Desoxycorticosterone Pivalate (DOCP)
Desoxycorticosterone pivalate
Also known as: Percorten-V · Cortiron · Zycortal · DOCP · deoxycorticosterone pivalate · deoxycorticosterone trimethyl-acetate · deoxycortone pivalate · deoxycortone trimethylacetate · desoxycorticosterone trimethyl-acetate
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Hypoadrenocorticism | 2.2 mg/kg IM every 25 days | IM | q25d | — | 🌎 NA |
| Hypoadrenocorticism | Initially, inject 2.2 mg/kg IM or SC every 25 days. Reevaluate at 12 and 25 days after initial injection. If hyponatremia and/or hyperkalemia are noted at 12 days, increase dose by 10%. If they are noted at 25 days (but not on day 12), shorten dosing interval by 2 days. | IM/SC | q25d | — | 🌎 NA |
| Hypoadrenocorticism | 1.5-2.2 mg/kg IM q20-30 days | IM | q20-30d | — | 🌎 NA |
| Hypoadrenocorticism | Initially, 2.2 mg/kg IM q25 days. If electrolytes remain in normal range at 30 days, reduce dose by 10% a month. In our clinic, we have used a dose of DOCP as low as 1 mg/kg q30 days with good control of hypoadrenocorticism. | IM | q25-30d | — | 🌎 NA |
- Hypoadrenocorticism: Dosage requirements are variable and should be individualized to the patient.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Maintenance therapy of hypoadrenocorticism | 2.2 mg/kg IM every 25 days plus prednisolone (0.25-1 mg/cat PO twice daily; if daily oral dosing not feasible, may give 10 mg of methylprednisolone acetate once a month IM) | IM | q25d | — | 🌎 NA |
| Maintenance therapy of hypoadrenocorticism | 10-12.5 mg (total dose) IM per month. Adjust dose based-upon follow-up serum electrolyte concentrations monitored every 1-2 weeks during initial maintenance period. Normal electrolyte values 2 weeks following injection, suggests adequate dosing, but does not provide information regarding duration of action. Prednisone at 1.25 mg PO once a day or IM methylprednisolone acetate 10 mg once a month can provide long-term glucocorticoid supplementation. | IM | monthly | — | 🌎 NA |
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Desoxycorticosterone pivalate (DOCP) is a long-acting, injectable mineralocorticoid used primarily for the management of typical hypoadrenocorticism (Addison's disease) in dogs, and extra-label in cats.
- Clinical Pearl: Unlike fludrocortisone, DOCP possesses zero glucocorticoid activity. Therefore, patients receiving DOCP must also receive concurrent glucocorticoid supplementation (e.g., physiologic doses of prednisone or hydrocortisone), especially during times of stress or illness.
- It is formulated as a microcrystalline depot suspension, allowing for slow dissolution and a prolonged duration of action (typically 21-30 days).
Mechanism of action
DOCP acts as an exogenous analog of aldosterone.
- Target Site: Acts primarily at the renal distal tubule and collecting ducts.
- Mechanism: Binds to mineralocorticoid receptors → upregulates Na+/K+ ATPase pumps and epithelial sodium channels (ENaC) → increases the absorption of sodium (Na+) and enhances potassium (K+) and hydrogen (H+) ion excretion.
- Requirement: To be effective, mineralocorticoids require a functioning kidney.
Safety & warnings
Contraindications
- Congestive heart failure
- Severe renal disease
- Edema
Adverse effects
- Injection site irritation
- Polyuria (PU)
- Polydipsia (PD)
- Hypernatremia
- Hypokalemia
- Hypertension
- Edema
- Weight gain (fluid retention)
Precautions
CRITICAL WARNING: Do NOT administer intravenously (IV). Acute collapse and shock may result. If given IV, treat immediately for shock with IV fluids and glucocorticoids.
- Glucocorticoid Supplementation: DOCP lacks glucocorticoid activity. All animals with hypoadrenocorticism should receive additional glucocorticoids (2-10 times basal) during periods of stress or acute illness.
- Contraindications: Contraindicated in dogs suffering from congestive heart failure, severe renal disease, or edema.
- Pregnancy: Use in pregnant animals only when potential benefits outweigh risks (safe use not established). Safe for nursing offspring.
- Individualized Dosing: 'Cookbook' dosing without ongoing monitoring is inappropriate due to variable sensitivity.
Drug interactions
Patients may develop hypokalemia if mineralocorticoids are administered concomitantly.
DOCP may reduce salicylate levels.
Because DOCP may cause hypokalemia, it should be used with caution and increased monitoring when used in patients receiving digitalis glycosides.
Potentially, DOCP could increase the insulin requirements of diabetic patients.
Patients may develop hypokalemia if administered concomitantly; as diuretics can cause a loss of sodium, they may counteract the effects of DOCP.
Monitoring
- Serum electrolytes (Na+, K+)
- BUN and Creatinine (initially every 1-2 weeks, then once stabilized, every 3-4 months)
- Body weight
- Physical examination for edema
Pharmacokinetics
Half-life
Absorption
Injected IM (or subcutaneously) as a microcrystalline depot for slow dissolution into the circulation.
Overdose
Overdosage may cause polyuria, polydipsia, hypernatremia, hypertension, edema, and hypokalemia. Cardiac enlargement is possible with prolonged overdoses. Excessive weight gain may be indicative of fluid retention secondary to sodium retention.
Treatment:
- Electrolytes should be aggressively monitored.
- Potassium may need to be supplemented.
- Discontinue the drug in patients until clinical signs associated with overdosage have resolved, then restart the drug at a lower dosage.
Available products
Formulations
- Injectable suspension: 25 mg/mL
Veterinary
- Desoxycorticosterone Pivalate Injectable Suspension: 25 mg/mL in 4 mL vials (Percorten-V®)
Regulatory status
No regulatory data for: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store the injectable suspension at room temperature and protect from light or freezing. Do not mix with any other agent.
Client information
- Watch for Addisonian Crisis: Clients should be familiar with the symptoms associated with hypoadrenocorticism (e.g., weakness, depression, anorexia, vomiting, diarrhea) and report these to the veterinarian immediately.
- Watch for Overdose: Signs of too much medication include excessive thirst and urination (PU/PD), swelling/edema, or rapid weight gain.
- Stress Dosing: Your pet will likely need extra oral steroids (like prednisone) during stressful events (boarding, vet visits, illness).
- At-Home Injections: If administering at home, shake the vial vigorously before drawing up the dose to ensure the macrocrystals are fully suspended. Ensure proper intramuscular (IM) or subcutaneous (SC) technique.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.