Triamcinolone 0.025% Cream 454gm
It is used to treat skin rashes and other skin irritation.
Drug Class
Topical Corticosteroid
Pharmacologic Class
Glucocorticoid Receptor Agonist
Pregnancy Category
Category C
FDA Approved
Aug 1958
DEA Schedule
Not Controlled
Overview
What is this medicine?
Triamcinolone cream is a medicine applied to the skin to reduce redness, swelling, and itching caused by various skin conditions like eczema or psoriasis. It belongs to a group of medicines called corticosteroids.
How to Use This Medicine
Proper Use of This Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. Use this medication only as directed, and continue to use it even if your symptoms improve.
Application Instructions
Apply this medication only to your skin, avoiding the mouth, nose, and eyes, as it may cause burning.
Wash your hands before and after applying the medication, unless your hand is the treated area.
Clean the affected area before applying the medication, and make sure it is dry.
Apply a thin layer of the medication to the affected skin and gently rub it in.
Avoid applying the medication to the face, underarms, or groin area unless your doctor instructs you to do so.
Do not use bandages, dressings, or other coverings unless your doctor advises you to do so.
If the treated area is in the diaper region, avoid using tight-fitting diapers or plastic pants, as this may increase the amount of medication absorbed into the body.
Do not use this medication to treat diaper rash.
Avoid applying the medication to cuts, scrapes, or damaged skin.
Storage and Disposal
Store this medication at room temperature, away from freezing temperatures.
Keep all medications in a safe place, out of the reach of children and pets.
Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist. Check with your pharmacist for guidance on the best way to dispose of medications, and consider participating in local drug take-back programs.
Missed Dose
If you miss a dose, apply it as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and resume your regular schedule.
* Do not apply two doses at the same time or use extra doses to make up for a missed dose.
To use this medication correctly, follow your doctor's instructions and read all the information provided. Use this medication only as directed, and continue to use it even if your symptoms improve.
Application Instructions
Apply this medication only to your skin, avoiding the mouth, nose, and eyes, as it may cause burning.
Wash your hands before and after applying the medication, unless your hand is the treated area.
Clean the affected area before applying the medication, and make sure it is dry.
Apply a thin layer of the medication to the affected skin and gently rub it in.
Avoid applying the medication to the face, underarms, or groin area unless your doctor instructs you to do so.
Do not use bandages, dressings, or other coverings unless your doctor advises you to do so.
If the treated area is in the diaper region, avoid using tight-fitting diapers or plastic pants, as this may increase the amount of medication absorbed into the body.
Do not use this medication to treat diaper rash.
Avoid applying the medication to cuts, scrapes, or damaged skin.
Storage and Disposal
Store this medication at room temperature, away from freezing temperatures.
Keep all medications in a safe place, out of the reach of children and pets.
Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist. Check with your pharmacist for guidance on the best way to dispose of medications, and consider participating in local drug take-back programs.
Missed Dose
If you miss a dose, apply it as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and resume your regular schedule.
* Do not apply two doses at the same time or use extra doses to make up for a missed dose.
Lifestyle & Tips
- Apply a thin layer of the cream to the affected skin area as directed by your doctor, usually 2 to 4 times a day.
- Gently rub it in completely.
- Wash your hands before and after applying the cream, unless your hands are the treated area.
- Do not cover the treated area with bandages or other dressings unless specifically instructed by your doctor, as this can increase absorption and side effects.
- Avoid applying the cream to the face, groin, or armpits unless directed by your doctor.
- Do not use this medication for longer than prescribed, especially on the face or in skin folds.
- Avoid contact with eyes, nose, and mouth. If contact occurs, rinse thoroughly with water.
- Do not use on broken or infected skin without specific medical advice.
