Desoxycorticosterone Pivalate (DOCP)

Mineralocorticoid (Systemic Drug)

Prescriber Highlights

• Parenteral mineralocorticoid used to treat hypoadrenocorticism (ie, Addison’s disease)

• Does not contain any glucocorticoid activity; a glucocorticoid must be used concurrently in the treatment of Addison’s disease

• Adjust dosage based on monitoring parameters

Uses, Indications

• Indicated for the parenteral treatment of adrenocortical insufficiency (ie, Addison’s disease) in dogs

• Used extra-label for the same indication in cats

Contraindications, Precautions, Warnings

• Contraindications

  • Patients with hypersensitivity to DOCP, congestive heart failure, severe renal disease, primary hepatic failure, or edema

• Precautions

  • Some animals may be more or less sensitive to the drug’s effects; dosing without ongoing monitoring is inappropriate

  • Do not administer intravenously as acute collapse and shock may result

• Warnings

  • Animals suffering from hypovolemia, prerenal azotemia, and inadequate tissue perfusion must be rehydrated with intravenous fluid therapy before starting DOCP

Side Effects

• Possible irritation at the injection site

• Depression, lethargy, vomiting, anorexia, polydipsia, polyuria, panting, diarrhea, facial and muzzle edema, urticaria, anaphylaxis, urinary tract infection, urinary incontinence, restlessness

• Anemia following injection has been reported

Drug Interactions

• Concurrent use with amphotericin B or potassium-depleting diuretics may result in hypokalemia

• Potassium-sparing diuretics may counter the DOCP effects

• May reduce salicylate levels when used with aspirin

• Use in diabetic patients may result in increased insulin requirement

Monitoring

• Serum electrolytes, BUN, creatinine

• Body weight, physical examination, evidence of edema

Client Information

• Most commonly injected into the muscle, but can be given subcutaneously

  • Must never be given intravenously

• Shake the vial vigorously before drawing up into the syringe

• Monitor for symptoms of the dose being too high (eg, increased thirst and urination, edema, weight gain) or too low (eg, lethargy, collapse, inappetence, weakness, vomiting, diarrhea)

Dosage Forms

• Desoxycorticosterone pivalate injectable suspension:

  • 25 mg/ml

‒Compiled and summarized from Plumb’s® Veterinary Drugs by Shannon Palermo, VMD