SWITCHING FROM DOCP TO FLORINEF

Use of Florinef (fludrocortisone acetate) for the off-label
Treatment of Canine Addison's Disease
" Information extracted from "Essentials of Small Animal Internal Medicine"

 

Q. What tests are needed to switch a dog from Percorten-V (desoxycorticosterone pivalate) to Florinef?
A. Florinef administration should begin on the day of the next scheduled Percorten-v injection. Initially, serum electrolyte concentrations should be assessed every 1 to 2 weeks. The goal is to maintain normal sodium and potassium concentrations. The initial Florinef dose may need to be adjusted depending on serum electrolyte concentrations.

Q. What is the proper dosage of Florinef for Canine Addison's Disease?
A. 0.02 mg/kg/day

Q. Who can prescribe Florinef?
A. Florinef can be prescribed by a veterinarian and is available in 0.1 mg tablets through pharmacies.

Q. How often do you need to administer a dosage of Florinef?
A. Administration of Florinef is required daily.

Q. Are there any side effects of risks involved when switching dogs to Florinef?
A. The major drawbacks to fludrocortisone acetate have been as follows:

• Wide range in doses required to control the serum electrolyte concentrations.
• Development of polyuria, polydipsia and incontinence (presumably caused by the potent glucocorticoid activity of this drug)
• Resistance to the effects of the drug
• Persistent mild hyperkalemia and hyponatremia

Q. Is there any information that a veterinarian should be aware of before prescribing Florinef?
A. Glucocorticoid supplementation is initially indicated for all dogs with primary adrenal insufficiency. Prednisone is given at an initial dose of 0.22 mg/kg BID. The dose of prednisone should gradually be reduced to the lowest one that still prevents the signs of hypocortisolism (i.e., inappetence, vomiting, diarrhea, lethargy). Because of its potent glucocorticoid activity, approximately 50% of dogs receiving fludrocortisone ultimately do not require glucocorticoid medication, except during times of stress (i.e., surgery). All owners should have glucocorticoids available to administer to their dogs in times of stress.

Q. What tests need to be performed on dogs in order to switch them back to Percorten-v from Florinef?
A. Percorten-v administration can be initiated the day after Florinef dosing is discontinued. Serum electrolyte concentrations should be assessed on day 14 and 25 after initiating therapy with Percorten-v. See product insert for more information for the use of Percorten-v.

Last Updated on 8/18/2005