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Zycortal Suspension 25 mg/ml (4ml)

Item# 624425RX
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Description

Zycortal Suspension is an injectable medication for use as replacement therapy for mineralocorticoid deficiency in dogs with primary hypoadrenocorticism (Addison's disease). This medication replaces the mineralocorticoid hormones only. Zycortal Suspension is an alternative to Percorten-V and requires a prescription from your veterinarian.

Key Benefits

  • Treats Addison's disease (hypoadrenocorticism) in dogs
  • Subcutaneous injectable medication
  • Replaces the mineralocorticoid hormone

How It Works

Zycortal Suspension works by replacing the mineralocorticoids, which are deficient in dogs with hypoadrenocorticism. Dogs with combined glucocorticoid and mineralocorticoid deficiency need to most likely be treated with other medication that your veterinarian will prescribe.

Indications

For use as replacement therapy for mineralocorticoid deficiency in dogs with primary hypoadrenocorticism (Addison’s disease).

Directions

View Zycortal Suspension Drug Facts Sheet.

Prior to each use, thoroughly shake the vial to resuspend the product. Zycortal Suspension replaces the mineralocorticoid hormones only. Dogs with combined glucocorticoid and mineralocorticoid deficiency should also be treated with an appropriate glucocorticoid.

Zycortal Suspension is intended for long term administration at intervals and dosages dependent upon individual patient response. Tailor the dose of Zycortal Suspension and the concurrently administered glucocorticoid replacement therapy to the individual animal based on clinical response and normalization of Na+/K+ concentrations.

Initial dose: The initial dose is 2.2 mg/kg body weight administered by subcutaneous injection.

Interim monitoring visit: Re-evaluate the dog and measure the serum sodium/potassium (Na+/K+ ratio) approximately 10 days after the first dose, which is the time to maximum concentration (Tmax) of desoxycorticosterone (see CLINICAL PHARMACOLOGY). If the dog's clinical signs have worsened or not resolved, adjust the dose of glucocorticoid and/or investigate other causes of the clinical signs.

Second dose of Zycortal Suspension: At approximately 25 days after the first dose, re-evaluate the dog and repeat the Na+/K+ ratio.

  • If the dog is clinically normal and has a normal Na+/K+ ratio on Day 25, adjust the dose based on the Day 10 Na+/K+ ratio using the guidelines in Table 1, below.
  • If the dog is both clinically normal and has a Na+/K+ ratio > 32 on Day 25, either adjust the dose based on the Day 10 Na+/K+ ratio according to Table 1 or delay the dose (see Prolonging the dosing interval).
  • If the dog is either not clinically normal or if the Na+/K+ ratio is abnormal on Day 25, adjust the dose of glucocorticoid or Zycortal Suspension (see Subsequent doses and long term management).
Table 1: Day 25: Administering the second dose of Zycortal Suspension
If the Day 10 Na+/K+ ratio is: 25 days after the first dose, administer Zycortal Suspension, as follows:
≥34 Do not administer Dose 2 on Day 10 Decrease dose to: 2.0 mg/kg
32 to <34 Do not administer Dose 2 on Day 10 Decrease dose to: 2.1 mg/kg
27 to 32 Do not administer Dose 2 on Day 10 Continue 2.2 mg/kg
≥24 to <27 Do not administer Dose 2 on Day 10 Increase dose to: 2.3 mg/kg
<24 Do not administer Dose 2 on Day 10 Increase dose to: 2.4 mg/kg

Prolonging the dosing interval: If the dog is clinically normal and the Day 25 Na+/K+ ratio is > 32, it is possible to prolong the dosing interval instead of adjusting the dose as described in Table 1. Evaluate the electrolytes every 3-7 days until the Na+/K+ ratio is < 32, and then administer 2.2 mg/kg of Zycortal Suspension.

