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Tempora Chewable Tablets are used to help in the treatment of heart conditions in dogs. They are given to help reduce further degeneration of the heart muscle and so hopefully prolong life in dogs with congestive heart disease. The precise mechanism of action within the body is not fully understood, but extensive clinical trials have shown a significant improvement in dogs given this treatment. Tempora Chewable Tablets contain spironolactone and are normally dosed once daily according to the bodyweight of the patient.
Each Tempora 10 mg Tablet contains: Spironolactone 10 mg
Each Tempora 50 mg Tablet contains: Spironolactone 50 mg
Each Tempora 100 mg Tablet contains: Spironolactone 100 mg
Tempora 10 mg: Oblong scored beige chewable tablet. The tablets can be divided into equal halves
Tempora 50 mg: Clover-shaped scored beige chewable tablet. The tablet can be divided into four equal parts
Tempora 100 mg: Clover-shaped scored beige chewable tablet. The tablet can be divided into four equal parts
For use in combination with standard therapy (including diuretic support, where necessary) for the treatment of congestive heart failure caused by degenerative mitral valve disease in dogs.
Do not use in animals used for or intended for use in breeding.
Do not use the product in dogs suffering from hypoadrenocorticism, hyperkalaemia or hyponatraemia.
Do not administer spironolactone in conjunction with NSAIDs to dogs with renal insufficiency.
Do not use in the case of hypersensitivity to spironolactone or any of the excipients
Kidney function and plasma potassium levels should be evaluated before initiating combined treatment with spironolactone and ACE inhibitors. Unlike in humans, an increased incidence of hyperkalaemia was not observed in clinical trials performed in dogs with this combination. However, in dogs with renal impairment, regular monitoring of renal function and plasma potassium levels is recommended as there may be an increased risk of hyperkalaemia.
Dogs treated concomitantly with spironolactone and NSAIDs should be correctly hydrated. Monitoring of their renal function and plasma potassium levels is recommended before initiation and during treatment with combined therapy (see 4.3).
As spironolactone has an antiandrogenic effect, it is not recommended to administer the product to growing dogs.
As spironolactone undergoes extensive hepatic biotransformation, care should be taken when using the product to treat dogs with hepatic dysfunction.
A reversible prostatic atrophy is often observed in entire male dogs. Vomiting and diarrhoea may commonly occur.
Spironolactone had developmental toxicity in laboratory animals.
The safety of the product has not been assessed in pregnant and lactating bitches.
Do not use during pregnancy and lactation.
In clinical studies, the product was co-administered with ACE-inhibitors, furosemide and pimobendan without evidence of associated adverse reactions.
Spironolactone decreases digoxin elimination and hence raises digoxin plasma concentration. As the therapeutic index for digoxin is very narrow, it is advisable to monitor closely dogs receiving both digoxin and spironolactone.
The administration of either deoxycorticosterone or NSAIDs with spironolactone may lead to a moderate reduction of the natriuretic effects (reduction of urinary sodium excretion) of spironolactone.
Concomitant administration of spironolactone with ACE-inhibitors and other potassium-sparing drugs (as angiotensin receptor blockers, ß-blockers, calcium channels blockers, etc..) may potentially lead to hyperkalaemia.
Spironolactone may cause both induction and inhibition of cytochrome P450 enzymes and could therefore affect the metabolism of other drugs utilizing these metabolic pathways.
2 mg of spironolactone per kg of body weight once daily, i.e. Tempora 10 mg: 1 tablet per 5 kg of body weight, Tempora 50 mg: 1 tablet per 25 kg of body weight, Tempora 100 mg: 1 tablet per 50 kg of body weight, by oral route. The product should be administered with meal.
The tablets are flavoured. If the dog does not accept the tablet from hand or bowl, then the tablets may be mixed with a small amount of food offered prior to the main meal, or administered directly into the mouth after feeding.
After administration of up to 5 times the recommended dose (10 mg/kg) to healthy dogs, dose-dependent adverse effects were noted, see section 4.6.
In case of an accidental massive ingestion by a dog, there is no specific antidote or treatment. It is therefore recommended to induce vomiting, lavage the stomach (depending on risk assessment) and monitor electrolytes. Symptomatic treatment, e.g., fluid therapy, should be provided.
Spironolactone and its active metabolites (including 7α-thiomethyl-spironolactone and canrenone) act as specific antagonists of aldosterone, and exert their effects by binding competitively to the mineralocorticoid receptor located in the kidneys, heart and blood vessels.
Spironolactone is a natriuretic drug (historically described as a soft diuretic). In the kidney, spironolactone inhibits the aldosterone-induced sodium retention leading to increase in sodium and subsequently water excretion, and potassium retention. The renal effects of spironolactone and its metabolites lead to a decrease in extracellular volume and consequently in a decrease of cardiac preload and left atrial pressure. The result is an improvement in heart function.
In the cardiovascular system, spironolactone prevents the detrimental effects of aldosterone. Although the precise mechanism of action is not yet clearly defined, aldosterone promotes myocardial fibrosis, myocardial and vascular remodelling and endothelial dysfunction.
