Zilretta Injection
Generic name: triamcinolone acetonide (injection) [ TRYE-am-SIN-oh-lone ]
Drug class: Glucocorticoids
What is Zilretta injection?
Zilretta is an extended-release corticosteroid injection used to manage osteoarthritis knee pain.
Zilretta is for injection directly into the knee and and should not be administered by any other injection method.
Zilretta injection is not suitable for use in small joints, such as the hand.
The risks and benefits of repeat injections have not been demonstrated.
Zilretta side effects
Get emergency medical help if you have signs of an allergic reaction to Zilretta: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Zilretta may cause serious side effects. Call your doctor at once if you have:
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(after injection into a joint space) increased pain or swelling, joint stiffness, fever, and general ill feeling;
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blurred vision, tunnel vision, eye pain, or seeing halos around lights;
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unusual changes in mood or behavior;
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swelling, rapid weight gain, feeling short of breath;
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stomach cramps, vomiting, diarrhea, bloody or tarry stools, rectal irritation;
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sudden numbness or weakness (especially on one side of the body);
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a seizure (convulsions);
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severe headache, blurred vision, pounding in your neck or ears;
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increased pressure inside the skull - severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes; or
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signs of low adrenal gland hormones - flu-like symptoms, headache, depression, weakness, tiredness, diarrhea, vomiting, stomach pain, craving salty foods, and feeling light-headed.
Certain side effects may be more likely with long-term use or repeated doses of Zilretta injection.
Steroids can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using this medicine.
Common Zilretta side effects may include:
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skin changes (acne, dryness, redness, bruising, discoloration);
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increased hair growth, or thinning hair;
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nausea, bloating, appetite changes;
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stomach or side pain;
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cough, runny or stuffy nose;
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headache, sleep problems (insomnia);
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a wound that is slow to heal;
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sweating more than usual; or
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changes in your menstrual periods.
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.
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Warnings
You may not be able to receive Zilretta if you have a fungal infection, or a condition called idiopathic thrombocytopenic purpura (ITP).
Before taking this medicine
You should not be treated with Zilretta if you are allergic to triamcinolone.
You may not be able to receive Zilretta injection if you have a fungal infection, or a condition called idiopathic thrombocytopenic purpura (ITP).
Tell your doctor if you have ever had:
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an active or chronic infection, including tuberculosis;
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idiopathic thrombocytopenic purpura (ITP);
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high blood pressure, heart problems;
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cataracts, glaucoma, or herpes infection of the eyes;
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a parasite infection that causes diarrhea (such as threadworms);
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a nerve-muscle disorder, such as myasthenia gravis;
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low bone mineral density; or
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a problem with your thyroid or adrenal gland.
Tell your doctor if you are pregnant or breastfeeding.
How is Zilretta injection given?
Zilretta injection is administered by a health professional as a single extended-release injection of triamcinolone acetonide directly into the knee joint.
Triamcinolone can weaken (suppress) your immune system, and you may get an infection more easily. Call your doctor if you have unusual bruising or bleeding, or signs of infection (fever, weakness, cold or flu symptoms, skin sores, diarrhea, frequent or recurring illness).
Your doctor may instruct you to limit your salt intake while you are receiving Zilretta injection. You may also need to take potassium supplements. Follow all instructions.
Triamcinolone can affect the results of certain medical tests. Tell any doctor who treats you that you are using Zilretta.
Dosing Information
Usual Adult Dose of Zilretta for Osteoarthritis:
Extended-release: 32 mg/5 mL:
For Osteoarthritic Knee Pain only: 32 mg as a single intra-articular injection
The safety and efficacy of repeat administration has not been evaluated
Comments:
If an excessive amount of synovial fluid is present in the joint, aspirate some (not all) to provide pain relief and prevent undue dilution of the steroid.
Zilretta is not suitable for use in small joints, such as the hand, it is only indicated for osteoarthritis of the knee.
What happens if I miss a dose?
