DESOXYCORTICOSTERONE PIVALATE, (DOCP)

Chemistry - A mineralocorticoid, desoxycorticosterone pivalate (DOCP) occurs as a white orcreamy white powder that is odorless and stable in air. It is practically insoluble in water, slightlysoluble in alcohol and vegetable oils. The injectable product is a white aqueous suspension and hasa pH between 5 - 8.5.

Storage, Stability, Compatibility

Store the injectable suspension at room temperature and protect from light or freezing. Do not mix with any other agent.

Pharmacology - DESOXYCORTICOSTERONE PIVALATE, (DOCP)

Desoxycorticosterone pivalate (DOCP) is a long-acting mineralocorticoid agent.
The site of action of mineralocorticoids is at the renal distal tubule where it increases the absorptionof sodium. Mineralocorticoids also enhance potassium and hydrogen ion excretion. To be effective, mineralocorticoids require a functioning kidney.
Uses, Indications - DOCP is indicated for the treatment of adrenocortical insufficiency in dogs.

Pharmacokinetics - DESOXYCORTICOSTERONE PIVALATE, (DOCP)

Little information is available. It is injected IM as a microcrystalline depot forslow dissolution into the circulation. DOCP usually has a duration of action in dogs for 21-30 daysafter injection.

Contraindications, Precautions, Reproductive Safety

The drug is labeled as being contraindicated in dogs suffereing from congestive hear failure, severe renal disease or edema.
The manufacturer states that the drug should not be used in pregnanat dogs as safe use duringpregnancy has not been established; use in pregnant animals when the potential benefits outweighthe risks.

Adverse Effects, Warnings

Occasionally, irritation at the site of injection may occur. Adverseeffects of DOCP are generally a result of excessive dosage (see Overdosage below). Because someanimals may be more (or less) sensitive to the effects of the drug, "cookbook" dosing withoutongoing monitoring is inappropriate. Some animals may require additional supplementation with aglucocorticoid agent on an ongoing basis. All animals with hypoadrenocorticism should receiveadditional glucocorticoids (2-10 times basal) during periods of stress or acute illness.
Do not administer DOCP IV as acute collapse and shock may result. If given IV, treat immediatelyfor shock with IV fluids and glucocorticoids.
Overdosage, Acute Toxicity - Overdosage may cause polyuria, polydipsia, hypernatremia, hypertension, edema and hypokalemia. Cardiac enlargement is possible with prolonged overdoses.
Electrolytes should be aggressively monitored and potassium may need to be supplemented.
Patients should have the drug discontinued until symptoms and signs associated with overdosagehave resolved and then restart the drug at a lower dosage.

Drug Interactions

Patients may develop hypokalemia if mineralocorticoids are administeredconcomitantly with amphotericin B or potassium-depleting diuretics (e.g., thiazides, furosemide). As diuretics can cause a loss of sodium, they may counteract the effects DOCP.
Potentially, DOCP could increase the insulin requirements of diabetic patients or reduce salicylate blood levels. The clinical significance of these potential interactions with DOCP have not beendetermined.
Because DOCP may cause hypokalemia, it should be used with caution and with increasedmonitoring when used in patients receiving digitalis glycosides.