Selection of 12 products from
£1.49 to £106.00
Vetoryl is used to treat Cushing's syndrome (also known as Cushings disease or hyperadrenocorticism). This is a hormone problem associated with abnormally high levels of cortisone in the blood stream of affected dogs. The main symptoms caused are excessive thirst and hunger. It also affects the dog's appearance and reduces its quality of life. Dogs may show hair loss, weight gain, lethargy, loss of bladder control and a bloated stomach.
The capsules need only be administered once each day (usually best n the mornings) and are given with food. The vet can also monitor your pet to ensure there are no major side effects and to adjust dosages if necessary as the condition improves.
Cushing's disease is a condition that will be present in the dog's system for the rest of its life and will need to be treated continually. Vetoryl tackles this problem in the pituitary and adrenal glands. Cortisol levels are reduced which leads to a reduction in symptoms and Vetoryl can make a difference in just three months.
The capsules are available in four strengths depending on the size of the dog and should only be prescribed by a vet. (Vetoryl 10mg capsules, Vetoryl 30mg capsules, Vetoryl 60mg capsules and Vetoryl 120mg capsules). There are a number of contra-indications which should be taken into consideration prior to treatment. Dogs that are pregnant or who have problems with the liver or kidneys should not take this medication.
Buying pet drugs online still requires a prescription from your vet. Discount pet medication can be obtained from us easily. To buy discount pet medication, the veterinary prescription must be posted or emailed to the online supplier VioVet, before the order can be supplied.
All prices include VAT where applicable.
Vetoryl 10 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 10 mg
Excipients: Titanium dioxide (E171) 0.942 mg
Ferric oxide (yellow) (E172) 0.035 mg
Ferric oxide (black) (E172) 0.532 mg
Vetoryl 30 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 30 mg
Excipients: Titanium dioxide (E171) 1.19 mg
Yellow iron oxide (E172) 0.045 mg
Black iron oxide (E172) 0.672 mg
Vetoryl 60 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 60 mg
Excipients: Titanium dioxide (E171) 1.19 mg
Yellow iron oxide (E172) 0.045 mg
Black iron oxide (E172) 0.672 mg
Vetoryl 120 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 120 mg
Excipients: Titanium dioxide (E171) 1.885 mg
Yellow iron oxide (E172) 0.071 mg
Black iron oxide (E172) 1.064 mg
Hard capsules. Ivory body and black cap with the capusle strength printed on the body of the capsule.
Dogs.
In dogs: For the treatment of pituitary-dependent and adrenal-dependent hyperadrenocorticism (Cushing's disease and syndrome).
Vetoryl 10 mg hard capsules for dogs: Do not use in dogs weighing less than 3 kg.
Vetoryl 30 mg hard capsules for dogs: Do not use in dogs weighing less than 3 kg.
Vetoryl 60 mg hard capsules for dogs: Do not use in dogs weighing less than 10 kg.
Vetoryl 120 mg hard capsules for dogs: Do not use in dogs weighing less than 20 kg.
Do not use in animals suffering from primary hepatic disease and/or renal insufficiency.
Do not use where there is suspected hypersensitivity to the active substance or to any of the excipients.
An accurate diagnosis of hyperadrenocorticism is essential.
Where there is no apparent response to treatment, the diagnosis should be re-evaluated. Dose increases may be necessary.
Veterinarians should be aware that dogs with hyperadrenocorticism are at increased risk of pancreatitis. This risk may not diminish following treatment with trilostane.
As the majority of cases of hyperadrenocorticism are diagnosed in dogs between the ages of 10-15 years, other pathological processes are frequently present. It is particularly important to screen cases for primary hepatic disease and renal insufficiency as the product is contraindicated in these cases.
Subsequent close monitoring during treatment should be carried out. Particular attention should be paid to liver enzymes, electrolytes, urea and creatinine.
The presence of diabetes mellitus and hyperadrenocorticism together requires specific monitoring.
If a dog has previously been treated with mitotane, its adrenal function will have been reduced. Experience in the field suggests that an interval of at least a month should elapse between cessation of mitotane and the introduction of trilostane. Close monitoring of adrenal function is advised, as dogs may be more susceptible to the effects of trilostane.
The product should be used with extreme caution in dogs with pre-existing anaemia as further reductions in packed-cell volume and haemoglobin may occur. Regular monitoring should be undertaken.
Trilostane may decrease testosterone synthesis and has anti-progesterone properties. Women who are pregnant or are intending to become pregnant should avoid handling the capsules.
Wash hands with soap and water following accidental exposure and after use.
The content of the capsules may cause skin and eye irritation and sensitisation. Do not divide or open capsules: in the event of accidental breakage of the capsules and contact of the granules with eyes or skin, wash immediately with plenty of water. If irritation persists, seek medical advice.
People with known hypersensitivity to trilostane or any of the excipients should avoid contact with the product.
In the event of accidental ingestion, seek medical advice immediately and show the package leaflet or carton to the physician.
Corticosteroid withdrawal syndrome or hypocortisolaemia should be distinguished from hypoadrenocorticism by evaluation of serum electrolytes.
Signs associated with iatrogenic hypoadrenocorticism, including weakness, lethargy, anorexia, vomiting and diarrhoea may occur, particularly if monitoring is not adequate (see Amounts to be administered and administration route). Signs are generally reversible within a variable period following withdrawal of treatment. Acute Addisonian crisis (collapse) may also occur (see Overdose). Lethargy, vomiting, diarrhoea and anorexia have been seen in dogs treated with trilostane in the absence of evidence of hypoadrenocorticism.
There have been occasional isolated reports of adrenal necrosis in treated dogs which may result in hypoadrenocorticism.
Subclinical renal dysfunction may be unmasked by treatment with the product.
Treatment may unmask arthritis due to a reduction in endogenous corticosteroid levels.
