Cascade

The Cascade is a legislative provision that allows a veterinary surgeon to prescribe unauthorised medicines in an EU country that would not otherwise be permitted.

The principle of the Cascade is that, if there is no suitable veterinary medicine authorised in a particular EU country to treat a condition, the veterinary surgeon responsible for the animal may, in particular to avoid causing unacceptable suffering, treat the animal in accordance with the following sequence, in descending order of priority: 

A veterinary medicine authorised in the EU country for use in another animal species or for a different condition in the same species. 

If there is no such product, the next option is either –  a medicine authorised in the EU country for human use, or a veterinary medicinal product (VMP) not authorised in this EU country but authorised in another Member State (MS) for use in any animal species (in the case of a food-producing animal the medicine must be authorised in a food producing species) in accordance with an import certificate issued by this MS. 

If there is no such product, the last option is a medicine prescribed by the veterinary surgeon responsible for treating the animal and prepared extemporaneously by a veterinary surgeon, a pharmacist or a person holding an appropriate manufacturer’s authorisation.