Trilostane for Dogs and Cats

Dosage Forms Available:

  • Tablets
  • Capsules
  • Oral Liquid
  • Chew Treats
  • Transdermal Gel

 

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Trilostane is used for the treatment of hyperadrenocorticism in dogs (Cushing’s disease) and cats and Alopecia X in dogs.

 What is Trilostane?

A synthetic enzyme inhibiting drug that is used to treat Cushing’s disease in dogs and cats. Trilostane decreases the production of excessive cortisol hormone by the adrenal gland. 

What is Trilostane Used for In Dogs?

Trilostane is used for the treatment of hyperadrenocorticism in dogs (Cushing’s disease) and cats and Alopecia X in dogs.

 Pimobendan Side Effects in Dogs

The more common side effects include loss of appetite, lethargy, weakness, vomiting, and diarrhea. Rarely, fatalities have been reported. Very rarely, trilostane can cause the adrenal gland to stop functioning totally.

Common Side Effects 

  • Decreased appetite
  • Diarrhea

Less Common Side Effects

  • Lethargy
  • Vomiting

If you notice any of these Trilostane side effects in dogs, contact your veterinarian right away. In the event of an allergic reaction, seek immediate medical attention for your animal.

Trilostane Precautions

Wash hands after handling. Do not break open capsules.

W     Who Should Not Use Trilostane .

Trilostane should not be used in pet that are hypersensitive or allergic to it or in pregnant animals. 

Trilostane should be used with caution in pets with kidney or liver impairment or in nursing animals. 

Safe use has not been evaluated in male dogs used for breeding.

Are There Any Drug Interactions With Trilostane?

Trilostane should be used with caution when given with the following drugs: ACE inhibitors (such as benazepril or enalapril), aminoglutethimide, ketoconazole, mitotane, potassium-sparing diuretics (spironolactone), and potassium supplements.

Be sure to tell your veterinarian about any medications including vitamins or supplements that your pet is taking.

Are There Any Risk Factors Associated With This Medication?

If any of the following serious side effects occur, stop giving Trilostane and seek emergency veterinary medical attention; an allergic reaction (difficulty breathing; swelling of the lips, tongue or face; hives), scratching, sudden onset of diarrhea, vomiting, shock, seizures, pale gums, coma.

 Discontinue giving Trilostane and contact your veterinarian if your pet develops; poor appetite, drowsiness, diarrhea, labored breathing, weakness, incoordination, fainting, accumulation of fluid in the lungs or abdomen, and cough. Other side effects may also occur. 

Talk to your veterinarian about any side effect that seems unusual or bothersome to the pet. 

Storage

Trilostane tablets are best stored in a cool dry place. Tablets should be in a tightly sealed container and kept away from direct sunlight.

Liquid Trilostane should also be stored at room temperature. Shake well before administering the dosage.

Medications should not be ingested by humans. In homes with children, a childproof container is recommended. If a human accidentally swallows this medication, call your doctor right away.

Instructions

Recommendations for trilostane use specify administration of an initial dose of 1 to 2 mg/kg Q 12 to 24 H. This dose is then increased or decreased based on evaluation of ACTH stimulation test results. Trilostane should be administered with food, including the days that ACTH stimulation tests are performed, to aid in absorption. 

ACTH stimulation testing should be performed 10, 30, and 90 days after initiation of treatment; then 30 days after each dose adjustment. While samples for testing can be collected either 4 or 6 H after drug administration, it is important that the same sampling time—4 or 6 H—always be maintained for a specific patient.

Maintenance Therapy. Hormonal end points are post cortisol concentrations less than 6 to 9 mcg/dL, in conjunction with remission of clinical signs. In patients that fail to reach clinical remission with continued elevations in post ACTH cortisol concentrations, the dose of trilostane should be increased by 25% and the pet retested in 7 to 10 days. If post ACTH cortisol concentrations demonstrate adequate hormonal control but clinical signs persist, twice daily dosing may be indicated. If you are switching from once daily to twice daily dosing, the once daily dose should be split in half and administered Q 12 H. For example, if the patient was initially on 60 mg Q 24 H, the dose would be changed to 30 mg Q 12 H.

Compared with higher doses administered Q 24 H, twice daily therapy, at a starting dose of 1 to 3 mg/kg, may:

  • Result in good control of clinical signs, with less risk of adverse effects
  • Be more effective at consistently controlling hypercortisolemia throughout the day
  • Be appropriate as a starting dose in dogs with diabetes and other related complications of Cushing’s disease.

Timeline Tips

  • Follow your veterinarian’s instructions as they may differ from these recommendations.

 

  • Finish the package and administer all doses. Don’t cease medication until your veterinarian has instructed.

Missed Dose

To maintain the effectiveness of the medication, be careful not to miss a dose, and have the refill on the way before you run out.

In the case of a missed dose, keep up the regular schedule whenever possible. Skip the missed dose if it’s almost time for the next dose, then with the regular schedule. Doubling up is not advised.

Trilostane Overdose 

Key signs to look out for after an overdose include lethargy, anorexia, vomiting, diarrhea and collapse. You should present your dog for veterinary attention immediately should such signs occur.

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