triamcinolone

Generic Name: triamcinolone (oral) (trye am SIN oh lone)
Brand Names: Aristocort

What is triamcinolone?

Triamcinolone is in a class of drugs called steroids. Triamcinolone prevents the release of substances in the body that cause inflammation.

Triamcinolone is used to treat many different conditions such as allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders.

Triamcinolone may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about triamcinolone?

Before taking triamcinolone, tell your doctor about all of your medical conditions, and about all other medicines you are using. There are many other disease that can be affected by steroid use, and many other medicines that can interact with steroids.

Your steroid medication needs may change if you have any unusual stress such as a serious illness, fever or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you during treatment.

Steroid medication can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had. Tell your doctor about any illness or infection you have had within the past several weeks.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medication.

Do not receive a "live" vaccine while you are taking triamcinolone. Vaccines may not work as well while you are taking a steroid.

What should I discuss with my healthcare provider before taking triamcinolone?

Steroid medication can weaken your immune system, making it easier for you to get an infection. Steroids can also worsen an infection you already have, or reactivate an infection you recently had. Before taking this medication, tell your doctor about any illness or infection you have had within the past several weeks.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take triamcinolone:

• liver disease (such as cirrhosis);

• kidney disease;

• a thyroid disorder;

• diabetes;

• a history of malaria;

• tuberculosis;

• osteoporosis;

• a muscle disorder such as myasthenia gravis;

• glaucoma or cataracts;

• herpes infection of the eyes;

• stomach ulcers, ulcerative colitis, or diverticulitis;

• depression or mental illness;

• congestive heart failure; or

• high blood pressure

How should I take triamcinolone?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Your steroid medication needs may change if you have unusual stress such as a serious illness, fever or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using triamcinolone.

What happens if I miss a dose?

If you miss a dose or forget to take your medicine, contact your doctor or pharmacist for instructions.

What happens if I overdose?

A single large dose of triamcinolone is not expected to produce life-threatening symptoms. However, high doses taken over a long period of time may cause weight gain, roundness of the face, increased facial hair growth, bruising, swelling, and muscle pain or weakness.

What should I avoid while taking triamcinolone?

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medication.

Do not receive a "live" vaccine while you are being treated with triamcinolone. Vaccines may not work as well while you are taking a steroid.

Triamcinolone side effects

• problems with your vision;

• swelling, rapid weight gain, feeling short of breath;

• severe depression, unusual thoughts or behavior, seizure (convulsions);

• bloody or tarry stools, coughing up blood;

• pancreatitis (severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate);

• low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling); or

• dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Less serious side effects may include:

• sleep problems (insomnia), mood changes;

• acne, dry skin, thinning skin, bruising or discoloration;

• slow wound healing;

• increased sweating;

• headache, dizziness, spinning sensation;

• nausea, stomach pain, bloating;

• muscle weakness;

• changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist);

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Triamcinolone Dosing Information

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 Chorioditis:

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).

What other drugs will affect triamcinolone?

There are many other medicines that can interact with steroids. Below is only a partial list of these medicines:

• aspirin (taken on a daily basis or at high doses);

• a diuretic (water pill);

• a blood thinner such as warfarin (Coumadin);

• cyclosporine (Gengraf, Neoral, Sandimmune);

• insulin or diabetes medications you take by mouth;

• ketoconazole (Nizoral);

• rifampin (Rifadin, Rifater, Rifamate, Rimactane); or

• seizure medications such as phenytoin (Dilantin) or phenobarbital (Luminal, Solfoton).

This list is not complete and there may be other drugs that can interact with triamcinolone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about triamcinolone.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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