Glucocorticoides
Glucocorticoids
Corticosteroids
También conocido como: Prednisone · Dexamethasone · Hydrocortisone · Methylprednisolone · Kenalog · Recicort · Glucocorticosteroids · Triamcinolone acetonide
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Anti-inflammatory (Prednisolone equivalent) | 0.5-1.0 mg/kg | PO | q12h to q24h | Taper to lowest effective alternate-day dose | 🌍 EU |
| Immunosuppressive (Prednisolone equivalent) | 2.0-4.0 mg/kg | PO | q24h (divided q12h initially) | Taper slowly over weeks to months | 🌍 EU |
- Anti-inflammatory (Prednisolone equivalent): Doses are highly variable depending on the specific glucocorticoid used.
- Immunosuppressive (Prednisolone equivalent): Monitor closely for severe adverse effects at these doses.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Anti-inflammatory (Prednisolone equivalent) | 1.0-2.0 mg/kg | PO | q12h to q24h | Taper to lowest effective alternate-day dose | 🌍 EU |
| Immunosuppressive (Prednisolone equivalent) | 2.0-4.0 mg/kg | PO | q12h to q24h | Taper slowly over weeks to months | 🌍 EU |
- Anti-inflammatory (Prednisolone equivalent): Cats require higher doses than dogs and should receive prednisolone, not prednisone.
- Immunosuppressive (Prednisolone equivalent): Monitor for signs of diabetes mellitus.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
Los glucocorticoides son una amplia clase de hormonas esteroideas con efectos profundos en prácticamente todos los tipos de células y sistemas en los mamíferos. En medicina veterinaria, se utilizan en cuatro rangos de dosificación e indicaciones generales:
- Physiologic Replacement: Para pacientes con insuficiencia adrenal (p. ej., Addison's disease).
- Anti-inflammatory: Para controlar estados alérgicos, enfermedades respiratorias (asma), afecciones dermatológicas y osteoartritis.
- Immunosuppressive: Para trastornos autoinmunes como Immune-mediated hemolytic anemia (IMHA), trombocitopenia, pénfigo y lupus eritematoso sistémico.
- Antineoplastic: Utilizados como agentes citotóxicos en ciertas neoplasias (p. ej., linfoma).
Clinical Pearl: Los gatos generalmente requieren dosis más altas que los perros para lograr el mismo efecto clínico, pero tienden a ser más resistentes al desarrollo de efectos adversos. Por el contrario, los perros son altamente sensibles a los glucocorticoides y desarrollan fácilmente hiperadrenocorticismo iatrogénico (Cushing's syndrome) con el uso crónico.
Mecanismo de acción
Glucocorticoids exert their effects primarily by binding to cytosolic glucocorticoid receptors (GR). The receptor-ligand complex translocates to the nucleus, where it binds to glucocorticoid response elements (GREs) on DNA, altering gene transcription (transactivation and transrepression).
- Anti-inflammatory Pathway: They induce the production of lipocortin (annexin-1), which inhibits phospholipase A2. This blocks the release of arachidonic acid from cell membranes → dramatically decreasing the synthesis of both prostaglandins and leukotrienes.
- Immune Suppression: They inhibit macrophage function, decrease circulating T-lymphocytes, suppress inflammatory cytokines (IL-1, IL-6, TNF-alpha), and inhibit the complement cascade.
- Metabolic Effects: Stimulate gluconeogenesis, mobilize amino acids, and redistribute adipose tissue, which can lead to insulin resistance.
Seguridad y advertencias
Contraindicaciones
- Systemic fungal infections (unless used for physiologic replacement)
- Intramuscular administration in patients with idiopathic thrombocytopenia
- Known hypersensitivity to the specific compound
- Chronic use of sustained-release injectables for systemic diseases
- Concurrent use with NSAIDs (relative contraindication due to severe GI ulcer risk)
- Pregnant animals
- Renal disease (systemic use)
- Diabetes mellitus (systemic use)
- Corneal ulcers
- Concurrent use of NSAIDs
- Uncontrolled diabetes mellitus
- Late pregnancy (may induce abortion or parturition)
Efectos adversos
- Polyuria (PU), polydipsia (PD), and polyphagia (PP)
- Weight gain and fat redistribution
- Panting (especially in dogs)
- Dull, dry haircoat and alopecia
- Vomiting and diarrhea
- Gastrointestinal ulceration
- Elevated liver enzymes (ALP > ALT) and vacuolar hepatopathy (dogs)
- Pancreatitis
- Insulin resistance leading to or worsening diabetes mellitus
- Muscle wasting and weakness
- Behavioral changes (depression, lethargy, viciousness)
- Iatrogenic hyperadrenocorticism (Cushing's syndrome) with chronic use
- Laminitis (horses)
- Hypothalamic-pituitary axis (HPA) suppression
- Adrenal atrophy
- Weight loss (catabolic effect)
- Cutaneous atrophy
- Diarrhoea
- Increased urine glucose levels
- Decreased serum T3 and T4 values
- Impaired wound healing
- Delayed recovery from infections
- Muscle weakness
- Obesity
- Thromboembolic disease
- Polyuria and polydipsia (PU/PD)
- Muscle atrophy and weakness
- Alopecia and thin skin
- Insulin resistance and secondary diabetes mellitus
- Immunosuppression and increased susceptibility to infections
- Hepatomegaly and elevated liver enzymes (steroid hepatopathy in dogs)
Precauciones
Animals receiving systemic glucocorticoids (other than short-term 'burst' therapy) MUST be tapered off the drugs slowly to allow endogenous ACTH and corticosteroid function to return. Abrupt withdrawal can precipitate a life-threatening Addisonian crisis. During periods of stress (e.g., surgery, trauma, severe illness) during the tapering process, additional glucocorticoids should be administered. Use with caution in young, growing animals as it can retard bone growth.
