Triamcinolone Dosage

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Usual Adult Dose for Adrenocortical Insufficiency

4 mg to 12 mg orally daily, in addition to mineralocorticoid therapy.

Usual Adult Dose for Ankylosing Spondylitis

Initial:
8 mg to 16 mg orally per day. Alternatively, 3 mg to 48 mg IM per day, administered in equally divided doses every 12 hours.

Intra-articular and intrasynovial Injection:
5 mg to 40 mg once depending on the size of the joint. The average for the knee is 25 mg.

The maximum weekly dosage of triamcinolone diacetate is 75 mg.

Usual Adult Dose for Bursitis

Initial:
8 mg to 16 mg orally per day. Alternatively, 3 mg to 48 mg IM per day, administered in equally divided doses every 12 hours.

Intra-articular and intrasynovial Injection:
5 mg to 40 mg once depending on the size of the joint. The average for the knee is 25 mg.

The maximum weekly dosage of triamcinolone diacetate is 75 mg.

Usual Adult Dose for Osteoarthritis

Initial:
8 mg to 16 mg orally per day. Alternatively, 3 mg to 48 mg IM per day, administered in equally divided doses every 12 hours.

Intra-articular and intrasynovial Injection:
5 mg to 40 mg once depending on the size of the joint. The average for the knee is 25 mg.

The maximum weekly dosage of triamcinolone diacetate is 75 mg.

Usual Adult Dose for Rheumatoid Arthritis

Initial:
8 mg to 16 mg orally per day. Alternatively, 3 mg to 48 mg IM per day, administered in equally divided doses every 12 hours.

Intra-articular and intrasynovial Injection:
5 mg to 40 mg once depending on the size of the joint. The average for the knee is 25 mg.

The maximum weekly dosage of triamcinolone diacetate is 75 mg.

Usual Adult Dose for Gouty Arthritis

Initial:
8 mg to 16 mg orally per day. Alternatively, 3 mg to 48 mg IM per day, administered in equally divided doses every 12 hours.

Intra-articular and intrasynovial Injection:
5 mg to 40 mg once depending on the size of the joint. The average for the knee is 25 mg.

The maximum weekly dosage of triamcinolone diacetate is 75 mg.

Usual Adult Dose for Psoriatic Arthritis

Initial:
8 mg to 16 mg orally per day. Alternatively, 3 mg to 48 mg IM per day, administered in equally divided doses every 12 hours.

Intra-articular and intrasynovial Injection:
5 mg to 40 mg once depending on the size of the joint. The average for the knee is 25 mg.

The maximum weekly dosage of triamcinolone diacetate is 75 mg.

Usual Adult Dose for Synovitis

Initial:
8 mg to 16 mg orally per day. Alternatively, 3 mg to 48 mg IM per day, administered in equally divided doses every 12 hours.

Intra-articular and intrasynovial Injection:
5 mg to 40 mg once depending on the size of the joint. The average for the knee is 25 mg.

The maximum weekly dosage of triamcinolone diacetate is 75 mg.

Usual Adult Dose for Systemic Lupus Erythematosus

Initial:
20 mg to 32 mg orally daily.

Maintenance:
48 mg orally or more daily.

Usual Adult Dose for Congestive Heart Failure

Initial:
20 mg to 60 mg orally daily.

Maintenance:
Dosage should be continued for at least 6 to 8 weeks, to a maximum of 3 months.

Usual Adult Dose for Allergic Reaction

Initial:
8 mg to 12 mg orally daily. Intractable cases may require higher dosage.

Usual Adult Dose for Allergic Rhinitis

Initial:
8 mg to 12 mg orally daily. Intractable cases may require higher dosage.

Usual Adult Dose for Neuritis

Initial:
12 mg to 40 mg orally daily.

Usual Adult Dose for Uveitis

Initial:
12 mg to 40 mg orally daily.

Usual Adult Dose for Iritis

Initial:
12 mg to 40 mg orally daily.

Usual Adult Dose for Keratitis

Initial:
12 mg to 40 mg orally daily.

Usual Adult Dose for Conjunctivitis

Initial:
12 mg to 40 mg orally daily.

Usual Adult Dose for Iridocyclitis

Initial:
12 mg to 40 mg orally daily.

Usual Adult Dose for Chorioretinitis

Initial:
12 mg to 40 mg orally daily.

Usual Adult Dose for Choroiditis

Initial:
12 mg to 40 mg orally daily.

Usual Adult Dose for Loeffler's Syndrome

Initial:
16 mg to 48 mg orally daily.

Usual Adult Dose for Sarcoidosis

Initial:
16 mg to 48 mg orally daily.

Usual Adult Dose for Berylliosis

Initial:
16 mg to 48 mg orally daily.

Usual Adult Dose for Idiopathic (Immune) Thrombocytopenic Purpura

16 mg to 60 mg orally daily.

Usual Adult Dose for Hemolytic Anemia

16 mg to 60 mg orally daily.

Usual Adult Dose for Erythroblastopenia

16 mg to 60 mg orally daily.

Usual Adult Dose for Thrombocytopenia Idiopathic

16 mg to 60 mg orally daily.

Usual Adult Dose for Leukemia

Lymphoma:
16 mg to 40 mg orally daily.

Acute leukemia:
16 mg to 40 mg orally daily, up to 100 mg daily.

Usual Adult Dose for Nephrotic Syndrome

Initial:
16 mg to 20 mg (up to 48 mg) orally daily until diuresis occurs.

Maintenance:
4 mg orally daily, or gradually reduced until discontinuation.

