Triamcinolone

DEA Class; Rx

Common Brand Names; Triesence, Trivaris Intravitreal

Indicated for sympathetic ophthalmia, temporal arteritis, uveitis, and ocular inflammatory conditions unresponsive to ophthalmic corticosteroids

Indicated for Topical Inflammatory Dermatoses

Indicated for Oral Inflammatory or Ulcerative Lesions

Indicated for macular edema associated with uveitis

Indicated for management of osteoarthritis knee pain, Allergic Rhinitis.

Treatment of rheumatic or arthritic disorders

Indicated for treatment of steroid-responsive dermatoses

Hypersensitivity

Idiopathic thrombocytopenia purpura

Systemic fungal infections

Cerebral malaria

Underlying fungal, bacterial, or viral infection

Ophthalmic use

Hypersensitivity to triamcinolone and other product components

• Abnormal sensation in eye
• Anterior chamber cells
• Anterior chamber flare
• Cataract
• Cataract cortical
• Cataract nuclear
• Cataract subcapsular
• Conjunctival hemorrhage
• Exophthalmos
• Eye irritation
• Eye pain
• Eye pruritus
• Foreign body sensation in eyes
• Glaucoma
• Hypopion
• Increased intraocular pressure
• Injection site hemorrhage
• Lacrimation increased
• Optic disc vascular disorder
• Vitreous detachment
• Vitreous floaters
• Rare instances of blindness associated with intravitreal or periocular injections
• Skin atrophy
• Striae
• Acneform lesions
• Pigmentation changes
• HPA suppression (with higher potency used >2 weeks)
• Increased intraocular pressure (IOP), nonacute (14%)Eye pain, nonacute (12%)
• Joint swelling (3%)Contusion (2%)Sinusitis (2%)Cough (2%)Contusions (2%)

• Flu syndrome [children] (9%)Pharyngitis (5-8%)Headache [children] (6%)Bronchitis [children] (3%)Dyspepsia (3-5%)Tooth disorder [children] (3%)Epistaxis (3-5%)Excoriation [children] (3%)Increased cough (2- 8%)Upper abdominal pain [children] (5%)Diarrhea [children] (3%)Rash [children] (3%)Asthma [children] (3%)Rhinorrhea [children] (2%)

Prolonged use may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to fungi or viruses

The use of oral corticosteroids is not recommended in the treatment of optic neuritis and may lead to an increase in the risk of new episodes

Intraocular pressure may become elevated in some individuals; if steroid therapy is continued for more than 6 weeks, IOP should be monitored

Corticosteroids should be used cautiously in patients with a history of ocular herpes simplex because of possible corneal perforation; do NOT use in active ocular herpes simplex

Rate of infectious culture positive endophthalmitis is 0.5%; proper aseptic techniques should always be used when administering triamcinolone acetonide

In addition, patients should be monitored following the injection to permit early treatment should an infection occur

Children who are treated with corticosteroids by any route, including systemically administered corticosteroids, may experience a decrease in their growth velocity

Chronic topical corticosteroid therapy may interfere with growth and development in children

Use medium to very high potency for <2 weeks to reduce local and systemic side effects

Use low potency for chronic therapy

Avoid medium to very high potency on face, folds, and groin because can increase steroid absorption

Use lower potency for children (ie, increase BSA/kg, therefore increase systemic absorption)

Prolonged use may result in bacterial or fungal superinferction; discontinue if dermatological infection persists despite antimicrobial therapy

Discontinue if local sensitization including irritation or redness occurs

Avoid use of high potency steroids in the face

Pregnancy Category: D

Lactation: Distributed in breast milk; caution advised

triamcinolone topical

Pregnancy category: C

Lactation: Not known whether topical corticosteroids are distributed into milk; however, systemic corticosteroids are distributed into milk; use with caution