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Percorten-V Injectable Suspension 25 mg/ml, 4ml Vial

Percorten-V l Addison's Diease Treatment For Dogs


 
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Description
 

Percorten-V Injectable Suspension

(desoxycorticosterone pivalate)

Percorten-V - Novartis is for use as replacement therapy for the mineral corticoid deficit in dogs with primary adrenocortical insufficiency (Addison's Disease, hypoadrenocorticism). Canine Addison's Disease is a condition where the adrenal glands are functioning inadequately which affects metabolism, blood pressure and stress response.

The active ingredient in PERCORTEN-V is desoxycorticosterone pivalate [DOCP], and like other adrenocorticoid hormones, is thought to act by controlling the rate of synthesis of proteins. It reacts with receptor proteins in the cytoplasm to form a steroid-receptor complex. This complex moves into the nucleus, where it binds to chromatin which results in genetic transcription of cellular DNA to messenger RNA. The steroid hormones appear to induce transcription and synthesis of specific proteins, which produce the physiologic effects seen after administration

The most important effect of DOCP is to increase the rate of renal tubular absorption of sodium. Another important effect of DOCP is enhanced renal excretion of potassium. DOCP also acts to increase extra cellular fluid volume. The enhanced retention of sodium, chloride and bicarbonate, creates an osmotic gradient that promotes water absorption from the renal tubules. The extra cellular fluid volume is supported, which expands the blood volume and improves the venous return to the heart and cardiac output. The expanded blood volume and increased cardiac output may result in elevated blood pressure. PERCORTEN-V prevents the life threatening hypotensive shock and pre-renal azotemia observed in animals suffering from hypoadrenocorticism.

The effects of PERCORTEN-V on electrolytes and extra cellular fluid volume is dependent on a functioning kidney. Animals suffering from hypovolemia, pre-renal azotemia, and inadequate tissue perfusion must be rehydrated with intravenous fluid (saline) therapy, before starting PERCORTEN-V therapy. Primary renal disease should be ruled out before starting PERCORTEN-V therapy.
Dosage and Administration:

Dosage: In treating canine hypoadrenocorticism, PERCORTEN-V replaces the mineral corticoid hormones only. Glucocorticoid replacement must be supplied by small daily doses of glucocorticoid hormones (e.g., Prednisone or prednisolone) (0.2-0.4 mg/kg/day).

Dosage requirements are variable and must be individualized on the basis of the response of the patient to therapy. Begin treatment with PERCORTEN-V at a dose of 1.0 mg per pound of body weight every 25 days. In some patients the dose may be reduced. Serum sodium and potassium levels should be monitored to assure the animal is properly compensated. Most patients are well controlled with a dose range of 0.75 to 1.0 mg per pound of body weight, given every 21 to 30 days.

The well-controlled patient will have normal electrolytes at 14 days after administration or may exhibit slight hyponatremia and hyperkalemia. This needs no additional therapy as long as the patient is active and eating normally. Watch closely for depression, lethargy, vomiting or diarrhea which indicate a probable glucocorticoid deficiency.
At the end of the 25-day dosing interval, the patient should be clinically normal and have normal serum electrolytes. Alternatively, they may have slight hyponatremia and slight hyperkalemia. This constellation of signs indicate that the dosage and dosage interval should not be altered.

If the dog is not clinically normal or serum electrolytes are abnormal, then the dosage interval should be decreased 2-3 days.

Occasionally, dogs on PERCORTEN-V therapy may develop polyuria and polydipsia (PU/PD). This usually indicates excess glucocorticoid but may also indicate a PERCORTEN-V excess. It is prudent to begin by decreasing the glucocorticoid dose first. If the PU/PD persists, then decrease the dose of PERCORTEN-V without changing the interval between doses.

Please note: Failure to administer glucocorticoids is the most common reason for treatment failure. Signs of glucocorticoid deficiency include; depression, lethargy, vomiting and diarrhea. Such signs should be treated with high doses of injectable glucocorticoids (prednisolone or dexamethasone), followed by continued oral therapy (0.2-0.4 mg/kg/day). Oral supplementation with salt (NaCl) is not necessary with animals receiving PERCORTEN-V.

Guide to Maintenance Therapy:

  • Starting Dose:
    • DOCP 1 mg/lb every 25 days
    • Prednisone 0.2-0.4 mg/kg/day
  • Guides for Adjustment:
      • Clinical Problem/Solution:
          • Polyuria/Polydipsia:
            • - decrease Prednisone dose first,
            • - then decrease DOCP dose,
            • - do not change DOCP interval
          • Depression, lethargy, vomiting or diarrhea:
            • - increase Prednisone dose
          • Hyperkalemia, Hyponatremia:
            • - decrease DOCP interval 2-3 days

Administration: Before injection, shake the vial thoroughly to mix the micro crystals with the suspension vehicle. PERCORTEN-V suspension is to be injected intramuscularly. Care should be used to prevent inadvertent intravenous injection, which may cause acute collapse and shock. Such animals should receive immediate therapy for shock with intravenous fluids and glucocorticoids.

Contraindications:
Do not use this drug in pregnant dogs. Do not use in dogs suffering from congestive heart disease, severe renal disease or edema.

Active Ingredients:
Each mL contains: Percorten-V is a white aqueous suspension, each mL contains 25 mg desoxycorticosterone pivalate.

Cautions:
Some patients are more sensitive to the actions of PERCORTEN-V and may exhibit side effects in an exaggerated degree. Some patients may show signs of hyponatremia or hyperkalemia. The dosage of PERCORTEN-V should be reduced in these patients.

Like other adrenocortical hormones, PERCORTEN-V may cause severe side effects if dosage is too high or prolonged. It may cause polyuria, polydipsia, increased blood volume, edema and cardiac enlargement. Excessive weight gain may indicate fluid retention secondary to sodium retention. DOCP should be used with caution in patients with congestive heart disease, edema or renal disease.

Warnings:
Keep this and all drugs out of the reach of children. In case of human consumption, contact a physician or Poison Control Center immediately.

Adverse Reactions:
The following adverse reactions have been reported following the use of PERCORTEN-V: depression, polyuria, polydipsia, anorexia, skin and coat changes, diarrhea, vomiting, weakness, weight loss, incontinence, pain on injection and injection site abscess. Some of these effects may resolve with adjustments in dose or interval of PERCORTEN-V or concomitant glucocorticoid medication.

Federal (U.S.A.) law restricts this drug to use by or on the order of a licensed veterinarian

Store at room temperature, preferably between 15° and 30°C (59° and 86°F). Protect from light. Protect from freezing.

How Supplied: Percorten-V Injectable Solution 25 mg/ml, 4 ml
Novartis Animal Health

Rx Medication Sold Only To Licensed Veterinarians & Pharmacies. Current License Must Be On File Prior To Shipping.


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