A small number of reports have been received of sudden death during treatment.
Other mild, rare, adverse effects include ataxia, hypersalivation, bloating, muscle tremors and skin changes.
Do not use in pregnant or lactating bitches or in any animals intended for breeding.
The possibility of interactions with other medicinal products has not been specifically studied. Given that hyperadrenocorticism tends to occur in older dogs, many will be receiving concurrent medication. In clinical studies, no interactions were observed.
The risk of hyperkalaemia developing should be considered if trilostane is used in conjunction with potassium-sparing diuretics or ACE inhibitors. The concurrent use of such drugs should be subject to a risk/benefit analysis by the veterinary surgeon, as there have been a few reports of deaths (including sudden death) in dogs when treated concurrently with trilostane and an ACE inhibitor.
Administer orally, once daily, with food. The starting dose for treatment is approximately 2 mg/kg, based on available combinations of capsule sizes. Titrate the dose according to individual response, as determined by monitoring (see below). If a dose increase is required, use combinations of capsule sizes to slowly increase the once daily dose. A wide range of capsule sizes enables optimum dosing for the individual dog. Administer the lowest dose necessary to control the clinical signs.
Ultimately, if symptoms are not adequately controlled for an entire 24 hour inter-dose period, consider increasing the total daily dose by up to 50% and dividing it equally between morning and evening doses.
Do not divide or open capsules.
A small number of animals may require doses significantly in excess of 10 mg per kg body weight per day. In these situations appropriate additional monitoring should be implemented.
Monitoring: Samples should be taken for biochemistry (including electrolytes) and an ACTH stimulation test pre-treatment and then at 10 days, 4 weeks, 12 weeks, and thereafter every 3 months, following initial diagnosis and after each dose adjustment. It is imperative that ACTH stimulation tests are performed 4-6 hours post-dosing to enable accurate interpretation of results.
Dosing in the morning is preferable as this will allow your veterinary surgeon to perform monitoring tests 4-6 hours following administration of the dose. Regular assessment of the clinical progress of the disease should also be made at each of the above time points.
In the event of a non-stimulatory ACTH stimulation test during monitoring, treatment should be stopped for 7 days and then re-started at a lower dose. Repeat the ACTH stimulation test after a further 14 days. If the result is still non-stimulatory, stop treatment until clinical signs of hyperadrenocorticism recur. Repeat the ACTH stimulation test one month after re-starting treatment.
Overdose may lead to signs of hypoadrenocorticism (lethargy, anorexia, vomiting, diarrhoea, cardiovascular signs, collapse). There were no mortalities following chronic administration at 36mg/kg to healthy dogs, however mortalities may be expected if higher doses are administered to dogs with hyperadrenocorticism.
There is no specific antidote for trilostane. Treatment should be withdrawn and supportive therapy, including corticosteroids, correction of electrolyte imbalances and fluid therapy may be indicated depending on the clinical signs.
In cases of acute overdosage, induction of emesis followed by administration of activated charcoal may be beneficial.
Any iatrogenic adrenocortical insufficiency is usually quickly reversed following cessation of treatment. However in a small percentage of dogs, effects may be prolonged. Following a one week withdrawal of trilostane treatment, treatment should be reinstated at a reduced dose rate.
Pharmacotherapeutic group: Antiadrenal preparations.
ATCvet code: QH02CA01.
Trilostane selectively and reversibly inhibits the enzyme system 3 beta hydroxysteroid isomerase, thus blocking the production of cortisol, corticosterone and aldosterone. When used to treat hyperadrenocorticism, it reduces the production of glucocorticoid and mineralocorticoid steroids in the adrenal cortex. Circulating concentrations of these steroids are thus reduced. Trilostane also antagonises the activity of exogenous adrenocorticotrophic hormone (ACTH). It has no direct effect on either the central nervous or cardiovascular systems.
Pharmacokinetic data in dogs have demonstrated large inter-individual variability. In a pharmacokinetic study in laboratory beagles, AUC ranged from 52 to 281 micrograms/ml/min in fed dogs, and from 16 to 175 micrograms/ml/min in fasted dogs. Generally trilostane is rapidly removed from the plasma with concentrations in the plasma reaching a maximum between 0.5 to 2.5 hours and returning almost to baseline by six to twelve hours after administration. The primary active metabolite of trilostane, ketotrilostane follows a similar pattern. Furthermore, there was no evidence that trilostane or its metabolites accumulated with time. An oral bioavailability study in dogs demonstrated that trilostane was absorbed more extensively when administered with food.
Trilostane has been demonstrated to be excreted primarily in the faeces of the rat, indicating biliary excretion as the major metabolic pathway. In the monkey, trilostane is excreted in equal amounts in the faeces and urine. Results have shown that trilostane is rapidly and well absorbed from the gastrointestinal tract in both the rat and monkey and that it accumulates in the adrenal glands of the rat.
Shelf life of the veterinary medicinal product as packaged for sale: 3 years.
Do not store above 25°C. Keep the blister strips in the outer carton.
PVC-PVdc / aluminium foil blister strips containing 10 capsules. Each carton contains 3 blister strips.
Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.
Dechra Limited, Snaygill Industrial Estate, Keighley Road, Skipton, North Yorkshire, BD23 2RW, United Kingdom.
Vetoryl 10 mg hard capsules for dogs:
Vm 10434/4068
Vetoryl 30 mg hard capsules for dogs:
Vm 10434/4071
Vetoryl 60 mg hard capsules for dogs:
Vm 10434/4070
Vetoryl 120 mg hard capsules for dogs:
Vm 10434/4069
Vetoryl 10 mg hard capsules for dogs:
13 July 2007
Vetoryl 30 mg hard capsules for dogs:
13 April 2005
Vetoryl 60 mg hard capsules for dogs:
4 April 2005
Vetoryl 120 mg hard capsules for dogs:
4 April 2005
October 2014
For animal treatment only. To be supplied only on veterinary prescription. Keep out of the sight and reach of children.
