Triamcinolone 55mcg Nasalsp (120)
It is used to ease allergy signs.
Drug Class
Corticosteroid, Nasal
Pharmacologic Class
Glucocorticoid
Pregnancy Category
Category C
FDA Approved
Jan 1996
DEA Schedule
Not Controlled
Overview
What is this medicine?
Triamcinolone nasal spray is a medicine used to treat allergy symptoms like sneezing, runny nose, and nasal congestion. It works by reducing swelling and inflammation in your nose.
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. It is essential to use this medication as directed.
This medication is for nasal use only. Do not take it by mouth, and avoid getting it in your eyes or mouth, as it may cause burning.
Before using the spray for the first time, prime the pump by spraying until a fine mist appears. If you haven't used the spray in more than 2 weeks, you will need to prime it again.
Shake the spray well before each use.
Blow your nose gently before using the spray.
Tilt your head forward slightly and insert the nose spray tube into one nostril. Close the other nostril and spray the medication up your nose while breathing in gently through your nose. Press the pump once to release the spray, then breathe out through your mouth.
Do not blow your nose for 15 minutes after using the spray.
Continue using this medication as directed by your doctor or healthcare provider, even if you start feeling better.
Storage and Disposal
Store the medication upright at room temperature, away from freezing temperatures.
Throw away the medication after the stated number of sprays have been used, even if it seems like there is still medication left in the container.
Keep the medication in a dry place, avoiding storage in a bathroom.
Missed Dose
If you miss a dose, use it as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and return to your regular schedule.
* Do not use two doses at the same time or take extra doses.
To use this medication correctly, follow your doctor's instructions and read all the information provided. It is essential to use this medication as directed.
This medication is for nasal use only. Do not take it by mouth, and avoid getting it in your eyes or mouth, as it may cause burning.
Before using the spray for the first time, prime the pump by spraying until a fine mist appears. If you haven't used the spray in more than 2 weeks, you will need to prime it again.
Shake the spray well before each use.
Blow your nose gently before using the spray.
Tilt your head forward slightly and insert the nose spray tube into one nostril. Close the other nostril and spray the medication up your nose while breathing in gently through your nose. Press the pump once to release the spray, then breathe out through your mouth.
Do not blow your nose for 15 minutes after using the spray.
Continue using this medication as directed by your doctor or healthcare provider, even if you start feeling better.
Storage and Disposal
Store the medication upright at room temperature, away from freezing temperatures.
Throw away the medication after the stated number of sprays have been used, even if it seems like there is still medication left in the container.
Keep the medication in a dry place, avoiding storage in a bathroom.
Missed Dose
If you miss a dose, use it as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and return to your regular schedule.
* Do not use two doses at the same time or take extra doses.
Lifestyle & Tips
- Identify and avoid allergy triggers (e.g., pollen, dust mites, pet dander).
- Use the spray regularly as prescribed, even when symptoms are mild, for best results.
- Shake the bottle gently before each use.
- Prime the pump before first use or if not used for several days by spraying into the air until a fine mist appears.
- Clear your nasal passages by gently blowing your nose before use.
- Tilt your head slightly forward, insert the nozzle into one nostril, aiming slightly away from the nasal septum (the wall between your nostrils).
- Close the other nostril with your finger.
- Press down firmly on the pump while sniffing gently.
- Repeat for the other nostril if directed.
- Avoid blowing your nose immediately after use.
- Clean the nozzle regularly as instructed in the package insert.
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:
2 sprays (110 mcg) per nostril once daily, then may reduce to 1 spray (55 mcg) per nostril once daily for maintenance.
Dose Range:
55 - 220 mg
Condition-Specific Dosing:
allergicRhinitis:
Initial: 2 sprays (110 mcg) per nostril once daily. Maintenance: 1 spray (55 mcg) per nostril once daily.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
2-5 years: 1 spray (55 mcg) per nostril once daily. 6-11 years: 1 spray (55 mcg) per nostril once daily, may increase to 2 sprays (110 mcg) per nostril once daily if needed, then reduce to 1 spray per nostril once daily for maintenance. Max 110 mcg/day.
Adolescent:
12 years and older: Same as adult dosing.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed due to minimal systemic absorption.
Moderate:
No adjustment needed due to minimal systemic absorption.
Severe:
No adjustment needed due to minimal systemic absorption.
Dialysis:
No adjustment needed due to minimal systemic absorption.
Hepatic Impairment:
Mild:
No adjustment needed due to minimal systemic absorption.
Moderate:
No adjustment needed due to minimal systemic absorption.
Severe:
No adjustment needed due to minimal systemic absorption.
Pharmacology
Mechanism of Action
Triamcinolone acetonide is a synthetic corticosteroid with potent anti-inflammatory and immunosuppressive properties. It exerts its effects by binding to intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus. This complex then modulates gene expression, leading to the inhibition of inflammatory mediators (e.g., prostaglandins, leukotrienes, cytokines) and the suppression of immune cell function (e.g., mast cells, eosinophils, lymphocytes, macrophages, neutrophils). In the nasal mucosa, this reduces inflammation, edema, mucus production, and nasal hyperresponsiveness.
