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triamcinolone (injection)

Pronunciation

Generic Name: triamcinolone (injection) (trye am SIN oh lone)
Brand Name: Aristospan Injection, Clinacort, Ken-Jec 40, Kenalog-10, Kenalog-40, TAC 3, Triamonide 40, U-Tri-Lone

What is triamcinolone injection?

Triamcinolone injection is a steroid. It prevents the release of substances in the body that cause inflammation.

Triamcinolone injection is injected into the joint space to treat inflammation of the joints or tendons to treat arthritis, bursitis, or epicondylitis (tennis elbow). It is usually given in these conditions only as a short-term treatment of a severe or aggravated episode.

Triamcinolone injection is injected into soft tissues of the body to treat certain skin disorders caused by autoimmune conditions such as lupus, psoriasis, lichen planus, and others.

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

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

You should not receive this medication if you are allergic to triamcinolone, or if you have a condition called idiopathic thrombocytopenic purpura (ITP).

Before receiving triamcinolone injection, tell your doctor if you are allergic to any drugs, or if you have any type of infection (including tuberculosis), a thyroid disorder, a muscle disorder, stomach or intestinal problems, or if you have recently had a heart attack.

Long-term use of steroids can also cause harmful effects on your eyes. Your doctor may want you to have regular eye exams while you are receiving triamcinolone injection.

Steroids can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medication.

Steroids can lower the blood cells that help your body fight infections, making it easier for you to get sick from being around others who are ill, or from bacteria in a skin wound. Use caution to prevent illness, infection, or injury.

Do not receive a "live" vaccine while you are being treated with triamcinolone injection. The live vaccine may not work as well during this time, and may not fully protect you from disease.

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 steroids.

What should I discuss with my health care provider before receiving triamcinolone injection?

You should not receive this medication if you are allergic to triamcinolone, or if you have a condition called idiopathic thrombocytopenic purpura (ITP).

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

  • any type of bacterial, fungal, or viral infection (including tuberculosis);

  • a thyroid disorder;

  • a muscle disorder such as myasthenia gravis;

  • diverticulitis, stomach or intestinal ulcer, or recent stomach surgery; or

  • if you have recently had a heart attack.

FDA pregnancy category C. It is not known whether triamcinolone injection will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Triamcinolone can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using triamcinolone injection.

This medication can decrease bone formation, which could lead to osteoporosis, especially with long-term use. Talk with your doctor about your specific risk of bone loss while receiving triamcinolone injection.

Steroids can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medication.

How is triamcinolone injection given?

This medication is injected into a joint or soft tissue (such as a psoriasis lesion). You will receive this injection in a clinic or hospital setting.

Steroids can lower the blood cells that help your body fight infections. This can make it easier for you to get sick from being around others who are ill, or from bacteria in a skin wound. Steroids can also slow the healing of skin wounds. Use caution to prevent illness, infection, or injury.

If you need surgery, tell the surgeon ahead of time if you have recently received a triamcinolone injection.

Long-term use of steroids can cause harmful effects on the eyes, such as glaucoma or cataracts. If you receive triamcinolone injection for longer than 6 weeks, your doctor may want you to have regular eye exams.

Steroid medications should not be stopped suddenly. You may need to receive less and less before you are taken off the medication completely.

Your doctor may instruct you to limit your salt intake while you are receiving triamcinolone injection. You may also need to take potassium supplements. Follow your doctor's instructions.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are being treated with triamcinolone injection.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid while receiving triamcinolone injection?

Do not receive a "live" vaccine while using triamcinolone injection. The vaccine may not work as well during this time, and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), oral polio, typhoid, chickenpox (varicella), BCG (Bacillus Calmette and Guérin), and nasal flu vaccine.

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 steroids.

Triamcinolone injection side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • fast, slow, or uneven heart rate;

  • feeling short of breath, even with mild exertion;

  • swelling, rapid weight gain;

  • dangerously high blood pressure (severe headache, buzzing in your ears, anxiety, confusion, chest pain);

  • problems with your vision;

  • eye swelling, redness, discomfort, or drainage (may be signs of infection);

  • severe depression, changes in mood or behavior;

  • seizure (convulsions); or

  • muscle pain, tenderness, or weakness.

Less serious side effects may include:

  • nausea, bloating, appetite changes;

  • stomach or side pain;

  • headache, sleep problems (insomnia);

  • acne, scaling, or other skin changes;

  • a wound that is slow to heal;

  • thinning hair;

  • bruising or swelling;

  • sweating more than usual; or

  • irregular menstrual periods.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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 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).

What other drugs will affect triamcinolone injection?

Tell your doctor about all other medicines you use, especially:

  • birth control pills or hormone replacement therapy;

  • a blood thinner such as warfarin (Coumadin);

  • cyclosporine (Neoral, Gengraf, Sandimmune);

  • digoxin (digitalis, Lanoxin);

  • insulin or diabetes medications you take by mouth;

  • isoniazid (used to treat tuberculosis);

  • rifampin (Rifadin, Rimactane);

  • seizure medication such as phenobarbital (Luminal, Solfoton), phenytoin (Dilantin), carbamazepine (Carbatrol, Tegretol), and others,

  • antibiotics such as azithromycin (Zithromax), clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Ery-Tab, Erythrocin), and others; or

  • aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others.

This list is not complete and other drugs may interact with triamcinolone injection. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about triamcinolone injection.
  • 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.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.02. Revision Date: 2010-12-15, 5:01:39 PM.

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