What is compounding?
Drug compounding is often regarded as the process of combining or mixing drugs to create a medication tailored to the needs of an individual patient.
The generic form of Vetmedin is Pimobendan.
Vetmedin is in limited supply. Orders placed will be shipped as product continues to come off backorder.
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.
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.
For use as replacement therapy for mineralocorticoid deficiency in dogs with primary hypoadrenocorticism (Addison’s disease).
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.
|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:
Prior to a stressful situation, consider temporarily increasing the dose of replacement glucocorticoid.
Do not use Zycortal Suspension in dogs that have previously had a hypersensitivity reaction to desoxycorticosterone pivalate.
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.
Keep out of reach of children.
Store between 15-30°C. Do not freeze. Use within 120 days of first puncture.