(For Vetoryl 10 mg/30 mg/60 mg hard capsules for dogs only): Penn Pharmaceutical Services, 23/24 Tafarnaubach Industrial Estate, Tredegar, South Wales, NP22 3AA.
Vetoryl 10 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 10 mg
Excipients: Titanium dioxide (E171) 0.942 mg
Ferric oxide (yellow) (E172) 0.035 mg
Ferric oxide (black) (E172) 0.532 mg
Vetoryl 30 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 30 mg
Excipients: Titanium dioxide (E171) 1.19 mg
Yellow iron oxide (E172) 0.045 mg
Black iron oxide (E172) 0.672 mg
Vetoryl 60 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 60 mg
Excipients: Titanium dioxide (E171) 1.19 mg
Yellow iron oxide (E172) 0.045 mg
Black iron oxide (E172) 0.672 mg
Vetoryl 120 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 120 mg
Excipients: Titanium dioxide (E171) 1.885 mg
Yellow iron oxide (E172) 0.071 mg
Black iron oxide (E172) 1.064 mg
Hard capsules. Ivory body and black cap with the capusle strength printed on the body of the capsule.
Dogs.
In dogs: For the treatment of pituitary-dependent and adrenal-dependent hyperadrenocorticism (Cushing's disease and syndrome).
Vetoryl 10 mg hard capsules for dogs: Do not use in dogs weighing less than 3 kg.
Vetoryl 30 mg hard capsules for dogs: Do not use in dogs weighing less than 3 kg.
Vetoryl 60 mg hard capsules for dogs: Do not use in dogs weighing less than 10 kg.
Vetoryl 120 mg hard capsules for dogs: Do not use in dogs weighing less than 20 kg.
Do not use in animals suffering from primary hepatic disease and/or renal insufficiency.
Do not use where there is suspected hypersensitivity to the active substance or to any of the excipients.
An accurate diagnosis of hyperadrenocorticism is essential.
Where there is no apparent response to treatment, the diagnosis should be re-evaluated. Dose increases may be necessary.
Veterinarians should be aware that dogs with hyperadrenocorticism are at increased risk of pancreatitis. This risk may not diminish following treatment with trilostane.
As the majority of cases of hyperadrenocorticism are diagnosed in dogs between the ages of 10-15 years, other pathological processes are frequently present. It is particularly important to screen cases for primary hepatic disease and renal insufficiency as the product is contraindicated in these cases.
Subsequent close monitoring during treatment should be carried out. Particular attention should be paid to liver enzymes, electrolytes, urea and creatinine.
The presence of diabetes mellitus and hyperadrenocorticism together requires specific monitoring.
If a dog has previously been treated with mitotane, its adrenal function will have been reduced. Experience in the field suggests that an interval of at least a month should elapse between cessation of mitotane and the introduction of trilostane. Close monitoring of adrenal function is advised, as dogs may be more susceptible to the effects of trilostane.
The product should be used with extreme caution in dogs with pre-existing anaemia as further reductions in packed-cell volume and haemoglobin may occur. Regular monitoring should be undertaken.
Trilostane may decrease testosterone synthesis and has anti-progesterone properties. Women who are pregnant or are intending to become pregnant should avoid handling the capsules.
Wash hands with soap and water following accidental exposure and after use.
The content of the capsules may cause skin and eye irritation and sensitisation. Do not divide or open capsules: in the event of accidental breakage of the capsules and contact of the granules with eyes or skin, wash immediately with plenty of water. If irritation persists, seek medical advice.
People with known hypersensitivity to trilostane or any of the excipients should avoid contact with the product.
In the event of accidental ingestion, seek medical advice immediately and show the package leaflet or carton to the physician.
Corticosteroid withdrawal syndrome or hypocortisolaemia should be distinguished from hypoadrenocorticism by evaluation of serum electrolytes.
Signs associated with iatrogenic hypoadrenocorticism, including weakness, lethargy, anorexia, vomiting and diarrhoea may occur, particularly if monitoring is not adequate (see Amounts to be administered and administration route). Signs are generally reversible within a variable period following withdrawal of treatment. Acute Addisonian crisis (collapse) may also occur (see Overdose). Lethargy, vomiting, diarrhoea and anorexia have been seen in dogs treated with trilostane in the absence of evidence of hypoadrenocorticism.
There have been occasional isolated reports of adrenal necrosis in treated dogs which may result in hypoadrenocorticism.
Subclinical renal dysfunction may be unmasked by treatment with the product.
Treatment may unmask arthritis due to a reduction in endogenous corticosteroid levels.
A small number of reports have been received of sudden death during treatment.
Other mild, rare, adverse effects include ataxia, hypersalivation, bloating, muscle tremors and skin changes.
Do not use in pregnant or lactating bitches or in any animals intended for breeding.
The possibility of interactions with other medicinal products has not been specifically studied. Given that hyperadrenocorticism tends to occur in older dogs, many will be receiving concurrent medication. In clinical studies, no interactions were observed.
The risk of hyperkalaemia developing should be considered if trilostane is used in conjunction with potassium-sparing diuretics or ACE inhibitors. The concurrent use of such drugs should be subject to a risk/benefit analysis by the veterinary surgeon, as there have been a few reports of deaths (including sudden death) in dogs when treated concurrently with trilostane and an ACE inhibitor.
Administer orally, once daily, with food. The starting dose for treatment is approximately 2 mg/kg, based on available combinations of capsule sizes. Titrate the dose according to individual response, as determined by monitoring (see below). If a dose increase is required, use combinations of capsule sizes to slowly increase the once daily dose. A wide range of capsule sizes enables optimum dosing for the individual dog. Administer the lowest dose necessary to control the clinical signs.