Interacciones farmacológicas
May cause hypokalemia when administered concomitantly
May lead to profound muscle weakness in myasthenia gravis patients; discontinue 24h prior if possible
Glucocorticoids may reduce salicylate blood levels; increased risk of GI ulceration
Glucocorticoids may inhibit hepatic metabolism of cyclophosphamide
May mutually inhibit hepatic metabolism, increasing blood levels of both drugs
Increased risk for arrhythmias secondary to glucocorticoid-induced hypokalemia
May cause additive hypokalemia
May increase glucocorticoid metabolism
May potentiate the effects of hydrocortisone and possibly other glucocorticoids
Insulin requirements may increase due to glucocorticoid-induced insulin resistance
May decrease glucocorticoid metabolism
May alter steroid metabolism; higher steroid doses may be necessary to treat mitotane-induced adrenal insufficiency
Significantly increased risk of severe gastrointestinal ulceration
May increase the metabolism of glucocorticoids
May increase the metabolism of glucocorticoids
May increase the metabolism of glucocorticoids
Live attenuated vaccines should be avoided due to augmented virus replication; diminished immune response to all vaccines may occur
Hypokalaemia may develop
Decreased metabolism of corticosteroids
Significantly increased risk of severe gastrointestinal ulceration and perforation.
Increased risk of hypokalemia due to additive potassium-wasting effects.
Monitorización
- Weight, appetite, and signs of edema
- Serum and/or urine electrolytes (potassium, calcium, sodium)
- Total plasma proteins and albumin
- Liver enzymes (ALP, ALT, GGT)
- Growth and development in young animals
- ACTH stimulation test (if assessing adrenal recovery or iatrogenic Cushing's)
- Clinical signs of hyperadrenocorticism
- Blood glucose (especially in diabetics)
- Thyroid panel (T3/T4 may decrease)
- Clinical signs of PU/PD and weight gain
- Blood glucose (due to diabetes mellitus risk)
- ACTH stimulation test (to monitor HPA axis suppression)
- Water intake and urine output
- Appetite and body weight
- Blood glucose (especially in cats)
- Liver enzymes (ALP is typically markedly elevated in dogs on steroids)
- Clinical signs of secondary infections (e.g., UTI, pyoderma)
- Gastrointestinal signs (vomiting, melena)
Farmacocinética
Vida media
Absorción
Varies significantly by ester formulation. Sodium succinate/phosphate esters are absorbed very rapidly (minutes). Acetate esters are absorbed moderately (days to weeks). Acetonide esters are absorbed poorly (weeks).
Distribución
Widely distributed. Unbound glucocorticoids can enter milk and cross the placenta.
Metabolismo
Primarily hepatic metabolism.
Eliminación
Metabolites are primarily excreted by the kidneys.
Sobredosis
Short-term massive overdoses are unlikely to cause acute harmful effects, though one case of acute CNS effects in a dog has been reported (treat supportively). Chronic overdosage leads to serious adverse effects manifesting as iatrogenic hyperadrenocorticism (Cushing's syndrome).
Productos disponibles
Formulaciones
- Oral tablets and liquids
- Injectable solutions (e.g., sodium succinate/phosphate esters for rapid onset)
- Injectable suspensions (e.g., acetate/acetonide esters for sustained release)
- Topical creams, ointments, and sprays
- Ophthalmic drops and ointments
- Injectable: 40 mg/ml suspension for deep i.m., intra-articular or intralesional use
- Topical: Solution containing 1.77 mg/ml with 17.7 mg/ml salicylic acid
- Systemic (Oral/Injectable)
- Local
- Inhaled
- Oral liquids
- Injectable solutions (e.g., sodium phosphate salts)
- Injectable suspensions (e.g., acetate or acetonide salts)
Veterinario
- Kenalog 40 mg/ml injectable suspension
- Recicort 1.77 mg/ml topical solution
- Prednicare (Prednisolone tablets)
- Dexadreson (Dexamethasone injection)
- Moderin (Methylprednisolone tablets)
Etiquetado para humanos
- Prednisolone tablets
- Dexamethasone tablets/injection
- Hydrocortisone tablets
Estado regulador
Tiempos de retirada: cattle meat Varies by specific drug and formulation
Widely approved across member states.
POM-V classification.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store according to specific product labeling, generally at room temperature away from light and moisture.
Información para el cliente
ADVERTENCIA CRÍTICA: Nunca suspenda este medicamento abruptamente a menos que su veterinario se lo indique específicamente. El cuerpo de su mascota deja de producir sus propios esteroides mientras toma este fármaco, y la retirada repentina puede causar una crisis que pone en peligro la vida.
- Cambios esperados: Es muy común que las mascotas (especialmente los perros) beban más agua, orinen con mayor frecuencia y tengan un apetito voraz mientras toman este medicamento. Asegúrese de que siempre tengan acceso a agua fresca y salidas frecuentes para ir al baño.
- Jadeo: Los perros pueden jadear excesivamente; este es un efecto secundario común.
- Comportamiento: Algunas mascotas pueden mostrarse letárgicas, deprimidas o inusualmente irritables.
- Cuándo llamar al veterinario: Contacte a su veterinario si nota vómitos severos, heces oscuras/alquitranadas (un signo de úlceras estomacales), debilidad extrema o si el aumento de la sed/orina se vuelve inmanejable.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.