트리암시놀론 아세토니드

Triamcinolone Acetonide

Triamcinolone acetonide

글루코코르티코이드POIMSCIntra-articular (IA)IntrasynovialIntralesionalSubmucosalTopicalInhaled개고양이말소

다른 이름: Vetalog · Kenalog · Aristospan · triamcinoloni acetonidum · TMC

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

2 mg PO once daily for 7 days; 0.11-0.22 mg/kg IM or SCPO/IM/SC· once daily (PO) or single dose (IM/SC)· 7 days for PO

체중— 🐕

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증	용량	경로	빈도	기간	지역
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.

고양이

적응증	용량	경로	빈도	기간	지역
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.

말

적응증	용량	경로	빈도	기간	지역
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

소

적응증	용량	경로	빈도	기간	지역
Glucocorticoid effects	0.02-0.04 mg/kg IM; 6-18 mg intra-articularly.	IM/IA	As directed	—	🌎 NA

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

트리암시놀론 아세토니드는 히드로코르티손보다 약 4~10배(일부 모델에서는 최대 40배) 더 강력한 합성 중시간 작용형 글루코코르티코이드입니다.

임상적 진주 및 주요 특징:

무기질코르티코이드 활성 없음: 히드로코르티손이나 프레드니손과 달리 트리암시놀론은 눈에 띄는 무기질코르티코이드 효과가 없어 유의미한 나트륨이나 수분 저류를 유발하지 않습니다.
다양한 투여 경로: 전신(경구, 주사), 국소, 관절 내(특히 말 스포츠 의학에서), 병변 내(예: 식도 협착 또는 핥음 육아종) 투여 등 다양하게 활용됩니다.
작용 시간: 경구 투여 시 대사 활성은 24~~48시간 지속됩니다. 그러나 근육 내(IM) 또는 피하(SC) 데포 주사는 4~~6주(때로는 최대 8주) 동안 지속될 수 있어 매일 투약하기 어려운 만성 염증이나 알레르기 질환에 유용하지만, 장기간의 부신 억제 위험을 증가시킵니다.
말에서의 사용: 활막염을 줄이고 파행을 개선하기 위해 움직임이 많은 관절의 관절 내 주사로 자주 사용됩니다. 경마 규정상 ARCI 클래스 4 약물에 해당합니다.

작용 기전

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.

안전성·주의사항

금기사항

Systemic fungal infections
Viral infections
Active tuberculosis
Peptic ulcers
Corneal ulcers
Acute psychoses
Cushingoid syndrome
Idiopathic thrombocytopenia (IM administration)
Hypersensitivity to the drug

부작용

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)

주의

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.

약물 상호작용

Amphotericin B

May cause hypokalemia when administered concomitantly

Opiate Analgesics / Local Anesthetics (Epidural)

Combination in epidurals has caused serious CNS injuries and death; restrict volume to very small intrathecal test doses

Anticholinesterase Agents (e.g., pyridostigmine)

May lead to profound muscle weakness in myasthenia gravis patients; discontinue 24h prior if possible

Aspirin

Glucocorticoids may reduce salicylate blood levels

Barbiturates

May increase the metabolism of glucocorticoids and decrease blood levels

Cyclophosphamide

Glucocorticoids may inhibit hepatic metabolism of cyclophosphamide; dosage adjustments may be required

Cyclosporine

May mutually inhibit hepatic metabolism, increasing blood levels of both drugs

Potassium-depleting Diuretics (e.g., spironolactone)

May cause hypokalemia

Erythromycin, Clarithromycin

May increase triamcinolone levels

Estrogens

May potentiate the effects of triamcinolone

Insulin

Insulin requirements may increase due to glucocorticoid-induced insulin resistance

Isoniazid

Triamcinolone may decrease isoniazid levels

Ketoconazole and Azole Antifungals

May decrease metabolism of glucocorticoids; ketoconazole may induce adrenal insufficiency upon steroid withdrawal

Mitotane

Higher than usual doses of steroids may be necessary to treat mitotane-induced adrenal insufficiency

NSAIDs

Increased risk of gastrointestinal ulceration

Phenobarbital

May increase the metabolism of glucocorticoids and decrease triamcinolone blood levels

Rifampin

May increase the metabolism of glucocorticoids and decrease triamcinolone blood levels

Vaccines

May augment viral replication of live vaccines; diminished immune response to killed vaccines/toxoids

Warfarin

May affect INR; requires monitoring

모니터링

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

약동학

대사

Hepatic metabolism

과다투여

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.

제품

제형

Tablets
Injection (suspension)
Topical preparations
Oral mucosal paste
Inhaled products

동물용의약품

Triamcinolone Acetonide Tablets: 0.5 mg, 1.5 mg (Vetalog)
Triamcinolone acetonide Suspension for Injection: 2 mg/mL; 6 mg/mL (Vetalog Parenteral)

인용의약품

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)

규제 현황

규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

Store at room temperature (15-30°C); the injection should be protected from light.

보호자 정보

반려동물 보호자를 위한 중요 안내:

예상되는 부작용: 이 약을 복용하는 동안 반려동물이 물을 더 많이 마시고, 소변을 더 자주 보며, 식욕이 증가하는 것은 매우 흔한 일입니다. 항상 신선한 물을 마실 수 있게 해주고 배변 기회를 자주 제공해 주세요.
갑자기 중단하지 마세요: 반려동물이 며칠 이상 이 약을 복용했다면, 절대 갑자기 투약을 중단해서는 안 됩니다. 이 약을 복용하는 동안 신체의 자연적인 스테로이드 생성은 휴면 상태가 되며, 갑작스러운 중단은 생명을 위협하는 위기를 초래할 수 있습니다. 반드시 수의사의 점진적 감량 일정을 따르세요.
행동 변화: 일부 반려동물은 평소보다 헐떡임이 심해지거나, 불안해하거나, 행동의 변화(무기력증 또는 과민성)를 보일 수 있습니다. 증상이 심하면 수의사에게 연락하세요.
위장 장애: 구토, 설사 또는 검고 끈적이는 변(위궤양의 징후일 수 있음)이 있는지 관찰하세요.
감염 위험: 이 약은 면역 체계를 억제하므로 감염의 징후(예: 낫지 않는 피부 상처, 발열)가 있는지 반려동물을 잘 살펴보고, 아픈 동물과의 접촉을 피하게 하세요.

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