Ultimately, if symptoms are not adequately controlled for an entire 24 hour inter-dose period, consider increasing the total daily dose by up to 50% and dividing it equally between morning and evening doses.
Do not divide or open capsules.
A small number of animals may require doses significantly in excess of 10 mg per kg body weight per day. In these situations appropriate additional monitoring should be implemented.
Monitoring: Samples should be taken for biochemistry (including electrolytes) and an ACTH stimulation test pre-treatment and then at 10 days, 4 weeks, 12 weeks, and thereafter every 3 months, following initial diagnosis and after each dose adjustment. It is imperative that ACTH stimulation tests are performed 4-6 hours post-dosing to enable accurate interpretation of results.
Dosing in the morning is preferable as this will allow your veterinary surgeon to perform monitoring tests 4-6 hours following administration of the dose. Regular assessment of the clinical progress of the disease should also be made at each of the above time points.
In the event of a non-stimulatory ACTH stimulation test during monitoring, treatment should be stopped for 7 days and then re-started at a lower dose. Repeat the ACTH stimulation test after a further 14 days. If the result is still non-stimulatory, stop treatment until clinical signs of hyperadrenocorticism recur. Repeat the ACTH stimulation test one month after re-starting treatment.
Overdose may lead to signs of hypoadrenocorticism (lethargy, anorexia, vomiting, diarrhoea, cardiovascular signs, collapse). There were no mortalities following chronic administration at 36mg/kg to healthy dogs, however mortalities may be expected if higher doses are administered to dogs with hyperadrenocorticism.
There is no specific antidote for trilostane. Treatment should be withdrawn and supportive therapy, including corticosteroids, correction of electrolyte imbalances and fluid therapy may be indicated depending on the clinical signs.
In cases of acute overdosage, induction of emesis followed by administration of activated charcoal may be beneficial.
Any iatrogenic adrenocortical insufficiency is usually quickly reversed following cessation of treatment. However in a small percentage of dogs, effects may be prolonged. Following a one week withdrawal of trilostane treatment, treatment should be reinstated at a reduced dose rate.
Pharmacotherapeutic group: Antiadrenal preparations.
ATCvet code: QH02CA01.
Trilostane selectively and reversibly inhibits the enzyme system 3 beta hydroxysteroid isomerase, thus blocking the production of cortisol, corticosterone and aldosterone. When used to treat hyperadrenocorticism, it reduces the production of glucocorticoid and mineralocorticoid steroids in the adrenal cortex. Circulating concentrations of these steroids are thus reduced. Trilostane also antagonises the activity of exogenous adrenocorticotrophic hormone (ACTH). It has no direct effect on either the central nervous or cardiovascular systems.
Pharmacokinetic data in dogs have demonstrated large inter-individual variability. In a pharmacokinetic study in laboratory beagles, AUC ranged from 52 to 281 micrograms/ml/min in fed dogs, and from 16 to 175 micrograms/ml/min in fasted dogs. Generally trilostane is rapidly removed from the plasma with concentrations in the plasma reaching a maximum between 0.5 to 2.5 hours and returning almost to baseline by six to twelve hours after administration. The primary active metabolite of trilostane, ketotrilostane follows a similar pattern. Furthermore, there was no evidence that trilostane or its metabolites accumulated with time. An oral bioavailability study in dogs demonstrated that trilostane was absorbed more extensively when administered with food.
Trilostane has been demonstrated to be excreted primarily in the faeces of the rat, indicating biliary excretion as the major metabolic pathway. In the monkey, trilostane is excreted in equal amounts in the faeces and urine. Results have shown that trilostane is rapidly and well absorbed from the gastrointestinal tract in both the rat and monkey and that it accumulates in the adrenal glands of the rat.
Shelf life of the veterinary medicinal product as packaged for sale: 3 years.
Do not store above 25°C. Keep the blister strips in the outer carton.
PVC-PVdc / aluminium foil blister strips containing 10 capsules. Each carton contains 3 blister strips.
Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.
Dechra Limited, Snaygill Industrial Estate, Keighley Road, Skipton, North Yorkshire, BD23 2RW, United Kingdom.
Vetoryl 10 mg hard capsules for dogs:
Vm 10434/4068
Vetoryl 30 mg hard capsules for dogs:
Vm 10434/4071
Vetoryl 60 mg hard capsules for dogs:
Vm 10434/4070
Vetoryl 120 mg hard capsules for dogs:
Vm 10434/4069
Vetoryl 10 mg hard capsules for dogs:
13 July 2007
Vetoryl 30 mg hard capsules for dogs:
13 April 2005
Vetoryl 60 mg hard capsules for dogs:
4 April 2005
Vetoryl 120 mg hard capsules for dogs:
4 April 2005
October 2014
For animal treatment only. To be supplied only on veterinary prescription. Keep out of the sight and reach of children.
(For Vetoryl 10 mg/30 mg/60 mg hard capsules for dogs only): Penn Pharmaceutical Services, 23/24 Tafarnaubach Industrial Estate, Tredegar, South Wales, NP22 3AA.
Vetoryl 10 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 10 mg
Excipients: Titanium dioxide (E171) 0.942 mg
Ferric oxide (yellow) (E172) 0.035 mg
Ferric oxide (black) (E172) 0.532 mg
Vetoryl 30 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 30 mg
Excipients: Titanium dioxide (E171) 1.19 mg
Yellow iron oxide (E172) 0.045 mg
Black iron oxide (E172) 0.672 mg
Vetoryl 60 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 60 mg
Excipients: Titanium dioxide (E171) 1.19 mg
Yellow iron oxide (E172) 0.045 mg
Black iron oxide (E172) 0.672 mg
Vetoryl 120 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 120 mg
Excipients: Titanium dioxide (E171) 1.885 mg
Yellow iron oxide (E172) 0.071 mg
Black iron oxide (E172) 1.064 mg
Hard capsules. Ivory body and black cap with the capusle strength printed on the body of the capsule.