Available Forms & Alternatives
Available Strengths:
- Triamcinolone 0.5% Cream 15gm
- Triamcinolone 0.5% Oint 15gm
- Triamcinolone 0.025% Ointment 15gm
- Triamcinolone 0.025% Ointment 80gm
- Triamcinolone 0.025% Cream 15gm
- Triamcinolone 0.1% Cream 30gm
- Triamcinolone 0.1% Cream 15gm
- Triamcinolone 0.025% Cream 454gm
- Triamcinolone 0.1% Ointment 15gm
- Triamcinolone 0.1% Cream 80gm
- Triamcinolone 0.1% Ointment 80gm
- Triamcinolone 0.1% Ointment 454gm
- Triamcinolone 0.1% Cream 454gm
- Triamcinolone 0.025% Ointment 454gm
- Triamcinolone 0.1% Ointment 15gm
- Triamcinolone 0.025% Cream 80gm
- Triamcinolone 0.1% Ointment 80gm
- Triamcinolone Topical Spray 100gm
- Triamcinolone Topical Spray 63gm
- Triamcinolone 0.1% Lotion 60ml
- Triamcinolone 0.1% Ointment 15gm
- Triamcinolone 0.1% Ointment 30gm
- Triamcinolone 55mcg Nasalsp (120)
- Triamcinolone Ace 40mg/ml, 1ml
- Triamcinolone Topical Spray 63gm
- Triamcinolone Topical Spray 100gm
- Triamcinolone Ace 40mg/ml Inj, 10ml
- Triamcinolone Ace 0.05% Oint 430gm
- Triamcinolone Ace 40mg/ml, 5ml
- Triamcin Ace 40mg/ml Inj, 10ml
- Triamcinolone 0.1% Lotion 60ml
- Triamcinolone 0.025% Lotion 60ml
- Triamcinolone 400mg/10ml Inj, 10ml
- Triamcinolone 0.1% Ointment 454gm
Dosing & Administration
Adult Dosing
Standard Dose:
Apply a thin film to the affected area 2 to 4 times daily, depending on the severity of the condition.
Dose Range:
2 - 4 mg
Condition-Specific Dosing:
psoriasis:
Apply 2-4 times daily.
eczema:
Apply 2-4 times daily.
Pediatric Dosing
Neonatal:
Not established
Infant:
Apply a thin film to the affected area 1 to 2 times daily. Use with caution, especially on large surface areas or under occlusive dressings, due to increased risk of systemic absorption and HPA axis suppression.
Child:
Apply a thin film to the affected area 1 to 2 times daily. Use with caution, especially on large surface areas or under occlusive dressings, due to increased risk of systemic absorption and HPA axis suppression.
Adolescent:
Apply a thin film to the affected area 2 to 4 times daily.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed for topical use.
Moderate:
No adjustment needed for topical use.
Severe:
No adjustment needed for topical use.
Dialysis:
No specific considerations for topical use.
Hepatic Impairment:
Mild:
No adjustment needed for topical use.
Moderate:
No adjustment needed for topical use.
Severe:
No adjustment needed for topical use.
Pharmacology
Mechanism of Action
Triamcinolone acetonide is a synthetic corticosteroid that possesses anti-inflammatory, antipruritic, and vasoconstrictive properties. It acts by inducing phospholipase A2 inhibitory proteins, lipocortins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
Pharmacokinetics
Absorption:
Bioavailability:
Variable (minimal systemic absorption, but can increase with skin integrity compromise, occlusive dressings, or large surface area application)
Tmax:
Not applicable for topical use (systemic absorption is minimal)
FoodEffect:
Not applicable for topical use
Distribution:
Vd:
Not applicable for topical use (minimal systemic distribution)
ProteinBinding:
Not applicable for topical use (minimal systemic protein binding)
CnssPenetration:
Limited (minimal systemic absorption)
Elimination:
HalfLife:
Not precisely determined for topical use (systemic half-life of absorbed drug is approximately 2-5 hours)
Clearance:
Not precisely determined for topical use
ExcretionRoute:
Renal (if systemically absorbed)
Unchanged:
Not significant for topical use
Pharmacodynamics
OnsetOfAction:
Within hours of application for symptomatic relief
PeakEffect:
Within days to weeks for full therapeutic effect
DurationOfAction:
Varies with application frequency and condition severity
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Attention Immediately
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood sugar, including:
+ Confusion
+ Feeling sleepy
+ Unusual thirst or hunger
+ Passing urine more often
+ Flushing
+ Fast breathing
+ Breath that smells like fruit
Signs of a weak adrenal gland, such as:
+ Severe upset stomach or vomiting
+ Severe dizziness or passing out
+ Muscle weakness
+ Feeling very tired
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, including:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Irritation at the site where the medication was applied
Skin changes, such as:
+ Pimples
+ Stretch marks
+ Slow healing
+ Hair growth
Change in skin color
Thinning of the skin
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or may only have minor ones. If you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor or seek medical help:
Burning
Itching
* Dry skin
This is not a complete list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood sugar, including:
+ Confusion
+ Feeling sleepy
+ Unusual thirst or hunger
