Triamcinolone 400mg/10ml Inj, 10ml
It is used to treat arthritis of the knee.It is used for many health problems like allergy signs, asthma, adrenal gland problems, blood problems, skin rashes, or swelling problems. This is not a list of all health problems that this drug may be used for. Talk with the doctor.
Drug Class
Corticosteroid
Pharmacologic Class
Glucocorticoid
Pregnancy Category
Category C
FDA Approved
Aug 1961
DEA Schedule
Not Controlled
Overview
What is this medicine?
Triamcinolone is a type of steroid medication that works by reducing inflammation and calming down the immune system. It's given as an injection, often into a muscle or joint, to treat conditions like severe allergies, arthritis, skin problems, or breathing issues.
How to Use This Medicine
Taking Your Medication Correctly
To ensure you get the most benefit from your medication, it's essential to use it exactly as directed by your doctor. Carefully read all the information provided to you and follow the instructions closely.
Administration
Your medication may be administered via injection, either directly into the knee or as a shot for other indications. The method of administration will depend on the specific reason for your treatment.
Storing and Disposing of Your Medication
If you need to store your medication at home, consult with your doctor, nurse, or pharmacist for guidance on proper storage procedures.
Missing a Dose
If you miss a dose, contact your doctor immediately to determine the best course of action. They will advise you on what to do next to ensure you stay on track with your treatment plan.
To ensure you get the most benefit from your medication, it's essential to use it exactly as directed by your doctor. Carefully read all the information provided to you and follow the instructions closely.
Administration
Your medication may be administered via injection, either directly into the knee or as a shot for other indications. The method of administration will depend on the specific reason for your treatment.
Storing and Disposing of Your Medication
If you need to store your medication at home, consult with your doctor, nurse, or pharmacist for guidance on proper storage procedures.
Missing a Dose
If you miss a dose, contact your doctor immediately to determine the best course of action. They will advise you on what to do next to ensure you stay on track with your treatment plan.
Lifestyle & Tips
- Avoid sudden discontinuation of the medication; doses should be tapered under medical supervision to prevent withdrawal symptoms.
- Report any signs of infection (fever, chills, sore throat, unusual fatigue) immediately, as steroids can mask infection symptoms and weaken the immune system.
- Maintain a balanced diet, potentially low in sodium and high in potassium, and ensure adequate calcium and vitamin D intake to support bone health, especially with long-term use.
- Engage in regular weight-bearing exercise to help maintain bone density.
- Monitor blood sugar levels if you have diabetes or are at risk, as this medication can increase blood glucose.
- Carry a steroid warning card or bracelet if on long-term therapy, especially if there's a risk of adrenal suppression.
- Avoid exposure to people with chickenpox or measles if you haven't had them or been vaccinated, as these infections can be more severe while on steroids.
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:
Intramuscular (IM): 40-80 mg once every 1-4 weeks, depending on response and indication. Intra-articular/Intrabursal: 2.5-60 mg, depending on joint size and severity, repeated as needed.
Dose Range:
2.5 - 80 mg
Condition-Specific Dosing:
allergic_rhinitis:
IM: 40-100 mg once per season.
rheumatoid_arthritis:
Intra-articular: 5-40 mg per joint, depending on size.
dermatologic_conditions:
IM: 40-80 mg, or Intralesional: 1 mg/injection site (max 30 mg total).
Pediatric Dosing
Neonatal:
Not established
Infant:
IM: 0.03-0.2 mg/kg at 1-7 day intervals, highly individualized.
Child:
IM: 0.03-0.2 mg/kg at 1-7 day intervals, highly individualized. Intra-articular: 2.5-15 mg depending on joint size.
Adolescent:
IM: 0.03-0.2 mg/kg at 1-7 day intervals, highly individualized. Intra-articular: 2.5-40 mg depending on joint size.
Dose Adjustments
Renal Impairment:
Mild:
No specific dose adjustment typically required.
Moderate:
No specific dose adjustment typically required.
Severe:
No specific dose adjustment typically required, but monitor for fluid and electrolyte imbalances.
Dialysis:
Not significantly removed by dialysis; no specific adjustment, but monitor for fluid and electrolyte imbalances.
Hepatic Impairment:
Mild:
No specific dose adjustment typically required.
Moderate:
No specific dose adjustment typically required, but monitor for increased systemic effects.
Severe:
No specific dose adjustment typically required, but monitor for increased systemic effects due to altered metabolism.