Dogs.
In dogs: For the treatment of pituitary-dependent and adrenal-dependent hyperadrenocorticism (Cushing's disease and syndrome).
Vetoryl 10 mg hard capsules for dogs: Do not use in dogs weighing less than 3 kg.
Vetoryl 30 mg hard capsules for dogs: Do not use in dogs weighing less than 3 kg.
Vetoryl 60 mg hard capsules for dogs: Do not use in dogs weighing less than 10 kg.
Vetoryl 120 mg hard capsules for dogs: Do not use in dogs weighing less than 20 kg.
Do not use in animals suffering from primary hepatic disease and/or renal insufficiency.
Do not use where there is suspected hypersensitivity to the active substance or to any of the excipients.
An accurate diagnosis of hyperadrenocorticism is essential.
Where there is no apparent response to treatment, the diagnosis should be re-evaluated. Dose increases may be necessary.
Veterinarians should be aware that dogs with hyperadrenocorticism are at increased risk of pancreatitis. This risk may not diminish following treatment with trilostane.
As the majority of cases of hyperadrenocorticism are diagnosed in dogs between the ages of 10-15 years, other pathological processes are frequently present. It is particularly important to screen cases for primary hepatic disease and renal insufficiency as the product is contraindicated in these cases.
Subsequent close monitoring during treatment should be carried out. Particular attention should be paid to liver enzymes, electrolytes, urea and creatinine.
The presence of diabetes mellitus and hyperadrenocorticism together requires specific monitoring.
If a dog has previously been treated with mitotane, its adrenal function will have been reduced. Experience in the field suggests that an interval of at least a month should elapse between cessation of mitotane and the introduction of trilostane. Close monitoring of adrenal function is advised, as dogs may be more susceptible to the effects of trilostane.
The product should be used with extreme caution in dogs with pre-existing anaemia as further reductions in packed-cell volume and haemoglobin may occur. Regular monitoring should be undertaken.
Trilostane may decrease testosterone synthesis and has anti-progesterone properties. Women who are pregnant or are intending to become pregnant should avoid handling the capsules.
Wash hands with soap and water following accidental exposure and after use.
The content of the capsules may cause skin and eye irritation and sensitisation. Do not divide or open capsules: in the event of accidental breakage of the capsules and contact of the granules with eyes or skin, wash immediately with plenty of water. If irritation persists, seek medical advice.
People with known hypersensitivity to trilostane or any of the excipients should avoid contact with the product.
In the event of accidental ingestion, seek medical advice immediately and show the package leaflet or carton to the physician.
Corticosteroid withdrawal syndrome or hypocortisolaemia should be distinguished from hypoadrenocorticism by evaluation of serum electrolytes.
Signs associated with iatrogenic hypoadrenocorticism, including weakness, lethargy, anorexia, vomiting and diarrhoea may occur, particularly if monitoring is not adequate (see Amounts to be administered and administration route). Signs are generally reversible within a variable period following withdrawal of treatment. Acute Addisonian crisis (collapse) may also occur (see Overdose). Lethargy, vomiting, diarrhoea and anorexia have been seen in dogs treated with trilostane in the absence of evidence of hypoadrenocorticism.
There have been occasional isolated reports of adrenal necrosis in treated dogs which may result in hypoadrenocorticism.
Subclinical renal dysfunction may be unmasked by treatment with the product.
Treatment may unmask arthritis due to a reduction in endogenous corticosteroid levels.
A small number of reports have been received of sudden death during treatment.
Other mild, rare, adverse effects include ataxia, hypersalivation, bloating, muscle tremors and skin changes.
Do not use in pregnant or lactating bitches or in any animals intended for breeding.
The possibility of interactions with other medicinal products has not been specifically studied. Given that hyperadrenocorticism tends to occur in older dogs, many will be receiving concurrent medication. In clinical studies, no interactions were observed.
The risk of hyperkalaemia developing should be considered if trilostane is used in conjunction with potassium-sparing diuretics or ACE inhibitors. The concurrent use of such drugs should be subject to a risk/benefit analysis by the veterinary surgeon, as there have been a few reports of deaths (including sudden death) in dogs when treated concurrently with trilostane and an ACE inhibitor.
Administer orally, once daily, with food. The starting dose for treatment is approximately 2 mg/kg, based on available combinations of capsule sizes. Titrate the dose according to individual response, as determined by monitoring (see below). If a dose increase is required, use combinations of capsule sizes to slowly increase the once daily dose. A wide range of capsule sizes enables optimum dosing for the individual dog. Administer the lowest dose necessary to control the clinical signs.
Ultimately, if symptoms are not adequately controlled for an entire 24 hour inter-dose period, consider increasing the total daily dose by up to 50% and dividing it equally between morning and evening doses.
Do not divide or open capsules.
A small number of animals may require doses significantly in excess of 10 mg per kg body weight per day. In these situations appropriate additional monitoring should be implemented.
Monitoring: Samples should be taken for biochemistry (including electrolytes) and an ACTH stimulation test pre-treatment and then at 10 days, 4 weeks, 12 weeks, and thereafter every 3 months, following initial diagnosis and after each dose adjustment. It is imperative that ACTH stimulation tests are performed 4-6 hours post-dosing to enable accurate interpretation of results.
Dosing in the morning is preferable as this will allow your veterinary surgeon to perform monitoring tests 4-6 hours following administration of the dose. Regular assessment of the clinical progress of the disease should also be made at each of the above time points.
