Welcome to the Pharmaceutical Service at the UC Davis Veterinary Medical Teaching Hospital. We provide systems-based services including drug procurement, drug preparation, drug distribution, drug information, and drug dosage monitoring services for all patients seen at the VMTH. All veterinary orders/prescriptions for medications are reviewed for appropriateness of therapy and entered into a pharmacy database. This database is available to veterinarians 24 hours/day and provides all prescription information. A central distribution area (the Main Pharmacy VMTH) and a satellite pharmacy (in the Center for Companion Animal Health building) support the delivery of product-related and clinical services to patients and other veterinary health care providers of the VMTH and to veterinarians and others at other locations.
Clinical pharmacy specialists provide direct patient care throughout the institution. Clinical pharmacists maintain faculty appointments through the Department of Medicine and Epidemiology and are active, integral members of the veterinary service teams. They assist them by providing services including; drug selection, drug dosing, drug information, medication counseling, and other patient focused services to optimize drug therapy outcomes.
Our clinical pharmacists also supply patient and health care provider education, participate in Adverse Drug Reaction (ADR) Reporting and Medication Error Programs, participate in investigational drug research, develop drug and therapeutic policy and procedures, and other cost and quality enhancement systems.
Our strategy is to provide first class pharmaceutical care while continuing to develop methods to improve the quality of our services. To achieve this, we have ongoing inpatient and outpatient dispensing services provided by the employees of the pharmaceutical care team.
Pharmaceutical care includes, but is not limited to, appropriate, accurate, and timely dispensing of medications to patients, assuring compliance with drug related regulations set by the California State Board of Pharmacy, the Veterinary Medical Board, and the Federal Government governing these practices. Professional and ethical practice is maintained at all times through adherence to the codes of professional conduct.
Clinical Activities and Procedures
Clinical Pharmacists Drug Information Services
Clinical pharmacists provide comprehensive direct patient care services, collaborate and initiate clinical research, and promote rational drug therapy. Clinical services provided are tailored to patient care needs and include drug information, dosing advice, adverse reaction information, monitoring, pharmacokinetic monitoring and client education. Our pharmacists are trained to search the available veterinary and pharmacy literature in response to a wide variety of questions posed by VMTH faculty, staff and students, VMTH clients, outside clinicians, and the general public.
Clinical and Didactic Teaching
Clinical Pharmacists are also involved in teaching and training of veterinary students both in didactic courses and on rotations, VMTH staff, and pharmacy students performing intern clerkships from various schools of pharmacy. In addition, our pharmacists participate in the education of other practitioners in the veterinary and pharmacy fields by writing continuing education (CE) and presenting in person and online CE courses.
Frequently Asked Questions
- How long will I need to wait for my animal's prescription to be filled and how will I know when it is ready?
- If the prescription has refills and we have the product on the shelf, your prescription will generally be filled within 10 minutes. Just call the main pharmacy at (530) 752-0187 and request that the prescription be refilled.
Medication orders can take up to 24 to 72 hours if there are no refills or if the doctor is not available. Special orders may take even longer if ordered from certain vendors. You should call the Main Pharmacy to check on your prescription. Medications can also be mailed to you for a fee.
- How do I refill my animal's prescriptions?
- If your veterinarian has given you refills for your prescription you may call the Main Pharmacy and request that it be filled again. The best way to do this is to call in the prescription number. The number of refills remaining is noted on the bottom of your vial. If your veterinarian has not given refills for the medication, you may request that we contact the veterinarian for you. Typically, the veterinarian will approve further refills if they have seen the animal within the past year and feel that the animal needs to be on the medication.
- What if I need refills and the veterinarian that saw my animal has left the University?
- If the doctor that has physically seen your animal has left the University, it is up to the discretion of the new veterinarian to either approve a refill or ask to see the animal before continuing refills. By law, the veterinarian must have a doctor-client-patient relationship with you and your animal within the year to prescribe medications to the animal. But, because we are a teaching facility and most clinicians spend a short period of time training here, typically if your animal is on a maintenance medication that does not require careful monitoring, the new veterinarian will provide a refill until an appointment can be made.
- How do I pay for my animal's medications?
- All medications are charged through the pharmacy to the Veterinary Medical and Administrative Computing System (VMACS) to your account. There are three cashier's desks located throughout the hospital. Cashiers are responsible for collecting all money on your account. If you have questions about the Pharmacy charges you may contact the Main Pharmacy directly or call (530) 752-0187. The costs of medications are constantly changing, and the cost to the client changes likewise as drug items are received.
