Triamcinolone(trye am sin’ oh lone)
Triamcinolone Acetonide
IM, intra-articular, or soft-tissue, injection; intraocular injection; respiratory inhalant; dermatologic ointment, cream lotion, aerosol: Kenalog, Nasacort AQ, Oracort (CAN), Triderm, Triesence, Trivaris
Dental paste: Kenalog in Orabase
Triamcinolone Hexacetonide
Intra-articular, intralesional, injection: Aristospan Intra-articular, Aristospan Intralesional
PREGNANCY CATEGORY C
Drug Classes
Corticosteroid (intermediate-acting)
Glucocorticoid
Hormone
Therapeutic Actions
Enters target cells and binds to cytoplasmic receptors, thereby initiating many complex reactions that are responsible for its anti-inflammatory and immunosuppressive effects.
Indications
Systemic: Hypercalcemia associated with cancer
Short-term management of inflammatory and allergic disorders such as rheumatoid arthritis, collagen diseases (eg, SLE), dermatologic diseases (eg, pemphigus), status asthmaticus, and autoimmune disorders
Adjunctive therapy for short-term treatment of acute gouty arthritis, bursitis, tenosynovitis, epicondylitis, rheumatoid arthritis, or synovitis of osteoarthritis
Hematologic disorders: Thrombocytopenia purpura, erythroblastopenia
Ulcerative colitis, acute exacerbations of MS, and palliation in some leukemias and lymphomas
Trichinosis with neurologic or myocardial involvement
Pulmonary emphysema with bronchial spasm or edema; diffuse interstitial pulmonary fibrosis; with diuretics in HF with edema and in cirrhosis with refractory ascites
Postoperative dental inflammatory reactions
Intra-articular, soft-tissue administration for conditions such as arthritis, psoriatic plaques
Respiratory inhalant: Control of bronchial asthma requiring corticosteroids in conjunction with other therapy
Prophylactic therapy in the maintenance treatment of asthma (bid use)
Dermatologic preparations: To relieve inflammatory and pruritic manifestations of dermatoses that are steroid responsive
Nasal spray: Treatment of seasonal and perennial allergic-rhinitis symptoms in patients 2 yr and older
Dental paste: Treatment of oral lesions
Contraindications and Cautions
Contraindicated with infections, especially TB, fungal infections, amebiasis, vaccinia and varicella, and antibiotic-resistant infections; lactation.
Use cautiously with pregnancy (teratogenic in preclinical studies), renal or liver disease, hypothyroidism, ulcerative colitis with impending perforation, diverticulitis, active or latent peptic ulcer, inflammatory bowel disease, heart failure, hypertension, thromboembolic disorders, osteoporosis, seizure disorders, diabetes mellitus.
Available Forms
Injection—10, 25, 40 mg/mL; intraocular suspension—40 mg/mL; aerosol—0.055 mg/actuation; topical ointment—0.025, 0.1, 0.5%; cream—0.025, 0.1, 0.5%; lotion—0.025, 0.1%; nasal spray—55 mcg/actuation; dental paste—0.1%; topical spray—0.147 mg/actuation
Dosages
Adults
Systemic
Individualize dosage, depending on the severity of the condition and the patient’s response. Administer daily dose before 9 AM to minimize adrenal suppression. If long-term therapy is needed, consider alternate-day therapy. After long-term therapy, withdraw drug slowly to avoid adrenal insufficiency. For maintenance therapy, reduce initial dose in small increments at intervals until the lowest effective dose is reached.
IM (triamcinolone acetonide)
2.5–100 mg/day IM.
Nasal spray
Two sprays (220 mcg total dose) in each nostril daily—maximum of four sprays/day (two sprays in each nostril daily).
Intraocular
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