+ Passing urine more often
+ Flushing
+ Fast breathing
+ Breath that smells like fruit
Signs of a weak adrenal gland, such as:
+ Severe upset stomach or vomiting
+ Severe dizziness or passing out
+ Muscle weakness
+ Feeling very tired
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, including:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Irritation at the site where the medication was applied
Skin changes, such as:
+ Pimples
+ Stretch marks
+ Slow healing
+ Hair growth
Change in skin color
Thinning of the skin
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or may only have minor ones. If you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor or seek medical help:
Burning
Itching
* Dry skin
This is not a complete list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Increased redness, swelling, or pus (signs of infection)
- Severe burning, itching, or irritation after application
- Skin thinning, easy bruising, or stretch marks in the treated area
- Acne-like breakouts or increased hair growth in the treated area
- Any signs of systemic effects, especially in children (e.g., unusual weight gain, rounding of the face, slow growth)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, any of its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor assess potential interactions between this medication and other substances you are taking.
* Any health problems you have, as they may affect the safety and efficacy of this medication.
To ensure your safety, it is crucial to verify that this medication can be taken with all your other medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, any of its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor assess potential interactions between this medication and other substances you are taking.
* Any health problems you have, as they may affect the safety and efficacy of this medication.
To ensure your safety, it is crucial to verify that this medication can be taken with all your other medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Adhere to the prescribed treatment duration, and do not use this drug for an extended period beyond what your doctor has recommended.
Before using any other medications or products on your skin, including soaps, consult with your doctor to ensure safe and effective treatment. Exercise caution when applying this medication to a large area of skin, and discuss this with your doctor if necessary.
Using this medication too frequently can exacerbate your skin condition. If the patient is a child, use this medication with caution, as the risk of certain side effects may be higher in children. In some cases, this drug may affect growth in children and teenagers, and regular growth checks may be necessary. Consult with your doctor to discuss this potential risk.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor, as they will need to weigh the benefits and risks of this medication to both you and your baby.
Before using any other medications or products on your skin, including soaps, consult with your doctor to ensure safe and effective treatment. Exercise caution when applying this medication to a large area of skin, and discuss this with your doctor if necessary.
Using this medication too frequently can exacerbate your skin condition. If the patient is a child, use this medication with caution, as the risk of certain side effects may be higher in children. In some cases, this drug may affect growth in children and teenagers, and regular growth checks may be necessary. Consult with your doctor to discuss this potential risk.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor, as they will need to weigh the benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Prolonged or excessive use can lead to systemic absorption and symptoms of hypercorticism (Cushing's syndrome), including:
- Weight gain, especially in the trunk and face (moon face)
- Thinning skin, easy bruising
- Muscle weakness
- High blood pressure
- High blood sugar
- Growth retardation in children
What to Do:
Discontinue the medication gradually under medical supervision. Symptomatic and supportive treatment. In case of suspected overdose or systemic effects, contact a poison control center or emergency services immediately. Call 1-800-222-1222 for poison control.
Drug Interactions
Monitoring
Baseline Monitoring
Skin condition assessment
Rationale: To establish baseline severity of dermatosis and identify any signs of infection or skin breakdown.
Timing: Prior to initiation of therapy
Routine Monitoring
Efficacy of treatment
Frequency: Weekly to bi-weekly initially, then as needed
Target: Reduction in inflammation, pruritus, and lesion size
Action Threshold: Lack of improvement or worsening of symptoms may indicate need for re-evaluation or alternative therapy.
