Triamcinolona acetónido
Triamcinolone Acetonide
Triamcinolone acetonide
También conocido como: Vetalog · Kenalog · Aristospan · triamcinoloni acetonidum · TMC
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 |
|---|---|---|---|---|---|
| Glucocorticoid effects | 2 mg PO once daily for 7 days; 0.11-0.22 mg/kg IM or SC | PO/IM/SC | once daily (PO) or single dose (IM/SC) | 7 days for PO | 🌎 NA |
| Antiinflammatory effects | 0.05 mg/kg PO two to three times daily | PO | q8-12h | — | 🌎 NA |
| General therapy (Tablets) | 0.11 mg/kg PO initially once a day, may increase to 0.22 mg/kg PO once daily if initial response is unsatisfactory. As soon as possible, but not later than 2 weeks, reduce dose gradually to 0.028-0.055 mg/kg/day. | PO | q24h | Taper within 2 weeks | 🌎 NA |
| Inflammatory, allergic, or dermatological disorders (Injectable) | 0.11-0.22 mg/kg for inflammatory or allergic disorders, and 0.22 mg/kg for dermatological disorders. | IM/SC | As needed | Effects generally persist for 7-15 days | 🌎 NA |
| Intralesional injection | Usual dose is 1.2-1.8 mg; inject around lesion at 0.5-2.5 cm intervals. Do not exceed 0.6 mg at any one site or 6 mg total dose. | Intralesional | As needed | — | 🌎 NA |
| To prevent re-stricture after esophageal dilation | Using an endoscopically directed needle, inject 0.5-1 mL of Vetalog (2 mg/mL) submucosally at time of dilation procedure. Infiltration is done circumferentially at four points around the site. | Submucosal | Once at time of procedure | — | 🌎 NA |
- Inflammatory, allergic, or dermatological disorders (Injectable): If symptoms recur, may repeat or institute oral therapy.
- Intralesional injection: May repeat as necessary.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Glucocorticoid effects | 0.25-0.5 mg PO once daily for 7 days | PO | q24h | 7 days | 🌎 NA |
| Pododermatitis, feline plasmacytic pharyngitis | 2-4 mg (total dose) PO once a day or every other day 0.4-0.6 mg/kg PO once daily, then taper. | PO | q24h or q48h | Tapered | 🌎 NA |
| Pemphigus complex | 0.4-0.8 mg/kg/day PO | PO | q24h | — | 🌎 NA |
| General therapy (Tablets) | 0.11 mg/kg PO initially once a day, may increase to 0.22 mg/kg PO once daily if initial response is unsatisfactory. As soon as possible, but not later than 2 weeks, reduce dose gradually to 0.028-0.055 mg/kg/day | PO | q24h | Taper within 2 weeks | 🌎 NA |
| Inflammatory, allergic, or dermatological disorders (Injectable) | 0.11-0.22 mg/kg for inflammatory or allergic disorders, and 0.22 mg/kg for dermatological disorders. | IM/SC | As needed | Effects generally persist for 7-15 days | 🌎 NA |
| Intralesional injection | Usual dose is 1.2-1.8 mg; inject around lesion at 0.5-2.5 cm intervals. Do not exceed 0.6 mg at any one site or 6 mg total dose. | Intralesional | As needed | — | 🌎 NA |
| To prevent re-stricture after esophageal dilation | Using an endoscopically directed needle, inject 0.5-1 mL of Vetalog (2 mg/mL) submucosally at time of dilation procedure. Infiltration is done circumferentially at four points around the site. | Submucosal | Once at time of procedure | — | 🌎 NA |
| Adjunctive treatment of miliary dermatitis | 0.2-0.6 mg/kg PO once daily for 10-14 days, then tapered. | PO | q24h | 10-14 days, then taper | 🌎 NA |
- Inflammatory, allergic, or dermatological disorders (Injectable): If symptoms recur, may repeat or institute oral therapy.
- Intralesional injection: May repeat as necessary.