- Can I fill my animal's prescriptions at my local pharmacy?
- If the medication is a human labeled drug it can be filled at your local pharmacy. If you prefer to use an outside pharmacy, please request a written prescription from your veterinarian that can be filled wherever you like. You may also want to request refills, so that it will be easier for you to get more medication when needed. For prescriptions that have already been filled here initially, it would be good to check whether the medication is available at your pharmacy before you request that refills be transferred. Some prescription drugs may not be readily available at outside pharmacies and adequate time should be allowed for the pharmacy to order the medication. If the prescription has refills, the pharmacy you select should call the VMTH Pharmacy at (530) 752-0187 directly to request a transfer of the prescription.
There are some prescriptions (veterinary-only and controlled drugs, i.e. phenobarbital, diazepam, lorazepam, clonazepam, hydrocodone, tramadol etc.) that cannot be transferred to an outside pharmacy because they are not able to obtain the medication or your VMTH veterinarian may not have the proper license to prescribe to outside pharmacies. Your referring veterinarian may be able to provide the medication or write a prescription for these medications.
- Can I get a refund on prescriptions my animal did not take?
- California State Health Code forbids the resale of any prescription medication that has been dispensed to a patient. Federal law also stipulates that any medications that leave the pharmacy cannot be returned for reuse due to the potential for tampering or incorrect storage of medications. To eliminate this problem, it is prudent to buy only small quantities of a medication that your animal has not taken previously until you know that the animal tolerates the therapy.
- How can I avoid running out of medications for my animal?
- First check the label on your bottle to see if you have refills. If you do not see refills indicated, call the pharmacy at (530) 752-0187 as soon as possible to initiate a refill request to be addressed to your veterinarian. Do not wait until you are out of medication. Always check your supply before weekends and holidays when it is difficult to make contact with our veterinarians. Mailing service from the University is slower on these occasions and it may take up to a week for you to receive your medications so please plan ahead especially around the holidays!
- How much does it cost to mail prescriptions?
- We can mail your prescriptions to you if you wish. There is a fee for sending regular US Postal Service from campus (currently $10.00). If you wish to have your prescription sent FedEx overnight, the current fee is $35.00. Fees are subject to change, so please check current fees when requesting your medication to be mailed. Controlled substances must be sent FedEx or picked up at the VMTH. There is no US Postal Service after 1 p.m. on Fridays. These medications will be mailed out on Monday. FedEx prescriptions can be sent out on Fridays before 4 p.m. for Saturday delivery for a $47.50 fee.
- Do you mail prescriptions out of state?
- We cannot legally mail your prescriptions out of state. It is best to find a local veterinarian and work with them to obtain the medication your pet needs if you have moved out of state. If you are planning a trip, for most medications, you may request a larger supply from us or your veterinarian prior to your trip or you may have a friend or relative pick the medication up for you and mail it themselves in an emergency.
- Can refrigerated prescriptions be mailed?
- Refrigerated prescriptions can be mailed on ice packs but it is not recommended, especially during summer months where the product may get too hot during transport. If someone insists that we mail products in the heat, we relinquish all responsibility for the viability of the product and it is up to the client to make certain that the product is quickly retrieved from the mail before it is damaged by heat. For all refrigerated products, we further recommend that they be sent FedEx overnight and make sure someone is available to sign for them and get them into the refrigerator as soon as possible.
- Who do I contact if I believe there has been an error on my animal's medication?
- If your medication looks different or has changed, it is prudent to double check that the medication is correct. Typically, the change is due to a change in the manufacturer and we usually place an auxiliary label on the bottle indicating the change. But occasionally an error may occur and it is important to notify us of any errors. We keep track of every reported error and use them to educate our staff in order to try to avoid the same error in the future. If you suspect a problem or wish to verify your prescription with us, you should call the main pharmacy at (530) 752-0187, and ask to confirm that you have the correct medication. If your animal has taken an incorrect medication or has been harmed by an error in their medication, please notify us as soon as possible.
- If my veterinarian outside the University prescribes a drug for my animal, can I have it filled at UC Davis?
- Unfortunately, we are not able to fill prescriptions written by clinicians without a VMTH appointment (i.e. your local veterinarian). This is regulated by federal law. Prescriptions can only be filled by our pharmacies if they have been written by veterinarians with privileges at the VMTH and filled for patients being treated at the VMTH.
- What do I do if the medication that my animal takes is no longer available?