Local adverse effects (e.g., skin atrophy, striae, telangiectasias)
Frequency: At each follow-up visit, especially with prolonged use
Target: Absence of skin thinning, bruising, or visible blood vessels
Action Threshold: Presence of these signs warrants reduction in frequency, potency, or discontinuation.
Signs of infection (e.g., redness, warmth, pus)
Frequency: At each follow-up visit and patient self-monitoring
Target: Absence of signs of secondary infection
Action Threshold: Presence of infection requires appropriate antimicrobial therapy and potential discontinuation of triamcinolone.
Signs of systemic absorption (e.g., Cushing's syndrome, HPA axis suppression)
Frequency: Rarely needed for typical topical use; consider if large areas, prolonged use, or occlusive dressings are applied, especially in children.
Target: Normal growth in children, absence of systemic corticosteroid effects
Action Threshold: Symptoms like weight gain, moon face, growth retardation, or abnormal cortisol levels require immediate medical attention and discontinuation.
Symptom Monitoring
- Burning
- Itching
- Irritation
- Dryness
- Folliculitis
- Hypertrichosis
- Acneiform eruptions
- Hypopigmentation
- Perioral dermatitis
- Allergic contact dermatitis
- Maceration of the skin
- Secondary infection
- Skin atrophy
- Striae
- Miliaria
Special Patient Groups
Pregnancy
Triamcinolone acetonide is Pregnancy Category C. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies have shown teratogenic effects with corticosteroids.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenic effects, though systemic absorption from topical use is generally low.
Second Trimester:
Generally considered safer than first trimester, but still use with caution.
Third Trimester:
No specific risks identified beyond general corticosteroid effects; however, use lowest effective dose for shortest duration.
Lactation
It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk. Caution should be exercised when triamcinolone acetonide cream is administered to a nursing woman. Avoid applying to the breast area to prevent infant ingestion.
Infant Risk:
L3 - Moderate risk. Potential for systemic effects in infant if significant absorption occurs in mother or if applied directly to breast.
Pediatric Use
Pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced HPA axis suppression and Cushing's syndrome than mature adults because of a larger skin surface area to body weight ratio. Use the least potent formulation for the shortest duration possible. Avoid occlusive dressings. Monitor for growth retardation and signs of systemic absorption.
Geriatric Use
No specific dosage adjustments are typically needed. However, elderly patients may have thinner skin, which could increase the risk of local adverse effects like skin atrophy and purpura. Monitor skin integrity closely.
Clinical Information
Clinical Pearls
- Triamcinolone 0.025% is a low-potency topical corticosteroid, suitable for mild to moderate dermatoses, and often preferred for sensitive areas like the face or intertriginous zones.
- Educate patients on the 'less is more' principle: apply a thin layer, just enough to cover the affected area.
- Advise patients not to use this cream for longer than prescribed, especially on the face, as it can lead to skin thinning, telangiectasias, and perioral dermatitis.
- If no improvement is seen after 2-4 weeks, re-evaluate the diagnosis or consider a different treatment.
- For chronic conditions, consider intermittent therapy (e.g., 2-3 days on, 4-5 days off) to minimize side effects and prevent tachyphylaxis.
Alternative Therapies
- Hydrocortisone cream (lower potency)
- Fluocinolone acetonide cream (similar potency)
- Desonide cream (similar potency)
- Mometasone furoate cream (medium potency)
- Betamethasone valerate cream (medium potency)
- Tacrolimus ointment (non-steroidal, calcineurin inhibitor)
- Pimecrolimus cream (non-steroidal, calcineurin inhibitor)
- Crisaborole ointment (non-steroidal, phosphodiesterase-4 inhibitor)
Cost & Coverage
Average Cost:
$20 - $60 per 454gm tube
Generic Available:
Yes
Insurance Coverage:
Tier 1 or 2 (preferred generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more details. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide information about the medication taken, the amount, and the time it happened.