Specialty Veterinary Pharmacy Catalog 2011 by Specialty Veterinary Pharmacy

Specialty Veterinary Pharmacy Specialty Veterinary Pharmacy

Thank you for considering Specialty Veterinary Pharmacy, the place for all your veterinary compounding needs. Our company specializes in services that can provide you, the veterinarian, with a variety of medicating options for your patients. Along with the unique compounding services our company provides, we also offer competitive pricing with 2-3 days delivery service. Here are just a few of the services and products that we provide. We take medications that come in higher strengths, and break them down to patient specific strengths. We formulate easy to administer forms of medication, including but not limited to flavored/soft chewables, flavored oral liquid, and transdermal gel.

Page 2-3: Capsules Page 4-6: Chewables Page 7: Injections Page 8: Mini-Tablets Page 9: Ophthalmics Page 10-11: Oral Liquids

We compound manufactured discontinued products.

Page 12: Otic Medication

More than just medication… we offer peace of mind for you and your patients.

Page 13: Transdermal Gels

Great selection… fast turnaround… cost savings… customer service is our specialty at Specialty Veterinary Pharmacy.

Page 14: Fax Order Form

Specialty Veterinary Pharmacy guarantees every product. If you are not happy in any way with your purchase feel free to call us for a complete refund.

SVPMEDS, Inc. 4159 Bluebonnet Dr, Stafford, TX 77477 Phone: 877.673.3705 - 832.532.7447 Fax: 877.329.7705 - 832.532.7473 E-Mail: info@svpmeds.com - www.svpmeds.com

Pg. 1

Specialty Veterinary Pharmacy Specialty Veterinary Pharmacy

Capsules Commonly Prescribed Drugs and Strengths

Are you looking for a different strength? We can compound it. Please call 877-673-3705 for pricing.

Amlodipine Besylate 1.25mg Aspirin 2.5mg Azithromycin 50mg Azathioprine 10mg Azathioprine 25mg Budesonide 0.5mg Budesonide 1mg - See Mini-Tablets Budesonide 2mg Carbimazole 5mg Cisapride 2.5mg, 5mg - See Mini-Tablets Cisapride 7.5mg Cisapride 15mg Chlorampheniccol 50mg Clarithromycin 50mg Clomipramine HCl 2mg Enalapril Maleate 1mg Diethylstilbestrol 0.25mg Diethylstilbestrol 0.5mg Diethylstilbestrol 1mg - See Mini- Tablets Diethylstilbestrol 5mg Doxycycline 25mg Fluoxetine 5mg Fludrocortisone Acetate 0.2mg Fludrocortisone Acetate 0.3mg Gabapentin 20mg Griseofulvin Microsized 100mg Hydroxyurea 170mg Itraconazole 25mg Ketoconazole 30mg

Hard Gelatin Capsule SpeciďŹ cations Capsule Size

Locked Length (mm)

Ext Diameter (mm)

Volume (mL)

14.30

5.31

0.21

15.90

5.82

0.3

18.00

6.35

0.37

19.40

6.91

0.5

21.70

7.65

0.68

23.30

8.53

0.95

000

26.14

9.91

1.37

Phone: 877.673.3705 Fax: 877.329.7705

Pg. 2

Specialty Veterinary Pharmacy Specialty Veterinary Pharmacy

Capsules - Continues Commonly Prescribed Drugs and Strengths

Are you looking for a different strength? We can compound it. Please call 877-673-3705 for pricing.

Mirtazapine 2mg Mitotane 50mg Pergolide Mesylate 0.5mg Phenoxybenzamine 2.5mg Phenoxybenzamine 5mg Phenylpropanolamine HCl (PPA) 50mg Piroxicam 1mg Piroxicam 2.5mg Piroxicam 5mg Potassium Bromide 500mg Potassium Bromide All Strengths Potassium Citrate 500mg Prednisone 1.25mg Prednisolone 1.25mg Ronidazole 30mg Terbutaline Sulfate 0.3mg Tylosin 450mg Ursodiol 35mg Ursodiol 50mg, 100mg - See Mini-Tablets Ursodiol 60mg Ursodiol 75mg Ursodiol 125mg Ursodiol 150mg Ursodiol 200mg Ursodiol 225mg Ursodiol 250mg Ursodiol 500mg

Hard Gelatin Capsule SpeciďŹ cations Capsule Size

Locked Length (mm)

