Our sister division, Stokes Pharmacy, formed an exclusive partnership with the Bova Group to bring safe, compounded treatment for feline infectious peritonitis (FIP) to the US. The partnership and new medication brought a lot of excitement for veterinarians and pet owners looking to save cats with FIP.
Not having access to treatment previously, Stokes’ release of Bova GS-441524 tablets was the first FIP treatment in the US, with the release of EIDD-1931 following for additional treatment options. As with any new treatment option though, there are questions.
To help you cut through all the stories you’re reading and announcements you’re hearing, Dr. Samantha Taylor, BVetMed(Hons) CertSAM DipECVIM-CA MANZCVS FRCVS, has answered the top FIP FAQs we’ve heard from veterinarians and pet owners.
Sam is an RCVS Recognized Specialist in Feline Medicine, European Specialist in Veterinary Internal Medicine and a Fellow of the RCVS. Sam was involved in the launch of legal medications in the UK and set up the FIP advice email service with other specialists, which has answered nearly 3000 emails about the novel FIP treatments from around the world. In 2023 she published a report on over 300 cats treated for FIP and continues to be involved in FIP research.
Check out her answers below and get the peace of mind you need to treat your patients or care for your pet.
Vet Questions about GS-441524
Can I legally prescribe this drug?
FDA’s Center for Veterinary Medicine (CVM) has notified veterinarians that compounded Bova GS-441524 falls under Guidance for Industry (GFI) #256 and is allowed to be compounded and legally prescribed. Read the CVM’s statement here.
Is this the same GS-441524 that’s on the black market?
No, unlike black market products, this GS-441524 product from Stokes Pharmacy contains a known amount of the antiviral using the Bova formulation that has been studied in three peer-reviewed publications to date. This means when prescribing, you can be confident about the recommended dosing.
Is GS-441524 absorbed from the gut when given orally?
The published studies and extensive experience in other countries using this formulation of oral GS-441524 has shown cats respond well to oral GS-441524 treatment, and 85% or more respond completely.
Should cats with FIP start on injections first and then switch to tablets?
The vast majority of cats can be treated with oral GS-441524 from day one. The exceptions are those severely unwell cats that have reduced mentation or cannot swallow, which thankfully are only a very small proportion of cases. Therefore, it is no longer recommended or necessary to start with injections for most cats with FIP, whatever the form.
Should veterinarians dose our tablets based off black market dosing or whatever medication they may have been getting before?
No, the current dosage advice is based on publications and clinical experience from multiple countries using the regulated formulations of Bova GS-441524 to treat what is now thousands of cats with FIP. The content of GS-441524 in black market products has been shown to vary, but the regulated formulation has a known amount of Bova GS-441524 which should be given according to recommendations.
Are molnupiravir or (active form of molnupiravir) an equivalent treatment to GS-441524 or do I start cats with GS tablets?
Bova GS-441524 is currently the preferred first choice based on the number of published studies suggesting it is slightly more effective with fewer adverse effects. Additionally, molnupiravir and EIDD-1931 carry concerns around caregiver handling of medication due to teratogenicity. In parts of the world with more than one treatment option, molnupiravir and EIDD-1931 are useful as second-line therapy for relapsed or poorly responsive cats, and as such, it is ideal to have these additional antivirals legally available.
Do your clients have questions?
Check out our Dr. Samantha Taylor's answers to FIP questions for cat owners.
Veterinary FIP Resources
1. Coggins, S. J., Norris, J. M., Malik, R., Govendir, M., Hall, E. J., Kimble, B., & Thompson, M. F. (2023). Outcomes of treatment of cats with feline infectious peritonitis using parenterally administered remdesivir, with or without transition to orally administered gs‐441524. Journal of Veterinary Internal Medicine, 37(5), 1772–1783. https://doi.org/10.1111/jvim.16803
