Prednisone vs Triamcinolone Acetonide-Reply

In Reply.— We have had no experience with monthly doses of intramuscular triamcinolone acetonide in the treatment of arthritis or asthma. The experience of others who have referred patients to us, however, suggests that this form of treatment is not as effective as a single daily dose of prednisone. Monthly intramuscular treatment is also more expensive. We have had little or no problem with patients abusing prednisone. Every patient is told the importance of taking the drug in a single dose every day and the possible serious side effects that may occur if the medicine is not taken properly. With a single daily dose of up to 15 mg of prednisone, the pituitary-adrenal axis is not completely suppressed, and it is not necessary to taper the dosage if the drug is withdrawn. With a single intramuscular dose of a long-acting corticosteroid such as triamcinolone acetonide, there is complete suppression of