Call your doctor for instructions if you miss an appointment for a scheduled Zilretta injection.
As Zilretta is used as a single dose, you will not be on a regular dosing schedule.
What happens if I overdose?
Since Zilretta is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
Using too much Zilretta is not likely to cause serious problems. However, long term use of high doses can lead to thinning skin, easy bruising, changes in body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.
What should I avoid while receiving Zilretta injection?
After injection of Zilretta into the knee joint, avoid overusing that joint through strenuous activity or high-impact sports. You could cause damage to the joint.
Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chickenpox or measles. These conditions can be serious or even fatal in people who are using triamcinolone.
Do not receive a "live" vaccine or a toxoid vaccine while using Zilretta, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine. Toxoid vaccines include diphtheria-tetanus toxoid (DT or Td).
What other drugs will affect Zilretta injection?
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Tell your doctor about all your current medicines. Many drugs can interact with triamcinolone, especially:
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an antibiotic or antifungal medication;
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birth control pills or hormone replacement therapy;
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a diuretic or "water pill";
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medicine to treat tuberculosis;
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a nonsteroidal anti-inflammatory drug or NSAID (aspirin, ibuprofen, naproxen, diclofenac, indomethacin, Advil, Aleve, Celebrex, and many others); or
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seizure medication.
This list is not complete and many other drugs may affect Zilretta. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Manufacturer
Flexion Therapeutics, Inc, 10 Mall Rd, Suite 301, Burlington, MA 01803, USA.
Popular FAQ
Where should you not use triamcinolone acetonide cream?
You should not use topical corticosteroids like triamcinolone acetonide cream on your face, groin, or axillae (underarm, armpit) unless directed by your doctor. Using triamcinolone in these areas may lead to unwanted side effects like acne, prominent blood vessels, skin thinning (atrophy), changes in skin color or unwanted hair growth. Continue reading
Is triamcinolone acetonide an antifungal cream?
Triamcinolone is not an antifungal cream. It is a topical corticosteroid (“steroid”) cream used to decrease inflammation and itching of skin conditions such as plaque psoriasis, atopic dermatitis (eczema) and allergic reactions. Topical corticosteroids work by reducing inflammation (redness, swelling, itching) on the skin. Continue reading
Is triamcinolone good for poison ivy?
Steroid prescription creams or ointments like high-potency triamcinolone 0.5% may be helpful during the first few days of a poison ivy rash on a small area, but have little effect once the fluid-filled blisters have appeared. Over-the-counter (OTC) products like hydrocortisone cream 1% are not usually strong enough for poison ivy. Your doctor may prescribe oral prednisone pills for a more severe rash. Continue reading
Clobetasol vs. triamcinolone - how do they compare?
Topical clobetasol (Clobex, Impoyz, generics) is considered a very high potency topical corticosteroid (“steroid”) used on the skin, while triamcinolone (Kenalog, Triderm, generics) is a medium-to-low potency medicine. These prescription products may be used to treat conditions such as eczema, dermatitis, psoriasis, skin allergies or rashes or serious insect bites. Continue reading
What are steroid injections (cortisone shots)?
Steroid injections (corticosteroid injections/cortisone shots) are injections given by a healthcare professional directly into joints or other areas of the body to relieve symptoms such as pain, inflammation, or restricted movement. They are commonly used to treat shoulder and other joint pain, tendonitis, bursitis, back pain, or arthritis or to manage conditions such as sciatica, inflammatory bowel disease, and skin conditions such as psoriasis. Examples include hydrocortisone, triamcinolone, and methylprednisolone. Continue reading
Halobetasol vs triamcinolone: which is better?
Which topical corticosteroid (“steroid”) product is best for you depends upon what skin condition you have, your symptoms and where it is located on your body. Other selection factors may include availability, cost and if the medicine is covered by your insurance. After examination, your doctor will be able to determine which topical steroid is best to treat your skin condition. Continue reading
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References
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Further information
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Zilretta only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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