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Glucocorticoid effects | 0.011-0.022 mg/kg PO twice daily; 0.011-0.022 mg/kg IM or SC; 6-18 mg intra-articularly or intrasynovially, may repeat after 3-4 days | PO/IM/SC/IA | q12h (PO) or as directed | — | 🌎 NA |
| Intra-articular injection | 12 mg IA on days 0, 13, 27 | IA | Specific days | 27 days | 🌎 NA |
- Glucocorticoid effects: ARCI UCGFS Class 4 Drug
Ganado
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Glucocorticoid effects | 0.02-0.04 mg/kg IM; 6-18 mg intra-articularly. | IM/IA | As directed | — | 🌎 NA |
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La triamcinolona acetónido es un glucocorticoide sintético de acción intermedia que es aproximadamente de 4 a 10 veces (y hasta 40 veces en algunos modelos) más potente que la hidrocortisona.
Perlas clínicas y características clave:
- Actividad mineralocorticoide nula: A diferencia de la hidrocortisona o la prednisona, la triamcinolona carece de efectos mineralocorticoides apreciables, lo que significa que no causa una retención significativa de sodio o agua.
- Administración versátil: Se utiliza por vía sistémica (oral, inyectable), tópica, intraarticular (especialmente en medicina deportiva equina) e intralesional (p. ej., para estenosis esofágicas o granulomas por lamido).
- Duración de la acción: Cuando se administra por vía oral, su actividad metabólica dura entre 24-48 horas. Sin embargo, las inyecciones de depósito intramusculares (IM) o subcutáneas (SC) pueden persistir de 4 a 6 semanas (a veces hasta 8 semanas), lo que la hace útil para afecciones inflamatorias o alérgicas crónicas donde la administración diaria de pastillas es difícil, aunque esto aumenta el riesgo de supresión adrenal prolongada.
- Uso en equinos: Se utiliza frecuentemente para inyecciones intraarticulares en articulaciones de alto movimiento para reducir la sinovitis y mejorar la cojera. Es un fármaco de Clase 4 de la ARCI en carreras.
Mecanismo de acción
Triamcinolone exerts its effects via classic genomic and non-genomic glucocorticoid pathways:
- Genomic Pathway: Free triamcinolone crosses the cell membrane and binds to the cytosolic glucocorticoid receptor (GR).
- The receptor-ligand complex translocates to the nucleus and binds to Glucocorticoid Response Elements (GREs) on DNA.
- Anti-inflammatory Protein Induction: It upregulates the expression of lipocortin-1 (annexin A1). Lipocortin-1 inhibits phospholipase A2, thereby blocking the release of arachidonic acid from membrane phospholipids.
- Eicosanoid Suppression: This → halts the synthesis of pro-inflammatory prostaglandins and leukotrienes (via COX and LOX pathways).
- Cytokine Inhibition: It suppresses the transcription of major inflammatory cytokines (e.g., IL-1, IL-6, TNF-α) and reduces inflammatory cell migration and capillary permeability.
Seguridad y advertencias
Contraindicaciones
- Systemic fungal infections
- Viral infections
- Active tuberculosis
- Peptic ulcers
- Corneal ulcers
- Acute psychoses
- Cushingoid syndrome
- Idiopathic thrombocytopenia (IM administration)
- Hypersensitivity to the drug
Efectos adversos
- Polyuria (PU)
- Polydipsia (PD)
- Polyphagia (PP)
- Weight gain
- Panting (dogs)
- Dull, dry haircoat
- Vomiting and diarrhea
- Elevated liver enzymes (e.g., ALP)
- Pancreatitis
- Gastrointestinal ulceration
- Lipidemias
- Insulin resistance / Activation of diabetes mellitus
- Muscle wasting
- Behavioral changes (depression, lethargy, viciousness)
- Iatrogenic hyperadrenocorticism (Cushing's syndrome) with chronic use
- Laminitis (horses)
Precauciones
Tapering Required: Animals receiving systemic glucocorticoids (other than short 'burst' therapy) must be tapered off slowly to allow endogenous ACTH and adrenal function to recover.
- Stress Dosing: If a patient undergoes a stressor (surgery, trauma, illness) during tapering, additional glucocorticoids should be administered.
- Pregnancy Warning: Corticosteroid therapy may induce parturition in large animal species during the latter stages of pregnancy. Teratogenic effects are possible with excessive doses early in pregnancy (FDA Category C).
- Growth Retardation: Can retard growth when administered to young, growing animals.