Usual Adult Dose for Meningitis

Tuberculous meningitis:
32 mg to 48 mg orally daily (in single or divided doses), as an adjunct to antituberculous therapy.

Usual Adult Dose for Alopecia

3 mg to 48 mg per day given as an intralesional injection. The average course of treatment for many conditions is 2 to 3 injections at one to two week intervals.

Alopecia areata and totalis:
25 mg to 30 mg subcutaneously once to twice weekly (at a concentration of 10 mg/mL). No more than 0.5 mL should be given in any one site.

The maximum weekly dose of triamcinolone diacetate is 75 mg.

Usual Adult Dose for Lichen Simplex Chronicus

3 mg to 48 mg per day given as an intralesional injection. The average course of treatment for many conditions is 2 to 3 injections at one to two week intervals.

Alopecia areata and totalis:
25 mg to 30 mg subcutaneously once to twice weekly (at a concentration of 10 mg/mL). No more than 0.5 mL should be given in any one site.

The maximum weekly dose of triamcinolone diacetate is 75 mg.

Usual Adult Dose for Psoriasis

3 mg to 48 mg per day given as an intralesional injection. The average course of treatment for many conditions is 2 to 3 injections at one to two week intervals.

Alopecia areata and totalis:
25 mg to 30 mg subcutaneously once to twice weekly (at a concentration of 10 mg/mL). No more than 0.5 mL should be given in any one site.

The maximum weekly dose of triamcinolone diacetate is 75 mg.

Usual Adult Dose for Lichen Planus

3 mg to 48 mg per day given as an intralesional injection. The average course of treatment for many conditions is 2 to 3 injections at one to two week intervals.

Alopecia areata and totalis:
25 mg to 30 mg subcutaneously once to twice weekly (at a concentration of 10 mg/mL). No more than 0.5 mL should be given in any one site.

The maximum weekly dose of triamcinolone diacetate is 75 mg.

Usual Adult Dose for Keloids

3 mg to 48 mg per day given as an intralesional injection. The average course of treatment for many conditions is 2 to 3 injections at one to two week intervals.

Alopecia areata and totalis:
25 mg to 30 mg subcutaneously once to twice weekly (at a concentration of 10 mg/mL). No more than 0.5 mL should be given in any one site.

The maximum weekly dose of triamcinolone diacetate is 75 mg.

Usual Adult Dose for Asthma

Bronchial asthma:
8 mg to 16 mg orally daily.

2 inhalations (150 mcg) given 3 to 4 times a day. Alternatively, 4 inhalations (300 mcg) given twice daily. In patients with severe asthma, initial higher doses may be used (12 to 16 inhalations per day).

The maximum daily dosage should not exceed 16 inhalations (1200 mcg) .

Usual Adult Dose for Dermatitis

Atopic and contact:
8 mg to 16 mg orally daily in a short treatment course as a supplement to topical therapy.

Usual Adult Dose for Dermal Necrosis - Prophylaxis

Case Report (n=1) - Extravasation of chemotherapeutic agent:
Intralesional injection, 7 to 8 mL of 10 mg/mL concentration, once weekly for 2 weeks.

Usual Pediatric Dose for Leukemia

Acute leukemia:
1 mg/kg (up to 2 mg/kg) orally daily, continued from 4 to 6 weeks.

Usual Pediatric Dose for Asthma

6 to 12 years:
1 to 2 inhalations (75 mcg to 150 mcg), given 3 to 4 times a day. Alternatively, 2 to 4 inhalations (150 mcg to 300 mcg) may be given twice daily.

The maximum daily dosage should not exceed 12 inhalations (900 mcg).

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

The usual dosage of an intra-articular injection of smaller joints (e.g., fingers) is 2 mg to 5 mg.

Short term administration is desirable as a rule. Generally dose is given as a single morning dose, daily or on alternate days. Occasionally, patients may obtain a more effective relief on divided daily doses, either 2 to 4 times daily.

A smaller initial dosage range of triamcinolone diacetate may produce the desired effect in intra-articular, intralesional and soft tissue use.

Intralesional and sublesional injections to large areas may require multiple injections with smaller doses per injection. The limit for any one lesion is 25 mg.

Alternate-day therapy may be initiated after the conventional dose has been established.

Adjust dose to keep symptoms at a level tolerable by the patient, and to reduce suppression of the pituitary-adrenal axis.

Precautions

Exposure to excessive amounts of benzyl alcohol has been associated with toxicity (hypotension, metabolic acidosis), particularly in neonates, and an increased incidence of kernicterus, particularly in small preterm infants. There have been rare reports of deaths, primarily in preterm infants, associated with exposure to excessive amounts of benzyl alcohol. The amount of benzyl alcohol from medications is usually considered negligible compared to that received in flush solutions containing benzyl alcohol. Administration of high dosages of medications containing this preservative must take into account the total amount of benzyl alcohol administered. The amount of benzyl alcohol at which toxicity may occur is not known. If the patient requires more than the recommended dosages or other medications containing this preservative, the practitioner must consider the daily metabolic load of benzyl alcohol from these combined sources.

Dialysis

Data not available

Other Comments

A needle not smaller than 24-gauge may be used for intralesional injections. The full strength suspension of the drug may be used or it may be diluted, either to a 1:1 or 1:10 concentration.

The duration of effect of an intra-articular injection ranges from one week to two months.

Shake the canister of the inhalation aerosol well before using.

The manufacturer recommends the mouth be rinsed after the inhalation dose.

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