Triamcinolone Acetonide

What is triamcinolone acetonide?

Triamcinolone acetonide (brand names: Vetalog®, Kenalog®, Cortalone®, TriamTabs®, Aristocort®) is a systemic glucocorticoid used to treat many conditions in many species.

Its uses include replacement therapy for Addison’s disease, as an anti-inflammatory, and as an immune suppressant. It is labeled for treating inflammation, acute arthritis, allergic, and dermatological disorders.

Some triamcinolone products for use with certain inflammatory conditions at certain doses are FDA-approved. However, other uses in cats, dogs, and horses is off label (extra label). Many drugs are commonly prescribed for off-label use in veterinary medicine. 

“Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How is triamcinolone acetonide given?

• Triamcinolone acetonide is given by mouth in the form of a tablet or powder. It can also be given as an injection in the hospital setting, either into the system or localized into a joint.
• Give with food.
• If on once daily dosing, if possible, give it in the morning to dogs and horses, and give it in the evening to cats.
• Do not stop this medication abruptly; taper slowly to avoid complications.
• Do not use in pets that are undergoing allergy testing within the next month, unless otherwise advised by your veterinarian.

This medication will take effect quickly, in about 1 to 2 hours, and improvement in clinical signs should follow.

What if I miss giving my pet the medication?

If you miss a dose, give it as soon as you remember, and then continue with the regular dosing schedule. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not give the pet two doses at once.

Are there any potential side effects?

Triamcinolone acetonide may cause the following side effects:

• Increased drinking
• Increased urination
• Increased appetite

Triamcinolone acetonide may cause the following side effects at higher doses and during long-term use:

• Vomiting
• Diarrhea
• Mild behavioral changes
• Panting

Serious adverse reactions may occur, including gastrointestinal ulceration. If any of the following signs develop, stop giving triamcinolone acetonide and contact your veterinarian immediately:

• Lack of appetite
• Black or bloody stools
• Bloody vomit
• High fever
• Haircoat changes
• Pot-belly, weight gain
• Liver and lipid elevations
• Aggressive behavior
• Muscle wasting
• Weakness, abnormally low energy
• Diabetes (characterized by weight loss in the face of good appetite, excessive thirst, and excessive urination)

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This moderate-acting medication should stop working in a few days, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

DO NOT USE triamcinolone acetonide in pets that:

• Are allergic to it
• Have systemic fungal infections (unless it is used to treat Addison’s disease)
• Have viral infections
• Have ulcers
• Have tuberculosis
• Have Cushing’s disease
• Are undergoing allergy testing within the next month (unless otherwise advised by your veterinarian)

USE WITH EXTREME CAUTION in pets that:

• Are pregnant or lactating
• Are receiving medications that can cause ulcers

USE WITH CAUTION in pets that:

• Have diabetes
• Have heart or vascular disease
• Have other types of infections
• Have osteoporosis
• Have high blood pressure
• Have kidney disease
• Are young (this medication can stunt growth)

Do not stop this medication abruptly; taper slowly to avoid complications.

Are there any drug interactions I should be aware of?

Several medications should be used with caution when given with triamcinolone acetonide, including:

• Analgesics
• Anticholinesterases
• Aspirin
• Azole antifungals
• Barbiturates
• Bupropion
• Cyclophosphamide
• Cyclosporine
• Erythromycin/clarithromycin
• Insulin
• Mitotane
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Phenobarbital
• Potassium-depleting diuretics
• Rifampin
• Vaccines

Be sure to tell your veterinarian about any medications (including vitamins, supplements or herbal therapies) that your pet is taking before starting any treatment.

This medication may also interact with laboratory tests, such as allergy tests, as well as cholesterol, urine glucose, potassium, and thyroid levels.

Is any monitoring needed with this medication?

• Monitoring recommendations vary depending on the reason for use, the dosage, duration of therapy, and your pet’s health status. Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects.
• Common monitoring includes bloodwork and urinalysis, blood sugar levels, ACTH stimulation tests, weight and appetite status, signs of swelling, and serious side effects.
• At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian.

How do I store triamcinolone acetonide?

• Store triamcinolone acetonide at room temperature, between 59°F and 86°F (15°C and 30°C).
• Protect from light.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet’s weight and symptoms.