More from Cenolon
Other strengths and forms by Incepta Pharmaceuticals Ltd.
Indications & Uses
Cenolon is indicated for:
Pharmacology
Triamcinolone acetonide is a white to cream-coloured crystalline powder. It has no more than a slight odour, is practically insoluble in water and is very soluble in alcohol. It is a synthetic glucocorticoid corticosteroid with anti-inflammatory action. This formulation is suitable for intramuscular and intra-articular use only.
Glucocorticoids, both natural and synthetic, are adrenocortical steroids that are readily absorbed from the gastrointestinal tract. The naturally occurring ones, such as hydrocortisone, also have salt-retaining properties and are used as replacement therapy in adrenocortical deficiency states. Synthetic analogues such as triamcinolone are used mainly for their anti-inflammatory effects in disorders affecting many organ systems.
Triamcinolone injection has a long-lasting effect that may be sustained over several weeks. Studies show that after a single intramuscular dose of 60 mg to 100 mg of triamcinolone acetonide, adrenal suppression occurs within 24 to 48 hours. The adrenal glands then gradually return to normal, usually in 30 to 40 days. This finding matches the long duration of therapeutic action that the drug provides.
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.
Pregnancy & Breastfeeding
Pregnancy Category C. In animal studies, corticosteroids have been shown to cause birth defects when given at doses equivalent to those used in humans. For this reason, corticosteroids should be used during pregnancy only if the expected benefit to the mother outweighs the potential risk to the unborn baby. Corticosteroids taken systemically can pass into breast milk and may slow a nursing infant's growth, affect the body's natural corticosteroid production, or cause other unwanted effects. Corticosteroids should therefore be used with caution in breastfeeding mothers.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Pediatric Use: Premature and low-birth-weight infants, and patients who receive high doses, may be more likely to develop toxicity with triamcinolone acetonide.
Geriatric Use: Studies and other clinical experience have found no overall difference in safety or effectiveness between elderly and younger patients, and no difference in how they respond. Even so, some older people may be more sensitive to the medicine, and this cannot be ruled out.
Overdose
Triamcinolone Acetonide, when applied to the skin, can be absorbed in large enough amounts to cause effects on the whole body. These include mild, reversible suppression of adrenal function, ecchymoses of the skin (bruising), peptic ulceration, hypertension and aggravation of infection. Hirsutism, acne, edema and muscle weakness can also occur.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Triamcinolone Acetonide at controlled room temperature, 20-25°C. Don't let it freeze, and protect it from light.
Drug Interactions
Common questions about Cenolon 55 mcg
What is Cenolon 55 mcg Nasal Spray?
Cenolon 55 mcg Nasal Spray is a medicine that contains Triamcinolone Acetonide. It is made by Incepta Pharmaceuticals Ltd. It belongs to the Corticosteroid group of medicines.
What is Cenolon used for?
Cenolon is used for: Allergic Rhinitis.
What are the side effects of Cenolon?
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.
Can I take Cenolon during pregnancy or while breastfeeding?
Pregnancy Category C. In animal studies, corticosteroids have been shown to cause birth defects when given at doses equivalent to those used in humans. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Cenolon?
Triamcinolone Acetonide, when applied to the skin, can be absorbed in large enough amounts to cause effects on the whole body. These include mild, reversible suppression of adrenal function, ecchymoses of the skin (bruising), peptic ulceration, hypertension and aggravation of infection. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Cenolon?
Keep Triamcinolone Acetonide at controlled room temperature, 20-25°C. Don't let it freeze, and protect it from light.
Can I take other medicines with Cenolon?
Some medicines can interact with Triamcinolone Acetonide, for example: Cyclosporine, Carbamazepine, Phenytoin, Isoniazid, Rifampicin, Aspirin. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Cenolon?
Cenolon is a prescription (Rx) medicine. Take it as your doctor advises.