Triamcinolone

Corticosteroid, Systemic · Corticosteroid

Indications

Suppression of inflammatory and allergic disorders; rheumatic disease.

Dosage

INJECTION: Lowest possible dose to be used. When reduction possible, reduce gradually. IM: Range: 2.5-100 mg/day. Children: Initial: 0.11-1.6 mg/kg/day in 3-4 divided doses; 6-12 yr: Initial: 40 mg; 12-18 yr, Initial: 60 mg. Adults: Initial: 60 mg. Hay fever/pollen asthma: Adults & Children above 12 yr: 40-100 mg as a single injection/season. Multiple sclerosis (acute exacerbation): Adults & Children above 12 yr: 160 mg/day for 1 wk, followed by 64 mg every other day for one mth. Intra-articular, intrabursal, tendon sheaths: Adults: Smaller joints: Initially 2.5-5 mg, may require up to 10 mg; larger joints: Initially 5-15mg, may require up to 40 mg. Max dose/treatment (several joints at one time): 20-80 mg. Intradermal: Adults: Initial: 1 mg. TABLET: Adults: Adrenocortical insufficiency (with mineralocorticoid therapy: 4-12 mg/day. Acute leukaemia or lymphoma: 16-40 mg/day (up to 100…

Administration

Intra-articular: The usual intra-articular technique should be followed. Care should be taken to ensure that the injection is made into tendon sheath rather than the tendon substance. Epicondylitis may be treated by infiltrating the preparation into the area of greatest tenderness. Intralesional: For treatment of dermal lesions, it should be injected directly into the lesions. IM: Shake IM suspension thoroughly before drawing it into syringe. The injection should be made deeply into the gluteal muscle. The minimum needle length of 1.5 inch is recommended. Reconstitution: May be diluted with D5NS, D10NS, or SWFI to a 1:1, 1:2 or 1:4 conc. Stability: Store at 20°C-25°C. Protect from light. Avoid freezing. Do not autoclave when it is desirable to sterilize the exterior of the vial.

Adverse Effects

Endocrine irregularities including menstrual problems, Cushingoid state, adrenal suppression, growth suppression in children. Increased susceptibility to infection, increased severity of infection. Fluid/electrolyte disturbance, hypertension, negative protein, nitrogen and calcium balance. Myopathy, tendon rupture, osteoporosis, osteonecrosis and fractures. Impaired wound healing, sweating, hirsutism, striae, telangiectasia, acne. GI disturbance, peptic ulceration, acute pancreatitis, candidiasis. Psychiatric effects, neurological effects, insomnia. Diabetes, impaired glucose tolerance, weight gain, increased appetite. Ocular disturbances including cataracts, raised intraocular pressure, optic nerve damage, corneal changes, glaucoma. Thromboembolism, leukocytosis.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Systemic fungal infections unless specific anti-infective therapy is used. Head injury, stroke. Precautions: Active infections not controlled by antibiotics. Latent or active amoebiasis. History of TB, septicaemia, symptoms may be masked. Avoid or maintain extreme cautions in chickenpox, measles, psychiatric disorders, renal impairment, hepatic failure, cirrhosis, active peptic ulcer, myasthaenia gravis, previous steroid myopathy, osteoporosis, epilepsy, hypothyroidism, diabetes, adrenal suppression, hypertension, recent MI, congestive heart failure, thromboembolic disorders, glaucoma, corneal perforation. WITHDRAWAL: Withdraw gradually. Withdrawal symptoms may include fever, myalgia, arthralgia, rhinitis, itchy skin nodules and weight loss.

Interactions

Live vaccines or other vaccines, anticoagulants, hypoglycaemia agents, antihypertensives, diuretics, erythromycin, rifamycin, amphotericin, azole antifungals, ritonavir, cyclosporin, cardiac glycosides. Oestrogens including oral contraceptives, somatropin. Carbamazepine, phenytoin, primidone, barbiturates. Muscle relaxants, NSAIDs, salicylates, sympathomimetics, mifepristone, methotrexate, theophylline, aprepitant.

Advice to Patient

Take oral form with or after meals. To prevent abdominal upset, take with meals. Do not stop taking medication abruptly, gradually lower down the dose then stop. Administer nasal aerosols properly, using manufacturer’s instructions, to avoid nasal irritation. Dispose of aerosol canister after 240 uses. Contact prescriber if there is worsening of condition, increased nervousness, unhealed injuries, sore throat, sleep disturbances, excessive body hair growth, changes in vision, loss of skin colour, rapid or sudden weight gain (>3 lb per week), swelling of face/hands/ankles/feet, black or dark coloured stools, difficulty in breathing, muscle weakness, joint pain, mood changes, constant abdominal pain or if there is no improvement in condition. Consult prescriber if you feel more stressed out than normal because dosage may need to be adjusted. Inform prescriber immediately if asthma fails…

Pharmacokinetics

Absorption: Inj: Slowly absorbed from inj site. Half-life elimination: 2-5 hrs.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.