptiles (including snakes, turtles, tortoises)	injectable solution	200 mg/ml	If an injectable solution is needed for urgent treatment, Amiglyde-V (NADA 127-892) or the amikacin injectable solutions FDA-approved for use in humans can be used in an extralabel manner under 21 CFR Part 530.
Amoxicillin (10/11/23)	non-human primates in a research setting	oral suspension	any	There are FDA-approved products that can be used as labeled or in an extralabel manner under 21 CFR Part 530 to treat cats and dogs in an urgent situation, until a patient-specific prescription can be filled, if needed.
Azithromycin (4/20/2023)	guinea pigs, birds (nonfood-producing), assorted captive exotic and zoo species rabbits	any any	any any	Insufficient information was submitted to support the need for urgent use in these species. Rabbits (except laboratory rabbits) are considered food-producing animals. Review of BDS nominations for food-producing animals is limited to antidotes for food-producing animals and sedatives and anesthetics for free-ranging wildlife.
Buprenorphine HCl (4/24/2023)	captive non-human primates, captive marine mammals large cats, bears, small exotic mammal pets, rodents (e.g., mice and rats), ferrets, large zoo animals rabbits	injectable polymeric matrix solution injectable solution oral solution injectable polymeric matrix solution injectable solution oral solution	any, except for 5.0-10 mg/ml any any any any any any	FDA-approved injectable solution is available as labeled for administration or for extralabel use under 21 CFR Part 530 for injection or oral administration. Specialty formulations can be obtained via patient-specific prescription and are not generally needed as office stock. Rabbits (except laboratory rabbits) are considered food-producing animals. Review of BDS nominations for food-producing animals is limited to antidotes for food-producing animals and sedatives and anesthetics for free-ranging wildlife.
Butorphanol-Azaperone-Medetomidine (BAM) (2/1/2022)	laboratory animals (mice, rats, and rabbits)	fixed-combination injectable solution	butorphanol (27.3 mg/ml)-azaperone (9.1 mg/ml)-medetomidine (10.9 mg/ml)	Butorphanol and medetomidine are FDA-approved animal drugs available in concentrations that can be used in an extralabel manner under 21 CFR part 530 for sedation and anesthesia in laboratory animals. While FDA-approved azaperone is not marketed in the United States, azaperone tartrate is included on the List of Bulk Drug Substances for Compounding Office Stock Drugs for Use in Nonfood-Producing Animals and can be used to compound office stock for use in laboratory animals.
Carprofen (12/19/2023)	non-human primates	any	any	FDA-approved animal drugs (carprofen and other non-steroidal anti-inflammatory drugs) can be used in an extralabel manner under 21 CFR Part 530 to treat the nominated conditions. Specialty formulations can be obtained via patient-specific prescription and are not generally needed as office stock.
Chloramphenicol (2/28/2023)	small mammal, birds	oral capsule oral suspension otic ointment/solution/suspension	30 - 1000 mg 125 - 500 mg/mL 1 - 2%	Insufficient information was submitted to support the need for urgent use in birds and small mammals.
Clomipramine (7/5/2023)	birds	oral suspension	any	Clomipramine should not be needed for urgent treatment to avoid animal suffering or death. There are FDA-approved formulations of clomipramine that could be used in an extralabel manner under 21 CFR Part 530. If clomipramine is needed in a formulation that is not FDA-approved, a patient-specific prescription for compounded clomipramine should be sufficient.
Corticotropin (ACTH) (1/19/2023)	birds	injectable	40 & 80 units/ml	There are FDA-approved products that can be used in an extralabel manner under 21 CFR Part 530 in birds. There is lack of supporting information that this drug is needed on an urgent basis in these species.
Fenbendazole (11/20/2023)	small mammals, large mammals, assorted exotic and captive zoo species	any	any	Nominator did not explain why FDA-approved drugs would not be suitable for use in these species and did not provide sufficient information to support the urgent use of fenbendazole in these species.
Flunixin (10/31/2023)	ferrets, rodents, chinchillas, small mammals, zoo, exotic spp. rabbits	any any	any any	Insufficient supporting information was submitted for CVM to adequately review the use of flunixin meglumine in the broad categories of minor species nominated, in multiple dosage forms, for urgent use. Rabbits (except laboratory rabbits) are considered food-producing animals. Review of BDS nominations for food-producing animals is limited to antidotes for food-producing animals and sedatives and anesthetics for free-ranging wildlife.
Haloperidol (2/1/2022)	large herbivores (zoo hoofed stock), exotic pet birds	Injectable (lactate, aqueous) capsules oral solution oral suspension	20 mg/ml 60 mg 0.1 mg/ml to 2 mg/ml 2 mg/ml	Haloperidol is available as FDA-approved human drug products that can be used as formulated or used to compound a different concentration or to add flavor if needed.
Hydroxyzine HCL (11/27/2023)	ferrets, nonfood-producing avian spp. rabbits	any any	any any	Hydroxyzine HCl is not typically needed urgently to avoid animal suffering or death. Specialty formulations can be obtained via patient-specific prescription and are not generally needed as office stock. Rabbits (except laboratory rabbits) are considered food-producing animals. Review of BDS nominations for food-producing animals is limited to antidotes for food-producing animals and sedatives and anesthetics for free-ranging wildlife.
Itraconazole (11/27/2023)	birds, reptiles, rodents, and other small mammals rabbits	any oral formulation any oral formulation	any any	The nominator did not provide sufficient information to support the need for itraconazole compounded from BDS for urgent use in these species. Rabbits (except laboratory rabbits) are considered food-producing animals. Review of BDS nominations for food-producing animals is limited to antidotes for food-producing animals and sedatives and anesthetics for free-ranging wildlife.
Marbofloxacin (11/15/2023)	assorted captive exotic and zoo species, birds (nonfood-producing), reptiles rabbits	any any	any any	The nominated animal groups are overly broad and non-specific and insufficient information was submitted to support the need for urgent use in these animals. Rabbits (except laboratory rabbits) are considered food-producing animals. Review of BDS nominations for food-producing animals is limited to antidotes for food-producing animals and sedatives and anesthetics for free-ranging wildlife.
Naloxone hydrochloride (2/1/2022)	bears, birds, camelids, canids, pocket pets, cervids, otters, primates, rabbits, lab rodents, ratites, sheep, and free-ranging wild animals	injectable solution	1 mg/ml	There are FDA-approved naloxone 1 mg/ml injection products that can be used in animals in an extralabel manner under 21 CFR part 530.
Oxantel pamoate/praziquantel/pyrantel pamoate (11/20/2023)	ferret, reptiles	any	any	Nominator did not explain why FDA-approved drugs would not be suitable for use in these species and did not provide sufficient information to support the urgent use of this drug combination in these species.
Praziquantel (11/20/2023)	captive exotic and zoo species, small mammals, birds, rodents, chinchilla, ferret, snakes, tortoises, camelids, amphibians, fish rabbits	any any	any any	Nominator did not explain why FDA-approved drugs would not be suitable for use in these species and did not provide sufficient information to support the urgent use of praziquantel in these species. Rabbits (except laboratory rabbits), sheep, and goats are considered food-producing animals. Review of BDS nominations for food-producing animals is limited to antidotes for food-producing animals and sedatives and anesthetics for free-ranging wildlife.
Praziquantel/pyrantel pamoate (11/20/2023)	ferret, reptiles rabbit, sheep, goat	any any	any any	Nominator did not explain why FDA-approved drugs would not be suitable for use in these species and did not provide sufficient information to support the urgent use of this drug combination in these species. Rabbits (except laboratory rabbits), sheep, and goats, are considered food-producing animals. Review of BDS nominations for food-producing animals is limited to antidotes for food-producing animals and sedatives and anesthetics for free-ranging wildlife.
Pyrantel pamoate (11/20/2023)	birds, reptiles, small mammals, donkeys, camelids, rodents	any	any	Nominator did not explain why FDA-approved drugs would not be suitable for use in these species and did not provide sufficient information to support the urgent use of pyrantel pamoate in these species.
Sodium chloride/edetate disodium (12/5/2023)	captive marine mammals	any	any	The BDS nomination did not include information to support the urgent use of this drug in marine mammals, and there is a lack of supporting information in the scientific literature about the use of this drug in these species or that it would be needed on an urgent basis as office stock. If a compounded preparation of ophthalmic sodium chloride/edetate disodium is needed, a patient-specific prescription should suffice.
Trilostane (7/6/2023)	small mammals	any	any	No information was submitted regarding the use of trilostane in small mammals.
Xylazine (3/28/2023)	any	any	any	FDA-approved xylazine products, can be used as labeled, or in an extralabel manner under 21 CFR Part 530, as a single agent or in combined drug protocols for sedation or immobilization of the nominated species.

