トリアムシノロンアセトニド
Triamcinolone Acetonide
Triamcinolone acetonide
別名: Vetalog · Kenalog · Aristospan · triamcinoloni acetonidum · TMC
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
馬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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
牛
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Glucocorticoid effects | 0.02-0.04 mg/kg IM; 6-18 mg intra-articularly. | IM/IA | As directed | — | 🌎 NA |
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
トリアムシノロンアセトニドは、ヒドロコルチゾンの約4〜10倍（一部のモデルでは最大40倍）の効力を持つ合成の中時間作用型糖質コルチコイドです。
臨床上のポイントと主な特徴：
- 鉱質コルチコイド作用なし： ヒドロコルチゾンやプレドニゾンとは異なり、トリアムシノロンには顕著な鉱質コルチコイド作用がないため、有意なナトリウムや水分の貯留を引き起こしません。
- 多様な投与方法： 全身投与（経口、注射）、局所投与、関節内投与（特に馬のスポーツ医学において）、および病変内投与（食道狭窄や舐性肉芽腫など）に使用されます。
- 作用時間： 経口投与の場合、代謝活性は24〜48時間持続します。しかし、筋肉内（IM）または皮下（SC）デポ注射は4〜6週間（場合によっては最大8週間）持続する可能性があり、毎日の投薬が困難な慢性炎症やアレルギー疾患に有用ですが、副腎抑制が長期化するリスクが高まります。
- 馬での使用： 滑膜炎を軽減し、跛行を改善するために、高運動関節への関節内注射に頻繁に使用されます。競馬においてはARCIクラス4薬物に指定されています。
作用機序
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.
安全性・警告
禁忌
- Systemic fungal infections
- Viral infections
- Active tuberculosis
- Peptic ulcers
- Corneal ulcers
- Acute psychoses
- Cushingoid syndrome
- Idiopathic thrombocytopenia (IM administration)
- Hypersensitivity to the drug
有害事象
- 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)
注意事項
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.
医薬品相互作用
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
監視
- 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
薬物動態
代謝
Hepatic metabolism
過剰投与
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.
製品
製剤
- Tablets
- Injection (suspension)
- Topical preparations
- Oral mucosal paste
- Inhaled products
動物用医薬品
- Triamcinolone Acetonide Tablets: 0.5 mg, 1.5 mg (Vetalog)
- Triamcinolone acetonide Suspension for Injection: 2 mg/mL; 6 mg/mL (Vetalog Parenteral)
ヒト用医薬品
- 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)
規制ステータス
規制データなし: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store at room temperature (15-30°C); the injection should be protected from light.
飼主向け情報
飼い主様への重要なご案内：
- 予想される副作用： この薬を服用している間、ペットの飲水量が増え、頻尿になり、食欲が増進することは非常に一般的です。常に新鮮な水を用意し、トイレの回数を増やしてあげてください。
- 急に服用を中止しないでください： ペットが数日以上この薬を服用している場合、絶対に急に服用を中止しないでください。この薬を服用している間、体内の自然なステロイド産生は休止状態になっており、急に中止すると生命を脅かす危機を引き起こす可能性があります。必ず獣医師の減量スケジュールに従ってください。
- 行動の変化： いつもよりパンティング（あえぎ呼吸）が多くなったり、落ち着きがなくなったり、行動の変化（無気力や攻撃性など）が見られるペットもいます。症状が重い場合は獣医師にご相談ください。
- 胃腸の不調： 嘔吐、下痢、または黒色/タール状の便（胃潰瘍の兆候の可能性があります）に注意してください。
- 感染リスク： この薬は免疫系を抑制するため、感染の兆候（治りにくい皮膚の傷、発熱など）がないかペットを観察し、病気の動物との接触を避けてください。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。