Desoxycorticosterone Pivalate (DOCP)

(des-ox-ee-kor-ti-ko-ster-ohn pih-vah-late)

Description: Mineralocorticoid Hormone Replacement

Other names for this medication: Percorten-V®, Zycortal®

Common dosage forms: Veterinary: 25 mg/mL in 4 mL vials for injection. Human: None.

•Injectable medication that can be given under the skin (subcutaneously) or into the muscle (intramuscularly) every 20-30 days. Not to be given into a vein. Your veterinarian will adjust the dose and times between doses based on blood test results and your animal’s response to the drug.

•Shake vial vigorously before drawing up into syringe.

•Watch for these signs, which may indicate the dose needs to be adjusted: greater thirst and need to urinate, swelling of the limbs, weakness, lack of energy, shaking, collapse, loss of appetite, weight loss, vomiting, and diarrhea. If any of these signs are seen, contact your veterinarian immediately.

How is this medication useful?

Desoxycorticosterone pivalate (DOCP) is used as a hormone-replacement therapy for dogs with inadequate levels of stress hormones in their body (ie, because of hypoadrenocorticism [Addison’s disease]). Treatment for hypoadrenocorticism often requires an additional hormone (eg, glucocorticoid, prednisolone) as well. The FDA (U.S. Food & Drug Administration) has approved this drug for use in dogs to treat hypoadrenocorticism. The FDA allows veterinarians to prescribe and use products containing this drug in different species or for other conditions in certain situations. You and your veterinarian can discuss why this drug is the most appropriate choice.

What should I tell my veterinarian to see if this medication can be safely given?

Many things might affect how well this drug will work in your animal. Be sure to discuss the following with your veterinarian so together you can make the best treatment decisions.

•Other drugs can interact with DOCP, so be sure to tell your veterinarian and pharmacist what medications (including vitamins, supplements, or herbal therapies) you give your animal, including the amount and time you give each.

•Tell your veterinarian about any conditions or diseases your animal may have now or has had in the past.

•If your animal has been treated for the same disease or condition in the past, tell your veterinarian about the treatment and how well it did or didn’t work.

•If your animal is pregnant or nursing, talk to your veterinarian about the risks of using this drug.

•Tell your veterinarian and pharmacist about any medication side effects (including allergic reactions, lack of appetite, diarrhea, itching, hair loss) your animal has developed in the past.

How long until I will know if this medication is working, and how long will the effects of this medication last?

This medication should start having effects within 1 to 2 days; however, you will not see the effects of this medication outwardly. Your veterinarian will need to run further tests to determine if the medication is working appropriately. The effects of this medication are long-lived, meaning they may last for multiple (ie, 4 to 6) weeks, although they may be prolonged if your animal has decreased kidney and/or liver function.

When should this medication not be used or be used very carefully?

No drug is 100% safe in all patients, but your veterinarian will discuss with you any specific concerns about using this drug in your animal.

This drug SHOULD NOT be used in patients that:

•Are allergic to it.

•Have congestive heart failure.

•Have advanced kidney disease.

•Have swelling of the limbs (edema).

This drug should be used WITH CAUTION in patients that:

•Have heart disease.

•Have elevated blood pressure.

•Are pregnant, as safety has not been established.

If your animal has any of these conditions, talk to your veterinarian about the potential risks versus benefits.

What are the side effects of this medication?

Side effects that usually are not serious include:

•Irritation at injection site.

If this side effect becomes severe, worsens, or continues to be a problem, contact your veterinarian.

Side effects that may be serious or indicate a serious problem:

•Increased thirst and need to urinate.

•Swelling of the limbs.

•Weakness, lack of energy.

•Shaking.

•Collapse.

•Loss of appetite, weight loss.

•Vomiting or diarrhea.

If you see any of these signs, contact your veterinarian immediately.

If my animal gets too much of this medication (an overdose), what should I do?

If you witness or suspect an overdose, contact your veterinarian or an animal poison control center for further advice. Animal poison control centers that are open 24 hours a day include: ASPCA Animal Poison Control Center (888-426-4435) and Pet Poison HELPLINE (855-764-7661); a consultation fee is charged for these services.

How should this medication be given?

For this medication to work, give it exactly as your veterinarian has prescribed. It’s a good idea to always check the prescription label to be sure you are giving the drug correctly. DOCP is injected under the skin (subcutaneously) or into the muscle (intramuscularly). Be sure you understand how to draw up the correct amount into the syringe and the proper places and technique to inject it (give the shots).

•Use a new needle and syringe to give each injection. Do not reuse old needles and syringes.

•Do not accidentally administer DOCP in the vein (intravenously) as acute collapse (passing out) and shock may result. If this does happen, contact your veterinarian immediately.

•If you have difficulty getting your animal to accept the injections, contact your veterinarian for tips to help with dosing and reducing the stress of medication time.

•If you are injecting this medication at home, place used needles and syringes in a sharps disposal container immediately after they have been used. Your veterinarian or pharmacist will help you obtain these containers. Be careful not to accidentally stick yourself; do not attempt to disconnect the needle from the syringe. Keep containers out of reach of children and pets. Once about ¾ full, dispose containers according to your community guidelines. Check with your local trash removal services or health department (listed online and in the city or county government [blue] pages in your phone book) to see which disposal methods are available in your area.

•Patients are usually on this medication for an extended period, often for the rest of their lives. Give this medication according to the label’s instructions and obtain refills as needed. Before stopping this medication, talk to your veterinarian, as there may be important reasons to continue its use.

What should I do if I miss giving a dose of this medication?

If you miss a dose, call your veterinarian for instructions before giving another dose. Do not double-up or give extra doses.

How should I store this medication?

•Store the injectable liquid solution at room temperature; protect from light and freezing.

•If your veterinarian or pharmacist has made (compounded) a special formulation for your animal, follow the storage recommendations and expiration date for the product.

•Keep away from children and other animals.

Can handling this medication be hazardous to me, my family, or other animals?

There are no specific precautions required when handling this medication unless you are allergic to it. Wash your hands after handling any medication.

How should I dispose of this medication if I don’t use it all?

•Do not flush this medication down the toilet or wash it down the sink. If a community drug “take-back” program is available, use this option. If there is no take-back program, mix the drug with coffee grounds or cat litter (to make it undesirable to children and animals and unrecognizable to people who might go through your trash), place the mixture in a sealable plastic bag to keep it from leaking out, and throw the bag out with the regular trash.

•Do not save leftover medication for future use or give it to others to use.

What other information is important for this medication?

•For the safety of your animal, your veterinarian will need to do periodic blood tests while your animal is on DOCP. Do not miss these important follow-up visits.

•Use of this drug may not be allowed in certain animal competitions. Check rules and regulations before entering your animal in a competition while this medication is being administered.