Ext Diameter (mm)

Volume (mL)

14.30

5.31

0.21

15.90

5.82

0.3

18.00

6.35

0.37

19.40

6.91

0.5

21.70

7.65

0.68

23.30

8.53

0.95

000

26.14

9.91

1.37

Phone: 877.673.3705 Fax: 877.329.7705

Pg. 3

Specialty Veterinary Pharmacy Specialty Veterinary Pharmacy

Chewables One of our most unique and innovative dosage forms that we offer is our special soft chewables. Our chewables are available in a wide assortment of flavors including but not limited to; tuna, chicken, liver, beef, and seafood. Our chewables not only come in a variety of flavors but also in a wide selection of commonly used medications and strengths. The chewables come in unit dose packaging sealed for freshness. The medication is distributed uniformally so that the chewable can be cut in half or quartererd if necessary.

Commonly Prescribed Drugs and Strengths Aluminum Hydroxide 500mg Amantadine HCl 25mg Aminocaproic Acid 500mg Aminophylline 100mg Amitriptyline HCl 5mg Amlodipine Besylate 0.625mg Aspirin 20mg Atenolol 6.25mg Azathioprine 20mg Azithromycin 60mg Benazepril HCl 2.5mg Bethanechol Chloride 2.5mg Budesonide 1mg Buspirone HCl 2.5mg Calcitriol 16ng Calcium Acetate 166mg Carbimazole 5mg Chlorambucil 1mg Chloramphenicol Palmitate 200mg Ciprofloxacin 90mg Cisapride 5mg Clindamycin 100mg Clomipramine HCl 3mg Colchicine 0.6mg Cyproheptadine HCl 4mg Desmopressin Acetate 0.2mg Diethylstilbestrol 1mg Diltiazem 30mg Diphenhydramine HCl 12.5mg Doxycycline 25mg Docusate Sodium 10mg Enalapril Maleate 7.5mg Enrofloxacin 22.7mg

Phone: 877.673.3705 Fax: 877.329.7705

Are you looking for a different strength? We can compound it. Please call 877-673-3705 for pricing.

Small Chewable Actual Diameter Actual Thickness

Pg. 4

Specialty Veterinary Pharmacy Specialty Veterinary Pharmacy

Chewables - Continues Commonly Prescribed Drugs and Strengths Fluoxetine HCl 5mg Fludrocortisone Acetate 0.5mg Furosemide 12.5mg Gabapentin 100mg Gemfibrozil 200mg Glipizide 1.25mg Griseofulvin 250mg Hydroxyzine HCl 10mg Itraconazole 50mg Levothyroxine Sodium 0.3mg Loperamide HCl 0.4mg Ketoconazole 100mg Megestrol Acetate 5mg Meloxicam 1.8mg Methazolamide 50mg Methimazole 5mg Methimazole 2.5mg Methimazole 10mg Methocarbamol 100mg Metronidazole 500mg Metroniazole 250mg Metronidazole 50mg Methylprednisolone 4mg Mirtazapine 2mg Misoprostol 25mcg Mitotane 500mg Nitrofurantoin 13mg Omeprazole 5mg Penicillamine 500mg Pentoxifylline 50mg Phenoxybenzamine 5mg Phenylpropanolamine HCl 50mg Pimobendan 7.5mg Piroxicam 5mg Potassium Bromide 500mg Potassium Citrate 400mg Potassium Gluconate 2meq

Phone: 877.673.3705 Fax: 877.329.7705

Are you looking for a different strength? We can compound it. Please call 877-673-3705 for pricing.

Small Chewable Actual Diameter Actual Thickness

Pg. 5

Specialty Veterinary Pharmacy Specialty Veterinary Pharmacy

Chewables - Continues Commonly Prescribed Drugs and Strengths Prazosin 0.5mg Prednisolone 5mg Praziquantel 23mg Praziquantel 34mg Prednisone 5mg Selegiline HCl 5mg Selegiline HCl 10mg Selegiline HCl 15mg Selegiline HCl 30mg Sildenafil 10mg Sulfamethoxazole/Trimethoprim 100mg/20mg Terbutaline Sulfate 1.25mg Tetracycline HCl 50mg Theophylline 50mg Tramadol HCL 10mg Triamcinolone 1mg Trilostane 10mg Trilostane 20mg Trilostane 30mg Trilsotane 45mg Trilostane 60mg Trilostane 90mg Trilostane 120mg Trimeprazine/Prednisolone 5mg/2mg Trimeprazine 10mg Tylosin 162mg Ursodiol 50mg Zonisamide 20mg

Phone: 877.673.3705 Fax: 877.329.7705

Are you looking for a different strength? We can compound it. Please call 877-673-3705 for pricing.