- Medications can be subject to availability problems and/or be taken off the market. If the VMTH is unable to purchase it, it is likely that other pharmacies cannot procure it either. In this case, your veterinarian will have to write a prescription for an alternative medication.
- Can I use drugs after the expiration date?
- Manufacturers place expiration dates on drugs based on how long they have studied the stability of the drug in a particular dosage form. After the expiration date, one can no longer verify that the drug is either active or safe. Some drugs, such as tetracyclines may actually be inactivated to toxic entities. Therefore, we cannot recommend that drugs be used past the expiration date on the original container.
- If my animal vomits after I give medicine, should I give it again?
- Whether or not a dose should be given again depends on how long after you gave the medication the animal vomited. Typically, most drugs are absorbed within 20-30 minutes after given by mouth. Vomiting after this amount of time is not related to the drug in the stomach as the vast majority, if not all, has already been absorbed. In this case do not give another dose.
In some cases, particularly with large tablets or capsules in small dogs, the entire tablet or capsule can be found in the vomit indicating that it did not get absorbed at all. In this case you may want to ask the veterinarian if another formulation of the drug is available.
If the drug is a chemotherapeutic agent (cyclophosphamide, lomustine, etc.) or another potentially toxic drug at high doses, it would be best to check with your veterinarian or our pharmacist before giving another dose.
- Which medications need to be given on an empty stomach and which are best given with food?
- Certain foods effect (increase or decrease) the absorption of drugs into the body. Generally, foods interfere with drug absorption; however, some drugs must be given with food to decrease the irritation they may have on the stomach lining. Several examples of drugs that should be given with or without food include:
Your doctor should indicate when to give your animals medications with food. If nothing is stated, then it is probably safe to give on an empty stomach with water. This means one hour before eating or two hours after. All non-steroidal anti-inflammatory drugs (NSAIDs) and steroids (prednisone) should be given with food to avoid ulcer formation. For further information, there are multiple websites were you can look up specific drugs, or you can call the VMTH and speak to one of our pharmacists.
Agents best on Empty Stomach
Agents best with food
Itraconazole Capsules (Acidic food)
* Drug should be followed by water
** If stomach upset occurs, may give with food
- Where can I find information about drug interactions and side effects?
- The package insert has most of the major side effects and drug interactions listed for drugs that are made for humans. You can request a package insert whenever you get a new drug from the pharmacy. Package inserts for drugs labeled only for animals may have some but not all the information. If the drug is purchased from the VMTH we are currently working to complete drug monographs that will provide most of the information you will need. Further details on medications can also be found on various websites or by calling the VMTH Drug Information Line at (530) 752-4858. Drug information is available during weekday normal pharmacy hours (8 a.m. - 6 p.m. Monday - Friday).
- Are OTC medications from pharmacies safe to give my animal?
- No, most over-the-counter (OTC) medications can be very hazardous to your animal. The OTC drug that is most frequently responsible for severe toxicity to animals is the NSAID ibuprofen (brand names Motrin and Advil). Animals metabolize medications very differently than people and even in small doses drugs like acetaminophen (Tylenol) that is perfectly safe in infants, can kill a cat. There are also ingredients that are used to flavor OTC drugs or keep them in solution that are toxic to animals (xylitol, etc.). Unless your veterinarian has specifically told you to buy a particular OTC drug from a pharmacy, do not give OTC medications to your pets. In addition, pharmacists who work in pharmacies that only dispense human medications (i.e. CVS, Walgreens, etc.) are usually not trained in veterinary pharmacy and unknowingly may suggest products that could be harmful.
- How do I know if the medications I am giving my animal are safe during pregnancy and lactation?
- In human medicine, there are references that evaluate drug use during pregnancy or lactation. These references can be used to predict if drugs can be safely used in most animal species. In fact, much of the data is derived from animal species. There are very few references that evaluate drugs in pregnancy and lactation in companion animals. References can be found in dairy cattle where products that are heavily secreted into milk may be hazardous to humans consuming the milk products.
In general, most products are excreted into milk and the infants, pups, etc. will be exposed to the medication. This may not be important for drugs that are safe to use in neonates or infants, but could be problematic for drugs affecting growth and development (chemotherapeutics, hormones, steroids, enrofloxacin, tetracyclines, etc. that may affect bone marrow, growing limb buds, alter bone or cartilage development or discolor teeth).
