Table of Contents
What is Triamcinolone?
Triamcinolone is a glucocorticoid used in the treatment of diseases such as rheumatoid arthritis, psoriasis, lupus, Asthma, Allergic Reactions, Dermatitis, Osteoarthritis, Sarcoidosis, etc. The product ingredienst are: Triamcinolone acetonide, Triamcinolone diacetate and Triamcinolone hexacetonide.
The brand names of Triamcinolone in the United States are: Kenalog-40, Zilretta, Azmacort, Aristocort.
Triamcinolone Mechanism of Action (MOA)
Powerful anti-inflammatory effect. Glucocorticoids produce various metabolic effects and may also modify the immune response.
Therapeutic indications, uses and benefits of Triamcinolone
– Intramuscular route:
- Non-suppurative thyroiditis.
- Post-traumatic osteoarthritis, osteoarthritis synovitis, rheumatoid arthritis, acute and subacute bursitis, epicondylitis, non-specific acute tenosynovitis, acute gouty arthritis, psoriatic arthritis, ankylosing spondylitis and juvenile rheumatoid arthritis.
- Systemic lupus erythematosus, acute rheumatic carditis.
- Pemphigus, severe erythema multiforme, dermatitis (exfoliative, vesiculosa herpetiforme, severe seborrheic), severe psoriasis.
- Bronchial asthma, dermatitis (contact, atopic), allergic rhinitis. Ophthalmic herpes zoster, iritis, iridocyclitis, chorioretinitis, uveitis and posterior diffuse choroiditis, optic neuritis, sympathetic ophthalmia, inflammation of the anterior segment.
- Ulcerative colitis, local enteritis.
- Symptomatic sarcoidosis, berylliosis, aspiration pneumonitis. Acquired hemolytic anemia.
- Palliative treatment of: leukemias and lymphomas in adults and acute leukemia in childhood.
- Edematous states.
– Intraarticular:
- Synovitis of osteoarthritis, rheumatoid arthritis, acute and subacute bursitis, acute gouty arthritis, epicondylitis, non-specific acute tenosynovitis, post-traumatic osteoarthritis.
Triamcinolone Dosage
Individualized dose according to the disease and response of the patient.
– Systemic: adults and children >12 years: recommended initial 60 mg IM deep in the gluteus muscle, usual: 40-100 mg.
Children 6-12 years: recommended initial 40 mg.
– Local: intraarticular or intrasynovial and injection into tendon sheath: 2.5-40 mg depending on joint or area to be treated, max. 80 mg.
Contraindications of Triamcinolone
- Systemic infections.
- Idiopathic thrombocytopenic purpura (IM).
- Hypersensitivity.
Warnings and Precautions with Triamcinolone
Elderly, hypothyroidism, cirrhosis, ocular herpes simplex, nonspecific ulcerative colitis, diverticulitis, recent intestinal anastomosis.
Active or latent peptic ulcer, renal failure, acute glomerulonephritis, chronic nephritis, high blood pressure, ICC, thrombophlebitis, thromboembolism.
Osteoporosis, exanthema, S. de Cushing, diabetes mellitus, convulsive disorders, metastatic carcinoma, myasthenia gravis.
In a stressful situation to avoid induced adrenocortical insuff. a support dosage may be needed.
Do not use for IV, intradermal, intraocular, epidural or intrathecal use.
It can produce subcapsular cataracts and glaucoma; elevation of blood pressure, retention of salt and water, increases of K and Ca.
Not recommended in < 6 years. Varicella and measles can have a more serious and even fatal evolution, avoid exposure, as well as in patients infected by strongyloids.
Do not vaccinate. Risk of anaphylactic reaction and psychiatric disorders. Do not inject into unstable joints or inflamed tendon.
In prolonged treatment: monitor the development of children, adequate protein intake.
Gradual suspension of treatment.
Risk of: menstrual irregularities and vaginal bleeding in postmenopausal women.
Kidney failure
Caution. If there is a kidney disorder with fixed or decreased renal filtration rate, edema may occur.
Interactions with Triamcinolone
- Increased effect by: cyclosporine, ketoconazole.
- Decreased effect of: barbiturates, phenytoin, carbamazepine, rifampicin.
- Increases or decreases the effect of: anticoagulants, muscle blockers.
- Adjust dose of: oral hypoglycemic and insulin.
- Adjust dose of triamcinolone with: thyroid drugs.
- Increases the effect of: cyclosporine.
- Increase toxicity of: digitalis glycosides.
- Increases the incidence and/or severity of ulceration and gastrointestinal bleeding associated with NSAIDs.
- Decreases serum concentration of: isoniazid.
- Decreases the effect of: antihypertensive and human growth hormone.
- Caliuretic effect increased with: injectable amphotericin B and agents that cause depletion of K.
- Average life and concentration increased by: estrogens.
- Not recommended with drugs that: prolong the QT interval or produce “torsades de pointes” or that produce hypomagnesemia and severe hypocalcemia.
- Antagonizes effect of: anticholinesterases.
- Lab: false – in test of bacterial infection of nitro-blue tetrazoline.
Pregnancy
Limited clinical experience.
Not to be administered unless the benefit to the mother is considered greater than the potential risk to the fetus/baby.
Breastfeeding
The use of these drugs in breastfeeding should only be considered if the potential benefit outweighs the potential risk to the mother and the embryo, foetus or infant.
Other systemic corticosteroids have been shown to occur in breast milk and slightly (around 1%) increase the risk of cleft palate in human fetuses.
Adverse reactions and side effects of Triamcinolone
- Infection.
- Headache.
- Cataracts.
- Reaction at the injection site.
⭐⭐⭐⭐⭐ VIDEO OF TRIAMCINOLONE/KENALOG (DRUG)
Source: The content of this active ingredient has been written taking into account the clinical and molecular information of all medicines authorised and marketed in the United States under the Unique Ingredient Identifier (UNII) by the Substance Registration System (SRS) of the Food and Drug Administration (FDA) and the United States Pharmacopeia (USP).
In order to know in detail the information authorized by the FDA for each drug, you should consult the corresponding medication guide authorized by the FDA.
Resources:
UNII: 1ZK20VI6TY
ChemIDplus
DrugPortal
PubChem CID: 31307
NCI Thesaurus: C901