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 and dogs.
Dosage and Administration:
Dogs: For medical treatment of pituitary-dependent hyperadrenocorticism (bilateral adrenal hyperplasia):
Maintenance therapy:
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steroids masks the clinical markers that signify when the endpoint of therapy has been reached and must be withdrawn 2-3 days before ACTH stimulation tests can be done.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 glucocorticoid administration may not be warranted.
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