Trilostane Compounded Oral Suspension for Dogs

Why it is compounded

The approved dog product is a capsule in six strengths [1]. A veterinarian who needs a dose between those strengths, or a liquid for a dog that won't take capsules, may order a suspension compounded.

Dosage forms and strengths

• Strength in mg per mL set by the veterinarian
• Suspending base chosen with the pharmacist, with flavor options
• Volumes matched to the prescription

Dosing is the veterinarian's decision.

How Mixwell prepares it

Mixwell compounds this liquid in Chino, California under USP 795 rules for non sterile preparations [3]. The FDA says compounding animal drugs from bulk drug substances is not allowed [2], so our pharmacist confirms the source of the trilostane before compounding. We also confirm the strength and base with the veterinarian. We ship across California. Veterinary prescriptions cannot be charged to an HSA or FSA account.

The Vetoryl label lists these contraindications: sensitivity to trilostane, primary liver disease, kidney insufficiency, and pregnancy. It says not to use it in pregnant dogs [1].

It warns that hypoadrenocorticism can develop at any dose, that adrenal function can take months to return, and that some dogs never recover it. It calls for an ACTH stimulation test and blood chemistry, with a recheck 10 to 14 days after each dose change. It advises care with ACE inhibitors and says not to combine it with potassium sparing diuretics such as spironolactone [1].

The most common reactions are reduced appetite, vomiting, lethargy, diarrhea, and weakness. Serious reactions include adrenal necrosis or rupture, hypoadrenocortical crisis, and death [1]. The label says not to empty the capsule contents or divide the capsules. It warns that pregnant women, or women trying to conceive, should not handle the capsules [1].

These warnings come from the capsule label. No FDA labeling describes a liquid. Diagnosis, dosing, and monitoring are the veterinarian's responsibility.