Pharmacology
Mechanism of Action
Triamcinolone is a synthetic glucocorticoid that exerts potent anti-inflammatory and immunosuppressive effects. It binds to intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus and modulates gene expression. This leads to the synthesis of anti-inflammatory proteins (e.g., lipocortin-1) and inhibition of pro-inflammatory mediators (e.g., cytokines, prostaglandins, leukotrienes). It also stabilizes lysosomal membranes, inhibits phagocytosis, and suppresses the immune response by reducing lymphocyte activity and antibody production.
Pharmacokinetics
Absorption:
Bioavailability:
Variable, depends on route of administration. Systemic absorption occurs from IM, IA, IL, and ID sites.
Tmax:
IM: Highly variable, can range from 8-24 hours to several days due to depot formulation.
FoodEffect:
Not applicable for injectable formulation.
Distribution:
Vd:
Approximately 0.2-1.5 L/kg (variable)
ProteinBinding:
Approximately 60-70% (primarily to albumin and transcortin), but can be lower at higher concentrations.
CnssPenetration:
Limited, but can cross the blood-brain barrier.
Elimination:
HalfLife:
Plasma half-life: Approximately 2-5 hours. Biological half-life (due to depot effect): Can be up to 18-36 hours for systemic effects, and weeks for local effects.
Clearance:
Approximately 0.5-1.5 L/hr/kg (variable)
ExcretionRoute:
Primarily renal (60-70%), with some biliary excretion.
Unchanged:
Less than 10% (renal)
Pharmacodynamics
OnsetOfAction:
IM: Within 24-48 hours for systemic effects. Intra-articular: Within hours for local effects.
PeakEffect:
IM: Days to weeks due to depot effect. Intra-articular: Days.
DurationOfAction:
IM: 1-6 weeks. Intra-articular: 1-6 weeks, depending on dose and site.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while 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
Note: In rare cases, allergic reactions can be fatal.
Signs of infection, including:
+ Fever
+ Chills
+ Severe sore throat
+ Ear or sinus pain
+ Cough
+ Increased or discolored sputum
+ Painful urination
+ Mouth sores
+ Wounds that won't heal
Signs of Cushing's syndrome, such as:
+ Weight gain in the upper back or abdomen
+ Moon face
+ Severe headache
+ Slow healing
Signs of a weak adrenal gland, including:
+ Severe nausea or vomiting
+ Severe dizziness or fainting
+ Muscle weakness
+ Fatigue
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of high blood sugar, such as:
+ Confusion
+ Drowsiness
+ Increased thirst or hunger
+ Frequent urination
+ Flushing
+ Rapid breathing
+ Fruity-smelling breath
Signs of high blood pressure, including:
+ Severe headache or dizziness
+ Fainting
+ Changes in vision
Signs of low potassium levels, such as:
+ Muscle pain or weakness
+ Muscle cramps
+ Abnormal heartbeat
Signs of pancreatitis, including:
+ Severe stomach pain
+ Severe back pain
+ Severe nausea or vomiting
Shortness of breath
Sudden weight gain
Swelling in the arms or legs
Abnormal heartbeat (fast, slow, or irregular)
Chest pain
Stomach pain
Black, tarry, or bloody stools
Vomiting blood or coffee ground-like material
Unexplained bruising or bleeding
Bone pain
Joint pain or swelling
Muscle pain or weakness
Fatigue or weakness
Redness or white patches in the mouth or throat
Changes in vision
New or worsening mental, mood, or behavioral changes
Menstrual changes
Seizures
Skin changes (acne, stretch marks, slow healing, hair growth)
Purple, red, blue, brown, or black bumps or patches on the skin or in the mouth
Burning, numbness, or tingling sensations
Redness or swelling at the injection site
Other Possible Side Effects
While many people may not experience any side effects or only minor ones, it's essential to be aware of the following potential side effects. If you're concerned about any of these symptoms or if they persist, contact your doctor:
Trouble sleeping
Upset stomach or nausea
Weight gain
Restlessness
Excessive sweating
Hair thinning
This is not an exhaustive list of possible side effects. If you have questions or concerns, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or visit https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while 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
Note: In rare cases, allergic reactions can be fatal.
