My friend George was visiting from Pyongyang when he suffered a minor hangnail. Unfortunately, it soon became infected and turned into something not-so-minor.

It was gonna be another two weeks before he could return to the land of universal health care, so he had no choice but to submit to the indignity of the American health care system. He went to the MinuteClinic at CVS.

MinuteClinic is a walk-in medical clinic designed to substitute the services of a primary care provider. Just like at a family doctor’s office, George spent two hours waiting, ten minutes with a nurse practitioner, and $127 for the ordeal ($99 for the visit, $28 for prescription antibiotics).

After he left, George did a Google search on his medication: Cephalexin. Much to his dismay, it was available online, for cheaper, and without a doctor visit or prescription. From an animal supply store!

Elaine, he said. You’re sort of a doctor — Is it safe for me to take animal medication that I get off the internet?

I’m not really a doctor, but I do watch a lot of medical shows on Netflix. That must count for something, so let’s take a look.

Hit up American Pharoah for the good stuff.

Five seconds into my review of animal med suppliers, I was distracted by all the fun stuff available for racehorses.

Myo-inositol trispyrophosphate (ITPP) stands out due to its cult popularity in nootropic and health-hacking forums. It’s used to increase the oxygen-releasing capacity of red blood cells, increasing the stamina of racehorses. Lance Armstrong doesn’t need a prescription for this dopant!

Xylazine is a horse sedative. It’s also a recreational drug that’s frequently cut with cocaine and heroin to create speedballs.

Clenbuterol is an amphetamine that celebrities use for rapid weight loss. It’s also illegal in the US, unless you’re a horse.

All of these drugs are available online, without prescription.

Pet meds are cheaper than prescription human meds.

Insurance companies are pretty good at insulating their customers from actual drug prices. Uninsured customers account for only 8.5% of prescriptions dispensed nationwide. As a result, pharmacies mark retail prices to whatever they like.

Pets, on the other hand, don’t always have health insurance. Their human owners are more motivated to shop around, or maybe replace the animal with a new one and hope the kids don’t notice. This forces animal drug manufacturers to be a little more competitive with their pricing.

For example, a 30-day supply of 10 mg Fluoxetine, aka Prozac, is $20 at my local CVS. Prozac for dogs is $2.70 for an equivalent strength and supply. Amlodipine, a blood pressure medication, is $34 for humans, $5.40 for dogs. Humulin N (insulin): $435.20 for people, $149.99 for dogs. Minocycline (antibiotic): $108 for people, $6.60 for dogs. Epinephrine: $430 for people, $17.98 for dogs.

So I can take animal drugs?

What’s the difference between animal meds and human meds?

Animal drugs often start off as human medications, because human drug research commands more money. But before a human drug can be marketed for animals, it has to go through an FDA approval process.

Both animal and human approval processes require safety and efficacy assessments consisting of lab and clinical studies. I understand how clinical trials might work for obvious indications like bacterial infection or hypertension, but how do you evaluate the efficacy of Dog Prozac? What about side effects? How do you ask a dog if he feels dizzy or has a headache? Or whether he notices an increase in suicidal thoughts?

Unless the drug is destined for mass administration in livestock, it doesn’t make sense for a manufacturer to invest millions towards FDA approval. Certainly no veterinarian would bother prescribing Prozac or insulin to a food-producing animal.

So none of the animal drugs I mentioned here are FDA-approved for their respective species. That’s okay, because veterinarians can prescribe FDA-approved human drugs for “extralabel use”:

Actual use or intended use of a drug in an animal in a manner that is not in accordance with the approved labeling. This includes, but is not limited to, use in species not listed in the labeling, use for indications not listed in the labeling, use at dosage levels, frequencies, or routes of administration other than those stated in the labeling, and deviation from labeled withdrawal time based on these different uses. (21 CFR 530.3(a))

The main restriction is that the drug manufacturer can’t market the drugs for animal uses.

Let’s look at those dog meds again.

Doggie minocycline is manufactured by Actavis, a pharmaceutical company that also makes human minocycline. Dog Prozac is made by Par Pharmaceutical, which also supplies a generic for humans. The dog version of Humulin N is manufactured by Elanco Animal Health… a division of Eli Lilly, which still holds a patent on Humulin N for people.

Same drugs, same manufacturers, different FDA approval status. Next time I need a prescription, I’ll go to the vet and pretend I’m a dog.

I AM NOT A MEDICAL DOCTOR AND NONE OF THIS IS MEDICAL ADVICE.

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