Triamcinolone Topical Spray 63gm
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 topical spray is a medicine that helps reduce redness, swelling, and itching caused by certain skin conditions like eczema or dermatitis. It works by calming down the skin's immune response.
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's essential to use this medication as directed, even if your symptoms improve.
Application Instructions
Apply this medication only to your skin, avoiding the mouth, nose, and eyes, as it may cause burning.
Wash your hands before and after applying the medication, unless your hand is the treated area.
Clean the affected area before applying the medication and dry it thoroughly.
Apply a thin layer of the medication to the affected skin and gently rub it in.
Avoid applying the medication to your face, underarms, or groin area unless your doctor instructs you to do so.
Do not use bandages or dressings to cover the treated area unless your doctor advises you to do so.
If the treated area is in the diaper region, avoid using tight-fitting diapers or plastic pants, as this may increase the amount of medication absorbed into the body.
Do not use this medication to treat diaper rash.
Avoid applying the medication to cuts, scrapes, or damaged skin.
Before use, shake the medication well.
Storage and Disposal
Store the medication at room temperature, away from freezing temperatures.
Protect the medication from heat and open flames.
Do not puncture or burn the medication, even if it appears empty.
Keep all medications in a safe location, out of the reach of children and pets.
Missed Dose
If you miss a dose, apply it as soon as you remember.
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 use this medication correctly, follow your doctor's instructions and read all the information provided. It's essential to use this medication as directed, even if your symptoms improve.
Application Instructions
Apply this medication only to your skin, avoiding the mouth, nose, and eyes, as it may cause burning.
Wash your hands before and after applying the medication, unless your hand is the treated area.
Clean the affected area before applying the medication and dry it thoroughly.
Apply a thin layer of the medication to the affected skin and gently rub it in.
Avoid applying the medication to your face, underarms, or groin area unless your doctor instructs you to do so.
Do not use bandages or dressings to cover the treated area unless your doctor advises you to do so.
If the treated area is in the diaper region, avoid using tight-fitting diapers or plastic pants, as this may increase the amount of medication absorbed into the body.
Do not use this medication to treat diaper rash.
Avoid applying the medication to cuts, scrapes, or damaged skin.
Before use, shake the medication well.
Storage and Disposal
Store the medication at room temperature, away from freezing temperatures.
Protect the medication from heat and open flames.
Do not puncture or burn the medication, even if it appears empty.
Keep all medications in a safe location, out of the reach of children and pets.
Missed Dose
If you miss a dose, apply it as soon as you remember.
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.
Lifestyle & Tips
- Use exactly as directed by your doctor. Do not use more often or for longer than prescribed.
- Shake the can well before each use.
- Hold the can 3 to 6 inches away from the affected skin area and spray lightly for a few seconds. Do not spray near your eyes, nose, or mouth.
- Do not rub the spray into your skin.
- Do not cover the treated area with bandages or other dressings unless specifically instructed by your doctor, as this can increase absorption.
- Wash your hands before and after applying the spray.
- Avoid contact with eyes. If contact occurs, rinse thoroughly with water.
- Do not use on broken, infected, or irritated skin unless directed by your doctor.
- Inform your doctor if your condition worsens or does not improve after a few days or weeks of treatment.
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 to affected area 2 to 4 times daily
Dose Range:
2 - 4 mg
Condition-Specific Dosing:
generalUse:
Spray lightly onto the affected skin area from a distance of 3 to 6 inches for a few seconds. Do not rub in.
Pediatric Dosing
Neonatal:
Not established (use with extreme caution due to increased systemic absorption risk)
Infant:
Not established (use with extreme caution due to increased systemic absorption risk)
Child:
Apply to affected area 2 to 4 times daily, similar to adults, but with increased caution regarding systemic absorption, especially with occlusive dressings or on large surface areas. Limit duration of therapy.
Adolescent:
Apply to affected area 2 to 4 times daily, similar to adults.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed for topical use
Moderate:
No adjustment needed for topical use
Severe:
No adjustment needed for topical use
Dialysis:
No specific considerations for topical use, as systemic absorption is minimal under normal conditions.