Signs of infection, including:
+ Fever
+ Chills
+ Severe sore throat
+ Ear or sinus pain
+ Cough
+ Increased or discolored sputum
+ Painful urination
+ Mouth sores
+ Wounds that won't heal
Signs of Cushing's syndrome, such as:
+ Weight gain in the upper back or abdomen
+ Moon face
+ Severe headache
+ Slow healing
Signs of a weak adrenal gland, including:
+ Severe nausea or vomiting
+ Severe dizziness or fainting
+ Muscle weakness
+ Fatigue
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of high blood sugar, such as:
+ Confusion
+ Drowsiness
+ Increased thirst or hunger
+ Frequent urination
+ Flushing
+ Rapid breathing
+ Fruity-smelling breath
Signs of high blood pressure, including:
+ Severe headache or dizziness
+ Fainting
+ Changes in vision
Signs of low potassium levels, such as:
+ Muscle pain or weakness
+ Muscle cramps
+ Abnormal heartbeat
Signs of pancreatitis, including:
+ Severe stomach pain
+ Severe back pain
+ Severe nausea or vomiting
Shortness of breath
Sudden weight gain
Swelling in the arms or legs
Abnormal heartbeat (fast, slow, or irregular)
Chest pain
Stomach pain
Black, tarry, or bloody stools
Vomiting blood or coffee ground-like material
Unexplained bruising or bleeding
Bone pain
Joint pain or swelling
Muscle pain or weakness
Fatigue or weakness
Redness or white patches in the mouth or throat
Changes in vision
New or worsening mental, mood, or behavioral changes
Menstrual changes
Seizures
Skin changes (acne, stretch marks, slow healing, hair growth)
Purple, red, blue, brown, or black bumps or patches on the skin or in the mouth
Burning, numbness, or tingling sensations
Redness or swelling at the injection site
Other Possible Side Effects
While many people may not experience any side effects or only minor ones, it's essential to be aware of the following potential side effects. If you're concerned about any of these symptoms or if they persist, contact your doctor:
Trouble sleeping
Upset stomach or nausea
Weight gain
Restlessness
Excessive sweating
Hair thinning
This is not an exhaustive list of possible side effects. If you have questions or concerns, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or visit https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Signs of infection (fever, chills, body aches, sore throat, cough, painful urination, non-healing sores)
- Severe stomach pain, black or tarry stools, or vomiting blood (signs of GI bleeding)
- Unusual swelling in the hands, ankles, or feet, or sudden weight gain (fluid retention)
- Extreme fatigue, weakness, dizziness, nausea, vomiting, or loss of appetite (signs of adrenal insufficiency, especially if stopping too quickly)
- Increased thirst, frequent urination, or blurred vision (signs of high blood sugar)
- Severe mood changes, depression, or unusual thoughts/behavior
- Muscle weakness or pain, especially in the shoulders or hips
- Vision problems, eye pain, or halos around lights (signs of glaucoma or cataracts)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
To ensure safe treatment, inform your doctor about the following:
Any allergies you have to this medication, its components, or other substances, including foods and drugs. Describe the allergic reactions you've experienced.
Stomach or bowel conditions, such as diverticulitis, diverticulosis, ulcerative colitis, or ulcers.
Current or recent infections, including bacterial, viral, or fungal infections, amoeba infections (like traveler's diarrhea), herpes eye infections, cerebral malaria, threadworm infestations, or any other type of infection.
Local infections at the intended injection site (if applicable).
Additional Considerations for Injection Administration (Intramuscular):
* If you have idiopathic thrombocytopenic purpura (ITP), inform your doctor.
It is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health issues with your doctor and pharmacist. This will help determine if it is safe to take this medication with your other treatments. Never start, stop, or adjust the dosage of any medication without consulting your doctor first.
To ensure safe treatment, inform your doctor about the following:
Any allergies you have to this medication, its components, or other substances, including foods and drugs. Describe the allergic reactions you've experienced.
Stomach or bowel conditions, such as diverticulitis, diverticulosis, ulcerative colitis, or ulcers.
Current or recent infections, including bacterial, viral, or fungal infections, amoeba infections (like traveler's diarrhea), herpes eye infections, cerebral malaria, threadworm infestations, or any other type of infection.
Local infections at the intended injection site (if applicable).
Additional Considerations for Injection Administration (Intramuscular):
* If you have idiopathic thrombocytopenic purpura (ITP), inform your doctor.
It is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health issues with your doctor and pharmacist. This will help determine if it is safe to take this medication with your other treatments. Never start, stop, or adjust the dosage of any medication without consulting your doctor first.
Precautions & Cautions
Important Information About Your Medication
It is crucial that you inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood tests, as directed by your doctor, are necessary to monitor your health. If you are taking this medication long-term, you may also need to have your eye pressure and bone density checked.
