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Nasacort Disease Interactions

There are 4 disease interactions with Nasacort (triamcinolone nasal).

Moderate

Inhaled corticosteroids (applies to Nasacort) hyperadrenocorticism

Moderate Potential Hazard, Moderate plausibility.

The use of inhaled and nasal corticosteroids may rarely precipitate or aggravate conditions of hyperadrenocorticism. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used. The development of symptoms such as menstrual irregularities, acneiform lesions, cataracts and cushingoid features during inhaled or nasal corticosteroid therapy may indicate excessive use.

References

  1. Kimmerle R, Rolla AR (1985) "Iatrogenic Cushing's syndrome due to dexamethasone nasal drops." Am J Med, 79, p. 535-7
  2. Monk B, Cunliffe WJ, Layton AM, Rhodes DJ (1993) "Acne induced by inhaled corticosteroids." Clin Exp Dermatol, 18, p. 148-50
  3. Brogden RN, Heel RC, Speight TM, Avery GS (1984) "Beclomethasone dipropionate. A reappraisal of its pharmacodynamic properties and therapeutic efficacy after a decade of use in asthma and rhinitis." Drugs, 28, p. 99-126
  4. Clark TJ (1982) "Safety of inhaled corticosteroids." Eur J Respir Dis Suppl, 122, p. 235-42
  5. Messerli C, Studer H, Scherrer M (1975) "Systemic side effects of beclomethasone dipropionate aerosols (becotide, aldecine, sanasthmyl) in otherwise non steroid treated asthmatic patients." Pneumonologie, 153, p. 29-42
  6. (2001) "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome
  7. (2001) "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome
  8. (2022) "Product Information. AeroBid (flunisolide)." Forest Pharmaceuticals
  9. (2001) "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc
  10. van As A, Bronsky E, Grossman J, Meltzer E, Ratner P, Reed C (1991) "Dose tolerance study of fluticasone propionate aqueous nasal spray in patients with seasonal allergic rhinitis." Ann Allergy, 67, p. 156-62
  11. Stevens DJ (1988) "Cushing's syndrome due to the abuse of betamethasone nasal drops." J Laryngol Otol, 102, p. 219-21
  12. Grahnen A, Eckernas SA, Brundin RM, Lingandersson A (1994) "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol, 38, p. 521-5
  13. Edsbacker S, Andersson KE, Ryrfeldt A (1985) "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol, 29, p. 477-81
  14. (2001) "Product Information. Flonase (fluticasone)." Glaxo Wellcome
  15. Barnes PJ (1995) "Drug therapy: inhaled glucocorticoids for asthma." N Engl J Med, 332, p. 868-75
  16. (2001) "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals
  17. Robinson DS, Geddes DM (1996) "Inhaled corticosteroids: benefits and risks." J Asthma, 33, p. 5-16
  18. Howland WC (1996) "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy, 26 ( Suppl, p. 18-22
  19. (2001) "Product Information. Flovent (fluticasone)." Glaxo Wellcome
  20. Thorsson L, Dahlstrom K, Edsbacker S, Kallen A, Paulson J, Wiren JE (1997) "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol, 43, p. 155-61
  21. McEvoy CE, Niewoehner DE (1997) "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest, 111, p. 732-43
  22. Wiseman LR, Benfield P (1997) "Intranasal fluticasone propionate: A reappraisal of its pharmacology and clinical efficacy in the treatment of rhinitis." Drugs, 53, p. 885-907
  23. "Product Information. Nasonex (mometasone nasal)." Scherer Laboratories Inc
  24. (2001) "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals
  25. (2001) "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer
  26. (2001) "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer
  27. Wales D, Makker H, Kane J, McDowell P, ODriscoll BR (1999) "Systemic bioavailability and potency of high-dose inhaled corticosteroids - A comparison of four inhaler devices and three drugs in healthy adult volunteers." Chest, 115, p. 1278-84
  28. Derom E, Schoor JV, Verhaeghe W, Vincken W, Pauwels R (1999) "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med, 160, p. 157-61
  29. (2008) "Product Information. Alvesco (ciclesonide)." Nycomed USA
  30. (2008) "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc
View all 30 references
Moderate

Inhaled corticosteroids (applies to Nasacort) infections

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral, Tuberculosis -- Latent

The immunosuppressant and anti-inflammatory effects of corticosteroids, particularly in higher dosages, may decrease host resistance to infectious agents, decrease the ability to localize infections, and mask the symptoms of infection. Secondary infections may be more likely to develop. Therapy with inhaled and nasal corticosteroids should be administered cautiously in patients with an infection, particularly active or quiescent tuberculosis infection of the respiratory tract or any untreated systemic fungal, bacterial, parasitic, or viral infection. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