Hepatic Impairment:
Mild:
No adjustment needed for topical use
Moderate:
No adjustment needed for topical use
Severe:
No adjustment needed for topical use
Pharmacology
Mechanism of Action
Triamcinolone acetonide is a synthetic corticosteroid that possesses anti-inflammatory, antipruritic, and vasoconstrictive properties. It acts by inducing phospholipase A2 inhibitory proteins, lipocortins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Corticosteroids also suppress the immune response by inhibiting the function of lymphocytes and macrophages.
Pharmacokinetics
Absorption:
Bioavailability:
Variable (depends on skin integrity, vehicle, site of application, duration of exposure, and use of occlusive dressings); systemic absorption can occur.
Tmax:
Not well-defined for topical application; systemic levels are generally low.
FoodEffect:
Not applicable for topical administration.
Distribution:
Vd:
Not well-defined for topical application; if absorbed systemically, widely distributed.
ProteinBinding:
Variable, generally high (e.g., >90% for systemic corticosteroids)
CnssPenetration:
Limited (minimal CNS penetration from topical application)
Elimination:
HalfLife:
Approximately 2-5 hours (systemic, but highly variable for topical absorption)
Clearance:
Not well-defined for topical application; primarily hepatic metabolism followed by renal excretion.
ExcretionRoute:
Renal (metabolites), some biliary
Unchanged:
Minimal (primarily metabolized)
Pharmacodynamics
OnsetOfAction:
Within hours for symptomatic relief (e.g., reduction in itching, redness)
PeakEffect:
Variable, depends on condition and individual response; generally within days of consistent application.
DurationOfAction:
Variable, typically lasts until next application or 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 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 fainting
+ Muscle weakness
+ Feeling very tired
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, including:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Irritation at the site where the medication was applied
Skin changes, such as:
+ Pimples
+ Stretch marks
+ Slow healing
+ Hair growth
Change in skin color
Thinning of the skin
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people experience no side effects or only mild ones. If you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical help if they bother you or do not go away:
Burning
Itching
* Dry skin
This is not an exhaustive list of all possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek 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 fainting
+ Muscle weakness
+ Feeling very tired
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, including:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Irritation at the site where the medication was applied
Skin changes, such as:
+ Pimples
+ Stretch marks
+ Slow healing
+ Hair growth
Change in skin color
Thinning of the skin
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people experience no side effects or only mild ones. If you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical help if they bother you or do not go away:
Burning
Itching
* Dry skin
This is not an exhaustive list of all possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Worsening of the skin condition
- Signs of skin infection (e.g., pus, increased redness, warmth, fever)
- Severe burning, itching, or irritation at the application site
- Skin thinning, stretch marks, or easy bruising
- Unusual hair growth on the treated area
- Acne-like rash
- Blurred vision or other eye problems (rare, but report immediately)
- Unexplained weight gain, swelling in ankles/feet, or unusual fatigue (signs of systemic absorption, rare)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, any of its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor assess potential interactions between this medication and other substances you are taking.
* Any health problems you have, as they may affect the safety and efficacy of this medication.
Remember, this is not an exhaustive list of potential interactions. To ensure your safety, it is crucial to consult with your doctor and pharmacist about all your medications and health conditions. Never start, stop, or change the dose of any medication without first discussing it with your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, any of its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor assess potential interactions between this medication and other substances you are taking.
* Any health problems you have, as they may affect the safety and efficacy of this medication.
Remember, this is not an exhaustive list of potential interactions. To ensure your safety, it is crucial to consult with your doctor and pharmacist about all your medications and health conditions. Never start, stop, or change the dose of any medication without first discussing it with your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Adhere to the prescribed 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. Therefore, it is crucial to follow the prescribed dosage and treatment schedule.
This medication is flammable, so it is vital to keep it away from open flames and not to smoke while using it. Additionally, avoid inhaling the vapors emitted by this drug.
When using this medication in children, extra caution is necessary, as the risk of certain side effects may be higher in this population. In some cases, this drug may affect growth in children and teenagers, and regular growth checks may be required. Consult with your doctor to discuss this potential risk.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor, as they will need to weigh the benefits and risks of this medication to both you and your baby.
Before using any other medications or products on your skin, including soaps, consult with your doctor to ensure safe 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. Therefore, it is crucial to follow the prescribed dosage and treatment schedule.
This medication is flammable, so it is vital to keep it away from open flames and not to smoke while using it. Additionally, avoid inhaling the vapors emitted by this drug.