In the event of a non-stimulatory ACTH stimulation test during monitoring, treatment should be stopped for 7 days and then re-started at a lower dose. Repeat the ACTH stimulation test after a further 14 days. If the result is still non-stimulatory, stop treatment until clinical signs of hyperadrenocorticism recur. Repeat the ACTH stimulation test one month after re-starting treatment.
Overdose may lead to signs of hypoadrenocorticism (lethargy, anorexia, vomiting, diarrhoea, cardiovascular signs, collapse). There were no mortalities following chronic administration at 36mg/kg to healthy dogs, however mortalities may be expected if higher doses are administered to dogs with hyperadrenocorticism.
There is no specific antidote for trilostane. Treatment should be withdrawn and supportive therapy, including corticosteroids, correction of electrolyte imbalances and fluid therapy may be indicated depending on the clinical signs.
In cases of acute overdosage, induction of emesis followed by administration of activated charcoal may be beneficial.
Any iatrogenic adrenocortical insufficiency is usually quickly reversed following cessation of treatment. However in a small percentage of dogs, effects may be prolonged. Following a one week withdrawal of trilostane treatment, treatment should be reinstated at a reduced dose rate.
Pharmacotherapeutic group: Antiadrenal preparations.
ATCvet code: QH02CA01.
Trilostane selectively and reversibly inhibits the enzyme system 3 beta hydroxysteroid isomerase, thus blocking the production of cortisol, corticosterone and aldosterone. When used to treat hyperadrenocorticism, it reduces the production of glucocorticoid and mineralocorticoid steroids in the adrenal cortex. Circulating concentrations of these steroids are thus reduced. Trilostane also antagonises the activity of exogenous adrenocorticotrophic hormone (ACTH). It has no direct effect on either the central nervous or cardiovascular systems.
Pharmacokinetic data in dogs have demonstrated large inter-individual variability. In a pharmacokinetic study in laboratory beagles, AUC ranged from 52 to 281 micrograms/ml/min in fed dogs, and from 16 to 175 micrograms/ml/min in fasted dogs. Generally trilostane is rapidly removed from the plasma with concentrations in the plasma reaching a maximum between 0.5 to 2.5 hours and returning almost to baseline by six to twelve hours after administration. The primary active metabolite of trilostane, ketotrilostane follows a similar pattern. Furthermore, there was no evidence that trilostane or its metabolites accumulated with time. An oral bioavailability study in dogs demonstrated that trilostane was absorbed more extensively when administered with food.
Trilostane has been demonstrated to be excreted primarily in the faeces of the rat, indicating biliary excretion as the major metabolic pathway. In the monkey, trilostane is excreted in equal amounts in the faeces and urine. Results have shown that trilostane is rapidly and well absorbed from the gastrointestinal tract in both the rat and monkey and that it accumulates in the adrenal glands of the rat.
Shelf life of the veterinary medicinal product as packaged for sale: 3 years.
Do not store above 25°C. Keep the blister strips in the outer carton.
PVC-PVdc / aluminium foil blister strips containing 10 capsules. Each carton contains 3 blister strips.
Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.
Dechra Limited, Snaygill Industrial Estate, Keighley Road, Skipton, North Yorkshire, BD23 2RW, United Kingdom.
Vetoryl 10 mg hard capsules for dogs:
Vm 10434/4068
Vetoryl 30 mg hard capsules for dogs:
Vm 10434/4071
Vetoryl 60 mg hard capsules for dogs:
Vm 10434/4070
Vetoryl 120 mg hard capsules for dogs:
Vm 10434/4069
Vetoryl 10 mg hard capsules for dogs:
13 July 2007
Vetoryl 30 mg hard capsules for dogs:
13 April 2005
Vetoryl 60 mg hard capsules for dogs:
4 April 2005
Vetoryl 120 mg hard capsules for dogs:
4 April 2005
October 2014
For animal treatment only. To be supplied only on veterinary prescription. Keep out of the sight and reach of children.
(For Vetoryl 10 mg/30 mg/60 mg hard capsules for dogs only): Penn Pharmaceutical Services, 23/24 Tafarnaubach Industrial Estate, Tredegar, South Wales, NP22 3AA.
Vetoryl 10 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 10 mg
Excipients: Titanium dioxide (E171) 0.942 mg
Ferric oxide (yellow) (E172) 0.035 mg
Ferric oxide (black) (E172) 0.532 mg
Vetoryl 30 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 30 mg
Excipients: Titanium dioxide (E171) 1.19 mg
Yellow iron oxide (E172) 0.045 mg
Black iron oxide (E172) 0.672 mg
Vetoryl 60 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 60 mg
Excipients: Titanium dioxide (E171) 1.19 mg
Yellow iron oxide (E172) 0.045 mg
Black iron oxide (E172) 0.672 mg
Vetoryl 120 mg hard capsules for dogs:
1 capsule contains: Active substance:
Trilostane 120 mg
Excipients: Titanium dioxide (E171) 1.885 mg
Yellow iron oxide (E172) 0.071 mg
Black iron oxide (E172) 1.064 mg
Hard capsules. Ivory body and black cap with the capusle strength printed on the body of the capsule.
Dogs.
In dogs: For the treatment of pituitary-dependent and adrenal-dependent hyperadrenocorticism (Cushing's disease and syndrome).
Vetoryl 10 mg hard capsules for dogs: Do not use in dogs weighing less than 3 kg.
Vetoryl 30 mg hard capsules for dogs: Do not use in dogs weighing less than 3 kg.
Vetoryl 60 mg hard capsules for dogs: Do not use in dogs weighing less than 10 kg.
Vetoryl 120 mg hard capsules for dogs: Do not use in dogs weighing less than 20 kg.
Do not use in animals suffering from primary hepatic disease and/or renal insufficiency.
Do not use where there is suspected hypersensitivity to the active substance or to any of the excipients.