Small Chewable Actual Diameter Actual Thickness

Pg. 6

Specialty Veterinary Pharmacy Specialty Veterinary Pharmacy

Injections Specialty Veterinary Pharmacy also have a wide selection of injectable products to choose from. Each injectable product is compounded following strict USP <797> guidelines and undergo a series of quality control checks. Each batch is tested for potency and sterility by an outside laboratory. Commonly Prescribed Drugs and Strengths Acetyl-D-Glucosamine 20% - 100mL ACTH Gel 40iu/mL - 2.5mL *Acepromazine Maleate 10mg/mL - 50mL *Amikacin Sulfate 150mg/mL - 50mL Apomorphine HCl 3mg/ml - 2.5mL Betamethasone 7mg/mL - 10mL (Similar to Betasone速) Active Ingredients: Betamethasone Dipropionate USP, & Betamethasone Sodium Phosphate USP

Caco Copper - 100mL (Active Ingredients: Cacodylic Acid, Ferric Chloride, & Copper Gluconate)

Chlorpheniramine Maleate 10mg/mL - 30mL & 100mL Chlorpromazine HCl 25mg/mL - 10mL *Diphenhydramine HCl 50mg/mL - 10mL *Famotidine Multidose Vial 10mg/mL - 30mL *Gentamicin As Sulfate 100mg/mL - 100mL *Guaifenesin 50mg/mL - 1000mL (1L) *Metoclopramide 5mg/mL - 30mL Iodine in Almond Oil - 50mL Prednisone 50mg/mL - 30mL Prednisolone Acetate 50mg/mL - 30mL Tripelennamine HCl 20mg/mL - 100mL *Vasopressin 20 u/mL - 1mL vial Diabetes Insipidus Diagnostic Agent * Pricing is subject to change.

Phone: 877.673.3705 Fax: 877.329.7705

Pg. 7

Specialty Veterinary Pharmacy Specialty Veterinary Pharmacy

Mini-Tablets -affordable -conveniently dosed -time saving -easy to administer -no bitter taste Our line of mini-tabs are affordable and time saving. Cutting pills not only wastes medication but is also time consuming. Donâ&#x20AC;&#x2122;t let your technicians spend one more minute cutting pills into the dosage your patients need. We specifically compound medication into common doses administered to small animals. Let us do the work for you! If you are tired of halving or quartering tablets and trying to administer crumbling, jagged pills Specialty Veterinary Pharmacy has the solution. Our new line of Mini-Tabs offer you a new option for treating your patients. Our specialty is compounding easy to administer commonly prescribed dosages, in Mini-tablet form. Save money, time and provide your patients an easy to administer mini-tablet today!

Commonly Prescribed Drugs and Strengths Aminopentamide Sulfate 0.2mg Amlodipine Besylate 0.625mg Apomorphine 6mg Tablet Atenolol 6.25mg Budesonide 1mg Cisapride 2.5mg Cisapride 5mg Cisapride 10mg Diethylstilbestrol (DES) 1mg Megestrol Acetate 5mg Metronidazole 25mg - (100ct) Metronidazole 50mg (100ct) Metronidazole 62.5mg Metronidazole 100mg Meloxicam 0.5mg Meloxicam 1.5mg Pergolide Mesylate 1mg Ursodiol 50mg Ursodiol 100mg

Phone: 877.673.3705 Fax: 877.329.7705

SMALLER THAN A TIC-A-TAC

Pg. 8

Specialty Veterinary Pharmacy Specialty Veterinary Pharmacy

Ophthalmic Commonly Prescribed Drugs and Strengths Acyclovir 3% Ointment - 5gm Artificial Tears Solution 15mL Chloramphenicol 1% Ointment - 5gm Cyclosporine 1% Drop - 10mL

Specialty Veterinary Pharmacy have a wide selection of sterile ophthalmic products to choose from. Each ophthalmic product is compounded following strict USP <797> guidelines and undergoes a series of quality control checks. Each batch is tested for potency and sterility by an outside laboratory.