Special Precautions
This medication may interfere with allergy skin tests, so be sure to notify your doctor and laboratory personnel that you are taking it.
You may need to reduce your salt intake and increase your potassium consumption; consult with your doctor for guidance.
If you have diabetes, it is essential to closely monitor your blood sugar levels.
Before receiving any vaccines, discuss the potential risks and benefits with your doctor, as some vaccines may not be effective or may increase the risk of infection when taken with this medication.
Infection Risks
Steroid medications like this one can increase your risk of infection, which can be severe or even life-threatening. Avoid close contact with individuals who have chickenpox or measles, and inform your doctor if you have been exposed to these illnesses.
If you have not had chickenpox or measles before, it is crucial to avoid exposure to these illnesses.
Wash your hands frequently, and avoid people with infections, colds, or flu. Notify your doctor immediately if you experience any signs of infection.
Certain infections, such as tuberculosis and hepatitis B, may reactivate in patients taking this medication. Inform your doctor if you have a history of these infections.
Additional Warnings
This medication may suppress your body's natural production of steroids. If you experience a fever, infection, surgery, or injury, consult with your doctor, as you may require additional oral steroids to help your body cope with these stresses. Carry a warning card indicating that you may need extra steroids in certain situations.
The use of this medication in the spine (epidural) has been associated with severe health problems, including paralysis, loss of vision, stroke, and death. Discuss the risks and benefits with your doctor.
If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects.
If you have been taking this medication for an extended period, consult with your doctor before stopping, as you may need to gradually taper off the medication.
Stopping the Medication
If you have missed a dose or recently stopped taking this medication and experience symptoms such as fatigue, weakness, shakiness, rapid heartbeat, confusion, sweating, or dizziness, inform your doctor promptly.
Long-term Use
Prolonged use of this medication may increase your risk of developing osteoporosis (weak bones) or cataracts and glaucoma. Discuss your individual risk factors with your doctor.
Some products containing this medication may include benzyl alcohol, which can be harmful to newborns and infants. Consult with your doctor to determine if this product contains benzyl alcohol.
Rare but Serious Side Effects
Long-term use of this medication has been associated with an increased risk of Kaposi's sarcoma, a type of cancer. Discuss this risk with your doctor.
This medication may affect growth in children and adolescents; regular growth checks may be necessary. Consult with your doctor to determine the best course of action.
Pregnancy and Breastfeeding
If you are pregnant, plan to become pregnant, or are breastfeeding, discuss the potential benefits and risks of this medication with your doctor.
It is crucial that you inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood tests, as directed by your doctor, are necessary to monitor your health. If you are taking this medication long-term, you may also need to have your eye pressure and bone density checked.
Special Precautions
This medication may interfere with allergy skin tests, so be sure to notify your doctor and laboratory personnel that you are taking it.
You may need to reduce your salt intake and increase your potassium consumption; consult with your doctor for guidance.
If you have diabetes, it is essential to closely monitor your blood sugar levels.
Before receiving any vaccines, discuss the potential risks and benefits with your doctor, as some vaccines may not be effective or may increase the risk of infection when taken with this medication.
Infection Risks
Steroid medications like this one can increase your risk of infection, which can be severe or even life-threatening. Avoid close contact with individuals who have chickenpox or measles, and inform your doctor if you have been exposed to these illnesses.
If you have not had chickenpox or measles before, it is crucial to avoid exposure to these illnesses.
Wash your hands frequently, and avoid people with infections, colds, or flu. Notify your doctor immediately if you experience any signs of infection.
Certain infections, such as tuberculosis and hepatitis B, may reactivate in patients taking this medication. Inform your doctor if you have a history of these infections.
Additional Warnings
This medication may suppress your body's natural production of steroids. If you experience a fever, infection, surgery, or injury, consult with your doctor, as you may require additional oral steroids to help your body cope with these stresses. Carry a warning card indicating that you may need extra steroids in certain situations.
The use of this medication in the spine (epidural) has been associated with severe health problems, including paralysis, loss of vision, stroke, and death. Discuss the risks and benefits with your doctor.
If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects.
If you have been taking this medication for an extended period, consult with your doctor before stopping, as you may need to gradually taper off the medication.
Stopping the Medication
If you have missed a dose or recently stopped taking this medication and experience symptoms such as fatigue, weakness, shakiness, rapid heartbeat, confusion, sweating, or dizziness, inform your doctor promptly.
Long-term Use
Prolonged use of this medication may increase your risk of developing osteoporosis (weak bones) or cataracts and glaucoma. Discuss your individual risk factors with your doctor.
