If your horse has been diagnosed with equine gastric ulcer syndrome (EGUS), your vet has almost certainly discussed omeprazole. GastroGard — the only FDA-approved omeprazole product for horses — works well. The price, however, is a significant burden for horse owners managing treatment or prevention long-term. The Kentucky Equine Research foundation estimates EGUS affects 60–90% of performance horses.

GastroGard vs. Compounded Omeprazole: What's the Difference?

GastroGard (omeprazole 2.28g paste) is FDA-approved for treatment of equine gastric ulcers at 4mg/kg/day. At $30–$50 per tube (one tube = one day's treatment dose for an average 500kg horse), a standard 28-day treatment course costs $840–$1,400.

UlcerGard is the same product at a lower (prevention) dose, marketed for gastric ulcer prevention.

Compounded omeprazole is prepared by licensed compounding pharmacies in paste, oral suspension, or powder form at substantially lower cost. Many horse owners who also manage PPID find significant savings by comparing both their pergolide and omeprazole pricing through CompoundingFinder.

Is Compounded Omeprazole Legal for Horses?

This is where it gets nuanced. Because GastroGard is FDA-approved for horses, compounding from bulk APIs has faced FDA scrutiny. However, licensed 503A pharmacies can legally compound omeprazole for an individual equine patient with a valid veterinary prescription when the commercial product doesn't meet the patient's clinical needs. For more background, see our guide to 503A compounding. Speak with your veterinarian about whether compounded omeprazole is appropriate for your horse's situation.

What Does Compounded Omeprazole Cost for Horses?

• Treatment dose (4mg/kg/day, 28 days): $200–$450 — vs. $840–$1,400 for GastroGard
• Prevention dose (1–2mg/kg/day, monthly): $60–$150 — vs. $250–$500 for UlcerGard

Savings potential is substantial for horses on long-term prevention protocols. See our full compounded omeprazole page for details.

Key Questions to Ask the Pharmacy

• What base is used in the paste formulation?
• What is the concentration (mg/gram or mg/ml)?
• What is the shelf life after dispensing?
• Is refrigeration required?

How to Compare Compounding Pharmacy Prices

Prices vary between licensed pharmacies. CompoundingFinder.com collects quotes from multiple pharmacies so you can compare before committing. Submit your horse's prescription details and receive quotes within 1–2 business days.