An accurate diagnosis of hyperadrenocorticism is essential.
Where there is no apparent response to treatment, the diagnosis should be re-evaluated. Dose increases may be necessary.
Veterinarians should be aware that dogs with hyperadrenocorticism are at increased risk of pancreatitis. This risk may not diminish following treatment with trilostane.
As the majority of cases of hyperadrenocorticism are diagnosed in dogs between the ages of 10-15 years, other pathological processes are frequently present. It is particularly important to screen cases for primary hepatic disease and renal insufficiency as the product is contraindicated in these cases.
Subsequent close monitoring during treatment should be carried out. Particular attention should be paid to liver enzymes, electrolytes, urea and creatinine.
The presence of diabetes mellitus and hyperadrenocorticism together requires specific monitoring.
If a dog has previously been treated with mitotane, its adrenal function will have been reduced. Experience in the field suggests that an interval of at least a month should elapse between cessation of mitotane and the introduction of trilostane. Close monitoring of adrenal function is advised, as dogs may be more susceptible to the effects of trilostane.
The product should be used with extreme caution in dogs with pre-existing anaemia as further reductions in packed-cell volume and haemoglobin may occur. Regular monitoring should be undertaken.
Trilostane may decrease testosterone synthesis and has anti-progesterone properties. Women who are pregnant or are intending to become pregnant should avoid handling the capsules.
Wash hands with soap and water following accidental exposure and after use.
The content of the capsules may cause skin and eye irritation and sensitisation. Do not divide or open capsules: in the event of accidental breakage of the capsules and contact of the granules with eyes or skin, wash immediately with plenty of water. If irritation persists, seek medical advice.
People with known hypersensitivity to trilostane or any of the excipients should avoid contact with the product.
In the event of accidental ingestion, seek medical advice immediately and show the package leaflet or carton to the physician.
Corticosteroid withdrawal syndrome or hypocortisolaemia should be distinguished from hypoadrenocorticism by evaluation of serum electrolytes.
Signs associated with iatrogenic hypoadrenocorticism, including weakness, lethargy, anorexia, vomiting and diarrhoea may occur, particularly if monitoring is not adequate (see Amounts to be administered and administration route). Signs are generally reversible within a variable period following withdrawal of treatment. Acute Addisonian crisis (collapse) may also occur (see Overdose). Lethargy, vomiting, diarrhoea and anorexia have been seen in dogs treated with trilostane in the absence of evidence of hypoadrenocorticism.
There have been occasional isolated reports of adrenal necrosis in treated dogs which may result in hypoadrenocorticism.
Subclinical renal dysfunction may be unmasked by treatment with the product.
Treatment may unmask arthritis due to a reduction in endogenous corticosteroid levels.
A small number of reports have been received of sudden death during treatment.
Other mild, rare, adverse effects include ataxia, hypersalivation, bloating, muscle tremors and skin changes.
Do not use in pregnant or lactating bitches or in any animals intended for breeding.
The possibility of interactions with other medicinal products has not been specifically studied. Given that hyperadrenocorticism tends to occur in older dogs, many will be receiving concurrent medication. In clinical studies, no interactions were observed.
The risk of hyperkalaemia developing should be considered if trilostane is used in conjunction with potassium-sparing diuretics or ACE inhibitors. The concurrent use of such drugs should be subject to a risk/benefit analysis by the veterinary surgeon, as there have been a few reports of deaths (including sudden death) in dogs when treated concurrently with trilostane and an ACE inhibitor.
Administer orally, once daily, with food. The starting dose for treatment is approximately 2 mg/kg, based on available combinations of capsule sizes. Titrate the dose according to individual response, as determined by monitoring (see below). If a dose increase is required, use combinations of capsule sizes to slowly increase the once daily dose. A wide range of capsule sizes enables optimum dosing for the individual dog. Administer the lowest dose necessary to control the clinical signs.
Ultimately, if symptoms are not adequately controlled for an entire 24 hour inter-dose period, consider increasing the total daily dose by up to 50% and dividing it equally between morning and evening doses.
Do not divide or open capsules.
A small number of animals may require doses significantly in excess of 10 mg per kg body weight per day. In these situations appropriate additional monitoring should be implemented.
Monitoring: Samples should be taken for biochemistry (including electrolytes) and an ACTH stimulation test pre-treatment and then at 10 days, 4 weeks, 12 weeks, and thereafter every 3 months, following initial diagnosis and after each dose adjustment. It is imperative that ACTH stimulation tests are performed 4-6 hours post-dosing to enable accurate interpretation of results.
Dosing in the morning is preferable as this will allow your veterinary surgeon to perform monitoring tests 4-6 hours following administration of the dose. Regular assessment of the clinical progress of the disease should also be made at each of the above time points.
In the event of a non-stimulatory ACTH stimulation test during monitoring, treatment should be stopped for 7 days and then re-started at a lower dose. Repeat the ACTH stimulation test after a further 14 days. If the result is still non-stimulatory, stop treatment until clinical signs of hyperadrenocorticism recur. Repeat the ACTH stimulation test one month after re-starting treatment.
Overdose may lead to signs of hypoadrenocorticism (lethargy, anorexia, vomiting, diarrhoea, cardiovascular signs, collapse). There were no mortalities following chronic administration at 36mg/kg to healthy dogs, however mortalities may be expected if higher doses are administered to dogs with hyperadrenocorticism.
There is no specific antidote for trilostane. Treatment should be withdrawn and supportive therapy, including corticosteroids, correction of electrolyte imbalances and fluid therapy may be indicated depending on the clinical signs.
In cases of acute overdosage, induction of emesis followed by administration of activated charcoal may be beneficial.
Any iatrogenic adrenocortical insufficiency is usually quickly reversed following cessation of treatment. However in a small percentage of dogs, effects may be prolonged. Following a one week withdrawal of trilostane treatment, treatment should be reinstated at a reduced dose rate.
