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Source overview
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View full clinical evidence and sources ↓Clinical evidence
Pending clinical review (PROPOSED)Rule-based (RULE_BASED)— applies to the facts and dose entries in this species selection; individual source records retain their own status.
Indications1
Pituitary pars intermedia dysfunction (PPID, equine Cushing's disease) — the definitive medical therapy
HorseExtra-label (EXTRA_LABEL)1 source record · View provenance
- Horse · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Pituitary pars intermedia dysfunction (PPID, equine Cushing's disease) — the definitive medical therapy — Extra-label (Plumb-era; Prascend later labeled)
- Horse · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Dose regimens6
This calculator performs arithmetic only on the sourced dosing field shown for each result — it does not verify the field's accuracy, does not select which field to use for a patient, and does not replace a veterinarian's order. Not for clinical use. Confirm every result against the primary source before dispensing.
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Adverse effects65
Anorexia (up to 10%) — The monitoring Keystone — drives the stop-ramp-restart protocol
HorseNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Horse · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Transient dullness/lethargy — Dopaminergic adjustment
HorseNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Horse · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Colic/diarrhea (occasional reports) — GI dopaminergic effects
HorseNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Horse · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pre-Approval Experience : A total of 122 horses treated with PRASCEND Tablets for six months were included in a field study safety analysis. *Three new cases and 7 pre-existing, recurring cases Inappetence or decreased appetite occurred at one or more meals in 40 of 122 horses treated with PRASCEND. At the baseline evaluation 1.6% of owners reported a history of inappetence or decreased appetite as compared to the 32.8% of horses that experienced inappetence or decreased appetite during the study. Most cases of inappetence were transient and occurred during the first month of treatment; however, some horses experienced sporadic inappetence throughout the study. Two horses required a temporary reduction in dose due to inappetence during the first month of the study. Both horses returned to their original dose within 30 days. Weight loss occurred in more than half of the horses in this study; however, weight loss that was considered abnormal was only reported in 11 horses. Lethargy was reported in 9.8% of horses during the study, and was not reported in any horses at the baseline evaluation. Behavioral changes were noted in 6 horses including aggression, kicking, agitation, nervous behavior and increased activity. One horse required a temporary reduction in dose due to energetic behavior during the first month of the study. Eight horses died or were euthanized during the study due to worsening of pre-existing conditions (laminitis, dental disease, septic tenosynovitis) or colic (strangulating lipomas, large colon volvulus). One mare was inadvertently enrolled in the study while pregnant and experienced dystocia resulting in the death of the foal. Post-Approval Experience (2019) : The following adverse events are based on post approval adverse drug experience reporting for PRASCEND. Not all adverse events are reported. It is not always possible to reliably estimate the adverse event frequency or establish a causal relationship to product exposure using these data. The following adverse events in horses are categorized in order of decreasing reporting frequency by body system and in decreasing order of reporting frequency within each body system: General : anorexia, lethargy, weight loss Gastrointestinal : diarrhea, abdominal pain/colic Dermatological : alopecia, hyperhidrosis, dermatitis Musculoskeletal : laminitis, muscle stiffness/soreness Neurological : ataxia, seizure, muscle tremors Behavioral : aggression (to other horses and humans), hyperactivity (anxiety, agitation), other behavioral changes (stud-like behavior, spooky, unpredictable, confused) Clinical pathology : anemia, elevated liver enzymes, thrombocytopenia The above adverse events were reported in some horses at starting dose levels, while in the others following a dose increase. Death (including euthanasia) has been reported. Adverse events have been reported in dogs following ingestion of tablets prepared for administration to horses. To report suspected adverse reactions, to obtain a Safety Data Sheet (SDS), or for technical assistance, contact Boehringer Ingelheim Animal Health USA Inc. at 1-888-637-4251. For additional information about adverse drug experience reporting for animal drugs, contact the FDA at 1-888-FDA-VETS or online at http://www.fda.gov/reportanimalae. Table 2 Summary of the most common adverse reactions (N=122) Clinical sign # Cases Cases (%) Decreased appetite 40 32.8 Lameness 22 18 Diarrhea/Loose stool 12 9.8 Colic 12 9.8 Lethargy 12 9.8 Abnormal Weight Loss 11 9 Laminitis* 10 8.2 Heart murmur 10 8.2 Death 8 6.6 Tooth disorder 8 6.6 Skin abscess 7 5.7 Musculoskeletal pain 6 4.9 Behavior change 6 4.9
Species not recordedOn-label (ON_LABEL)United States1 source record · View provenance
- Species not recorded · SPL section 34084-4 (ADVERSE REACTIONS SECTION) · United States · On-label (ON_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Pre-Approval Experience: A total of 122 horses treated with pergolide tablets for six months were included in a field study safety analysis. *Three new cases and 7 pre-existing, recurring cases Inappetence or decreased appetite occurred at one or more meals in 40 of 122 horses treated with pergolide tablets. At the baseline evaluation 1.6% of owners reported a history of inappetence or decreased appetite as compared to the 32.8% of horses that experienced inappetence or decreased appetite during the study. Most cases of inappetence were transient and occurred during the first month of treatment; however, some horses experienced sporadic inappetence throughout the study. Two horses required a temporary reduction in dose due to inappetence during the first month of the study. Both horses returned to their original dose within 30 days. Weight loss occurred in more than half of the horses in this study; however, weight loss that was considered abnormal was only reported in 11 horses. Lethargy was reported in 9.8% of horses during the study, and was not reported in any horses at the baseline evaluation. Behavioral changes were noted in 6 horses including aggression, kicking, agitation, nervous behavior and increased activity. One horse required a temporary reduction in dose due to energetic behavior during the first month of the study. Eight horses died or were euthanized during the study due to worsening of pre-existing conditions (laminitis, dental disease, septic tenosynovitis) or colic (strangulating lipomas, large colon volvulus). One mare was inadvertently enrolled in the study while pregnant and experienced dystocia resulting in the death of the foal. Post-Approval Experience (2019): The following adverse events are based on post approval adverse drug experience reporting for pergolide tablets. Not all adverse events are reported. It is not always possible to reliably estimate the adverse event frequency or establish a causal relationship to product exposure using these data. The following adverse events in horses are categorized in order of decreasing reporting frequency by body system and in decreasing order of reporting frequency within each body system: General: Gastrointestinal: Dermatological: Musculoskeletal: Neurological: Behavioral: Clinical pathology: anorexia, lethargy, weight lossdiarrhea, abdominal pain/colicalopecia, hyperhidrosis, dermatitislaminitis, muscle stiffness/sorenessataxia, seizure, muscle tremorsaggression (to other horses and humans), hyperactivity (anxiety, agitation), other behavioral changes (stud-like behavior, spooky, unpredictable, confused)anemia, elevated liver enzymes, thrombocytopenia The above adverse events were reported in some horses at starting dose levels, while in the others following a dose increase. Death (including euthanasia) has been reported. Adverse events have been reported in dogs following ingestion of tablets prepared for administration to horses. Table 2 Summary of the most common adverse reactions (N=122) Clinical sign # Cases Cases (%) Decreased appetite 40 32.8 Lameness 22 18 Diarrhea/Loose stool 12 9.8 Colic 12 9.8 Lethargy 12 9.8 Abnormal Weight Loss 11 9 Laminitis* 10 8.2 Heart murmur 10 8.2 Death 8 6.6 Tooth disorder 8 6.6 Skin abscess 7 5.7 Musculoskeletal pain 6 4.9 Behavior change 6 4.9
Species not recordedOn-label (ON_LABEL)United States1 source record · View provenance
- Species not recorded · SPL section 34084-4 (ADVERSE REACTIONS SECTION) · United States · On-label (ON_LABEL) · Pending clinical review (PROPOSED) · Rule-based
These are counts of spontaneously reported events, not proven adverse effects, causal relationships, or incidence rates.
Bars compare report counts within each species; they do not show incidence.
More reportsFewer reportsDog
- Accidental exposure44 reports
- Vomiting30 reports
- Emesis25 reports
- Emesis (multiple)17 reports
- Lethargy (see also Central nervous system depression in 'Neurological')17 reports
- Shaking7 reports
- Diarrhoea6 reports
- Lethargy (see also Central nervous system depression in Neurological)4 reports
- Ataxia3 reports
- Behavioural disorder NOS3 reports
- Nausea3 reports
- Dilated pupils2 reports
Cat
- Third eyelid protrusion3 reports
- Dilated pupils2 reports
- Accidental exposure1 reports
- Anxiety1 reports
- Behavioural disorder NOS1 reports
- Hallucination1 reports
- Hyperexcitation1 reports
- Hyperthermia1 reports
- Third eyelid extrusion1 reports
Monitoring1
Clinical: ACTH (season-aware reference ranges), clinical signs (hair coat, laminitis, PU/PD, muscle, lethargy), appetite from day 1, weight/body condition; periodic CBC/chemistry
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Monitoring Parameters · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Contraindications2
PRASCEND is contraindicated in horses with hypersensitivity to pergolide mesylate or other ergot derivatives.
Species not recordedOn-label (ON_LABEL)United States1 source record · View provenance
- Species not recorded · SPL section 34070-3 (CONTRAINDICATIONS SECTION) · United States · On-label (ON_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Zygolide is contraindicated in horses with hypersensitivity to pergolide mesylate or other ergot derivatives.
Species not recordedOn-label (ON_LABEL)United States1 source record · View provenance
- Species not recorded · SPL section 34070-3 (CONTRAINDICATIONS SECTION) · United States · On-label (ON_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Precautions9
Life-long therapy — no cure, weeks-to-months to judge; owners must know the commitment + cost
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
The PPID trifecta: pergolide (dopamine restores the missing brake) + nutrition/weight control + laminitis vigilance — the drug controls peptide output, management controls the rest.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Anorexia = the dose-limiting signal with a scripted response (stop-ramp-restart) — memorize the ramp (0.25→0.5→0.75 over alternating 2-day steps).
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Dose-units zoo alert (Plumb's own note): total-mg, µg/kg, and mg/kg regimens coexist — 1 mg total ≈ 0.002 mg/kg ≈ 2 µg/kg; know they're the same start.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
The human-withdrawal → compounding → Prascend saga is pharmacy-history in one drug.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Interactions3
Cyproheptadine — Deliberate add-on (serotonin-axis complement)
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Other dopaminergics/antagonists (metoclopramide) — Pharmacologic opposition
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Phenothiazines (acepromazine) — Theoretical α/dopamine interactions (class)
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pharmacokinetics4
Mechanism — Dopamine agonist → restores dopaminergic inhibition of the pars intermedia → ↓POMC peptide expression (ACTH/α-MSH cascade)
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Horse PK — Peak ~1 h; t½ ~27 h (high variability) — supports daily (or split) dosing
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Human context — Ergot derivative; 10+ metabolites; human withdrawal (cardiac-valve fibrosis at Parkinson's doses) — the availability story that drove compounding
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
1 Pergolide mesylate is a synthetic ergot derivative and is a potent dopamine receptor agonist. As with other dopamine agonists, pergolide inhibits the release of prolactin which suggests that it may interfere with lactation. In horses with PPID, pergolide is believed to exert its therapeutic effect by stimulating dopamine receptors, and has been shown to decrease the plasma levels of adrenocorticotropic hormone (ACTH), melanocyte stimulating hormone (MSH), and other pro-opiomelanocortin peptides. 2 Pharmacokinetic information in the horse is based on a study using single oral doses of 10 mcg/kg in six healthy mares between 3 and 17 years of age.Pergolide was rapidly absorbed; the mean maximum concentration (Cmax) was 4.05±2.02 ng/mL with the median time to maximum concentration (Tmax) being 0.415 hours. The area under the curve (AUC) was 14.08±7.46 hr∙ng/mL. The mean half life (T1/2) was 5.86±3.42 hours; the mean apparent oral clearance (CL/F) was 1204 mL/kg/hr; and the mean apparent volume of distribution (V/F) was 3082±1354 mL/kg.
Species not recordedOn-label (ON_LABEL)United States1 source record · View provenance
- Species not recorded · SPL section 34090-1 (CLINICAL PHARMACOLOGY SECTION) · United States · On-label (ON_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Pregnancy / lactation considerations1
Not applicable in the typical PPID geriatric population.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 957–958 — Pregnancy & Lactation · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Literature references18
References are linked to this drug. Species applicability is not recorded here, so the species filter does not narrow this list. Imported dates do not retain their original precision; confirm dates in the original citation.
- Influence of Extended Photoperiod Using Blue Light Masks on Hypertrichosis, Coat Condition and General Health Parameters in Horses with Pituitary Pars Intermedia Dysfunction.
Study summary not available in the imported record. Open the original citation to review the study.
- Long-Term Response of Equids With Pituitary Pars Intermedia Dysfunction to Treatment With Pergolide.
Study summary not available in the imported record. Open the original citation to review the study.
- Pharmacokinetic properties of pergolide mesylate following single and multiple-dose administration in donkeys (Equus asinus).
Study summary not available in the imported record. Open the original citation to review the study.
- Preliminary study on the effects of pergolide on left ventricular function in the horses with pituitary pars intermedia dysfunction.
Study summary not available in the imported record. Open the original citation to review the study.
- Pergolide dosing compliance and factors affecting the laboratory control of equine pituitary pars intermedia dysfunction.
Study summary not available in the imported record. Open the original citation to review the study.
Sources: DailyMed, U.S. National Library of Medicine; PubMed, National Library of Medicine; openFDA, U.S. Food and Drug Administration; Plumb DC. Plumb's Veterinary Drug Handbook. 7th ed. PharmaVet Inc; 2011.
Owner information handout
Plain-language medication information to review with the owner. Open the handout to print it or download a PDF.