Cortalone 0.5 mg Tablets

Caution: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. Keep this and all drugs out of the reach of children.

Description:Triamcinolone acetonide is a highly potent synthetic glucocorticoid and anti-inflammatory agent.1 Its advantage over the older corticoids lies in its ability to achieve equal anti-inflammatory effect with a lower dose.2 3 4 Triamcinolone has very weak sodium-retaining effects and is probably the least electrolyte-retaining compound of the corticosteroid group.2 4 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.

Uses:Triamcinolone acetonide is a highly potent glucocorticoid effective in the treatment of inflammation and related disorders in dogs and cats. It is indicated in the management and treatment of acute arthritis and allergic and dermatologic disorders.

Dosage: 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. Important: In the therapeutic management of animals with chronic diseases, such as rheumatoid arthritis, triamcinolone should be regarded as a highly valuable adjunct, to be used in conjunction with but not as a replacement for standard therapeutic measures.

Precautions: Because of its inhibitory effect on fibroplasia, triamcinolone may mask the signs of infection and enhance dissemination of the infecting organism. Hence, all animals receiving triamcinolone should be watched for evidence of intercurrent infection. Should infection occur, it must be brought under control by use of appropriate antibacterial measures or administration of triamcinolone should be discontinued. Because this anti-inflammatory steroid manifests little sodium-retaining activity, the usual early sign of cortisone or hydrocortisone overdosage (i.e., increase in body weight due to fluid retention) is not a reliable index of overdosage. Hence, recommended dosage levels should not be exceeded, and all animals receiving triamcinolone acetonide should be under close medical supervision. Use of corticosteroids may result in the inhibition of endogenous steroid production which sometimes persists for weeks following drug withdrawal. In patients presently receiving or recently withdrawn from corticosteroid treatments, administration of a rapid acting corticosteroid before, during and after an unusually stressful situation is recommended. Single or multiple doses of 1 mg/kg of a corticosteroid induced hepatopathy in the dog and rabbit in a study by Rogers and Ruebner in 1977.4 The condition was determined in the dog by a biopsy of the liver and was accompanied by elevated serum glutamic-pyruvic transaminase, SAP and SGGT (in some dogs) and increased bromsulphalein retention.