Name Triamcinolone Acetonide
Classes Dermatological/Topical Agent
Hormonal Agent
Steroid
Nasal Preparation
Astringent
Glucocorticoid
Diseases Inflammatory Disease
Irritation
Itching
Psoriasis
Redness
Swelling

Triamcinolone Acetonide

Triamcinolone Acetonide belongs to a class of drugs, called the glucocorticoids. It is a synthetic glucocorticoid. Natural glucocorticoids (hydrocortisone and cortisone), which have salt-retaining characteristics, are employed in adrenocortical deficit replacement therapy. Their synthetic analogs are largely employed for anti-inflammatory actions in a variety of organ system illnesses.

Glucocorticoids have a wide range of metabolic consequences. Furthermore, they alter the immune system's reaction to a variety of stimuli.

Triamcinolone Acetonide injection

  • The intra-articular or soft  tissue administration: Triamcinolone Acetonide is indicated for acute  gouty  arthritis, acute  and subacute  bursitis, acute  nonspecific  tenosynovitis, epicondylitis, rheumatoid arthritis, synovitis of osteoarthritis.
  • The  intralesional  administration: Triamcinolone Acetonide is indicated for alopecia areata; discoid lupus  erythematosus;  keloids;  localized hypertrophic, infiltrated,  inflammatory  lesions  of granuloma annulare, lichen planus, lichen simplex  chronicus  (neurodermatitis), and psoriatic plaques;  necrobiosis  lipoidica diabeticorum. Triamcinolone Acetonide  Injection may  also be  useful  in cystic tumors of an aponeurosis  or  tendon  (ganglia)
  • Nasal Spray: Triamcinolone Acetonide is indicated for seasonal and perennial allergic rhinitis in adults and children 12 years of age or older.

Injection: 

  • Depending on the disease entity being treated, the initial dose of Triamcinolone Acetonide Injection for intra-articular injection might range from 2.5 mg to 5 mg for smaller joints and from 5 mg to 15 mg for larger joints. Single injections of up to 20 mg or more into numerous joints have been given.
  • The initial dose per injection site for intralesional administration will vary based on the disease entity and lesion being treated. Because of the risk of cutaneous atrophy, the injection site and volume should be carefully assessed.

Nasal Spray:

  • For most patients, the recommended starting dose of the nasal spray is 200 mcg per day, administered as two sprays (about 50 mcg/spray) in each nostril once a day. The maximum dose per day should not exceed 400 mcg. If the 400 mcg dose is utilized, it can be used once a day (4 sprays in each nostril) or twice a day in two dosages of two sprays each nostril.

When used systemically, the following adverse reactions may appear-

  • Allergic reactions: Anaphylaxis including death, angioedema.
  • Cardiovascular: Bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, fat embolism, hypertension, hypertrophic cardiomyopathy in premature infants, myocardial rupture following recent myocardial infarction, pulmonary edema, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis.
  • Dermatologic: Acne, allergic dermatitis, cutaneous and subcutaneous atrophy, dry scaly skin, ecchymoses and petechiae, edema, erythema, hyperpigmentation, hypopigmentation, impaired wound healing, increased sweating, lupus erythematosus-like lesions, purpura, rash, sterile abscess, striae, suppressed reactions to skin tests, thin fragile skin, thinning scalp hair, urticaria.
  • Endocrine: Decreased carbohydrate and glucose tolerance, development of cushingoid state, glycosuria, hirsutism, hypertrichosis, increased requirements for insulin or oral hypoglycemic agents in diabetes, manifestations of latent diabetes mellitus, menstrual irregularities, postmenopausal vaginal hemorrhage, secondary adrenocortical and pituitary unresponsiveness (particularly in times of stress, as in trauma, surgery, or illness), suppression of growth in pediatric patients.
  • Fluid and electrolyte disturbances: Congestive heart failure in susceptible patients, fluid retention, hypokalemic alkalosis, potassium loss, sodium retention. 
  • Gastrointestinal: Abdominal distention, bowel/bladder dysfunction (after intrathecal administration, elevation in serum liver enzyme levels (usually reversible upon discontinuation), hepatomegaly, increased appetite, nausea, pancreatitis, peptic ulcer with possible perforation and hemorrhage, perforation of the small and large intestine (particularly in patients with inflammatory bowel disease), ulcerative esophagitis.
  • Metabolic: Negative nitrogen balance due to protein catabolism.
  • Musculoskeletal: Aseptic necrosis of femoral and humeral heads, calcinosis (following intra-articular or intralesional use), Charcot-like arthropathy, loss of muscle mass, muscle weakness, osteoporosis, pathologic fracture of long bones, post injection flare (following intra-articular use), steroid myopathy, tendon rupture, vertebral compression fractures
  • The injection of corticosteroids into the epidural space has been linked to serious neurologic events, some of which have resulted in death. Spinal cord infarction, paraplegia, quadriplegia, cortical blindness, and stroke are only a few of the specific events reported.
  • Excessive benzyl alcohol exposure has been linked to toxicity (hypotension, metabolic acidosis), particularly in neonates, as well as an increased risk of kernicterus, particularly in small preterm newborns. There have been a few cases of mortality linked to exposure to high quantities of benzyl alcohol, mostly in premature newborns.
  • Triamcinolone acetonide Injection (triamcinolone acetonide injectable suspension, USP) should not be given intravenously because it is a suspension. The use of strict aseptic procedure is required.
  • Patients on corticosteroid therapy who are exposed to unusual stress before, during, or after the stressful circumstance should receive a higher dose of quickly acting corticosteroids.
  • Some indications of infection may be hidden by corticosteroids, and new infections may develop as a result of their use. Infections with any pathogen, including viral, bacterial, fungal, protozoan, or helminthic infections, may be linked to the use of corticosteroids alone or in combination with other immunosuppressive agents that affect cellular immunity, humoral immunity, or neutrophil function, in any part of the body.
  • The risk of drug-induced secondary adrenocortical insufficiency can be reduced by gradually lowering the dosage. This form of relative insufficiency can last for months after you stop taking hormone therapy, therefore if you have a stressful circumstance during that time, hormone therapy should be resumed.
  • Corticosteroids have a stronger effect on hypothyroidism patients and those with cirrhosis.
  • Because of the risk of corneal perforation, corticosteroids should be taken with caution in individuals with ocular herpes simplex.
  • To regulate the condition being treated, the lowest possible amount of corticosteroid should be utilized, and when dosage reduction is possible, it should be done gradually.
  • In individuals with systemic sclerosis, caution is advised since corticosteroids, particularly methylprednisolone, have been linked to an increased risk of scleroderma renal crisis.
  • If there is a risk of impending perforation, abscess, or other pyogenic infection, steroids should be used with caution in nonspecific ulcerative colitis; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency;
  • Infants and children receiving long-term corticosteroid medication should have their growth and development monitored closely.

Contraindication

Contraindicated in patients hypersensitive to Triamcinolone or other glucocorticoids, such as-

There is no known contraindications of triamcinolone in terms of food and drinks.

Intramuscular corticosteroid preparations are contraindicated for idiopathic thrombocytopenic purpura.