Some products containing this medication may include benzyl alcohol, which can be harmful to newborns and infants. Consult with your doctor to determine if this product contains benzyl alcohol.
Rare but Serious Side Effects
Long-term use of this medication has been associated with an increased risk of Kaposi's sarcoma, a type of cancer. Discuss this risk with your doctor.
This medication may affect growth in children and adolescents; regular growth checks may be necessary. Consult with your doctor to determine the best course of action.
Pregnancy and Breastfeeding
If you are pregnant, plan to become pregnant, or are breastfeeding, discuss the potential benefits and risks of this medication with your doctor.
Overdose Information
Overdose Symptoms:
- Acute overdose is rare due to the nature of the drug and administration.
- Chronic overdose or prolonged high doses can lead to Cushingoid features (moon face, buffalo hump, central obesity), severe hyperglycemia, hypertension, fluid retention, hypokalemia, osteoporosis, muscle weakness, and increased susceptibility to infection.
What to Do:
Acute overdose generally requires supportive and symptomatic treatment. There is no specific antidote. Chronic overdose requires gradual dose reduction and management of symptoms. In case of suspected overdose, contact a poison control center (e.g., 1-800-222-1222) or seek immediate medical attention.
Drug Interactions
Contraindicated Interactions
- Live or live attenuated vaccines (when administered with immunosuppressive doses of corticosteroids)
Major Interactions
- Barbiturates (e.g., phenobarbital)
- Phenytoin
- Rifampin
- Carbamazepine
- Ketoconazole
- Itraconazole
- Ritonavir
- Non-depolarizing neuromuscular blockers (e.g., vecuronium, pancuronium)
- Anticholinesterases (e.g., neostigmine, pyridostigmine) - risk of severe weakness in myasthenia gravis
Moderate Interactions
- NSAIDs (e.g., ibuprofen, naproxen) - increased risk of GI ulceration/bleeding
- Diuretics (potassium-depleting, e.g., furosemide, hydrochlorothiazide) - increased risk of hypokalemia
- Anticoagulants (e.g., warfarin) - may alter anticoagulant effect (increase or decrease)
- Antidiabetics (e.g., insulin, metformin) - corticosteroids can increase blood glucose, requiring dose adjustment of antidiabetics
- Cardiac glycosides (e.g., digoxin) - increased risk of toxicity with hypokalemia
- Cyclosporine - increased blood levels of both drugs
- Oral contraceptives/Estrogens - may increase corticosteroid effects
- Fluoroquinolones - increased risk of tendon rupture
Minor Interactions
- Aspirin (high dose) - decreased salicylate levels
- Aminoglutethimide - may decrease corticosteroid effect
Monitoring
Baseline Monitoring
Blood Pressure (BP)
Rationale: Corticosteroids can cause fluid retention and hypertension.
Timing: Prior to initiation.
Blood Glucose
Rationale: Corticosteroids can induce hyperglycemia, especially in predisposed individuals.
Timing: Prior to initiation.
Serum Electrolytes (Na, K)
Rationale: Risk of fluid retention, hypokalemia.
Timing: Prior to initiation.
Bone Mineral Density (BMD)
Rationale: For long-term therapy, to assess osteoporosis risk.
Timing: Prior to initiation of long-term therapy.
Ophthalmic Exam (intraocular pressure)
Rationale: For long-term therapy, risk of glaucoma and cataracts.
Timing: Prior to initiation of long-term therapy.
Routine Monitoring
Blood Pressure (BP)
Frequency: Regularly, especially during initial therapy and dose changes.
Target: <140/90 mmHg (or patient's target)
Action Threshold: Sustained elevation requiring intervention.
Blood Glucose
Frequency: Periodically, more frequently in diabetics or those at risk.
Target: Fasting <100 mg/dL, Postprandial <140 mg/dL
Action Threshold: Persistent hyperglycemia requiring intervention.
Serum Electrolytes (Na, K)
Frequency: Periodically, especially with concomitant diuretics or cardiac disease.
Target: Na: 135-145 mEq/L, K: 3.5-5.0 mEq/L
Action Threshold: Significant hypokalemia or hypernatremia.
Weight
Frequency: Regularly.
Target: Stable
Action Threshold: Significant unexplained weight gain.
Growth (in pediatric patients)
Frequency: Regularly.
Target: Normal growth curve
Action Threshold: Growth retardation.
Signs of Infection
Frequency: Continuously.
Target: Absence of fever, localized pain, redness, swelling.
