Triamcinolone

Indications
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.
Intramuscular
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.
Contraindications
Untreated systemic fungal, bacterial, viral or parasitic infection, hypersensitivity. Neonates (Parenteral)
Warnings / 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 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.
See Below for More triamcinolone Drug Interactions
Mechanism of Actions
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).
Administration
Should be taken with food.
Storage Conditions
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.
ATC Classification
D07AB09 - triamcinolone ; Belongs to the class of moderately potent (group II) corticosteroids. Used in the treatment of dermatological diseases.
D07XB02 - triamcinolone ; Belongs to the class of moderately potent (group II) corticosteroids in other combinations. Used in the treatment of dermatological diseases.
H02AB08 - triamcinolone ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations.
A01AC01 - triamcinolone ; Belongs to the class of local corticosteroid preparations. Used in the treatment of diseases of the mouth.
R01AD11 - triamcinolone ; Belongs to the class of topical corticosteroids used for prophylaxis and treatment of allergic rhinitis.
R03BA06 - triamcinolone ; Belongs to the class of other inhalants used in the treatment of obstructive airway diseases, glucocorticoids.
S01BA05 - triamcinolone ; Belongs to the class of corticosteroids. Used in the treatment of inflammation of the eye.
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.
Available As
  • Triamcinolone Acetonide 0.1%
  • Triamcinolone 0.1%
  • Triamcinolone Acetonide 0.1% w/w
  • Triamcinolone 0.1% w/w
  • Triamcinolone 1 mg
  • Triamcinolone 10 mg
  • Triamcinolone 4 mg
  • Triamcinolone Acetonide 4 mg
  • Triamcinolone Acetonide 40 mg
  • Triamcinolone 40 mg
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