Pharmacokinetics
Absorption:
Bioavailability:
<1% (systemic bioavailability after nasal administration)
Tmax:
3.4 hours (for systemic absorption, which is minimal)
FoodEffect:
Not applicable for nasal administration
Distribution:
Vd:
Not readily quantifiable due to low systemic absorption
ProteinBinding:
68% (for systemic triamcinolone)
CnssPenetration:
Limited (for nasal administration)
Elimination:
HalfLife:
Approximately 3.1 hours (for systemic triamcinolone)
Clearance:
Not readily quantifiable due to low systemic absorption
ExcretionRoute:
Primarily urine and feces (for systemically absorbed drug)
Unchanged:
Not available (minimal systemic absorption)
Pharmacodynamics
OnsetOfAction:
Within 12 hours, but full effect may take 3-4 days of consistent use.
PeakEffect:
3-4 days of consistent use.
DurationOfAction:
24 hours (once daily dosing).
Safety & Warnings
Side Effects
Serious Side Effects: Seek Medical Attention Immediately
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 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 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 high blood sugar, such as:
+ Confusion
+ Drowsiness
+ Excessive thirst or hunger
+ Frequent urination
+ Flushing
+ Rapid breathing
+ Fruity-smelling breath
Signs of a weak adrenal gland, including:
+ Severe nausea or vomiting
+ Severe dizziness or fainting
+ Muscle weakness
+ Extreme fatigue
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, such as:
+ Weight gain in the upper back or abdomen
+ Moon face
+ Severe headache
+ Slow wound healing
Nose sores
Whistling sound while breathing
Redness or white patches in the mouth or throat
Changes in vision
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 persist, contact your doctor for guidance:
Nosebleed
Flu-like symptoms
Headache
Nose or throat irritation
Changes in taste
This is not an exhaustive list of potential 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 online at 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 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 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 high blood sugar, such as:
+ Confusion
+ Drowsiness
+ Excessive thirst or hunger
+ Frequent urination
+ Flushing
+ Rapid breathing
+ Fruity-smelling breath
Signs of a weak adrenal gland, including:
+ Severe nausea or vomiting
+ Severe dizziness or fainting
+ Muscle weakness
+ Extreme fatigue
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, such as:
+ Weight gain in the upper back or abdomen
+ Moon face
+ Severe headache
+ Slow wound healing
Nose sores
Whistling sound while breathing
Redness or white patches in the mouth or throat
Changes in vision
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 persist, contact your doctor for guidance:
Nosebleed
Flu-like symptoms
Headache
Nose or throat irritation
Changes in taste
This is not an exhaustive list of potential 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 online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Frequent or severe nosebleeds
- Persistent nasal irritation or dryness
- Sores in your nose that do not heal
- Whistling sound from your nose (may indicate septal perforation)
- Signs of infection (e.g., fever, facial pain, thick discolored nasal discharge)
- Vision changes or eye pain (rare, but seek medical attention)
- Slowed growth in children (report to doctor)
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, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
Potential interactions with other medications or health conditions. This drug may interact with other prescription or over-the-counter (OTC) medications, natural products, or vitamins, which could affect its safety and efficacy.
A comprehensive list of all your current medications, including prescription and OTC drugs, natural products, and vitamins. This information will help your doctor and pharmacist assess potential interactions and ensure safe use.
Any existing health problems, as they may impact the safety and effectiveness of this medication.
To ensure your safety, do not start, stop, or change the dose of any medication without first consulting your doctor. It is crucial 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, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
Potential interactions with other medications or health conditions. This drug may interact with other prescription or over-the-counter (OTC) medications, natural products, or vitamins, which could affect its safety and efficacy.
A comprehensive list of all your current medications, including prescription and OTC drugs, natural products, and vitamins. This information will help your doctor and pharmacist assess potential interactions and ensure safe use.
Any existing health problems, as they may impact the safety and effectiveness of this medication.
To ensure your safety, do not start, stop, or change the dose of any medication without first consulting your doctor. It is crucial 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.
This drug may increase your risk of developing cataracts or glaucoma. Be sure to discuss this potential risk with your doctor.
If you have not had chickenpox, measles, or been vaccinated against these diseases, and you come into contact with someone who has them, consult your doctor promptly.
Prior to taking this medication, inform your doctor if you have recently undergone nose surgery, experienced a nose injury, or have nose ulcers or sores.
Note that different brands of this medication may be approved for use in children of varying ages. Before administering this drug to a child, consult with your doctor to ensure you are using the appropriate brand and dosage.
In some cases, this medication may affect growth in children and teenagers. Regular growth checks may be necessary for these individuals. Discuss this potential effect with your doctor.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor. It is crucial to weigh the benefits and risks of this medication for both you and your baby.
This drug may increase your risk of developing cataracts or glaucoma. Be sure to discuss this potential risk with your doctor.
If you have not had chickenpox, measles, or been vaccinated against these diseases, and you come into contact with someone who has them, consult your doctor promptly.