Action Threshold: Any signs of infection, especially with immunosuppressive doses.
Symptom Monitoring
- Signs of infection (fever, chills, sore throat, unusual fatigue, non-healing wounds)
- Symptoms of adrenal insufficiency (severe fatigue, weakness, dizziness, nausea, vomiting, loss of appetite, weight loss) upon withdrawal
- Symptoms of hyperglycemia (increased thirst, increased urination, blurred vision)
- Fluid retention (swelling in ankles/feet, weight gain)
- Mood changes (irritability, anxiety, depression, euphoria)
- Muscle weakness or pain
- Gastrointestinal upset (stomach pain, black/tarry stools)
- Vision changes (blurred vision, halos around lights)
Special Patient Groups
Pregnancy
Triamcinolone is classified as Pregnancy Category C. Animal studies have shown teratogenic effects. There are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Infants born to mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism.
Trimester-Specific Risks:
First Trimester:
Potential for increased risk of cleft palate in animal studies; human data are limited and inconsistent.
Second Trimester:
Risk of fetal growth restriction and adrenal suppression.
Third Trimester:
Risk of fetal growth restriction and adrenal suppression. Neonates should be monitored for hypoadrenalism.
Lactation
Triamcinolone is excreted in breast milk. The amount is generally considered low, but potential for adverse effects on the infant (e.g., growth suppression, interference with endogenous corticosteroid production) exists. Use with caution. Consider the developmental and health benefits of breastfeeding, the mother’s clinical need for triamcinolone, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition.
Infant Risk:
L3 (Moderately safe). Monitor infant for signs of adrenal suppression (e.g., poor weight gain, irritability) and developmental milestones.
Pediatric Use
Corticosteroids can cause growth retardation in children and adolescents. Long-term use should be carefully monitored. Adrenal suppression is a significant risk. Pediatric patients are also more susceptible to certain adverse effects, such as intracranial hypertension. Dosing should be the lowest effective dose for the shortest duration possible.
Geriatric Use
Elderly patients may be at increased risk for adverse effects such as osteoporosis, fluid retention, hypertension, diabetes, and cataracts. Use with caution and monitor closely for these effects. Lower doses or less frequent administration may be appropriate.
Clinical Information
Clinical Pearls
- Triamcinolone acetonide injectable suspension is for IM, IA, IL, or ID use only. It is NOT for intravenous (IV) administration.
- The 40 mg/mL concentration (400mg/10ml vial) is a depot formulation designed for prolonged systemic or local effects.
- Patients on long-term corticosteroid therapy should not abruptly discontinue the medication due to the risk of adrenal insufficiency. Dosing must be tapered gradually.
- Educate patients about signs of infection, as corticosteroids can mask symptoms and increase susceptibility.
- Monitor blood glucose, blood pressure, and electrolytes regularly, especially in patients with pre-existing conditions like diabetes or hypertension.
- Consider calcium and vitamin D supplementation for patients on long-term therapy to mitigate osteoporosis risk.
- Intra-articular injections should be performed under strict aseptic technique to prevent septic arthritis.
- Repeated intra-articular injections into the same joint may lead to joint destruction and should be avoided.
Alternative Therapies
- Other systemic corticosteroids (e.g., prednisone, methylprednisolone, dexamethasone)
- NSAIDs (for inflammatory conditions, less potent)
- DMARDs (Disease-Modifying Antirheumatic Drugs) for rheumatic conditions
- Immunosuppressants (e.g., methotrexate, azathioprine, biologics) for severe autoimmune conditions
- Topical corticosteroids (for dermatologic conditions)
- Inhaled corticosteroids (for respiratory conditions)
Cost & Coverage
Average Cost:
Varies widely by pharmacy and insurance plan, typically $50-$300+ per 10ml vial (400mg)
Generic Available:
Yes
Insurance Coverage:
Tier 1 or 2 (Generic), Tier 3 (Brand)
General Drug Facts
If your symptoms or health problems persist or worsen, it is essential to contact your doctor for further guidance. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed to do so by a healthcare professional, do not flush medications down the toilet or pour them down the drain. If you are unsure about the proper disposal method, consult your pharmacist for advice. Many communities offer drug take-back programs, which your pharmacist can help you locate. Some medications may come with an additional patient information leaflet; check with your pharmacist to see if this applies to your prescription. If you have any questions or concerns about your medication, 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. Be prepared to provide information about the medication taken, the amount, and the time it was taken to ensure prompt and effective treatment.