Triamcinolone 0.1% Ointment 454gm
It is used to treat skin rashes and other skin irritation.
Drug Class
Topical Corticosteroid
Pharmacologic Class
Glucocorticoid
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Triamcinolone ointment is a strong corticosteroid medicine applied to the skin. It helps reduce redness, swelling, itching, and discomfort caused by various skin conditions like eczema, psoriasis, or allergic reactions.
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 irritation.
Application Instructions
1. Wash your hands before and after applying the medication, unless your hand is the area being treated.
2. Clean the affected area before applying the medication and dry it thoroughly.
3. Apply a thin layer of the medication to the affected skin and gently rub it in.
4. Do not apply the medication to your face, underarms, or groin area unless your doctor instructs you to do so.
5. Avoid using bandages, dressings, or tight-fitting diapers or plastic pants on the treated area, as this may increase the amount of medication absorbed into your body.
6. Do not use this medication to treat diaper rash.
7. 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 Instructions
If you miss a dose, apply it as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and resume your regular application 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 on your skin, as directed. Avoid getting it in your mouth, nose, or eyes, as it may cause irritation.
Application Instructions
1. Wash your hands before and after applying the medication, unless your hand is the area being treated.
2. Clean the affected area before applying the medication and dry it thoroughly.
3. Apply a thin layer of the medication to the affected skin and gently rub it in.
4. Do not apply the medication to your face, underarms, or groin area unless your doctor instructs you to do so.
5. Avoid using bandages, dressings, or tight-fitting diapers or plastic pants on the treated area, as this may increase the amount of medication absorbed into your body.
6. Do not use this medication to treat diaper rash.
7. 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 Instructions
If you miss a dose, apply it as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and resume your regular application 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 only to the affected skin area as directed by your doctor. Do not use more than prescribed.
- Wash your hands thoroughly before and after applying the ointment.
- Do not cover the treated area with bandages, plastic wrap, or tight dressings unless specifically instructed by your doctor, as this can increase absorption and side effects.
- Avoid contact with eyes, mouth, and other mucous membranes. If contact occurs, rinse thoroughly with water.
- Do not use on the face, groin, or armpits unless specifically directed by a doctor, as these areas are more susceptible to side effects.
- Inform your doctor if your skin condition worsens or does not improve within 2 weeks of starting treatment.
- Do not use this medication for longer than prescribed, especially in children, to avoid potential side effects.
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.
Condition-Specific Dosing:
corticosteroid-responsive dermatoses:
Apply a thin film to the affected area two to four times daily.
Pediatric Dosing
Neonatal:
Not established; use with extreme caution and only if clearly needed due to increased systemic absorption risk.
Infant:
Not established; use with extreme caution and only if clearly needed due to increased systemic absorption risk. Limit duration and area.
Child:
Apply a thin film to the affected area two to four times daily. Use with caution, limit duration of therapy and amount applied. Avoid occlusive dressings.
Adolescent:
Apply a thin film to the affected area two to four times daily.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment needed due to minimal systemic absorption.
Moderate:
No specific adjustment needed due to minimal systemic absorption.
Severe:
No specific adjustment needed due to minimal systemic absorption.
Dialysis:
No specific adjustment needed due to minimal systemic absorption.
Hepatic Impairment:
Mild:
No specific adjustment needed due to minimal systemic absorption.
Moderate:
No specific adjustment needed due to minimal systemic absorption.
Severe:
No specific adjustment needed due to minimal systemic absorption.
Pharmacology
Mechanism of Action
Topical corticosteroids, such as triamcinolone acetonide, are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins 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. They also possess antipruritic and vasoconstrictive properties.
Pharmacokinetics
Absorption:
Bioavailability:
Varies greatly depending on skin integrity, vehicle, site of application, and use of occlusive dressings. Generally low systemic absorption.
Tmax:
Not well-defined for systemic absorption from topical application; local effect is rapid.
FoodEffect:
Not applicable for topical administration.
Distribution:
Vd:
Not well-defined for systemic absorption from topical application.
ProteinBinding:
Systemically absorbed corticosteroids are highly protein-bound.
CnssPenetration:
Limited, only with significant systemic absorption.
Elimination:
HalfLife:
Not well-defined for systemic absorption from topical application.
Clearance:
Not well-defined for systemic absorption from topical application.
ExcretionRoute:
Primarily renal for systemically absorbed drug.
Unchanged:
Minimal.
Pharmacodynamics
OnsetOfAction:
Within hours to days for anti-inflammatory and antipruritic effects.
PeakEffect:
Days to weeks of consistent application.
DurationOfAction:
Varies with application frequency and severity of condition.
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 immediate medical attention:
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
Most people do not experience significant side effects, but some may occur. If you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical attention if they bother you or do not go away:
Burning
Itching
* Dry skin
This is not an exhaustive list of 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 immediate medical attention:
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
Most people do not experience significant side effects, but some may occur. If you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical attention if they bother you or do not go away:
Burning
Itching
* Dry skin
This is not an exhaustive list of 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 new skin problems (e.g., severe irritation, burning, itching, dryness)
- Signs of a skin infection (e.g., increased redness, warmth, swelling, pus, fever)
- Thinning of the skin, stretch marks, easy bruising, or acne in the treated area
- Any signs of systemic side effects, such as unusual weight gain, swelling in the face or ankles, increased thirst or urination, or unexplained fatigue.
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 any 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 discuss all your medications and health conditions with your doctor and pharmacist to ensure safe use.