- Disease Exacerbation: Use with extreme caution in patients with diabetes mellitus, osteoporosis, predisposition to thrombophlebitis, hypertension, congestive heart failure (CHF), and renal insufficiency.
Interacciones farmacológicas
May cause hypokalemia when administered concomitantly
Combination in epidurals has caused serious CNS injuries and death; restrict volume to very small intrathecal test doses
May lead to profound muscle weakness in myasthenia gravis patients; discontinue 24h prior if possible
Glucocorticoids may reduce salicylate blood levels
May increase the metabolism of glucocorticoids and decrease blood levels
Glucocorticoids may inhibit hepatic metabolism of cyclophosphamide; dosage adjustments may be required
May mutually inhibit hepatic metabolism, increasing blood levels of both drugs
May cause hypokalemia
May increase triamcinolone levels
May potentiate the effects of triamcinolone
Insulin requirements may increase due to glucocorticoid-induced insulin resistance
Triamcinolone may decrease isoniazid levels
May decrease metabolism of glucocorticoids; ketoconazole may induce adrenal insufficiency upon steroid withdrawal
Higher than usual doses of steroids may be necessary to treat mitotane-induced adrenal insufficiency
Increased risk of gastrointestinal ulceration
May increase the metabolism of glucocorticoids and decrease triamcinolone blood levels
May increase the metabolism of glucocorticoids and decrease triamcinolone blood levels
May augment viral replication of live vaccines; diminished immune response to killed vaccines/toxoids
May affect INR; requires monitoring
Monitorización
- Weight, appetite, signs of edema
- Serum and/or urine electrolytes
- Total plasma proteins, albumin
- Blood glucose
- Growth and development in young animals
- ACTH stimulation test if necessary
Farmacocinética
Metabolismo
Hepatic metabolism
Sobredosis
Short-term administration of massive doses is unlikely to cause harmful effects, though one case of acute CNS effects in a dog after accidental ingestion has been reported. If acute clinical signs occur, provide supportive treatment.
Chronic Toxicity: Chronic overdosage or prolonged use leads to serious adverse effects, primarily manifesting as iatrogenic hyperadrenocorticism (Cushing's syndrome), immunosuppression, and adrenal axis suppression.
Productos disponibles
Formulaciones
- Tablets
- Injection (suspension)
- Topical preparations
- Oral mucosal paste
- Inhaled products
Veterinario
- Triamcinolone Acetonide Tablets: 0.5 mg, 1.5 mg (Vetalog)
- Triamcinolone acetonide Suspension for Injection: 2 mg/mL; 6 mg/mL (Vetalog Parenteral)
Etiquetado para humanos
- Triamcinolone Acetonide Injection: 10 mg/mL & 40 mg/mL suspension (Kenalog-10 & -40)
- Triamcinolone Hexacetonide Injection: 5 mg/mL & 20 mg/mL suspension (Aristospan Intralesional & Intra-articular)
Estado regulador
Sin datos reguladores para: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store at room temperature (15-30°C); the injection should be protected from light.
Información para el cliente
Guía importante para los propietarios de mascotas:
- Efectos secundarios esperados: Es muy común que su mascota beba más agua, orine con mayor frecuencia y tenga un aumento del apetito mientras toma este medicamento. Asegúrese de que siempre tengan acceso a agua fresca y salidas frecuentes para ir al baño.
- No suspenda el tratamiento abruptamente: Si su mascota ha estado tomando este medicamento durante más de unos pocos días, nunca lo suspenda repentinamente. La producción natural de esteroides del cuerpo se inhibe mientras toma este fármaco, y suspenderlo abruptamente puede causar una crisis potencialmente mortal. Siga siempre el programa de reducción gradual de dosis indicado por su veterinario.
- Cambios de comportamiento: Algunas mascotas pueden jadear más de lo habitual, parecer inquietas o mostrar cambios en el comportamiento (letargo o irritabilidad). Contacte a su veterinario si estos son graves.
- Malestar gastrointestinal: Esté atento a vómitos, diarrea o heces oscuras/alquitranadas, lo cual podría indicar una úlcera estomacal.
- Riesgo de infección: Debido a que este fármaco suprime el sistema inmunológico, vigile a su mascota ante cualquier signo de infección (p. ej., llagas en la piel que no sanan, fiebre) y evite exponerla a animales enfermos.
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.
