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Triamcinolone acetonide is a highly potent synthetic glucocorticoid and anti-inflammatory agent.1 advantage over the older corticoids lies in its ability to achieve equal anti-inflammatory effect with a lower dose. Triamcinolone has very weak sodium-retaining effects and is probably the least electrolyte-retaining compound of the corticosteroid group. Triamcinolone has a plasma half-life of approximately 300 minutes and is classified as an intermediate acting glucocorticoid, whereas the acetonide salt has a longer duration of action and a higher lipid-water distribution co-efficient. Each tablet contains 0.5 mg or 1.5 mg of triamcinolone acetonide.
Dosage and Administration:
The keystone of satisfactory therapeutic management with triamcinolone acetonide, as with other steroids, is individualization of dosage in reference to the severity of the disease, the anticipated duration of steroid therapy and the animal's threshold or tolerance for steroid excess. The prime objective of steroid therapy should be to achieve a satisfactory degree of control with a minimum effective dose. The initial suppressive dose level of 0.5-1.0 mg per 10 pounds of body weight daily should be administered until a satisfactory clinical response is obtained, a period not to exceed 14 days. If a satisfactory response is not obtained in 14 days, re-evaluation of the case to confirm the original diagnosis should be made. As soon as a satisfactory clinical response is obtained, the daily dose should be reduced gradually, either to termination of treatment in the case of acute conditions (e.g., seasonal asthma, dermatitis, acute ocular inflammations) or to the minimal effective maintenance dose level in the case of chronic conditions (e.g., rheumatoid arthritis). Symptoms of adrenal insufficiency following withdrawal may persist for several days, weeks or years. Some cases have resulted in death. To minimize the adverse effects from withdrawal or reduction in dosage, cautiously decrease dosage in a gradual manner. In dogs, dosing in the morning may also be beneficial in minimizing effects because nocturnal pituitary/adrenal activity will be less inhibited. In chronic conditions, and in rheumatoid arthritis especially, it is important that the reduction in dosage from initial maintenance dose levels be accomplished slowly. The maintenance dose level should be adjusted from time to time as required by fluctuation in the activity of the disease and the animal's general status. Maintenance dosage levels of 0.125-0.25 mg per 10 pounds of body weight daily are recommended. Accumulated experience has shown that the long-term benefits to be gained from continued steroid maintenance are probably greater the lower the maintenance dose level. In rheumatoid arthritis in particular, maintenance steroid therapy should be at the lowest possible level.
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