Triamcinolone 0.1% 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 1961
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 works by calming down the body's inflammatory response in the skin.
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 on your skin, as directed. Avoid getting it in your mouth, nose, or eyes, as it may cause burning.
Continue using the medication as instructed, even if your symptoms improve. Before and after applying the medication, wash your hands thoroughly. However, if you're applying the medication to your hand, do not wash your hand after use.
Prepare the affected area by cleaning it before application and drying it well. Apply a thin layer of the medication to the affected skin and gently rub it in. Unless your doctor advises otherwise, do not apply the medication to your face, underarms, or groin area.
Important Usage Precautions
Do not cover the treated area with bandages, dressings, or tight-fitting diapers or plastic pants, as this may increase the amount of medication absorbed into your body.
Avoid using this medication to treat diaper rash.
* Do not apply the medication to cuts, scrapes, or damaged skin.
Storage and Disposal
Store the medication at room temperature, avoiding freezing. 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. If you have questions about disposal, consult your pharmacist, who may be aware of drug take-back programs in your area.
Missed Dose Instructions
If you miss a dose, apply it as soon as you remember. However, if it's 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 one.
To use this medication correctly, follow your doctor's instructions and read all the information provided. Use this medication only on your skin, as directed. Avoid getting it in your mouth, nose, or eyes, as it may cause burning.
Continue using the medication as instructed, even if your symptoms improve. Before and after applying the medication, wash your hands thoroughly. However, if you're applying the medication to your hand, do not wash your hand after use.
Prepare the affected area by cleaning it before application and drying it well. Apply a thin layer of the medication to the affected skin and gently rub it in. Unless your doctor advises otherwise, do not apply the medication to your face, underarms, or groin area.
Important Usage Precautions
Do not cover the treated area with bandages, dressings, or tight-fitting diapers or plastic pants, as this may increase the amount of medication absorbed into your body.
Avoid using this medication to treat diaper rash.
* Do not apply the medication to cuts, scrapes, or damaged skin.
Storage and Disposal
Store the medication at room temperature, avoiding freezing. 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. If you have questions about disposal, consult your pharmacist, who may be aware of drug take-back programs in your area.
Missed Dose Instructions
If you miss a dose, apply it as soon as you remember. However, if it's 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 one.
Lifestyle & Tips
- Wash hands before and after applying the cream.
- Apply a thin layer to the affected skin area and rub it in gently until it disappears.
- Do not cover the treated area with bandages or tight dressings unless directed by your doctor, as this can increase absorption and side effects.
- Avoid applying the cream to the eyes, mouth, or inside the nose.
- Do not use for longer than prescribed, especially on the face, groin, or armpits.
- Do not use on children without specific doctor's instructions and close monitoring.
- Keep out of reach of children.
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 two to four times daily, depending on severity and formulation (cream/ointment). Rub in gently.
Condition-Specific Dosing:
eczema:
Apply 2-3 times daily
psoriasis:
Apply 2-4 times daily
Pediatric Dosing
Neonatal:
Not established (use with extreme caution, if at all, due to high risk of systemic absorption and adrenal suppression)
Infant:
Not established (use with extreme caution, if at all, due to high risk of systemic absorption and adrenal suppression)
Child:
Apply a thin film to the affected area 1-2 times daily. Limit duration of therapy and amount used. Avoid occlusive dressings. Closely monitor for systemic effects.
Adolescent:
Apply a thin film to the affected area 2-3 times daily. Limit duration of therapy and amount used. Avoid occlusive dressings.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment needed for topical use.
Moderate:
No specific adjustment needed for topical use.
Severe:
No specific adjustment needed for topical use.
Dialysis:
No specific considerations for topical use.
Hepatic Impairment:
Mild:
No specific adjustment needed for topical use.
Moderate:
No specific adjustment needed for topical use.
Severe:
No specific 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 (typically <1% to 5% systemically absorbed, but can be higher with inflamed skin, occlusive dressings, or large surface areas)
Tmax:
Not typically measured for topical application; local effect is rapid.
FoodEffect:
Not applicable for topical formulation.
Distribution:
Vd:
Not well-quantified for topical systemic absorption; primarily localized to skin.
