Triamcinolone Acetonide side effects and drug information

Triamcinolone Acetonide is a medication that is intended to provide relief for skin inflammation, redness, dryness, and itching. This topical corticosteroid comes from a group of primarily synthetic steroids that work as an antipruritic and anti-inflammatory agents.

Trade NameKenalog, Nasacort
ChEMBL Id1451
ChemSpider ID29046
Protein Binding68%
CAS ID124-94-7
Molar Mass394.434 g/mol

Overview

This medication comes in the form of a cream, and 1mg of this drug is composed of cetyl alcohol, propylene glycol, polysorbate- 60, polysorbate- 80, purified water, glyceryl monostearate, cetyl esters wax, and isopropyl palmitate. It can also be availed in its generic version.

Side Effects

As in any other medication, Triamcinolone Acetonide may cause potential side effects. Some are common, while others are serious ones.

Its common side effects include:

  • Skin redness
  • Burning
  • Thinning of skin
  • Stretch marks
  • Itching
  • Irritation
  • Blistering skin
  • Excessive dryness
  • Peeling
  • Acne

Some serious side effects that it may cause are:

  • Blurred vision
  • Uneven heartbeats
  • Insomnia
  • Puffiness in the face
  • Seeing halos around lights
  • Mood changes
  • Weight gain
  • Fatigue

This topical cream comes in a tube and is available in 0.1% with strengths in 15g, 30g, and 80g. It is applied in the affected area for about 2 to 4x daily. After the cream has been applied, the affected area should not be covered unless instructed by the doctor.

Drug Interactions

Triamcinolone Acetonide may cause interactions with some cancer chemotherapy agents as well as other certain topical medications.

This drug should be used with caution in people who have eye conditions, infections, immune disorders, or circulatory disorders, also if using in children. For safety, it is best to avoid its usage when pregnant or breastfeeding.

Indication and Dosage

This medicine is usually applied by rubbing the cream gently to the affected area for 2 to 3x per day.

Occlusive Dressing Technique

This technique in treatment is used for managing psoriasis or other unmanageable conditions. When using an occlusive dressing technique, rub a small amount of cream gently into the lesion until the cream disappears then reapply it leaving a thin coating over the lesion. Then cover the treated area with a flexible and nonporous film. Seal the edges.

If you want more moisture, you may cover the affected area with a clean, damp cotton cloth prior to putting the nonporous film. Or you may also get the affected area a bit wet with water before putting on the cream. 

The number of times that the dressing needs to be changed depends on the person’s condition. Using this technique is best to be utilized at night, so you can let the dressing stay overnight, then remove it in the morning.

For every dressing change, make sure to reapply the cream. In case an infection develops, stop doing this technique and treat the infection using antibacterial or antifungal medications. 

Triamcinolone Acetonide is not meant to be used for the eyes.

Laboratory Tests

To evaluate HPA axis suppression, urinary free cortisol test, as well as the ACTH stimulation test, is performed.

Carcinogenesis, Mutagenesis, and Impairment of Fertility

Studies to evaluate whether this product is a health hazard when used along with hydrocortisone and prednisolone showed negative results.

Pregnancy

This drug can affect fetus development, which is why it is not advised to be used over an extended period on pregnant women, nor should it be used in big amounts. When recommending to a pregnant woman, the benefits must outweigh the possible risks of using this product.

Nursing Mothers

It is not known if through topical means the drug can be passed into the breast milk. Consult your healthcare provider if you are breastfeeding before using this medication like oxybutinin.

Pediatric Use

Young children who are using this product are more susceptible to topical corticosteroid-induced HPA axis suppression and Cushing’s syndrome than older patients. 

If children are using this medication, the smallest amount should be prescribed, as this may interfere with the child’s growth and development.

Warnings and Precautions

General:

Absorption of topical corticosteroids in the circulatory system has caused HPA axis suppression, Cushing’s syndrome, glucosuria, and hyperglycemia in some patients. These though, are reversible, and patients may recover as soon as the treatment is discontinued. 

These reactions may occur if the cream is applied over a large area, or if used at an extended period of time, or if the occlusive dressing is added to the treatment.

If this medication is to be used for a longer period, the patient needs to be assessed for symptoms of HPA axis suppression. If confirmed, or if the patient’s body temperature has risen, discontinue the treatment with Triamcinolone Acetonide. The doctor may also suggest lessening the frequency of the application, or a less potent alternative steroid may be substituted.

If the occlusive dressing technique is utilized, the patient may develop sensitivity to a certain occlusive dressing material or adhesive. If any of these happens, an alternative material may be used instead.

It is important to note that children are more prone to systemic toxicity.

Overdose and Contraindications

The topical application of corticosteroids may be absorbed in the circulatory system and may cause potential reactions.

Contraindications

This topical medication may cause adverse reactions to those with a history of hypersensitivity to this drug or any of its components.

Clinical Pharmacology

Topical corticosteroids have vasoconstrictive and antipruritic functions, though its anti-inflammatory action is still not clear. Several different laboratory methods are used to compare and predict its potencies, including vasoconstrictor assays.

There is some proof that there may be a correlation between vasoconstrictor potency and therapeutic efficacy in humans.

Pharmacokinetics

The use of corticosteroids topically may be absorbed even through intact and normal skin, but this possibility increases if there is an inflammation or other types of skin diseases. 

The use of occlusive dressing technique can greatly increase absorption through the skin, and once already absorbed, topical corticosteroids are then controlled through pharmacokinetic pathways. 

An occlusive dressing may be a great help as a complementary treatment of resistant dermatoses. 

Corticosteroids are eliminated through the kidneys and are metabolized mostly in the liver.

Medication Guide

  1. Use this medication exactly as prescribed.
  2. It should not be used for any other purposes other than for what it was intended for.
  3. The affected area treated with the cream should not be covered unless directed by the doctor.
  4. See your doctor for any symptoms of side effects.
  5. Caution its use when prescribed to a child.