Entyce

Entyce (Capromorelin) is a ghrelin receptor agonist that works to increase hunger. It is FDA-approved for use in dogs. Entyce mimics ghrelin (called the “hunger hormone”) in the stomach at the ghrelin receptor, which signals the hypothalamus to increase appetite. Entyce also causes release of growth hormone from the pituitary, which induces the release of insulin-like growth factor (IGF-1). Entyce is metabolized by the liver by CYP3A4 and CYP3A5. Its metabolites are excreted in the urine (~37%) and feces (62%).

Formulation

  • 30mg/ml flavored solution
  • Available in 10, 15, and 30 ml bottles (Ethos currently stocks 10ml and 30ml bottles)

Dosage

  • Dogs (FDA-approved): 3 mg/kg PO q24 hours. Effectiveness after 4 days has not been evaluated, but safety studies indicate excellent safety profile
    • If long-term administration is indicated, do not dose intermittently. This could lead to unsafe surges or prolonged elevated in growth hormone. Instead, daily administration is recommended until no longer needed for appetite stimulation.
    • If not effective within 4 days, can increase dose to 4 mg/kg PO q24 for 4 days then return to regular dosing
  • Cats (off-label): 2 mg/kg PO q24

Relative contraindications

  • Renal disease
  • Hepatic insufficiency
  • Diabetes – has not been evaluated in diabetic patients and could lead to insulin resistance

Drug interactions

  • CYP3A4 inhibitors may reduce metabolism (amiodarone, cimetidine, diltiazem, erythromycin, ketoconazole, itraconazole)
  • CYP3A4 inducers may increase metabolism (rifampin, phenobarbital)

Side effects

  • Diarrhea, flatulence
  • Vomiting, nausea
  • Polydypsia
  • Hypersalivation (may occur right way)
  • Abdominal discomfort
  • Head shaking (cats; rare)

Overdose
Safety studies show a wide margin of safety with prolonged overdosage

  • Increased liver values
  • Anemia
  • Increased PR intervals (dogs)

Additional resources

  • Capromorelin. Plumb’s Veterinary Drugs. Accessed January 2018.
  • Entyce Package Insert. Aratana Therapeutics Inc., Leawood, KS. Download package insert
  • Wofford JA, Zollers B, Rhodes L, Bell M, Heinen E. Evaluation of the safety of daily administration of capromorelin in cats published online October 22, 2017. J Vet Pharmacol Ther. 2017. doi:10.1111/jvp/12459. Download article
  • Zollers B, Allen J, Kennedy C, et al. Capromorelin, an orally active ghrelin agonist, caused sustained increases in IGF-1, increased food intake and body weight in cats. ACVIM Poster abstract. Indianapolis, IN. 2015. Download article
  • Zollers B, Huebner M, Armintrout G, et al. Evaluation of the safety in dogs of long-term, daily oral administration of capromorelin (Entyce®), a novel drug for stimulation of appetite. J Vet Pharm 2016. doi: 10.1111/jvp.12358. Download article
  • Zollers B, Wofford JA, Heinen E, Huebner M, Rhodes L. A prospective, randomized, masked, placebo-controlled clinical study of capromorelin in dogs with reduced appetite. J Vet Intern Med. 2016;30(6):1851-1857. Download article
Last updated: 2018-03-31