ProteinBinding:
Variable, if systemically absorbed, binds to plasma proteins (e.g., albumin, corticosteroid-binding globulin).
CnssPenetration:
Limited (minimal systemic absorption).
Elimination:
HalfLife:
Not well-defined for topical systemic absorption; systemic half-life of triamcinolone is approximately 2-5 hours.
Clearance:
Not well-defined for topical systemic absorption.
ExcretionRoute:
Renal (primarily as metabolites, if systemically absorbed).
Unchanged:
Minimal (if systemically absorbed).
Pharmacodynamics
OnsetOfAction:
Within hours for symptomatic relief (e.g., reduction in itching, redness).
PeakEffect:
Within days of consistent application for full anti-inflammatory effect.
DurationOfAction:
Depends on frequency of application; local effects persist for several hours.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
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 attention immediately:
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. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Burning
Itching
* Dry skin
This is not an exhaustive list of all possible side effects. If you have questions or concerns about side effects, consult 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 attention immediately:
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. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Burning
Itching
* Dry skin
This is not an exhaustive list of all possible side effects. If you have questions or concerns about side effects, consult 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:
- Worsening of your skin condition or no improvement after 1-2 weeks.
- Signs of a skin infection (e.g., pus, increased pain, fever, spreading redness).
- Severe burning, itching, or irritation where the cream is applied.
- Thinning of the skin, stretch marks, or easy bruising in the treated area.
- Unusual fatigue, weight gain, or swelling in the face (signs of systemic absorption).
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 to this medication, its components, or other substances, including foods and drugs. Be sure to describe the allergic reaction you experienced, including the symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is not an exhaustive list, and it is crucial to disclose all your medications and health issues to your doctor and pharmacist.
Any health problems you have, as they may interact with this medication. Your doctor and pharmacist need to be aware of your complete medical profile to ensure safe treatment.
Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor. It is vital to verify that it is safe to take this medication with all your other medications and health conditions.
It is essential to inform your doctor about the following:
Any allergies you have to this medication, its components, or other substances, including foods and drugs. Be sure to describe the allergic reaction you experienced, including the symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is not an exhaustive list, and it is crucial to disclose all your medications and health issues to your doctor and pharmacist.
Any health problems you have, as they may interact with this medication. Your doctor and pharmacist need to be aware of your complete medical profile to ensure safe treatment.
Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor. It is vital to verify that it is safe to take this medication with all your other medications and health conditions.
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 duration of treatment 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 any concerns with your doctor.
Using this medication too frequently can exacerbate your skin condition. If you are treating a child with this drug, use it with caution, as children may be at a higher risk for certain side effects. In some cases, this medication 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 are breastfeeding, inform your doctor, as they will need to weigh the benefits and risks of this medication for 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 any concerns with your doctor.
Using this medication too frequently can exacerbate your skin condition. If you are treating a child with this drug, use it with caution, as children may be at a higher risk for certain side effects. In some cases, this medication 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 are breastfeeding, inform your doctor, as they will need to weigh the benefits and risks of this medication for both you and your baby.
Overdose Information
Overdose Symptoms:
- Prolonged or extensive use, especially under occlusion or on large surface areas, can lead to systemic absorption and symptoms of hypercorticism (Cushing's syndrome), including: moon face, buffalo hump, central obesity, thinning skin, easy bruising, striae, hyperglycemia, hypertension, and adrenal suppression.
- In children, chronic overdose can lead to growth retardation and delayed weight gain.
What to Do:
Discontinue the medication gradually under medical supervision. Symptomatic and supportive treatment. Call 1-800-222-1222 (Poison Control Center) for advice.
Drug Interactions
Monitoring
Baseline Monitoring
Skin condition assessment
Rationale: To determine severity of dermatosis and identify any pre-existing skin infections or atrophy.
Timing: Prior to initiation of therapy.
Routine Monitoring
Efficacy (reduction in inflammation, pruritus, erythema)
Frequency: Daily to weekly, depending on severity.
Target: Improvement in symptoms.
Action Threshold: Lack of improvement or worsening of condition after 1-2 weeks may indicate need for re-evaluation or alternative therapy.