FOOD-PRODUCING ANIMALS OR FREE-RANGING WILDLIFE SPECIES

Bulk Drug Substance (BDS)	Species	Dosage form(s)	Strength/concentration	Reason
Azithromycin (4/20/2023)	rabbits	any	any	Azithromycin is not an antidote, sedative, or anesthetic.
Buprenorphine HCl (4/24/2023)	rabbits, free-ranging wildlife	any	any	Buprenorphine is not an antidote, sedative, or anesthetic.
Flunixin (10/31/2023)	rabbits, free-ranging wildlife	any	any	Flunixin meglumine is not an antidote, anesthetic or sedative.
Hydroxyzine HCl (11/27/2023)	rabbits	any	any	Hydroxyzine HCl is not an antidote, sedative, or anesthetic.
Itraconazole (11/27/2023)	rabbits	any	any	Itraconazole is not an antidote, sedative, or anesthetic.
Marbofloxacin (11/15/2023)	rabbits	any	any	Marbofloxacin is not an antidote, sedative, or anesthetic.
Naloxone hydrochloride (2/1/2022)	sheep and free-ranging wild animals	injectable solution	1 mg/ml	There are FDA-approved naloxone 1 mg/ml injection products that can be used in animals in an extralabel manner under 21 CFR part 530.
Praziquantel (11/20/2023)	rabbit, sheep, goat, fish	any	any	Praziquantel is not an antidote, sedative, or anesthetic.
Pyrantel pamoate (11/20/2023)	rabbit	any	any	Pyrantel pamoate is not an antidote, sedative, or anesthetic.
Xylazine (3/28/2023)	any	any	any	FDA-approved xylazine products, can be used as labeled, or in an extralabel manner under 21 CFR Part 530, as a single agent or in combined drug protocols for sedation or immobilization of the nominated species.

These bulk drug substances are not covered by FDA’s enforcement discretion policy described in GFI #256. FDA will consider them for inclusion on any List if they are nominated again with new information, using the nomination procedure described in the appendix to GFI #256.