Isoflupredone
Isoflupredone is a fluorinated corticosteroid supplied mainly as an injectable acetate suspension. Its principal veterinary applications are inflammatory disorders in large animals, especially musculoskeletal and allergic conditions. It also has a traditional adjunctive role in bovine ketosis. Its glucocorticoid actions are accompanied by clinically relevant mineralocorticoid activity.
Group
Glucocorticoid
Mechanism of Action
Isoflupredone binds intracellular glucocorticoid receptors and changes transcription of genes involved in inflammatory and immune responses. Reduced mediator production and inflammatory-cell recruitment limit tissue swelling and inflammatory dysfunction. Glucocorticoid effects on hepatic substrate metabolism contribute to its use in selected ketosis cases. Mineralocorticoid activity also alters renal electrolyte handling, which is a separate component of its pharmacologic profile.
Dose Rates
Cattle
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Inflammatory disease | 10–20 mg/animal | IM | Every 12–24 h | Acetate formulation. For ketosis, concurrent IV glucose is advised; reassess before repeating. |
| Ketosis | 10–20 mg/animal | IM | Every 12–24 h | Acetate formulation. For ketosis, concurrent IV glucose is advised; reassess before repeating. |
Horses
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Inflammatory disease | 5–20 mg/animal | IM | Every 12–24 h | Acetate formulation. |
| Recurrent airway obstruction | 0.03 mg/kg | IM | Every 24 h | Up to 14 days; Acetate formulation; serum potassium can decrease significantly. |
| Recurrent airway obstruction fixed-dose example | Reference only | IM | 10-14 mg/animal daily is described specifically for 450-500 kg horses; retain this weight qualification. |
Pigs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Inflammatory disease | 0.036 mg/kg | IM | Every 24 h | Acetate formulation. |
Indications
- Treatment of selected inflammatory musculoskeletal conditions in cattle, horses and other veterinary patients.
- Suppression of selected allergic or hypersensitivity-associated inflammatory disease with a corresponding product.
- Treatment of airway inflammation in selected horses with equine asthma.
- Adjunctive treatment of selected bovine ketosis cases; evidence of benefit varies with the metabolic setting.
- Treatment of selected immune-mediated conditions when isoflupredone is the chosen corticosteroid.
Contraindications
- Use cautiously with diabetes, active infection, gastrointestinal ulceration, impaired wound healing or pregnancy.
- Downer cows or animals vulnerable to hypokalaemia; systemic fungal infection except necessary replacement therapy.
Interactions
- NSAIDs increase gastrointestinal ulceration and bleeding.
- May antagonize insulin and impair glycaemic control.
Adverse effects
- Polyphagia, polydipsia and polyuria
- Adrenal suppression, hyperglycaemia, hepatopathy and secondary infection
- Delayed wound healing
Toxicity
Excessive exposure causes iatrogenic hyperadrenocorticism and immunosuppression; abrupt withdrawal after prolonged treatment may cause adrenal insufficiency.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Predef 2X isoflupredone acetate 2 mg/mL Aqueous suspension; do not administer IV. | Injection | 2 mg / mL | IM |
| Neo-Predef with tetracaine powder Keep dry; replace cap tightly. Multi-active topical product; no single-component calculator opt-in. | Powder | isoflupredone-acetate 1 mg / g + neomycin-sulfate 5 mg / g + tetracaine-hydrochloride 5 mg / g + myristyl-gamma-picolinium-chloride 0.2 mg / g | TOPICAL |
Monitoring and Administration
Monitor glucose, hepatic and renal parameters, infection and adrenal function when indicated.
Taper sustained systemic treatment according to response rather than stopping abruptly; depot injections cannot be withdrawn after administration.
Local joint treatment is described as 5-20 mg per joint. Use an appropriate joint formulation and aseptic technique.
Small-animal anti-inflammatory extrapolation is 0.125-0.25 mg/kg/day IM, without established routine use. Septic shock efficacy is not supported.
Monitor potassium during systemic treatment, particularly recurrent-airway-obstruction courses. Intra-articular alternatives are 4-20 mg per joint; select an appropriate sterile suspension. Topical neomycin/tetracaine combinations are applied sparingly to cleaned lesions 1-3 times daily; avoid eyes and licking for 20-30 minutes. Prolonged use, especially beyond 7 days, can impair healing and cause skin atrophy or adrenal suppression.
Tritop ointment lists isoflupredone acetate 0.1%, neomycin sulfate 0.5% and tetracaine HCl 0.5%. Its percentage denominator is not stated in the reproduced table, so these are not converted into assumed mg/mL.
Predef 2X suspension is 2 mg/mL. The explicit 0.03 mg/kg IM recurrent-airway-obstruction course establishes a route for that specific pulmonary regimen; it does not assign routes to every earlier pulmonary dose.