* Any health problems you have, as they may interact with this medication.
Do not start, stop, or change the dose of any medication without first consulting your doctor to confirm it is safe to do so. Your doctor and pharmacist need to be aware of all your medications and health conditions to help you use this medication safely and effectively.
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 any 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 discuss all your medications and health conditions with your doctor and pharmacist to ensure safe use.
* Any health problems you have, as they may interact with this medication.
Do not start, stop, or change the dose of any medication without first consulting your doctor to confirm it is safe to do so. Your doctor and pharmacist need to be aware of all your medications and health conditions to help you use this medication safely and effectively.
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 longer than recommended by your doctor.
Before using any other medications or products on your skin, including soaps, consult with your doctor to ensure safe use. 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 drug with caution, as the risk of certain side effects may be increased in children. 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 breast-feeding, 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 use. 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 drug with caution, as the risk of certain side effects may be increased in children. 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 breast-feeding, 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, especially over large areas of skin, on broken skin, or with occlusive dressings, can lead to systemic corticosteroid effects such as Cushing's syndrome (e.g., moon face, central obesity, thin skin), hyperglycemia, and adrenal suppression.
- Local symptoms include severe skin irritation, thinning, or atrophy.
What to Do:
Discontinue use gradually under medical supervision. Seek immediate medical attention or call Poison Control (1-800-222-1222) if systemic symptoms occur.
Drug Interactions
Monitoring
Baseline Monitoring
Skin condition assessment (type, severity, extent of dermatosis)
Rationale: To establish baseline severity, guide treatment, and monitor efficacy.
Timing: Prior to initiation of therapy.
Routine Monitoring
Efficacy (reduction in inflammation, pruritus, lesion size)
Frequency: Weekly to bi-weekly initially, then as needed based on clinical response.
Target: Resolution or significant improvement of symptoms.
Action Threshold: Lack of improvement, worsening of condition, or development of adverse effects.
Local adverse effects (skin atrophy, striae, telangiectasias, folliculitis, perioral dermatitis, skin infection)
Frequency: At each follow-up visit and with patient self-monitoring.
Target: Absence of adverse effects.
Action Threshold: Presence of any adverse effects, especially skin thinning or signs of infection.
Systemic adverse effects (e.g., signs of HPA axis suppression, Cushing's syndrome, hyperglycemia)
Frequency: Periodically, especially with extensive use, prolonged therapy, occlusive dressings, or in pediatric patients.
Target: Normal HPA axis function (e.g., normal cortisol levels).
Action Threshold: Signs or symptoms suggestive of systemic corticosteroid effects (e.g., unexplained weight gain, fatigue, weakness, moon face).
Symptom Monitoring
- Worsening of skin condition
- Development of new skin lesions
- Signs of skin infection (redness, warmth, swelling, pus, fever)
- Severe burning, itching, irritation, or dryness at the application site
- Thinning of skin, easy bruising, stretch marks
- Acne or increased hair growth in treated areas
- Signs of systemic corticosteroid effects (e.g., unusual weight gain, swelling, fatigue, muscle weakness, mood changes)
Special Patient Groups
Pregnancy
Category C. Use only if the potential benefit justifies the potential risk to the fetus. Avoid large amounts, prolonged use, or occlusive dressings.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenicity with high systemic exposure (unlikely with proper topical use).
Second Trimester:
Similar to first, but risk generally lower.
Third Trimester:
Potential for low birth weight or adrenal suppression in the neonate with high systemic exposure.
Lactation
Use with caution. It is not known whether topical corticosteroids are excreted in human milk. Systemic absorption is minimal. Avoid applying to the breast area to prevent infant ingestion.
Infant Risk:
Low risk with proper use, but monitor infant for any unusual signs or symptoms.
Pediatric Use
Children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic adverse effects (e.g., HPA axis suppression, Cushing's syndrome, intracranial hypertension). Limit duration of therapy and amount applied. Avoid occlusive dressings. Closely monitor growth and development.
Geriatric Use
No specific dosage adjustments needed. Use with caution in patients with thin or fragile skin, as they may be more prone to local adverse effects such as skin atrophy and purpura.
Clinical Information
Clinical Pearls
- Triamcinolone 0.1% ointment is a medium-to-high potency topical corticosteroid. Ointments are generally more potent than creams for the same concentration due to increased penetration.
- Avoid prolonged use, especially on the face, intertriginous areas (skin folds), or in children, due to increased risk of local side effects (skin atrophy, telangiectasias) and systemic absorption (HPA axis suppression).
- Not for use on infected skin without concomitant appropriate antimicrobial therapy.
- Patients should be educated on proper application technique (thin film, gentle rub) and the importance of not exceeding prescribed duration or amount.
- Consider tapering off if used for prolonged periods to avoid rebound flares of the skin condition.
Alternative Therapies
- Other topical corticosteroids of varying potencies (e.g., hydrocortisone, fluocinonide, clobetasol propionate)
- Topical calcineurin inhibitors (e.g., tacrolimus, pimecrolimus) for steroid-sparing effect, especially on sensitive areas like the face.
- Emollients and moisturizers for barrier repair and hydration.
- Systemic therapies (e.g., oral corticosteroids, biologics, immunosuppressants) for severe or widespread conditions.
Cost & Coverage
Average Cost:
Varies widely, typically $20-$100+ per 454gm tube/jar
Generic Available:
Yes
Insurance Coverage:
Tier 1 or 2 (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 discuss them with 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 medication taken, the amount, and the time it occurred.