When using this medication in children, extra caution is necessary, as the risk of certain side effects may be higher in this population. In some cases, this drug may affect growth in children and teenagers, and regular growth checks may be required. Consult with your doctor to discuss this potential risk.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor, as they will need to weigh the benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Prolonged or excessive use can lead to systemic absorption and symptoms of hypercorticism (Cushing's syndrome), including: moon face, buffalo hump, central obesity, skin thinning, easy bruising, muscle weakness, high blood pressure, high blood sugar, and adrenal suppression.
What to Do:
Discontinue use and seek medical attention. Call 1-800-222-1222 (Poison Control Center) for advice. Management is supportive and may involve gradual withdrawal of the corticosteroid if adrenal suppression is present.
Drug Interactions
Monitoring
Baseline Monitoring
Skin condition assessment
Rationale: To establish baseline severity of dermatosis and identify any signs of infection or contraindications.
Timing: Prior to initiation of therapy
Routine Monitoring
Local skin reactions (e.g., atrophy, striae, telangiectasias, burning, itching, irritation)
Frequency: At each follow-up visit or as symptoms arise
Target: Absence of new or worsening reactions
Action Threshold: If severe or persistent reactions occur, discontinue use and reassess.
Signs of HPA axis suppression (e.g., Cushing's syndrome, hyperglycemia, glucosuria)
Frequency: Periodically, especially with prolonged use, extensive body surface area application, or in pediatric patients.
Target: Normal cortisol levels, absence of clinical signs
Action Threshold: If suspected, perform ACTH stimulation test or plasma cortisol levels; discontinue or reduce frequency.
Signs of infection (e.g., worsening redness, pus, fever)
Frequency: At each follow-up visit or as symptoms arise
Target: Absence of infection
Action Threshold: If infection develops, discontinue corticosteroid and initiate appropriate antimicrobial therapy.
Symptom Monitoring
- Worsening of skin condition
- Increased redness, swelling, or pain at application site
- Development of pus or signs of infection
- Skin thinning, easy bruising, striae (stretch marks)
- Increased hair growth at application site
- Acne-like eruptions
- Changes in vision (rare, with systemic absorption)
- Unusual fatigue or weakness (rare, with systemic absorption)
Special Patient Groups
Pregnancy
Use during pregnancy should only be considered if the potential benefit justifies the potential risk to the fetus. Category C.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenicity with high doses of systemic corticosteroids; topical absorption is generally low but caution advised.
Second Trimester:
Generally considered safer than first trimester, but still use with caution and limit duration/area.
Third Trimester:
No specific risks identified beyond general corticosteroid effects; HPA axis suppression in neonate is theoretical with extensive maternal use.
Lactation
Use with caution. It is not known whether topical corticosteroids are excreted in human milk. Systemic corticosteroids are excreted in breast milk. Avoid applying to the breast area to prevent infant ingestion.
Infant Risk:
Low risk with limited topical use; potential for adverse effects if significant systemic absorption occurs in mother or if applied directly to breast and ingested by infant.
Pediatric Use
Pediatric patients 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, growth retardation). Use the least potent effective corticosteroid for the shortest duration possible. Avoid occlusive dressings.
Geriatric Use
No specific dosage adjustments are generally needed. However, geriatric patients may have thinner skin, which could potentially increase systemic absorption. Monitor for adverse effects.
Clinical Information
Clinical Pearls
- Topical triamcinolone spray is useful for hairy areas or large body surface areas where creams/ointments are difficult to apply.
- Instruct patients to spray lightly and briefly; excessive spraying does not increase efficacy and can increase systemic absorption.
- Warn patients about potential for skin atrophy, especially with prolonged use or on sensitive areas like the face or skin folds.
- If no improvement is seen after 2 weeks, re-evaluate diagnosis and treatment plan.
- Avoid use on infected skin without concomitant antimicrobial therapy.
Alternative Therapies
- Other topical corticosteroids (e.g., hydrocortisone, betamethasone, clobetasol, fluocinonide) of varying potencies.
- Topical calcineurin inhibitors (e.g., tacrolimus, pimecrolimus) for steroid-sparing therapy.
- Emollients and moisturizers for dry skin conditions.
- Antihistamines for pruritus.
Cost & Coverage
Average Cost:
$30 - $100 per 63gm spray can
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 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 emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it occurred.