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All About Adequan Dosing


Our 22 yr old QH mare has been on Adequan for more than one year. She had the proper loading dose and has had a dose each month since then, with her last dose in July, 2013. Since she did not have a dose in August, will we have to do the loading dose again when the drug is available? Thank you. LS, Michigan

Dear LS,

Good news! Those seven injections that were given every four days? That wasn’t a “loading dose,” that was actually the correct way to administer Adequan. It turns out there IS no official “maintenance dose” from the company such as the once-a-month injections that are commonly given. The only regimen that has been proven to reverse the effects of degenerative joint disease (DJD or osteoarthritis) in horses and that is approved by the FDA is a 500mg intramuscular injection of Adequan once every four days for seven treatments. Once-a-month dosing will offer relief for a four day period but is unable to reestablish the cartilage that has degraded from training, conformation, or age-related changes.

According to Luitpold, the manufacturer, a more effective schedule both in terms of cost and benefit to the joints would be a seven-dose series once or twice a year to address on-going DJD. So until your veterinarian evaluates your mare and together you determine that it’s time to give her the seven-dose series again, absolutely no harm has been done by not being able to give her one injection of Adequan each month!

Of course, the absolute best regimen would be a combination of the seven-dose Adequan series once or twice a year and daily administration of an oral joint supplement. This combined approach would ensure she was starting with the healthiest joints possible and keeping them that way with consistent, optimum levels of key active ingredients.

Lydia F. Gray, DVM, MA SmartPak Staff Veterinarian and Medical Director Dr. Lydia Gray has earned a Bachelor of Science in agriculture, a Doctor of Veterinary Medicine (DVM), and a Master of Arts focusing on interpersonal and organizational communication. After “retiring” from private practice, she put her experience and education to work as the American Association of Equine Practitioner’s first-ever Director of Owner Education. Dr. Gray continues to provide health and nutrition information to horse owners through her position at SmartPak, through publication in more than a dozen general and trade publications, and through presentations around the country. She is the very proud owner of a Trakehner named Newman that she actively competes with in dressage and combined driving. In addition to memberships in the USDF and USEF, Dr. Gray is also a member of the Illinois Dressage and Combined Training Association (IDCTA). She is a USDF “L” Program Graduate and is currently working on her Bronze Medal. Find Dr. Gray on Google+

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12 comments on “All About Adequan Dosing
  1. Melissa says:

    Does this apply to pentosan as well?

    • SmartPak SmartPak says:

      Thanks for your question. Unfortunately, pentosan polysulfate is not approved for use in the U.S. for equine arthritis. This means neither the manufacturing process nor safety and efficacy studies have been reviewed by the FDA. For dosage, dosage intervals, and other questions about this product, your veterinarian is your best source of information. – Dr. Lydia Gray

  2. 22 years old seems pretty old for a horse. You must take really good care of it.

  3. Melissa says:

    So if I am using the adequan injection once a month and not using another joint supplement is what I am doing not effective at all?

    • SmartPak SmartPak says:

      Thanks for your question. You and your veterinarian are the most well-equipped for making decisions about incorporating Adequan I.M. into your individual horse¹s overall joint support strategy. While the only regimen that has been proven to reverse the effects of DJD (and is approved by the FDA) is one injection every four days for seven treatments, many owners choose to administer the product just prior to a clinic or show to maximize cartilage protection during a stressful event.
      That¹s because Adequan I.M. reaches peak therapeutic levels in joints two hours after intramuscular injection and can be detected in cartilage up to
      96 hours afterwards. We hope this additional information helps! – Dr.
      Lydia Gray

  4. Audrey reynolds says:

    What days are “every 4 days” for injecting Adequan…
    If I start on a Fri, is the next day Mon or Tues?

    • SmartPak SmartPak says:

      Great question! If the first injection was given on a Monday, the next injection would be given on Friday (the logic is: Tuesday would be every day, Wednesday would be every two days, Thursday would be every three days, so Friday would be every four days). The third injection would be the following Tuesday and so on.
      – Dr. Lydia Gray

  5. Melanie Vetter says:

    Will Adequa test positive at drug test? How long before a show should I administer Adequan?

    • SmartPak SmartPak says:

      Thank for your question, Melanie! While we can never say whether a drug will test positive or is legal, Adequan® i.m. is not currently listed on the USEF forbidden substance list. The manufacturer of Adequan does not have specific guidelines for how long before a more stressful event, like a horse show, Adequan should be administered and we would recommend working with your veterinarian to determine the ideal time to get started. In addition, some show organizations like USEF do have requirements as to how long before a show any injections may be given and we’d suggest reviewing the guidelines for all of the organizations under which you compete.

      – Dr. Lydia Gray

  6. Wendy says:

    So you give it once every 4 days for seven days? How much adequan should I be buying for that?

    • SmartPak SmartPak says:

      Hi Wendy,
      The manufacturers of Adequan® Equine I.M have a catchy slogan for their recommended protocol — 1/4/7 – or, give one vial (1) every four (4) days for a total of seven (7) treatments. That means it will take 28 days to complete the entire series. The series can be repeated on an annual basis or more frequently, if necessary. We encourage you to work with your veterinarian to find the product size and quantity that is most appropriate for your needs.
      – Dr. Lydia Gray

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