Indications & Uses
Triamsic is indicated for:
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
General Dosage: The initial dose of Triamcinolone injection may vary from 2.5 mg to 100 mg per day, depending on the specific disease being treated. However, in certain overwhelming, acute, life-threatening situations, doses exceeding the usual range may be justified. Dosage requirements vary and must be individualised according to the disease under treatment and the patient's response. Administration: Strict aseptic technique is mandatory. The vial should be shaken before use to ensure a uniform suspension. Before withdrawal, the suspension should be inspected for clumping or a granular appearance (agglomeration). Systemic Dosage: The suggested initial dose is 60 mg, injected deeply into the gluteal muscle. Atrophy of subcutaneous fat may occur if the injection is not given properly. The dose is usually adjusted within the range of 40 mg to 80 mg, depending on the patient's response and the duration of relief. However, some patients may be well controlled on doses as low as 20 mg or less. Pediatric patients: The range of initial doses is 0.11 to 1.6 mg/kg/day, given in 3 or 4 divided doses. Administration: For systemic therapy, the injection should be made deeply into the gluteal muscle. For adults, a minimum needle length of 11/2 inches is recommended. In obese patients, a longer needle may be required. Use alternative sites for subsequent injections. Local Dosage: Intra-articular administration: A single local injection of Triamcinolone Acetonide is often sufficient, but several injections may be needed for adequate relief of symptoms. Initial dose: 2.5 mg to 5 mg for smaller joints and 5 mg to 15 mg for larger joints, depending on the specific disease being treated. For adults, doses of up to 10 mg for smaller areas and up to 40 mg for larger areas have usually been sufficient. Single injections into several joints, up to a total of 80 mg, have been given. Administration: For treatment of joints, the usual intra-articular injection technique should be followed. If an excessive amount of synovial fluid is present in the joint, some, but not all, should be aspirated to help relieve pain and to prevent undue dilution of the steroid.
Side Effects
The following side effects may occur with corticosteroid therapy: Allergic reactions: anaphylactoid reaction, anaphylaxis and angioedema. Cardiovascular: bradycardia (slow heart rate), cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, fat embolism, hypertension, tachycardia (fast heart rate), thromboembolism, thrombophlebitis and vasculitis. Dermatologic: acne, allergic dermatitis, cutaneous and subcutaneous atrophy, dry scaly skin, purpura, rash, sterile abscess, striae (stretch marks), suppressed reactions to skin tests, thin fragile skin, thinning scalp hair and urticaria (hives). Endocrine: decreased carbohydrate and glucose tolerance, development of a cushingoid state, glycosuria, hirsutism, hypertrichosis, increased requirements for insulin or oral hypoglycemic agents in diabetes, manifestations of latent diabetes mellitus, menstrual irregularities, secondary adrenocortical and pituitary unresponsiveness, and suppression of growth in pediatric patients. Fluid and electrolyte disturbances: congestive heart failure in susceptible patients, fluid retention, hypokalemic alkalosis, potassium loss and sodium retention. Gastrointestinal: abdominal distention, bowel/bladder dysfunction, elevation in serum liver enzyme levels, hepatomegaly, increased appetite, nausea, pancreatitis, peptic ulcer with possible perforation and hemorrhage, perforation of the small and large intestine, and ulcerative esophagitis. Metabolic: negative nitrogen balance due to protein catabolism. Musculoskeletal: aseptic necrosis of the femoral and humeral heads, calcinosis, Charcot-like arthropathy, loss of muscle mass, muscle weakness, osteoporosis, pathologic fracture of long bones, post-injection flare, steroid myopathy, tendon rupture and vertebral compression fractures. Neurologic/Psychiatric: convulsions, depression, emotional instability, euphoria, headache, increased intracranial pressure with papilledema (usually following discontinuation of treatment), insomnia, mood swings, neuritis, neuropathy, paresthesia, personality changes, psychic disorders and vertigo. Arachnoiditis, meningitis, paraparesis/paraplegia and sensory disturbances have occurred after intrathecal administration. Ophthalmic: exophthalmos, glaucoma, increased intraocular pressure, posterior subcapsular cataracts, and rare instances of blindness associated with periocular injections.
Cautions & Contraindications
Warnings & Precautions
General: Cenolon, like many other steroid formulations, is sensitive to heat. It should therefore not be autoclaved when the exterior of the vial needs to be sterilised. The lowest possible dose of corticosteroid should be used to control the condition being treated. When a reduction in dosage is possible, the reduction should be gradual. Because the complications of glucocorticoid treatment depend on the size of the dose and the duration of treatment, a risk/benefit decision must be made in each individual case regarding dose, duration of treatment, and whether daily or intermittent therapy should be used. Cardio-renal: Since sodium retention with resultant oedema and potassium loss may occur in patients receiving corticosteroids, these agents should be used with caution in patients with congestive heart failure, hypertension or renal insufficiency. Endocrine: Drug-induced secondary adrenocortical insufficiency may be minimised by gradual reduction of dosage. This type of relative insufficiency may persist for months after therapy is discontinued; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Because mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently. Gastrointestinal: Steroids should be used with caution in active or latent peptic ulcers, diverticulitis, fresh intestinal anastomoses, and nonspecific ulcerative colitis, since they may increase the risk of perforation. Intra-articular administration: Corticosteroids injected into a joint may be absorbed systemically. Appropriate examination of any joint fluid present is necessary to exclude a septic process. Musculoskeletal: Corticosteroids decrease bone formation and increase bone resorption, both through their effect on calcium regulation (i.e. decreasing absorption and increasing excretion) and through inhibition of osteoblast function. Neuro-psychiatric: Psychic disturbances may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes and severe depression to frank psychotic manifestations. Existing emotional instability or psychotic tendencies may also be aggravated by corticosteroids. Ophthalmic: Intraocular pressure may become elevated in some individuals. If steroid therapy is continued for more than 6 weeks, intraocular pressure should be monitored.
Contraindications
Triamcinolone injection should not be used in anyone who is allergic to any of its ingredients. Corticosteroid preparations given by intramuscular injection should also not be used in people with idiopathic thrombocytopenic purpura.