Local adverse effects (skin atrophy, striae, telangiectasias, folliculitis, perioral dermatitis, hypertrichosis)
Frequency: Weekly to monthly, or at each follow-up visit.
Target: Absence of new or worsening skin changes.
Action Threshold: Development of significant skin atrophy or other adverse effects warrants discontinuation or reduction in potency/frequency.
Signs of infection (bacterial, fungal, viral)
Frequency: At each follow-up visit, or if symptoms worsen.
Target: Absence of signs of infection.
Action Threshold: Presence of infection requires appropriate antimicrobial therapy and potential discontinuation of corticosteroid.
Signs of systemic absorption (e.g., Cushing's syndrome, adrenal suppression, hyperglycemia, growth retardation in children)
Frequency: Periodically, especially with prolonged use, large surface areas, or occlusive dressings.
Target: Absence of systemic symptoms.
Action Threshold: Any signs of systemic effects require immediate medical evaluation and discontinuation of therapy.
Symptom Monitoring
- Worsening of skin condition
- Increased redness or irritation at application site
- Pus or signs of infection (fever, warmth, swelling)
- Thinning of skin
- Stretch marks (striae)
- Easy bruising
- Increased hair growth in treated area
- Changes in vision (if applied near eyes)
- Unusual fatigue or weakness (signs of adrenal suppression)
Special Patient Groups
Pregnancy
Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Avoid large amounts, prolonged use, or application to large surface areas.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenicity, though data for topical corticosteroids is limited and generally low risk with appropriate use.
Second Trimester:
Risk of systemic absorption and potential fetal effects (e.g., growth restriction) with extensive use.
Third Trimester:
Risk of systemic absorption and potential fetal effects (e.g., adrenal suppression) with extensive use.
Lactation
Use with caution. It is not known whether topical corticosteroids are excreted in human milk. Systemic absorption is minimal, but caution is advised. Avoid applying to the breast area to prevent infant ingestion.
Infant Risk:
Low risk with appropriate use, but potential for systemic effects in infant if significant absorption occurs or if applied to breast and ingested.
Pediatric Use
Children are more susceptible to systemic adverse effects (e.g., HPA axis suppression, Cushing's syndrome, growth retardation) due to a larger skin surface area to body weight ratio. Use the lowest effective dose for the shortest duration possible. Avoid occlusive dressings. Close monitoring is essential.
Geriatric Use
Generally safe for use in the elderly. However, geriatric patients may have thinner skin, which could increase susceptibility to local adverse effects like skin atrophy and purpura. Use with caution and monitor skin integrity.
Clinical Information
Clinical Pearls
- Triamcinolone 0.1% is a medium-potency topical corticosteroid, suitable for various inflammatory dermatoses.
- The 454gm jar is a large quantity, often prescribed for chronic conditions or large body surface areas. Educate patients on appropriate use to avoid overuse.
- Ointment formulations are generally more potent and occlusive than creams, often preferred for dry, scaly lesions.
- Cream formulations are generally less greasy and better for weeping or intertriginous areas.
- Always advise patients to use the smallest amount needed for the shortest duration to achieve control, then taper or switch to a lower potency if possible.
- Warn patients about rebound flares if discontinued abruptly after prolonged use, especially for chronic conditions like psoriasis.
Alternative Therapies
- Other topical corticosteroids (e.g., hydrocortisone, fluocinolone, betamethasone, clobetasol - varying potencies)
- Topical calcineurin inhibitors (e.g., tacrolimus, pimecrolimus) for steroid-sparing therapy, especially on sensitive areas.
- Topical phosphodiesterase-4 (PDE4) inhibitors (e.g., crisaborole)
- Topical retinoids (for certain conditions like psoriasis)
- Emollients and moisturizers (as adjunctive therapy)
- Systemic therapies (for severe, widespread conditions)
Cost & Coverage
Average Cost:
$30 - $100+ per 454gm jar
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 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 information. If you have any questions or concerns about this 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 emergency medical attention. When seeking help, be prepared to provide details about the overdose, including the medication taken, the amount, and the time it occurred.