Cyclosporine 1% Ointment - 5gm Cyclosporine 2% Drop - 10mL Ofloxacin 0.3% Solution - 10mL Optimmune 0.2% Ointment - 3.5gm Desmopressin Acetate 0.01% - 10mL Drop Flurbiprofen Sodium Solution 0.03% - 2.5mL Gentamicin-Betamethasone 1% Drop - 5mL Gentamicin 0.3% Solution - 5mL Gentamicin 0.3% Ointment - 3.5gm Idoxuridine 0.1% Drop - 10mL Itraconazole 1% & DMSO Ointment - 5gm Latanoprost 0.005% Solution - 2.5mL Neomycin/Polymyxin B Ointment - 5gm Neomycin/Polymyxin B w/ Hydrocortisone Oint - 5gm Neomycin/Polymyxin B w/ Dexamethasone Oint- 5mL Neomycin/Polymyxin B w/ Dexamethasone Oint- 3.5gm Prednisolone Acetate 1% Suspension 10mL Sicca-G Drops - 15mL - Inactive Ingredients Acetylcystine 5%, Gentamicin Sulfate 0.3%, & Pilocarpine 0.25% in Artificial Tears

Tacrolimus 0.03% Drop - 5mL Tacrolimus 0.03% Drop - 15mL Tacrolimus 0.03% Ointment - 5gm Terramycin Ointment - 3.5gm Tobramycin 0.3% Solution - 5mL

Phone: 877.673.3705 Fax: 877.329.7705

Pg. 9

Specialty Veterinary Pharmacy Specialty Veterinary Pharmacy

Flavored Oral Liquids All of our liquids are available in 30mL(1oz), 60mL(2oz), 90mL (3oz), 120mL(4oz), 240mL(8oz), 360mL (12oz) and 480mL (16oz). Each one of our oral liquid bottles come with a Press-In Bottle Adapter and Oral Syringe for an easy to use dosing system.

All of our liquids are available in a variety of flavors including: Fish Liver Apple Cherry

Chicken Marshmallow Banana Peanut Butter

Beef Vanilla Tutti Frutti

Can’t find what your looking for? Ask our pharmacist about any other drug or strength.

Commonly Prescribed Drugs and Strengths Aluminum Hydroxide 100mg/mL, & 250mg/mL Aminocaproic Acid 250mg/mL Aminophylline 50mg/mL, & 100mg/mL Amitriptyline HCl 10mg/mL, & 25mg/mL Amlodipine Besylate 1.25mg/mL, & 2.5mg/mL (similar to Norvasc®) Amphotericin B 100mg/mL Atenolol 6.25mg/mL, & 12.5mg/mL Azithromycin 50mg/mL, & 100mg/mL Benazepril HCl 2.5mg/mL, 5mg/mL , & 10mg/mL Budesonide 1mg/mL, & 5mg/mL Buspirone HCl 1mg/mL, & 10mg/mL Calcitriol 24ng/mL, 32ng/mL, 48ng/mL, & 64ng/mL Carbimazole 5mg/mL Chlorambucil 2mg/mL Chloramphenicol Palmitate 50mg/mL, & 100mg/mL Chlorpheniramine Maleate 2mg/mL, & 10mg/mL Cisapride 5mg/mL, 7.5mg/mL, & 15mg/mL Clindamycin 75mg/mL & 100mg/mL Clomipramine Hydrochloride 10mg/mL (similar to Clomicalm®) Cyclosporine 10mg/mL, & 50mg/mL Cyproheptadine HCl 2mg/mL Dexamethasone 1mg/mL, & 2mg/mL Diazoxide 50mg/mL Diltiazem 30mg/mL Doxycycline 25mg/mL, 50mg/mL, & 100mg/mL Enalapril Maleate 2.5mg/mL & 5mg/mL Enrofloxacin 22.7mg/mL, 50mg/mL, & 100mg/mL

