To the Editor.—
Carson et al made an interesting, if limited, study of long-term intramuscular administration of triamcinolone acetonide,1 and while the number of cases was too few to permit any firm conclusions, they drew, in my opinion, an incorrect one and failed to observe the real one. They also overlooked an important reference—the study by Mikhail et al2 in which it was shown that a six-week interval between 40- and 80-mg doses of triamcinolone acetonide is attended by little or no lasting adrenal suppression.Their conclusion—that periodic ophthalmologic examinations for evidence of beginning cataract should be performed in patients receiving parenterally administered corticosteroids—is not the most meaningful one to be drawn from their observations. They might better have concluded that it is hazardous to exceed the safe dosage limit of 60 mg every four to six weeks in the administration of triamcinolone acetonide. In the two patients
Arnold HL. Long-Term Triamcinolone Acetonide Therapy. Arch Dermatol. 1976;112(9):1327. doi:10.1001/archderm.1976.01630330081036
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