Triamcinolone

(trye am sin' oh lone)

P  - Caution when used during pregnancy

L  - Caution when used during lactation

Molecule Info

 
Indication & Dosage

Oral
Allergic and inflammatory disorders
Adult: 4-48 mg 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 yr: as acetonide: 1 spray (55 mcg) into each nostril once daily. Increased to 220 mcg daily in severe cases.

Intramuscular
Suppression of allergic and inflammatory disorders
Adult: As acetonide: 20-80 mg via deep IM into gluteal muscles. As diacetate: 40 mg inj.
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.

Symptomatic control for hay fever
Adult: As acetonide: 40-100 mg via deep IM into gluteal muscles. As diacetate: 40 mg wkly. 
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.

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. 

Intradermal
Inflammatory skin conditions
Adult: As acetonide: 1-3 mg/site. Max: 30 mg in total if several sites of inj 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/inj site. Max: 25 mg/lesion. As hexacetonide: max 500 mcg per square inch or 80 mcg/cm2 of affected skin.

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. 

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.

Administration Erythromycin base: Should be taken on an empty stomach. Best taken on an empty stomach at least ½ hr & preferably 2 hr before meals.
Contraindications Untreated systemic fungal, bacterial, viral or parasitic infection, hypersensitivity. Neonates (Parenteral)
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.
Adverse Drug Reactions 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.
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. Please consult detailed drug interactions before prescribing
Pregnancy Category (US FDA)

ROUTE(S) : TOPICAL / Dental / Inhalation / I-ARTIC / I-LESION / IM / Nasal
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.

ROUTE(S) : PO / PAREN

Category 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.

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.
Pharmacology 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 hr (plasma).
ATC Classification H02AB08 - triamcinolone ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations. 
D07AB09 - triamcinolone ; Belongs to the class of moderately potent (group II) corticosteroids. Used in the treatment of dermatological diseases. 
R03BA06 - triamcinolone ; Belongs to the class of other inhalants used in the treatment of obstructive airway diseases, glucocorticooids. 
R01AD11 - triamcinolone ; Belongs to the class of topical corticosteroids used as nasal decongestants. 
A01AC01 - triamcinolone ; Belongs to the class of local corticosteroid preparations. Used in the treatment of diseases of the mouth. 
D07XB02 - triamcinolone ; Belongs to the class of moderately potent (group II) corticosteroids in other combinations. Used in the treatment of dermatological diseases. 
S01BA05 - triamcinolone ; Belongs to the class of corticosteroids. Used in the treatment of inflammation of the eye.

Brand/Product Info


Total Products : 18                  
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
ALFACORT Ziska Pharmaceuticals Ltd. Triamcinolone acetonide 40mg/1ml IM Injection 1ml vial: 60.00 MRP
ARISTOCORT Aristopharma Ltd. Triamcinolone acetonide BP 0.1% w/w Cream/Ointment 10gm Cream & Oint.: 20.00 MRP, 20.00 MRP
ARISTOCORT Injection Aristopharma Ltd. Triamcinolone acetonide 40mg/1ml IM Injection 2 amps: 120.00 MRP
AZMACORT Sanofi Triamcinolone acetonide 200mcg/actuation, 60mg Oral Inhaler 240 inhalations: 498.00 MRP
Cenolon Incepta Pharmaceuticals Limited 120 metered doses of Triamcinolone Acetonide. Each actuation delivers Triamcinolone Acetonide BP 55mcg Nasal Spray 120 Metered Dose:MRP 200 Tk
Cenolon Injection Incepta Pharmaceuticals Limited 1 ml suspension of Triamcinolone Acetonide BP 40mg Injection 1x1's:MRP 75 Tk
CORTEFIN ACI Ltd. Triamcinolone acetonide BP 0.1% w/w Cream/Ointment 10gm Cream & Oint.: 25.09 MRP, 25.00 MRP
CYNOCORT Techno Drugs Triamcinolone acetonide 40mg/1ml IM Injection 1ml amp: 60.00 MRP
NASACORT AQ Sanofi Triamcinolone acetonide USP 55mcg/actuation, 10gm Nasal Spray 100 doses spray unit: 523.72 MRP
SKINADERM Kemiko Pharmaceuticals Ltd Triamcinolone acetonide BP 0.1% w/w Ointment 10gm: 20.00 MRP
STELONE General Pharmaceuticals Ltd Triamcinolone acetonide BP 0.1% w/w Ointment 10gm: 25.09 MRP
TRECILON Rephco Laboratories Ltd. Triamcinolone acetonide 40mg/1ml IM Injection 1ml amp: 60.00 MRP
TRIACIN Kemiko Pharmaceuticals Ltd Triamcinolone acetonide 40mg/1ml IM Injection 1ml amp: 60.00 MRP
TRIALON Drug International Ltd Triamcinolone acetonide USP 0.1% w/w Oral Paste 10gm: 100.00 MRP
TRIALON Injection Drug International Ltd Triamcinolone acetonide 40mg/1ml IM Injection 3's: 180.00 MRP
TRIMCORT Chemist Laboratories Ltd. Triamcinolone acetonide USP 0.1% w/w Oral Paste 10gm: 100.00 MRP
TRIMCORT Injection Chemist Laboratories Ltd. Triamcinolone acetonide 40mg/1ml IM Injection 2's & 20's: 120.00 & 1200.00 MRP
TRISPRAY N-SPRAY Square Pharmaceuticals Ltd. Triamcinolone Acetonide 55 mcg/spray Nasal Spray 120 sprays: 201.35 MRP

