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Triamcinolone information from DrugsUpdate  

See Available Brands of Triamcinolone in India

P - Caution when used during pregnancy
L - Caution when used during lactation

Triamcinolone (trade names Kenalog, Aristocort, Nasacort, Tri-Nasal, Triderm, Azmacort, Trilone, Volon A, Tristoject, Fougera, Tricortone,Triesence;) is a synthetic corticosteroid given orally, by injection, inhalation, or as a topical ointment or cream.

Pharmacodynamics

Pharmacokinetics

Triamcinolone has mainly glucocorticoid activity. It suppresses the migration of polymorphonuclear leukocytes and reduces capillary permeability thereby decreasing inflammation.

Absorption

Absorbed systemically (topical).

Distribution

Crosses the placenta. Protein-binding: Plasma albumin (much smaller extent than hydrocortisone).

Excretion
Elimination half-life: 2-5 hours (plasma).

Triamcinolone Indications / Triamcinolone Uses

Information Not Available

Triamcinolone Adverse Reactions / Triamcinolone Side Effects

HPA axis supression, intracranial hypertension, Cushing's syndrome, growth retardation in children; osteoporosis, fractures. Peptic ulceration; glaucoma; hyperglycaemia; GI upsets; increased appetite; increased fragility of skin; behavioural changes. Topical: Systemic absorption if applied to large areas, broken skin or under occlusive dressing.

Potentially Fatal: Acute adrenal insufficiency may be precipitated by infection or trauma in patients on long-term corticosteroid therapy or rapid withdrawal.

Precautions

Monitor
Following intraocular injection, monitor for elevation in IOP and endophthalmitis. Monitor bone density in patients receiving long-term therapy. Routinely monitor growth of pediatric patients.

Special Precautions

Diabetes; hypertension, renal and liver impairment; glaucoma; psychosis; delayed tissue healing; cirrhosis; heart failure; recent MI; hypothyroidism; osteoporosis; peptic ulceration; thromboembolic disorders. Monitor height in children on prolonged therapy. Avoid rapid drug withdrawal. Elderly, children, pregnancy, lactation.

Other Drug Interactions

Lowering of plasma salicylates levels. Increased risk of GI bleeding and ulceration with NSAIDs. Antagonised blood glucose-lowering effects of the antidiabetics. Increased risk of hyperkalaemia with amphotericin B, β agonists, β-blockers, potassium-depleting diuretics, theophylline. Increased clearance of the triamcinolone with ciclosporin, carbamazepine, phenytoin, barbiturate, rifampicin. Infections may develop if given with live vaccines.

Other Interactions

Information Not Available

Dosage

Oral
Allergic and inflammatory disorders
Adult: 4-48 mg daily.

Intramuscular
Suppression of allergic and inflammatory disorders
Adult: As acetonide: 20-80 mg via deep IM into gluteal muscles. As diacetate: 40 mg injection.
Child: As acetonide: deep IM into gluteal muscle: initial 0.11 to 1.6 mg/kg/day in 3-4 divided doses. Do not use in premature infants and infants of low birth weight as it contains benzyl alcohol.

Intramuscular
Symptomatic control for hay fever
Adult: As acetonide: 40-100 mg via deep IM into gluteal muscles. As diacetate: 40 mg weekly.
Child: As acetonide: deep IM into gluteal muscle: initial 0.11 to 1.6 mg/kg/day in 3-4 divided doses. Do not use in premature infants and infants of low birth weight as it contains benzyl alcohol.

Topical/Cutaneous
Inflammatory skin conditions
Adult: As acetonide: Apply a 0.025-0.5% cream/lotion/ointment sparingly onto affected area 2-3 times daily. Lower concentrations may be used up to 4 times daily.

Nasal
Treatment and prophylaxis of allergic rhinitis
Adult: As acetonide: Initially, 2 sprays (110 mcg) into each nostril once daily, reduced to 1 spray (55 mcg) when under control.
Child: 6-12 years: as acetonide: 1 spray (55 mcg) into each nostril once daily. Increased to 220 mcg daily in severe cases.

Mouth/Throat
Mouth ulceration
Adult: A small amount (about 0.6 cm) of the 0.1% paste is pressed onto the lesion without rubbing until a thin film develops. Apply 2 or 3 times daily, preferably after meals. Re-evaluate if recovery does not occur after 7 days of treatment.

Intradermal
Inflammatory skin conditions
Adult: As acetonide: 1-3 mg/site. Max: 30 mg in total if several sites of injection used. As diacetate: 5 mg in divided doses for small lesions or up to 48 mg in divided doses for large lesions. Max: 12.5 mg/injection site. Max: 25 mg/lesion. As hexacetonide: max 500 mcg per square inch or 80 mcg/cm2 of affected skin.

Intra-articular
Inflammatory joint diseases
Adult: As acetonide: Smaller joints: 2.5-5 mg (up to 10 mg), larger joints: 5-15 mg (up to 40 mg). Max: 20-80 mg/treatment. As hexacetonide: Initial: 2-20 mg/day.

Food(before/after)

Should be taken with food

List of Contraindications

Triamcinolone and Pregnancy

Caution when used during pregnancy

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
D in 1st trimester.

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Triamcinolone and Lactation

Caution when used during lactation

Triamcinolone and Children

Children may be more susceptible to adverse reactions from topical use. Monitor growth and development of infants and children on prolonged therapy. Data for safety and efficacy are available for treatment of nephrotic syndrome in children older than 2 years of age and for aggressive lymphomas and leukemia for children older than 1 month of age.

Triamcinolone and Geriatic

May require lower doses. Use with caution, usually starting at the low end of the dosage range, because of the greater frequency of decreased hepatic, renal, or cardiac function, and concomitant diseases or other drug therapy.

Triamcinolone and Other Contraindications

Untreated systemic fungal, bacterial, viral or parasitic infection, hypersensitivity. Neonates (Parenteral)

Storage

Intra-articular
Store between 20-25°C (68–77°F).

Intradermal
Store between 20-25°C (68–77°F).

Intramuscular
Store between 20-25°C (68–77°F).

Topical/Cutaneous

Store between 15-30°C.

Lab interference

Intra-articular
Store between 20-25°C (68–77°F).

Intradermal
Store between 20-25°C (68–77°F).

Intramuscular
Store between 20-25°C (68–77°F).

Topical/Cutaneous

Store between 15-30°C.

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