Phone: 877.673.3705 Fax: 877.329.7705

Pg. 10

Specialty Veterinary Pharmacy Specialty Veterinary Pharmacy

Flavored Oral Liquids - Continues Commonly Prescribed Drugs and Strengths

Commonly Prescribed Drugs and Strengths

Famotidine 10mg/mL, 20mg/mL (similar to Pepcid®) Fenbendazole 100mg/mL & 200mg/mL Fluconazole 25mg/mL, & 200mg/mL (similar to Diflucan®) Fludrocortisone Acetate 0.1mg/mL, & 0.5mg/mL Fluoxetine HCl 5mg/mL, & 10mg/mL (similar to Prozac®) Furosemide 12.5mg/mL (similar to Lasix®) Gabapentin 50mg/mL, 100mg/mL Griseofulvin 100mg/mL, & 250mg/mL Hydroxyzine HCl 50mg/mL Interferon Alfa-2b, Recombinant 30iu/mL Itraconazole 25mg/mL, 50mg/mL & 100mg/mL Ivermectin 10mg/mL (1%) Ketoconazole 50mg/mL, & 100mg/mL Levothyroxine Sodium 0.3mg/mL Lysine 250mg/mL Megestrol Acetate 10mg/mL, & 20mg/mL Methimazole 5mg/mL, & 10mg/mL (similar to Tapazole®) Metoclopramide HCl 1mg/mL, 5mg/mL (similar to Reglan®) Metronidazole 25mg/mL, 50mg/mL, & 100mg/mL Neomycin Sulfate 300mg/mL Omeprazole 2mg/mL, & 20mg/mL Ondansetron 1mg/mL (similar to Zofran®) Pentoxifylline 50mg/mL , & 100mg/mL Pergolide Mesylate 0.2mg/mL (similar to (Permax®) Phenoxybenzamine 5mg/mL, & 10mg/mL Phenylpropanolamine HCl 25mg/mL, 50mg/mL, & 100mg/mL Potassium Bromide 250mg/mL Piroxicam 2.5mg/mL, 5mg/mL & 10mg/mL Ponazuril 90mg/mL Potassium Citrate 150mg/mL & 200mg/mL Potassium Gluconate 2meq/mL (similar to Tumil-K®) Praziquantel 34mg/mL, & 68mg/mL Prazosin 1mg/mL Prednisolone 5mg/mL & 10mg/mL Prednisone 5mg/mL, & 10mg/mL Primidone 25mg/mL (similar to Neurosyn®) Sodium Bromide 400mg/mL Spironolactone 25mg/mL Sulfasalazine 90mg/mL Terbutaline Sulfate 0.625mg/mL, & 2mg/mL

Tetracycline HCl 100mg/mL Theophylline 25mg/mL, 50mg/mL & 100mg/mL Tramadol HCl 10mg/mL, 25mg/mL, & 50mg/mL (similar to Ultram®) Tylosin 100mg/mL (similar to Tylan®) Ursodiol 25mg/mL, 50mg/mL & 100mg/mL Zonisamide 10mg/mL & 50mg/mL

Phone: 877.673.3705 Fax: 877.329.7705

Can’t find what your looking for? Ask our pharmacist about any other drug or strength.

Pg. 11

Specialty Veterinary Pharmacy Specialty Veterinary Pharmacy

Otic Commonly Prescribed Drugs and Strengths EKT Otic Ointment SVPMEDS is now compounding Enrofloxacin 1%, Ketoconazole 2%, and Triamcinolone 0.1% in an easy to administer otic ointment. EKT Otic Ointment is now packed in a 15mL Dial-A-Dose syringe with a 1 inch otic tip. Each batch is run through an ointment mill to eliminate any gritty textures. Inactive Ingredients: Lanolin, and Mineral Oil

TKT Otic Ointment - 15mL Tube Ticarcillin 2.7%, Ketoconazole 2%, & Triamcinolone 0.1% Inactive Ingredients: Lanolin, and Mineral Oil

CKT Otic Ointment - 15mL Tube Chloramphenicol 1%, Ketoconazole 2%, & Triamcinolone 0.1% Inactive Ingredients: Lanolin, and Mineral Oil

CPT-Chlor Otic Solution SVPMEDS is now compounding a product similar to LiquichlorÂŽ. Each mL contains Chloramphenicol (antibiotic) 0.42%, Prednisolone (corticosteroid) 0.17%, Tetracaine (local anesthetic) 0.42%, & Squalane 21% in a mineral oil and petrolatum otic solution.

Clotrimazole 1% Otic Solution 480mL Inactive Ingredients: propylene glycol, and polyethylene glycol

Recalitol Otic Ointment 20gm Tube Active Ingredients: Resorcinol, bismuth subgallate, bismuth subnitrate zinc oxide, calamine, and juniper tar. Inactive Ingredients: Glycerin and Petrolatum

Canâ&#x20AC;&#x2122;t find what your looking for? Ask our pharmacist about any other drug or strength.