References

  1. Horton DJ, Spector SL (1977) "Clinical pulmonary tuberculosis in an asthmatic patient using a steroid aerosol." Chest, 71, p. 540-2
  2. Carrel TP, Schaffner A, Schmid ER, Schneider J, Bauer EP, Laske A, von Segesser LK, Turina MI (1991) "Fatal fungal pericarditis after cardiac surgery and immunosuppression." J Thorac Cardiovasc Surg, 101, p. 161-4
  3. Vogt FC (1979) "The incidence of oral candidiasis with use of inhaled corticosteroids." Ann Allergy, 43, p. 205-10
  4. Milne LJ, Crompton GK (1974) "Beclomethasone dipropionate and oropharyngeal candidiasis." Br Med J, 3, p. 797-8
  5. Toogood JH, Jennings B, Greenway RW, Chuang L (1980) "Candidiasis and dysphonia complicating beclomethasone treatment of asthma." J Allergy Clin Immunol, 65, p. 145-53
  6. Webb EL (1993) "Nasal candidiasis in a patient on long-term topical intranasal corticosteroid therapy." J Allergy Clin Immunol, 91, p. 680-1
  7. Shaikh WA (1992) "Pulmonary tuberculosis in patients treated with inhaled beclomethasone." Allergy, 47, p. 327-30
  8. Kesten S, Hyland RH, Pruzanski WR, Kortan PP (1988) "Esophageal candidiasis associated with beclomethasone dipropionate aerosol therapy." Drug Intell Clin Pharm, 22, p. 568-9
  9. Brogden RN, Heel RC, Speight TM, Avery GS (1984) "Beclomethasone dipropionate. A reappraisal of its pharmacodynamic properties and therapeutic efficacy after a decade of use in asthma and rhinitis." Drugs, 28, p. 99-126
  10. Messerli C, Studer H, Scherrer M (1975) "Systemic side effects of beclomethasone dipropionate aerosols (becotide, aldecine, sanasthmyl) in otherwise non steroid treated asthmatic patients." Pneumonologie, 153, p. 29-42
  11. Executive Committee American Academy of Allergy and Immunology (1993) "Inhaled corticosteroids and severe viral infections." J Allergy Clin Immunol, 92, p. 223-8
  12. (2001) "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome
  13. (2001) "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome
  14. (2022) "Product Information. AeroBid (flunisolide)." Forest Pharmaceuticals
  15. (2001) "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc
  16. Grahnen A, Eckernas SA, Brundin RM, Lingandersson A (1994) "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol, 38, p. 521-5
  17. Edsbacker S, Andersson KE, Ryrfeldt A (1985) "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol, 29, p. 477-81
  18. (2001) "Product Information. Flonase (fluticasone)." Glaxo Wellcome
  19. (2001) "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals
  20. Howland WC (1996) "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy, 26 ( Suppl, p. 18-22
  21. (2001) "Product Information. Flovent (fluticasone)." Glaxo Wellcome
  22. Thorsson L, Dahlstrom K, Edsbacker S, Kallen A, Paulson J, Wiren JE (1997) "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol, 43, p. 155-61
  23. McEvoy CE, Niewoehner DE (1997) "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest, 111, p. 732-43
  24. "Product Information. Nasonex (mometasone nasal)." Scherer Laboratories Inc
  25. (2001) "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals
  26. (2001) "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer
  27. (2001) "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer
  28. Wales D, Makker H, Kane J, McDowell P, ODriscoll BR (1999) "Systemic bioavailability and potency of high-dose inhaled corticosteroids - A comparison of four inhaler devices and three drugs in healthy adult volunteers." Chest, 115, p. 1278-84
  29. Derom E, Schoor JV, Verhaeghe W, Vincken W, Pauwels R (1999) "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med, 160, p. 157-61
  30. (2008) "Product Information. Alvesco (ciclesonide)." Nycomed USA
  31. (2008) "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc
View all 31 references
Moderate

Inhaled corticosteroids (applies to Nasacort) ocular herpes simplex

Moderate Potential Hazard, Moderate plausibility.

Pharmacologic dosages of corticosteroids may increase the risk of corneal perforation in patients with ocular herpes simplex. Therapy with inhaled and nasal corticosteroids should be administered cautiously in such patients.