In experimental models in dogs, it was shown that long term therapy with an aldosterone antagonist prevents progressive left ventricle dysfunction and attenuates left ventricle remodelling in dogs with chronic heart failure.
When used in combination with ACE-inhibitors, spironolactone may counteract the effects of “aldosterone escape”.
A slight increase in aldosterone blood levels may be observed in animals on treatment. This is thought to be due to activation of feedback mechanisms without adverse clinical consequence. There may be a dose related hypertrophy of the adrenal zona glomerulosa at high dose rates.
The pharmacokinetics of spironolactone are based on its metabolites, as the parent compound is rapidly metabolised.
In dogs, oral bioavailability of spironolactone as measured by canrenone AUCs was 83% relative to the iv route. It has been shown that feeding significantly increases the oral bioavailability of all measured metabolites resulting from dosing dogs with spironolactone. After multiple oral doses of 2 mg spironolactone per kg for 5 consecutive days, steady-state conditions are reached by day 3 and only a slight accumulation of canrenone is observed. After oral administration of spironolactone in dogs at 2 mg/kg, mean Cmax of 41 ng/mL are achieved for the primary metabolites, canrenone and 7α-thiomethyl-spironolactone, after 4 hours, respectively.
The mean apparent volume of distribution during elimination phase after oral dosing in dogs was 41 L/kg for canrenone.
The mean residence time of the metabolites ranges from 11 hours.
The protein binding is about 90%.
Spironolactone is rapidly and completely metabolised by the liver into its active metabolites, canrenone, 7α-thiomethyl-spironolactone and 6β-hydroxy-7α-thiomethyl-spironolactone, which are the primary metabolites in the dog.
Spironolactone is mainly excreted via its metabolites. Plasma clearance of canrenone is 3 L/h/kg for canrenone, in dogs. After oral administration of radiolabelled spironolactone to the dog, 66 % of the dose is recovered in faeces and 12 % in the urine. 74% of the dose is excreted within 48 hours
Artificial chicken flavour, Yeast, Crospovidone type A, Sodium lauryl sulfate, Maltodextrine, Magnesium stearate, Silica (colloidal anhydrous), Silicified microcrystalline cellulose, Lactose monohydrate
Tempora 10 mg: 36 months
Shelf-life after first opening the immediate packaging: 24 hours
Tempora 50 mg and 100 mg: 36 months
Shelf-life after first opening the immediate packaging: 72 hours
These veterinary medicinal products do not require any special storage conditions. Store in original package.
Tempora 10 mg: Any part-used tablet should be returned to the opened blister and used within 24 hours
Tempora 50 mg and 100 mg: Any part-used tablet should be returned to the opened blister and used within 72 hours
Tempora 10 mg: (PA-AL-PVC – aluminium heat sealed) containing 10 tablets per blister
Cardboard box of 10 tablets containing 1 blister of 10 tablets; Cardboard box of 20 tablets containing 2 blisters of 10 tablets; Cardboard box of 30 tablets containing 3 blisters of 10 tablets; Cardboard box of 60 tablets containing 6 blisters of 10 tablets; Cardboard box of 100 tablets containing 10 blisters of 10 tablets; Cardboard box of 180 tablets containing 18 blisters of 10 tablets.
Tempora 50 mg: (PA-AL-PVC – aluminium heat sealed) containing 10 tablets per blister
Cardboard box of 10 tablets containing 1 blister of 10 tablets; Cardboard box of 20 tablets containing 2 blisters of 10 tablets; Cardboard box of 30 tablets containing 3 blisters of 10 tablets; Cardboard box of 100 tablets containing 10 blisters of 10 tablets; Cardboard box of 180 tablets containing 18 blisters of 10 tablets.
Tempora 100 mg: (PA-AL-PVC – aluminium heat sealed) containing 8 tablets per blister
Cardboard box of 8 tablets containing 1 blister of 8 tablets; Cardboard box of 16 tablets containing 2 blisters of 8 tablets; Cardboard box of 24 tablets containing 3 blisters of 8 tablets; Cardboard box of 56 tablets containing 7 blisters of 8 tablets; Cardboard box of 80 tablets containing 10 blisters of 8 tablets.
Not all pack sizes may be marketed.
Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.
Tempora 10 mg: Vm 20749/4027.
Tempora 50 mg: Vm 20749/4028.
Tempora 100 mg: Vm 20749/4029.
Tempora 10 mg, 50 mg and 100 mg tablets: 8 August 2012
Tempora 10 mg, 50 mg and 100 mg: August 2012
Special precautions to be taken by the person administering the veterinary medicinal product to animals: May cause skin sensitisation: persons known to be allergic to spironolactone or other components of the formulation, should not handle this product.
Handle this product with great care to avoid unnecessary exposure, taking all recommended precautions. Wash hands after use.
If you develop symptoms following exposure such as a skin rash, you should seek medical advice and show the doctor this warning. Swelling of the face, lips or eyes or difficulty with breathing are more serious symptoms and require urgent medical attention.
In case of accidental ingestion, seek medical advice immediately and show the package leaflet or the label to the physician.
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