Gen. MedInfo

Why is this medication prescribed?

Triamcinolone, a corticosteroid, is similar to a natural hormone produced by your adrenal glands. It often is used to replace this chemical when your body does not make enough of it. It relieves inflammation (swelling, heat, redness, and pain) and is used to treat certain forms of arthritis; skin, blood, kidney, eye, thyroid, and intestinal disorders (e.g., colitis); severe allergies; and asthma. Triamcinolone is also used to treat certain types of cancer.

Topical Triamcinolone is used to treat the itching, redness, dryness, crusting, scaling, inflammation, and discomfort of various skin conditions. It is also used to relieve the discomfort of mouth sores. 

Triamcinolone nasal spray is used to treat symptoms of seasonal (occurs only at certain times of year), and perennial (occurs all year round) allergic rhinitis and perennial nonallergic rhinitis. These symptoms include sneezing and stuffy, runny, or itchy nose. Triamcinolone is in a class of medications called corticosteroids. It works by decreasing inflammation (swelling that can cause other symptoms) in the nose.

This medication is sometimes prescribed for other uses; ask your doctor for more information.

How should this medicine be used?

Oral Triamcinolone: 

Triamcinolone may come as a tablet and syrup to be taken by mouth. Your doctor will prescribe a dosing schedule that is best for you. Follow the directions on your prescription label carefully, and ask your doctor to explain any part you do not understand. Do not stop taking triamcinolone without talking to your doctor. Stopping the drug abruptly can cause loss of appetite, upset stomach, vomiting, drowsiness, confusion, headache, fever, joint and muscle pain, peeling skin, and weight loss. If you take large doses for a long time, your doctor probably will decrease your dose gradually to allow your body to adjust before stopping the drug completely. Watch for these side effects if you are gradually decreasing your dose and after you stop taking the tablets or oral liquid, even if you switch to an inhalation. If these problems occur, call your doctor immediately. You may need to increase your dose of tablets or liquid temporarily or start taking them again.

Topical Triamcinolone:

Triamcinolone comes in ointment, cream, lotion, liquid, and aerosol (spray) in various strengths for use on the skin and as a paste for use in the mouth. It usually is applied two to four times a day. For mouth sores, it is applied at bedtime and, if necessary, two or three times daily, preferably after meals. Follow the directions on your prescription label carefully, and ask your doctor to explain any part you do not understand. Use triamcinolone exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. Do not apply it to other areas of your body or wrap or bandage the treated area unless directed to do so by your doctor.

Wash or soak the affected area thoroughly before applying the medicine, unless it irritates your skin. Apply the ointment, cream, liquid, or lotion sparingly in a thin film and rub it in gently.

To use the lotion or liquid on your scalp, part your hair, apply a small amount of the medicine on the affected area, and rub it in gently. Protect the area from washing and rubbing until the lotion or liquid dries. You may wash your hair as usual but not right after applying the medicine.

To apply an aerosol, shake well and spray on the affected area holding the container about 3 to 6 inches away. Spray for about 2 seconds to cover an area the size of your hand. Take care not to inhale the vapors. If you are spraying near your face, cover your eyes.

To apply the paste, press a small amount on the mouth sore without rubbing until a thin film develops. You may need to use more paste if the mouth sore is large. If the mouth sore does not begin to heal within 7 days, call your doctor.

Avoid prolonged use on the face, in the genital or rectal areas, and in skin creases and armpits unless directed to do so by your doctor.