Subsequent doses and long term management: For subsequent doses, use the following guidelines if the dog is not clinically normal and/or has abnormal Na+ or K+ concentrations:

  • Clinical signs of polyuria/polydipsia: Decrease the glucocorticoid dose first. If the polyuria/polydipsia persists, then decrease the dose of Zycortal Suspension without changing the dosing interval.
  • Clinical signs of depression, lethargy, vomiting, diarrhea or weakness: Increase glucocorticoid dose.
  • Hyperkalemia, hyponatremia or Na+/K+ ratio < 27: Decrease the Zycortal Suspension dosing interval by 2-3 days.
  • Hypokalemia or hypernatremia: Decrease the Zycortal Suspension dose.

Prior to a stressful situation, consider temporarily increasing the dose of replacement glucocorticoid.

Contraindications:

Do not use Zycortal Suspension in dogs that have previously had a hypersensitivity reaction to desoxycorticosterone pivalate.

Caution:

Any dog presenting with severe hypovolemia, dehydration, pre-renal azotemia and inadequate tissue perfusion ("Addisonian crisis") must be rehydrated with intravenous fluid (saline) therapy before starting treatment with Zycortal Suspension.

Avoid inadvertent intravenous injection which may have an adverse effect on the dog.The effectiveness of Zycortal Suspension may be reduced if potassium-sparing diuretics, such as spironolactone, are administered concurrently.

Use Zycortal Suspension with caution in dogs with congestive heart disease, edema, severe renal disease or primary hepatic failure. Desoxycorticosterone pivalate may cause polyuria, polydipsia, increased blood volume, edema and cardiac enlargement. Excessive weight gain may indicate fluid retention secondary to sodium retention.

The safety of desoxycorticosterone pivalate has not been established in breeding, pregnant and lactating dogs and dogs less than 6 months of age.

Warnings:

Keep out of reach of children.

Storage:

Store between 15-30°C. Do not freeze. Use within 120 days of first puncture.

FAQ

Zycortal Suspension is a subcutaneous injectable medication used to treat Addison's disease in dogs as replacement therapy for mineralocorticoid deficiency. It is available by veterinary prescription only.
Tell your veterinarian if your dog is pregnant or lactating. Also, inform your veterinarian if your pet has congestive heart disease, edema (swelling), severe renal disease or primary hepatic failure.
Shake the vial vigorously prior to use. Use only according to your veterinarian's instructions. The usual recommended initial dosage is 2.2 mg/kg (1 mg/lb) of your dog's body weight, administered by subcutaneous injection. An interim monitoring veterinary visit is usually required for re-evaluation and to measure the serum sodium/potassium (Na+/K+) ratio approximately 10 days after the first dose. The second dose is usually given approximately 25 days after the first dose, after which your pet will likely be re-evaluated by your veterinarian to measure the serum sodium/potassium (Na+/K+) ratio and recommendations for subsequent doses and long-term management will be made.
Possible side effects of Zycortal Suspension include polyuria (excessive urination), polydipsia (excessive thirst), increased blood volume, edema, and cardiac enlargement. Excessive weight gain may indicate fluid retention secondary to sodium retention.
Give the missed dose as soon as you remember. If it is almost time for the next dose, skip the dose you missed and give the next regularly scheduled dose. Do not give a double dose unless otherwise directed by your veterinarian.
Signs of Zycortal Suspension overdose include increased thirst, excessive urination, changes in heart rate or rhythm or edema. Enlargement of the heart is possible in cases of long-term overdosage. If you suspect that your pet has received an overdose of Zycortal Suspension, consult your veterinarian or emergency veterinary clinic immediately.
Do not use Zycortal Suspension on pets who may be pregnant or lactating. Zycortal Suspension should be injected subcutaneously (under the skin); do not inject intravenously (in the vein). Do not use in dogs with congestive heart failure, kidney disease, or edema. Do not use in dogs who are allergic or hypersensitive to Zycortal Suspension or any of its ingredients.
Consult your veterinarian if your pet is currently taking any other medications, including vitamins and supplements. Interactions may occur with insulin, diuretics, digitalis, amphotericin B or potassium-depleting diuretics such as Furosemide (Lasix, Salix).

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