References

  1. (2001) "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome
  2. (2001) "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome
  3. (2022) "Product Information. AeroBid (flunisolide)." Forest Pharmaceuticals
  4. (2001) "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc
  5. (2001) "Product Information. Flonase (fluticasone)." Glaxo Wellcome
  6. (2001) "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals
  7. (2001) "Product Information. Flovent (fluticasone)." Glaxo Wellcome
  8. "Product Information. Nasonex (mometasone nasal)." Scherer Laboratories Inc
  9. (2001) "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals
  10. (2001) "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer
  11. (2001) "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer
  12. (2008) "Product Information. Alvesco (ciclesonide)." Nycomed USA
  13. (2008) "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc
View all 13 references
Moderate

Inhaled corticosteroids (applies to Nasacort) ocular toxicities

Moderate Potential Hazard, Low plausibility. Applicable conditions: Glaucoma/Intraocular Hypertension, Cataracts

Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with inhaled and nasal corticosteroids has only rarely produced these effects but should be administered cautiously nonetheless in patients with a history of cataracts, glaucoma, or increased intraocular pressure. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

References

  1. Fraunfelder FT, Meyer SM (1990) "Posterior subcapsular cataracts associated with nasal or inhalation corticosteroids." Am J Ophthalmol, 109, p. 489-90
  2. Karim AK, Thompson GM, Jacob TJ (1989) "Steroid aerosols and cataract formation." BMJ, 299, p. 918
  3. Allen MB, Ray SG, Leitch AG, Dhillon B, Cullen B (1989) "Steroid aerosols and cataract formation." BMJ, 299, p. 432-3
  4. Kewley GD (1980) "Possible association between beclomethasone diproprionate aerosol and cataracts." Aust Paediatr J, 16, p. 117-8
  5. Messerli C, Studer H, Scherrer M (1975) "Systemic side effects of beclomethasone dipropionate aerosols (becotide, aldecine, sanasthmyl) in otherwise non steroid treated asthmatic patients." Pneumonologie, 153, p. 29-42
  6. Ghanchi F (1993) "Young patients on inhaled steroids and cataract." Lancet, 342, p. 1306-7
  7. Dreyer EB (1993) "Inhaled steroid use and glaucoma." N Engl J Med, 329, p. 1822
  8. (2001) "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome
  9. (2001) "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome
  10. (2022) "Product Information. AeroBid (flunisolide)." Forest Pharmaceuticals
  11. (2001) "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc
  12. Spaeth GL, Rodrigues MM, Weinreb S (1977) "Steroid-induced glaucoma: A. Persistent elevation of intraocular pressure B. Histopathological aspects." Trans Am Ophthalmol Soc, 75, p. 353-81
  13. Grahnen A, Eckernas SA, Brundin RM, Lingandersson A (1994) "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol, 38, p. 521-5
  14. Edsbacker S, Andersson KE, Ryrfeldt A (1985) "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol, 29, p. 477-81
  15. (2001) "Product Information. Flonase (fluticasone)." Glaxo Wellcome
  16. Barnes PJ (1995) "Drug therapy: inhaled glucocorticoids for asthma." N Engl J Med, 332, p. 868-75
  17. (2001) "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals
  18. Howland WC (1996) "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy, 26 ( Suppl, p. 18-22
  19. Garbe E, LeLorier J, Boivin JF, Suissa S (1997) "Inhaled and nasal glucocorticoids and the risks of ocular hypertension or open-angle glaucoma." JAMA, 277, p. 722-7
  20. (2001) "Product Information. Flovent (fluticasone)." Glaxo Wellcome
  21. Thorsson L, Dahlstrom K, Edsbacker S, Kallen A, Paulson J, Wiren JE (1997) "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol, 43, p. 155-61
  22. McEvoy CE, Niewoehner DE (1997) "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest, 111, p. 732-43
  23. Cumming RG, Mitchell P, Leeder SR (1997) "Use of inhaled corticosteroids and the risk of cataracts." N Engl J Med, 337, p. 8-14
  24. "Product Information. Nasonex (mometasone nasal)." Scherer Laboratories Inc
  25. (2001) "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals
  26. Agertoft L, Larsen FE, Pedersen S (1998) "Posterior subcapsular cataracts, bruises and hoarseness in children with asthma receiving long-term treatment with inhaled budesonide." Eur Resp J, 12, p. 130-5
  27. (2001) "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer
  28. (2001) "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer
  29. Wales D, Makker H, Kane J, McDowell P, ODriscoll BR (1999) "Systemic bioavailability and potency of high-dose inhaled corticosteroids - A comparison of four inhaler devices and three drugs in healthy adult volunteers." Chest, 115, p. 1278-84
  30. Derom E, Schoor JV, Verhaeghe W, Vincken W, Pauwels R (1999) "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med, 160, p. 157-61
  31. (2008) "Product Information. Alvesco (ciclesonide)." Nycomed USA
  32. (2008) "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc
View all 32 references

Nasacort drug interactions

There are 37 drug interactions with Nasacort (triamcinolone nasal).


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.