On this page, I will explain what is in a bottle of injection-type GS and mention a few of the leading brands. In principle, they should all be the same but there are differences. The baseline mixture is defined in the UC Davis paper:
“GS-441524 was provided by Gilead Sciences as a pure and highly stable powder and diluted to a concentration of 10 or 15 mg/ml in 5% ethanol, 30% propylene glycol, 45% PEG 400, 20% water (pH 1.5 with HCI). The mixture was placed in sterile 50 ml glass injection bottles, agitated until in suspension, and then placed in a sonicated water bath for 5–20 mins until clear.”
However, we have no way to verify that the different brands follow this exact formulation. We have seen differences in thickness “viscosity) and I have personally measured the acid level (pH) of most of the major brands. I measured the UC Davis mixture to have a pH of 2.1 and most of the leading brands currently available have a pH of 1.8 to 1.9 (slightly more acidic) than the UC Davis mix. You can see that HCl (hydrochloric acid) is a necessary ingredient. One reason for this is that GS powder will not dissolve in pure water. The solubility increases as the acid concentration increases (lower pH). While this may sound bad, HCl is very common in the pharmaceutical world. Many drugs are supplied in the HCl or hydrochloride form.
Until recently, we had no no way of knowing anything about actual vs claimed concentration or purity. As of July 2020, we have tested a number of the current brands and some of the no longer available brands. The detail are discussed on the Testing page. Some of the results are surprising. We will repeat here what we say on the testing page. The Test results should never be the sole basis for choosing a GS brand. Much higher weight should be assigned to extensive clinical testing.
In China, there are a large number of brands available as various groups compete for market share. Only a few of the many brands are available in USA. I only endorse certain brands. To choose these brands, I rely heavily on input from the Facebook FIP Group in Hong Kong (the HK group). The HK Group has a Tier system to rate the various brands. Tier 1 is best and Tier 4 is the worst. I am in constant contact with one of their Admins and am always working to get the latest information and the available brands in terms of quality, efficacy, price, and availability.
Recommended, Hong Kong Tier 1, GS Brands
Capella: Capella makes both injection and pill forms of GS. It is a highly recommended brand and has been available since February 2020. As of May 2020, it became rated as Tier 1 by the HK Group. Capella injection is supplied in 6ml bottles for $90 and has rated concentration of 15mg/ml. Capella is therefore $1/mg of active GS-441524. It is the least expensive Tier 1 brand.
Capella Pills: Capella makes two sizes of pills, a 1kg pill and a 2kg pill. For FIP cases without Ocular or neurological symptoms, you would give one 1kg pill per day per 1kg of cat weight or one 2kg pill per 2kg of cat weight. Round up to nearest half pill. Multiply the number of pills per day by 1.5 for ocular or by 2 for neurological forms. Capella 1kg pills cost $8.5 (effectively $1.70/mg) and 2kg pills cost $16 (effectively $1.60/mg).
Brava: Brava is an established brand (maybe the first real brand in China) and is HK Tier 1. Brava is supplied in 5ml bottles with rated concentration of 15mg/ml and costs $115 per bottle. Brava is therefore $1.53/mg. It is still very popular in Hong Kong. Its pH used to be on the low side (pH 1.3) but after seeing my measurements, they increased the pH to a more reasonable pH 1.6. Brava is very high quality and very effective.
Brava Pills: Brava also makes an oral form (pills). Brava will admit that injection is always better but pills can be considered after doing injections for a while and seeing improved condition (appetite, energy, weight gain, etc). Brava pills come in a two sizes. The yellow pills are $11 each (effectively $2.2/mg) and are dosed at 1 pill per day per kilogram of weight for wet or dry FIP, 1.5 pills per day per kg for ocular, or 2 pills per day per kg for Neuro. The pink are twice as strong and cost $22 ((effectively $2.2/mg) each. The pink pills are dosed at .5 pill/kg/day for wet or dry and 1pill/kg/day for Neuro.
Mutian: Mutian injection is rated Tier1 in Hong Kong. It costs $360 per 5ml bottle with a rated concentration of 17mg/ml. Mutian is therefore $4.23/mg. Mutian also makes an oral form (capsules). See below for further discussion. I believe the relative is cost is $3.20/mg. See below for further discussion.
Other Brands worth considering
Spark/Aura: Spark was at one time rated a Tier1 brand but had sporadic shipping problems in early 2020. They now have several versions of their injection form and also pills. See my Facebook Groups page for a link to Spark Group where you can get more information. The Spark injection and pills are is similar in cost to the equivalent Brava products.
Lucky is another brand which is available in some groups and also through a website. Its price point is similar to Capella . Lucky comes in a 15mg/ml version ($0.96/mg) and a “high concentration” 20mg/ml version ($0.92/mg).
Note that high concentration versions typically require more acid (lower pH) to keep the extra GS in solution. Your shot volume will be smaller but the injection may sting more.
Oscar is a relatively new brand on the market and is currently under examination. Initial results look encouraging and cost is similar to Capella.
Brands I am aware of but don’t recommend
Ruby, Atlas, Hero, Cotton, Pine, Miner, Slayer, Kitty Care, HuaHua, Tian Xing, Freecat, Proline. These are brands that I have seen supplied by some in the USA. Some are identical with the different names. None are considered Tier 1 by the HK group. We can talk in private about these brands if you want more information.
My position on Oral forms of GS
New position on GS pills: Consider switching to pills after doing injections for “a while” and seeing your cats condition and blood work improve. At this time, I can recommend Capella, Brava, or Spark pills from the various pills out there.
Previous position on GS pills: As you read about treating FIP with GS-441524, you may see that there are oral forms of GS available. With oral forms, you give your cat pills or capsules instead of injections. This may seem appealing at first glance because giving shots sounds harder than giving pills. However, injection is the most reliable method of giving GS and here is why. The only published clinical trail regarding GS is the UC Davis paper and they only studied injection-type GS treatment. While they mentioned oral form should be possible, no one has published an actual clinical trial with any of oral GS products. While oral forms of GS have apparently worked on some cats, Dr. Pedersen has stated that absorption of any oral medication will vary from cat to cat. So pills can be expected to work better with some cats than others. Some cats are easy to pill and some very difficult. You won’t have injection pain but you may have diarrhea or vomiting. Some cats may back-slide or relapse due to poor absorption. In the case of Mutian’s product, they claim that the active ingredient in their capsules is not GS-441524 but rather what they call Mutian X. Based on that claim, Mutian feels that the Gilead patent does not apply to their product. If this is true, then the UC Davis paper about efficacy would also not apply. I feel strongly that GS treatment by injection has the highest probability of curing your cat’s FIP and is the only treatment method backed by published research. All that said, if you decide you want to treat with one of the oral forms of GS, I will do my to help you locate a reputable oral form.