Prior to taking this medication, inform your doctor if you have recently undergone nose surgery, experienced a nose injury, or have nose ulcers or sores.
Note that different brands of this medication may be approved for use in children of varying ages. Before administering this drug to a child, consult with your doctor to ensure you are using the appropriate brand and dosage.
In some cases, this medication may affect growth in children and teenagers. Regular growth checks may be necessary for these individuals. Discuss this potential effect with your doctor.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor. It is crucial to weigh the benefits and risks of this medication for both you and your baby.
Overdose Information
Overdose Symptoms:
- Acute overdose is unlikely due to low systemic absorption.
- Chronic excessive use may lead to systemic corticosteroid effects (e.g., Cushingoid features, adrenal suppression), though rare with nasal spray.
What to Do:
In case of suspected overdose or significant adverse effects, contact a poison control center (1-800-222-1222) or seek immediate medical attention. Management is supportive.
Drug Interactions
Major Interactions
- Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir): May increase systemic exposure to triamcinolone, but clinical significance is generally low due to minimal nasal absorption. Monitor for signs of systemic corticosteroid effects.
Monitoring
Baseline Monitoring
Nasal examination
Rationale: To assess baseline nasal mucosa, identify any pre-existing conditions (e.g., septal perforation, nasal ulcers) and ensure proper administration.
Timing: Prior to initiation of therapy
Routine Monitoring
Symptom control (nasal congestion, rhinorrhea, sneezing, itching)
Frequency: Regularly, at follow-up visits
Target: Significant improvement in allergic rhinitis symptoms
Action Threshold: Lack of improvement after 1-2 weeks, or worsening symptoms, warrants re-evaluation.
Nasal mucosa examination (for epistaxis, irritation, septal perforation, candidiasis)
Frequency: Periodically, especially if symptoms occur or with long-term use
Target: Healthy, intact nasal mucosa
Action Threshold: Presence of persistent epistaxis, nasal ulcers, septal perforation, or signs of infection requires discontinuation or dose adjustment.
Growth monitoring (in pediatric patients)
Frequency: Regularly (e.g., every 3-6 months) with long-term use
Target: Normal growth velocity for age
Action Threshold: Growth suppression warrants re-evaluation of therapy and consideration of alternative treatments.
Symptom Monitoring
- Nasal congestion
- Rhinorrhea (runny nose)
- Sneezing
- Nasal itching
- Post-nasal drip
- Nosebleeds (epistaxis)
- Nasal irritation or dryness
- Sore throat
- Headache
- Unusual taste or smell
- Signs of infection (e.g., fever, purulent discharge)
Special Patient Groups
Pregnancy
Triamcinolone nasal spray is Pregnancy Category C. Use during pregnancy should only be considered if the potential benefit justifies the potential risk to the fetus. Studies in animals have shown teratogenic effects, but human data are limited. Minimal systemic absorption reduces risk compared to oral corticosteroids.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenicity, though low risk due to minimal systemic absorption.
Second Trimester:
Generally considered lower risk than first trimester, but still Category C.
Third Trimester:
No specific risks identified beyond general corticosteroid effects; minimal systemic absorption limits risk.
Lactation
Triamcinolone is excreted in breast milk following systemic administration. However, due to the very low systemic absorption of triamcinolone nasal spray, the amount transferred into breast milk is expected to be negligible. Considered L3 (moderately safe) by some sources, but generally low risk for the infant.
Infant Risk:
Low risk of adverse effects to the breastfed infant due to minimal systemic exposure.
Pediatric Use
Growth velocity should be monitored in pediatric patients receiving long-term treatment with nasal corticosteroids, as they may cause growth suppression. Use the lowest effective dose. Not recommended for children under 2 years of age.
Geriatric Use
No specific dose adjustments are required for geriatric patients. The safety and efficacy profiles are similar to those in younger adults. Monitor for potential systemic effects, though rare.
Clinical Information
Clinical Pearls
- Patients should be instructed on the correct administration technique to ensure optimal drug delivery and minimize local side effects.
- Full therapeutic effect may not be seen for several days (3-4 days) after starting treatment; patients should be advised to continue regular use.
- Triamcinolone nasal spray is for regular, preventative use, not for immediate relief of acute symptoms.
- If symptoms are severe, a short course of oral corticosteroids may be used concurrently to bridge the gap until the nasal spray takes full effect.
- Advise patients to avoid spraying directly onto the nasal septum to reduce the risk of irritation or epistaxis.
- Regular cleaning of the nasal spray applicator is important to prevent blockage and contamination.
Alternative Therapies
- Other intranasal corticosteroids (e.g., fluticasone propionate, mometasone furoate, budesonide, ciclesonide)
- Oral antihistamines (e.g., loratadine, fexofenadine, cetirizine)
- Nasal antihistamines (e.g., azelastine, olopatadine)
- Nasal cromolyn sodium
- Oral decongestants (short-term use)
- Nasal saline rinses
- Immunotherapy (allergy shots or sublingual tablets)
Cost & Coverage
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 2 (for 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 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 details about the medication taken, the amount, and the time it happened.