If you are using triamcinolone on your face, keep it out of your eyes.

Do not apply cosmetics or other skin preparations on the treated area without talking with your doctor.

If you are using triamcinolone on a child's diaper area, do not use tight-fitting diapers or plastic pants. Such use may increase side effects.

If your doctor tells you to wrap or bandage the treated area, follow these instructions:

  1. Soak the area in water or wash it well.

  2. While the skin is moist, gently rub the medication into the affected areas.

  3. Cover the area with plastic wrap (such as Saran Wrap or Handi-Wrap). The plastic may be held in place with a gauze or elastic bandage or adhesive tape on the normal skin beside the treated area. (Instead of using plastic wrap, plastic gloves may be used for the hands, plastic bags for the feet, or a shower cap for the scalp.)

  4. Carefully seal the edges of the plastic to make sure the wrap adheres closely to the skin. If the affected area is moist, you can leave the edges of the plastic wrap partly unsealed or puncture the wrap to allow excess moisture to escape.

  5. Leave the plastic wrap in place as long as directed by your doctor. Usually plastic wraps are left in place no more than 12 hours each day.

  6. Cleanse the skin and reapply the medication each time a new plastic wrapping is applied. Do not discontinue treatment abruptly without talking to your doctor.

Triamcinolone Nasal Spray:

Triamcinolone comes as a liquid to spray in the nose. It is usually sprayed in each nostril once daily. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use triamcinolone spray exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Triamcinolone nasal spray is only for use in the nose. Do not swallow the nasal spray and be careful not to spray it in your eyes.

Your doctor will probably start you on a high dose of triamcinolone nasal spray and may decrease your dose after your symptoms are controlled.

Triamcinolone nasal spray controls the symptoms of rhinitis but does not cure them. It may take up to one week before you feel the full benefit of triamcinolone. Call your doctor if your symptoms do not get better within 3 weeks of treatment with triamcinolone. Continue to use triamcinolone even if you feel well. Do not stop using triamcinolone without talking to your doctor.

Before you use triamcinolone nasal spray the first time, read the written instructions that come with it. Ask your doctor, pharmacist, or respiratory therapist to show you the proper way to use the nasal spray. Practice using the nasal spray with the help of a health care professional.

Each bottle of triamcinolone nasal spray is designed to provide 120 sprays. The bottle might not be empty after 120 sprays have been used, but after this point, each spray might not contain the correct amount of medication. You should keep track of the number of sprays you have used and throw away the bottle after you have used 120 sprays even if it still contains some liquid.

If this medication is prescribed for a child, an adult should help give this medication.

To use the nasal spray, follow these steps:

  1. Shake the bottle gently.

  2. Remove the dust cover. If the top part of the spray pump comes off of the bottle while removing the cover, put the stem back into the pump.

  3. If you are using the pump for the first time or have not used it for 2 weeks or more, you must prime it by following steps 4 to 5 below. If you have used the pump in the past 2 weeks, skip to step 6.

  4. Hold the pump with the applicator between your forefinger and middle finger and the bottom of the bottle resting on your thumb. Point the applicator away from your body.

  5. If you are using the pump for the first time, press down and release the pump five times. If you have used the pump before, but not within the past week, press down once and release the pump until you see a fine spray.

  6. Gently blow your nose until nostrils are clear. For small children, help them gently blow their nose as much as possible.

  7. Hold one nostril closed with your finger.

  8. Hold the pump with the applicator between your forefinger and middle finger and the bottom resting on your thumb.

  9. Put the spray tip into one side of your nose. The tip should not reach far into the nose, and it should not touch or be pointed toward the side of your nose. Rest the side of your index finger against your upper lip. Tip your head forward a little and aim the spray toward the back of your nose.

  10. Begin to breathe in through your nose.

  11. While you are breathing in, use your forefinger and middle finger to press firmly down on the applicator and release a spray.

  12. Breathe gently in through the nostril and breathe out through your mouth.

  13. If your doctor told you to use two sprays in that nostril, repeat steps 7 to 12.

  14. Repeat steps 6 to 13 in the other nostril.

  15. Do not blow your nose for 15 minutes after using the spray.

  16. Wipe the applicator with a clean tissue and cover it with the dust cover.

Take triamcinolone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Other uses for this medicine

Please note, this medication is prescribed for other uses as well; ask your doctor for more information.

What special precautions should I follow? 