Phone: 877.673.3705 Fax: 877.329.7705

Pg. 12

Specialty Veterinary Pharmacy Specialty Veterinary Pharmacy

Transdermal Gels Transdermal gel preparations are available for patients that are extremely difficult to administer oral medications. The medication is administered on the pinna of the cats ear and is absorbed through the skin and into the blood stream. Each of our transdermal gels is prepared with a pluronic lecithin base gel. They are packaged in a 1mL syringe, which contains ten 0.1mL doses. 3mL minimum order.

Commonly Prescribed Drugs and Strengths Amlodipine Besylate 0.625mg/0.1mL Amitriptyline HCl 5mg/0.1mL; 10mg/0.1mL Atenolol 6.25mg/0.1mL; 12.5mg/0.1mL Aminophylline 25mg/0.1mL Buspirone HCl 5mg/0.1mL Carbimazole 5mg/0.1mL Cisapride 2.5mg/0.1mL; 5mg/0.1mL Chlorpheniramine 2mg/0.1mL; 5mg/0.1mL Cyproheptadine HCl 1mg/0.1mL; 2mg/0.1mL Clomipramine 2.5mg/0.1mL Diltiazem 7.5mg/0.1mL Enalapril 1mg/0.1mL; 2.5mg/0.1mL Enrofloxacin 22.7mg/0.1mL Fluoxetine 5mg/0.1mL; 10mg/0.1mL Furosemide 5mg/0.1mL Glipizide 2.5mg/0.1mL Hydroxyzine HCl 5mg/0.1mL Megestrol Acetate 5mg/0.1mL Meloxicam 1mg/0.1mL; 0.5mg/0.1mL Methimazole 2.5mg/0.1mL; 5mg/0.1mL; 10mg/0.1mL Metronidazole 25mg/0.1mL Metoclopramide 1mg/0.1ml; 2mg/0.1mL Prednisolone 2.5mg/0.1mL; 5mg/0.1mL; 10mg/0.1mL Prednisone 1mg/0.1mL; 5mg/0.1mL Theophylline 25mg/0.1mL Tramadol HCl 10mg/0.1mL; 15mg/0.1mL

Phone: 877.673.3705 Fax: 877.329.7705

Canâ&#x20AC;&#x2122;t find what your looking for? Ask our pharmacist about any other drug or strength.

1.0mL 0.9mL

The whole syringe equals 10 doses

0.8mL

Each transdermal gel prescription comes with finger cots for safe administration.

0.7mL 0.6mL 0.5mL 0.4mL 0.3mL 0.2mL 0.1mL Equal 1 Dose

Pg. 13

Specialty

PHONE: 877.673.3705 FAX: 877.329.7705 info@svpmeds.com

veterinary pharmacy 1. This fax order form is for licensed veterinarians only. 2. Only use this order form if you already have an account with SVPMEDS or is accompanied with a new account form. 3. Fill out one or both prescriptions and fax this entire sheet to our toll free fax number 877-329-7705.

www.svpmeds.com

Name of person faxing prescriptions: _______________________________

Bill Clinic / Mail to Owner

Bill Clinic / Mail to Clinic

Bill Owner / Mail to Owner

Date:________________

Owner Name:____________________________________

Last Name:______________________________________

Pets Name:__________________ Species:_____________

Address:_________________________________________

City:_______________________ State:______ Zip:______

Drug Name:_____________________________________

Strength:___________________

Quantity:___________

Refills: 1 2 3 ___ PRN

Directions:_____________________________________

Dosage Forms

CAPS CHEW INJ OPHTH. ORAL LIQUID PASTE TABLET Transdermal Gel OTIC ORAL PWD

Flavoring TUNA CHICK BEEF LIVER SEAFOOD CHERRY FISH BANANA OTHER_________

Dr. Signature:____________________________________ Dispense as written

CAPS CHEW INJ OPHTH. ORAL LIQUID PASTE TABLET Transdermal Gel OTIC ORAL PWD

Flavoring TUNA CHICK BEEF LIVER SEAFOOD CHERRY FISH BANANA OTHER_________

Dr. Signature:____________________________________ Dispense as written

Phone #:

Clinic Name: _____________________________________

Address: ___________________________

City: _______________ State: ____ Zip: _____

Pg. 14