Most drugs also cross the blood-placenta barrier, some more than others. If your animal is pregnant, veterinarians will assess the risk of putting your animal on medications versus the benefits. In general, most side effects to drugs that affect growing fetuses will occur early in the pregnancy when limb buds are forming and development of organs is occurring. In later pregnancy, the drug will generally have fewer side effects. Please talk to your veterinarian if you believe your animal is pregnant. If you or your veterinarian would like more information, please call the VMTH Drug Information Line at (530) 752-4858.
- What vaccines does UC Davis recommend?
- The large number and types of vaccines available currently has made it difficult to establish specific protocols that work for most animals. Therefore, your veterinarian is the best person to assess your animal's individual needs for certain vaccines which is based on their exposure to other animals, the environment, their medical condition, their prior history of vaccinations, the competence of their immune system and other factors. Please talk to your veterinarian about what they believe is best for your animal.
- What should I do if my animal eats my medication?
- It is very important that you quickly contact a veterinarian. There are many medications designed for safe use in humans that can be very toxic to animals (NSAIDs, birth control pills, etc.). If your animal just ingested the medication, the veterinarian may want to induce vomiting as soon as possible before the drug is absorbed. If you wait too long (20 to 30 minutes for most drug formulations given orally), the drug may become fully absorbed and depending on the medication may cause serious side effects in your animal. It is important to keep your local Animal Poison Control phone numbers handy and have hydrogen peroxide available (to induce vomiting ONLY after you speak with and if recommended by your veterinarian) in the case that an accidental ingestion occurs.
- How do I get rid of old medications?
- The Office of National Drug Control Policy in conjunction with the Department of Health and Human Services and the Environmental Protection Agency has issued consumer-driven guidelines for the proper disposal of unused, unneeded, or expired prescription drugs. The consortium recommends that drugs be removed from their original packaging and mixed with an undesired substance, such as used coffee grounds or kitty litter, and placed in impermeable, non-descript containers, such as empty cans or sealable bags, prior to disposal. The guideline instructs clients to refer to printed material accompanying medication for flushing restrictions. To reduce the incidence of diversion, the following can be flushed down the toilet for disposal: fentanyl citrate (Actiq), methlyphenidate (Daytrana), fentanyl (Duragesic), oxycodone (OxyContin), morphine sulfate (Avinza), entecavir (Baraclude), atazanavir sulfate (Ryataz), gatifloxacin (Tequin), stavudine (Zerit), meperidine, oxycodone/acetaminophen (Percocet), sodium oxybate (Xyrem), fentanyl (Fentora). Finally, patients are urged to take advantage of community pharmaceutical take-back programs at central locations locally described at your sanitary service. http://www.whitehousedrugpolicy.gov/drugfact/factsht/proper_disposal.html
- What should I do with used needles and syringes that have been used on my animal?
- Biohazard buckets are often for sale in pharmacies. If you are a VMTH client, these can also be purchased from Central Services at the VMTH. However, any large, thick, plastic container that can be closed tightly will work just as well. Old bleach containers or other laundry soap containers are usually thick enough and have openings large enough for used needles and syringes. If you are a client of the VMTH, when these are full, you can bring them back with you for disposal. Many referring veterinarians are also happy to accept these containers for disposal as well. Alternatively, check with your local sanitary service for recommended procedures in your area.
- Why does my animal’s medication say to wear gloves now, but it didn’t previously?
- NIOSH, which provides recommendations on safe use of hazardous drugs, has recently revised its list of hazardous drugs. The drugs on the list are thought to be hazardous when ingested by humans. However, we don’t know what the risks are with skin contact through daily administration to your pet or if accidental ingestion or eye contact would occur. The likelihood of adverse effects is low for the average person, but if you are pregnant or trying to become pregnant, extra caution is advised. We strive to provide the most current precautions and information to our clients. For the medications that state “wear gloves,” we recommend wearing gloves as a precaution when administering the medication, especially if your animal commonly spits out the medication and a wet pill needs to be re-administered.
Info for Industry
In order to expedite dialogue between the VMTH and the industry, the following policies have been adopted:
- Drug company representatives are asked to call only at the main pharmacy. Printed material, samples or information left at the pharmacy will be distributed to either specific clinicians or to the clinician(s) most likely to find the material useful.
- The remainder of the hospital (including offices, exam rooms, barns, etc.) will be 'off-limits' without a specific appointment made with an individual clinician.
In order to contact clinicians for specific appointments, the following numbers can be used:
Large animal clinicians: (530)-752-1393
Large animal ambulatory clinicians: (530)-752-0292
Small animal clinicians: (530)-752-1393
The VMTH appreciates the cooperation and generosity of the industry and looks forward to a continuation of this mutually beneficial relationship.