Lysodren (mitotane) is used for the
medical treatment of Cushing's Disease (pituitary-dependent hyperadrenocorticism) in dogs. It has also been used for the palliative treatment of adrenal carcinoma in humans
Dosage and Administration:
Dogs: For medical treatment of
pituitary-dependent hyperadrenocorticism (bilateral adrenal hyperplasia):
Contraindications and Precautions:
Mitotane is contraindicated in patients known to be hypersensitive to it. Patients with concurrent diabetes mellitus may have rapidly
changing insulin requirements during the initial treatment period. These animals should
be closely monitored until they are clinically stable. Dogs with preexisting renal or hepatic disease should receive
the drug with caution and with more intense monitoring.
Some veterinarians recommend giving prednisolone at 0.2
mg/kg/day during the initial treatment period (0.4 mg/kg/day to diabetic dogs) to reduce the potential for
side effects from acute endogenous steroid withdrawal. Other clinicians have argued that
routinely administering steroids masks the clinical markers that signify when the endpoint
of therapy has been reached and must be withdrawn 2-3 days before ACTH stimulation
tests can be done. Since in adequately observed patients, adverse effects requiring
glucocorticoid therapy may only be necessary in 5% of patients, the benefits of routine
administration may not be warranted.
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