Pharmacotherapeutic group: Antiadrenal preparations.
ATCvet code: QH02CA01.
Trilostane selectively and reversibly inhibits the enzyme system 3 beta hydroxysteroid isomerase, thus blocking the production of cortisol, corticosterone and aldosterone. When used to treat hyperadrenocorticism, it reduces the production of glucocorticoid and mineralocorticoid steroids in the adrenal cortex. Circulating concentrations of these steroids are thus reduced. Trilostane also antagonises the activity of exogenous adrenocorticotrophic hormone (ACTH). It has no direct effect on either the central nervous or cardiovascular systems.
Pharmacokinetic data in dogs have demonstrated large inter-individual variability. In a pharmacokinetic study in laboratory beagles, AUC ranged from 52 to 281 micrograms/ml/min in fed dogs, and from 16 to 175 micrograms/ml/min in fasted dogs. Generally trilostane is rapidly removed from the plasma with concentrations in the plasma reaching a maximum between 0.5 to 2.5 hours and returning almost to baseline by six to twelve hours after administration. The primary active metabolite of trilostane, ketotrilostane follows a similar pattern. Furthermore, there was no evidence that trilostane or its metabolites accumulated with time. An oral bioavailability study in dogs demonstrated that trilostane was absorbed more extensively when administered with food.
Trilostane has been demonstrated to be excreted primarily in the faeces of the rat, indicating biliary excretion as the major metabolic pathway. In the monkey, trilostane is excreted in equal amounts in the faeces and urine. Results have shown that trilostane is rapidly and well absorbed from the gastrointestinal tract in both the rat and monkey and that it accumulates in the adrenal glands of the rat.
Shelf life of the veterinary medicinal product as packaged for sale: 3 years.
Do not store above 25°C. Keep the blister strips in the outer carton.
PVC-PVdc / aluminium foil blister strips containing 10 capsules. Each carton contains 3 blister strips.
Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.
Dechra Limited, Snaygill Industrial Estate, Keighley Road, Skipton, North Yorkshire, BD23 2RW, United Kingdom.
Vetoryl 10 mg hard capsules for dogs:
Vm 10434/4068
Vetoryl 30 mg hard capsules for dogs:
Vm 10434/4071
Vetoryl 60 mg hard capsules for dogs:
Vm 10434/4070
Vetoryl 120 mg hard capsules for dogs:
Vm 10434/4069
Vetoryl 10 mg hard capsules for dogs:
13 July 2007
Vetoryl 30 mg hard capsules for dogs:
13 April 2005
Vetoryl 60 mg hard capsules for dogs:
4 April 2005
Vetoryl 120 mg hard capsules for dogs:
4 April 2005
October 2014
For animal treatment only. To be supplied only on veterinary prescription. Keep out of the sight and reach of children.
(For Vetoryl 10 mg/30 mg/60 mg hard capsules for dogs only): Penn Pharmaceutical Services, 23/24 Tafarnaubach Industrial Estate, Tredegar, South Wales, NP22 3AA.
Under almost all products on our website is an Estimated dispatch time, check this for a delivery prediction specific to the item you are looking to purchase. These badges are updated live based on the stock levels we have and also those of our suppliers - so are usually very accurate, but cannot be guaranteed. In more general terms, we aim to dispatch all orders within 1 working day of receiving payment (and a prescription if required). If we cannot do so within 3 working days we will contact you by email.
For UK delivery, we charge the following:
| Order Total | Weight | Delivery |
| £0-£28.99 | Under 2kg | £2.99 |
| 2kg+ | £4.99 | |
| £29-£38.99 | Under 2kg | Free |
| 2kg+ | £4.99 | |
| £39+ | Under 2kg | Free |
| 2kg+ | Free |
Prices quoted are for delivery to all parts of mainland UK except certain Scottish postcodes (where the price is higher for items sent by courier. Delivery of food abroad (including Channel Islands, N. Ireland and other islands around the UK) is charged at a higher price and free delivery is not available. Temperature controlled products, such as Insulin, are also not always subject to the standard and/or free delivery options.
For full information on our delivery charges, including prices on heavy deliveries to Scotland and abroad, see our delivery information page.
We can deliver most items to all around the world, but prices do vary. The majority of light weight orders (less than 1.5kg) can be delivered for a flat rate of £10. For an accurate estimate of the delivery charge, please put the items you require in your basket and use the "Estimate Delivery" system on the shopping basket page (you only need to enter your country and postal/zip code) for a quick quote. For deliveries to the USA you may need to go to the checkout page and enter your full address to get a quote (as some services need your state in order to quote too). For more information on international deliveries, please see our delivery information page.
Due to restrictions aerosols can't be sent by Royal Mail. We appreciate your understanding.
Some products, such as insulin and frozen food, need to be delivered in insulated packaging to prevent them from getting too warm (or too cold) during transit from us to you. Purchasing any of these items in your order will result in a £1.99 charge being added to the total to cover the high cost of the insulated packaging materials. You only pay the £1.99 once per order, regardless of how many temperature controlled items you purchase in that order.
Please call us as soon as possible if you need to amend or cancel an order on 01582 842096. If your order has been processed for dispatch we will be unable to cancel or amend the order. You will however be able to return your product for a full refund*.
To return an item, you must contact us by phone or email to arrange this BEFORE posting any product back to us. We will explain the process at this stage for you.
*For full details on returns, see our terms and conditions page.
Below are some recent questions we've received regarding Vetoryl Capsules, including answers from our team.
Sheila
Will you be having Vetoryl 5 mg capsules soon?
We will add these to our website just as soon as they become available. I hear that they are in the pipeline, but they have not yet been released in the UK by the manufacturer.
