Percorten-V Injectable Suspension
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
administrationThe 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:
- decrease Prednisone dose first,
- then decrease DOCP dose,
- do not change DOCP interval
Depression, lethargy, vomiting or diarrhea:
- increase Prednisone dose
- 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.
Do not use this drug in pregnant dogs.
Do not use in dogs suffering from congestive heart disease, severe renal disease
Each mL contains: Percorten-V is a white aqueous suspension, each
mL contains 25 mg desoxycorticosterone pivalate.
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
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.
Keep this and all drugs out of the reach
of children. In case of human consumption, contact a physician or Poison Control
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
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.