Before taking triamcinolone, 

  • tell your doctor if you are allergic to triamcinolone, aspirin, tartrazine (a yellow dye in some processed foods and drugs), or any other drugs.
  • tell your doctor what prescription and nonprescription medications you are taking, especially anticoagulants ('blood thinners') such as warfarin, arthritis medications, aspirin, cyclosporine (Neoral, Sandimmune), digoxin, diuretics ('water pills'), estrogen, ketoconazole (Nizoral), oral contraceptives, phenobarbital, phenytoin, rifampin, theophylline and vitamins.
  • if you have a fungal infection (other than on your skin), do not take triamcinolone without talking to your doctor.
  • tell your doctor if you have or have ever had liver, kidney, intestinal, or heart disease; diabetes; an underactive thyroid gland; high blood pressure; mental illness; myasthenia gravis; osteoporosis; herpes eye infection; seizures; tuberculosis (TB); or ulcers.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking triamcinolone, call your doctor.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking triamcinolone.
  • if you have a history of ulcers or take large doses of aspirin or other arthritis medication, limit your consumption of alcoholic beverages while taking this drug. Triamcinolone makes your stomach and intestines more susceptible to the irritating effects of alcohol, aspirin, and certain arthritis medications. This effect increases your risk of ulcers.

Before using triamcinolone nasal spray,

  • tell your doctor if you are allergic to triamcinolone, any other medications, or any of the ingredients in triamcinolone nasal spray. Ask your pharmacist for a list of the ingredients.
  • tell your doctor what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention medications that suppress the immune system such as azathioprine, cyclosporine, methotrexate, sirolimus, tacrolimus, and medications to treat cancer; and oral steroids such as dexamethasone, methylprednisolone, and prednisone.
  • tell your doctor if you have or have ever had tuberculosis (TB, a type of infection in your lungs), cataracts (clouding of the lens of the eye), or glaucoma (an eye disease), and if you now have sores in your nose, any type of untreated infection, or a herpes infection (a type of infection that causes a sore on the eyelid or eye surface) in your eye. Also tell your doctor if you have recently had surgery on your nose or injured your nose in any way.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using triamcinolone, call your doctor.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are using triamcinolone.
  • if you have been taking oral steroids such as dexamethasone, methylprednisolone (Medrol), prednisolone or prednisone, your doctor may want to gradually decrease your steroid dose after you begin using triamcinolone nasal spray. Special caution is needed for several months as your body adjusts to the change in medication. If you have any other medical conditions, such as arthritis, or eczema (a skin disease), they may worsen when your oral steroid dose is decreased. Tell your doctor if this happens or if you experience any of the following symptoms during this time: extreme tiredness, muscle weakness or pain; sudden pain in stomach, lower body or legs; loss of appetite; weight loss; upset stomach; vomiting; diarrhea; dizziness; fainting; depression; irritability; and darkening of the skin. Your body may be less able to cope with stress such as surgery, illness, severe asthma attack, or injury during this time. Call your doctor right away if you get sick and be sure that all healthcare providers who treat you know that you recently replaced your oral steroid with triamcinolone nasal spray. Carry a card or wear a medical identification bracelet to let emergency personnel know that you may need to be treated with steroids in an emergency.
  • you should know that triamcinolone may decrease your body's ability to fight infection. Stay away from people who are sick and wash your hands often. Be especially careful to stay away from people who have chicken pox or measles. Tell your doctor right away if you find out that you have been around someone who has one of these viruses.

What special dietary instructions should I follow?

Your doctor may instruct you to follow a low-sodium, low-salt, potassium-rich, or high-protein diet. Follow these directions.

Triamcinolone may cause an upset stomach. Take triamcinolone with food or milk.

What should I do if I forget a dose? 

When you start to take triamcinolone, ask your doctor what to do if you forget a dose. Write down these instructions so that you can refer to them later. 

If you take triamcinolone once a day, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Triamcinolone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: 

  • upset stomach

  • stomach irritation

  • vomiting

  • headache

  • dizziness

  • insomnia

  • restlessness

  • depression

  • anxiety

  • acne

  • r
  • increased hair growth

  • easy bruising

  • irregular or absent menstrual periods

If you experience any of the following symptoms, call your doctor immediately:

  • skin rash

  • swollen face, lower legs, or ankles

  • vision problems

  • cold or infection that lasts a long time

  • muscle weakness

  • black or tarry stool

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to this medicine.

Do not let anyone else use your medication. If you still have symptoms and need further treatment, consult your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Ref:  U.S. National Library of Medicine.


This information is provided for reference only and not a replacement for and should only be used in conjunction with full consultation with a registered medical practitioner. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, mph-bd shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise.