When your horse has PPID, you just want to get him back to normal again. Today’s PPID treatment programs can help. The latest option you have is a new FDA-approved medicine called PRASCEND® (pergolide mesylate) that’s designed just for horses. On this page, we’ll take a closer look at the various PPID treatment options available. Your veterinarian can help you decide which choice is best for your horse.

Benefits of PRASCEND1

As of November 2011, things just got a whole lot better for horses in need of PPID treatment. New PRASCEND is now available in the US through your veterinarian. PRASCEND is the first and only medicine approved by the FDA to treat signs of PPID in horses. Strict studies required by the FDA have proved that PRASCEND safely and effectively reduces common signs of disease in horses with PPID. And, for your added peace of mind, it is made just for horses under stringent manufacturing conditions that enable consistent, reliable quality.

Click here to get the whole story about how PRASCEND can bring back your horse's spark of life!

Other options

Other treatment options that have been used for PPID in horses include compounded pergolide, natural or organic remedies, or letting nature run its course without treatment. You’ll notice nutraceuticals, botanicals, and other natural treatments available on the market.

These products have not been proven safe or effective in helping horses with PPID and generally are not recommended for use in treating horses with PPID.2 Only one of these natural products, a commercial chasteberry extract, has been tested in horses with PPID. It did not improve disease signs or test results in horses with PPID.2,3 In fact, PPID signs got worse in several of the horses following treatment with chasteberry.2,3

Another option that some owners choose is to not treat their horses for PPID. As PPID gets worse, laminitis, dental problems, grooming, and repeat visits to the veterinarian can become costly—not to mention painful and hectic for your horse! And untreated PPID increases the risk of other dangerous, even life-threatening conditions. Why pay the ultimate price, when an approved treatment option is now available and could help your horse live a normal life?

Compounded pergolide

Until PRASCEND became available, there has been no drug specifically approved by the FDA for treating horses with PPID. So, for the past few years, compounded pergolide mesylate, has been most often used to treat PPID in horses.3,4 Compounded drugs are NOT the same as generic drugs, which are FDA-approved. Compounding means that many veterinarians and pharmacies have mixed or prepared their own custom medicines.

The FDA allows this practice, called compounding, to meet a patient’s medical need when there is no specifically approved drug available.5 This is not the case for PPID any longer, so there is no need to turn to compounders. In fact, compounding is illegal unless driven by a veterinarian’s prescription in order to meet the dosing needs of an individual patient. Even in these rare cases, the pharmacy must use an FDA-approved product as the main ingredient.

Compounded preparations are not tested and regulated, like FDA-approved drugs. Quality control issues are a serious concern. These compounded drugs can be risky because it is unknown whether the ingredients are of high quality or if the preparation is stable.5,6

All in all, because compounded pergolide is prepared and stored in many different ways, it is inconsistent in strength, stability (how long it maintains its strength and stays effective), and storage needs.6

Important safety information

PRASCEND is for use in horses only. Treatment with PRASCEND may cause loss of appetite. Most cases are mild. Weight loss, lack of energy, and behavioral changes also may be observed. If severe, a temporary dose reduction may be necessary. PRASCEND has not been evaluated in breeding, pregnant, or lactating horses and may interfere with reproductive hormones in these horses. Using PRASCEND at the same time as drugs known as dopamine antagonists should be avoided. These drugs may diminish the effectiveness of PRASCEND. If your horse is especially sensitive to pergolide mesylate or similar products, PRASCEND should not be used. Refer to the package insert for complete product information.


  1. PRASCEND® (pergolide mesylate) [Freedom of Information Summary]. St Joseph, MO: Boehringer Ingelheim Vetmedica, Inc.; 2011.
  2. McFarlane D. Equine pituitary pars intermedia dysfunction. Vet Clin North AmEquine Pract. 2011;27(1):93-113.
  3. Beech J, Donaldson MT, Lindborg S. Comparison of vitex agnus castus extract and pergolide in treatment of equine Cushing's syndrome. In: Proceedings from the 48th American Association of Equine Practitioners Annual Convention; December 4-8, 2002; Orlando, FL.
  4. Posnikoff J. Advances against Cushing's disease. Available at: http://www.horsechannel.com/horse-health/equine-cushings-disease-24321.aspx. Accessed August 16, 2011.
  5. American Veterinary Distributors Association. Veterinary compounding; 2011. Available at: http://www.avda.net/compounding2011finalversion.pdf. Accessed August 16, 2011.
  6. Davis JL, Kirk LM, Davidson GS, Papich MG. Effects of compounding and storage conditions on stability of pergolide mesylate. J Am Vet Med Assoc. 2009;234(3):385-389.