The product should be administered orally, once daily. To facilitate administration, the required daily dose should be placed in a small amount of water and/or mixed with molasses or other sweetener and agitated until dissolved. In this case, the dissolved tablets should be administered with a syringe. The whole amount should be administered immediately. Tablets should not be crushed.
Starting dose
The starting dose is 2 µg pergolide/kg (dose range: 1.3 to 2.4 µg/kg) body weight. Studies from the published literature cite the most common, average dose as 2 µg pergolide/kg with a range from 0.6 to 10 µg pergolide/kg (0.25 mg to 5 mg total daily dose per horse). The starting dose (2 µg pergolide/kg) should then be titrated according to the individual response as determined by monitoring (see below). Starting doses are recommended as follows:
Horse Body Weight | Number of Tablets | Starting Dose | Dosage Range |
200 - 400 kg | ½ | 0.5 mg | 1.3 - 2.5 μg/kg |
401 - 600 kg | 1 | 1.0 mg | 1.7 - 2.5 μg/kg |
601 - 850 kg | 1 ½ | 1.5 mg | 1.8 - 2.5 μg/kg |
851 - 1000 kg | 2 | 2.0 mg | 2.0 - 2.4 μg/kg |
Maintenance dose
Life long treatment is anticipated for this disease. Most horses respond to therapy and are stabilised at an average dose of 2 µg pergolide/kg body weight. Clinical improvement with pergolide is expected within 6 to 12 weeks. Horses may respond clinically at lower or varying doses; it is therefore recommended to titrate to the lowest effective dose per individual based on response to therapy, whether it is effectiveness or signs of intolerance. Some horses may require doses as high as 10 µg pergolide/kg body weight per day. In these rare situations, appropriate additional monitoring is advised.
Following initial diagnosis, repeat endocrinologic testing for dose titration and monitoring of treatment at intervals of 4 to 6 weeks until stabilisation or improvement of clinical signs and/or diagnostic testing occurs.
Clinical signs are: hirsutism, polyuria, polydipsia, muscle wasting, abnormal fat distribution, chronic infections, laminitis, sweating, etc.
The approach to treatment is the dose titration to the lowest effective dose per individual, based on response to therapy, whether it is effectiveness or signs of intolerance. Depending on the severity of the disease, time to treatment response may vary among individuals.
If clinical signs or the diagnostic testing have not yet improved at the first 4 to 6 week interval, the total daily dose may be increased by 0.5 mg. In case clinical signs have improved but are not yet normalised, the veterinarian may decide to titrate or not to titrate the dose, considering the individual’s response/tolerance to the dose.
In case clinical signs are not adequately controlled (clinical evaluation and/or diagnostic testing) it is recommended to increase the total daily dose by 0.5 mg increments every 4 to 6 weeks until stabilisation occurs and if the drug is tolerated at that dose. If signs of dose intolerance develop, treatment should be stopped for 2-3 days and reinstated at one-half of the previous dose. The total daily dose may then be titrated back up to the desired clinical effect by 0.5 mg increments every 2-4 weeks. If a dose is missed, the next scheduled dose should be administered as prescribed.
Following stabilisation, regular clinical assessment and diagnostic testing should be performed every 6 months to monitor treatment and dose. Where there is no apparent response to treatment, the diagnosis should be re-evaluated.