1649
needed during the course of treatment. A dose of 1 to mg Triamcinolone Hexacetonide 4 may be used for visualisation during vitrectomy. (BAN, USAN, riNN) ® For doses used in children, see below. Other esters of triamcinolone that have occasionally been used include the acetonide dipotassium phosphate, acetonide hemisuccinate, aminobenzal benzamidoisobuty rate, and benetonide. Flupamesone (triamcinolone aceto nide metembonate) has also been used.
Administration in children. Triamcinolone acetonide and hexacetonide have been used for intra-articular injec Ph. Eur. 8: tion in children. Although unlicensed in the UK for use (Triamcinolone). A white or almost white, in children under 6 years of age, the BNFC includes doses crystalline powder. It shows polymorphism. Practically for injection into larger joints in those aged from 1 to 18 insoluble in water and in dichloromethane; slightly soluble years. A dose of triamcinolone acetonide 2 mglkg may be in methyl alcohol. Protect from light. used, to a usual maximum of 40 mg, or triamcinolone USP 36: (Triamcinolone). A white or practically white, hexacetonide 1 mglkg to a usual maximum of 20 mg. odourless, crystalline powder. Very slightly soluble in water, However, higher doses have been used. Treatment may be in chloroform, and in ether; slightly soluble in alcohol and repeated for relapse if necessary, although each joint in methyl alcohol. Pharmacopoeias. In Bur. (see p. vii) and US. should usually be treated no more than 3 or 4 times in a year. Ph. Eur. 8: (Triamcinolone Hexacetonide). A white or In the treatment of allergic rhinitis triamcinolone almost white, crystalline powder. Practically insoluble in acetonide may be given by a nasal spray. Children aged 6 Triamcinolone Acetonide (BANM, rJNNMJ ® water; sparingly soluble in dehydrated alcohol and in to 12 years may be given 1 spray (55 micrograms) into each methyl alcohol. Protect from light. Acet (lido cte •'friamdno!Otm:. Trf�n•dnofor{ a�et (lld; nostril once daily. This dose may be increased to 2 sprays £ � USP 36: (Triamcinolone Hexacetonide). A white to cream Triarncinoiona, . &<;et(lpido .de; Triarncinolona<;etonld; Tri ( 110 micrograms) into each nostril once daily for control of de; coloured powder. Practically insoluble in water; soluble in am<:if1olone, .· t;cetonide. Tria(rldnoloni · �cet�mkl urni severe symptoms. The lowest effective dose should be used Triamdflolor1o <>cetcmi0nid; Tri;lm chloroform; slightly soluble in methyl alcohol. once symptoms have been controlled. In children aged from sinolon t;setonid:_. T(iamsinoloniasetonidi; rpvtaM!ilH!:!OilOHa 2 to 5 years, the recommended and maximum dose is Uses and Administration 55 micrograms into each nostril once daily. Triamcinolone is a corticosteroid with mainly glucocorticoid Asthma. Corticosteroids and beta2-adrenoceptor agonists activity (p. 1597.1); 4mg of triamcinolone is equivalent in form the cornerstone of the management of asthma (see anti-inflammatory activity to about 5 mg of prednisolone. It p. 1600.3). is used, either in the form of the free alcohol or in one of the Intramuscular triamcinolone acetonide has been esterified forms, in the treatment of conditions for which reported to be more effective than oral low-dose prednisone corticosteroid therapy is indicated (see p. 1597.3 ), except in controlling exacerbations in patients with severe, adrenocortical insufficiency for which hydrocortisone with chronic, life-threatening asthma, 1 although this conclusion supplementary fludrocortisone is preferred. is controversiai.2·7 The dose may be expressed in terms of the base, and the I. Ogirala RG, et a!. High-dose intramuscular triamcinolone in severe, Pharmacopoeias. In Chin., Bur. (see p. vii), Jpn, and US. following are each equivalent to about 10mg of triamcino chronic, life-threatening asthma. N Eng! J Med 1991; 324: 589-9. lone: Correction. ibid.; 1380. d 2. Salmeron S, et al. Intramuscular triamcinolone in severe asthma. N Eng! Chin. also inclu es Triamcinolone Acetonide Acetate. triamcinolone acetonide ll mg • J Med 1991; 325: 429-30. triamcinolone acetonide sodium phosphate 14 mg Ph. Eur. 8: (Triamcinolone Acetonide). A white or almost • 3. Nicholas SS. Intramuscular triamcinolone in severe asthma. N Eng! 1 Mfd triamcinolone diacetate 12 mg 1991; 325: 430. white, crystalline powder. It shows polymorphism. • triamcinolone hexacetonide 14 mg 4. Kidney JC, et al. Intramuscular triamcinolone in severe asthma. N Eng! J Practically insoluble in water; sparingly soluble in alcohol. • Med 1991; 325: 430. Protect frmn light. However, esterification generally alters potency and 5. Capewcll S, Mcleod DT. Intramuscular triamcinolone in severe asthma. compounds with equivalent triamdnolone content may N Eng! J Med 1991; 325: 430. USP 36: (Triamcinolone Acetonide). A white to cream not have equivalent clinical effect. 6. Ogirala RG, et al. Intramuscular triamcinolone in severe asthma. N Eng! J coloured crystalline powder, having not more than a slight For oral dosage triamcinolone is used in doses ranging Med 1991; 325: 431. odour. Practically insoluble in water; sparingly soluble in 7. Capewell S, McLeod D. Injected corticosteroids in refractory asthma. from 4 to 48 mg daily. Lancet 1991; 338: 1075-6. dehydrated alcohol. in chloroform, and in methyl alcohol. For parenteral use the acetonide ester is given in doses of Store at a temperature of 2 5 degrees, excursions permitted about 40 to 80 mg by intramuscular injection. It is between 15 degrees and 30 degrees. usually given as a suspension to provide a prolonged Chronic obstructive pulmonary disease. Inhaled corticos systemic effect. A single dose of 40 to 100 mg of the teroids may be used in chronic obstructive pulmonary dis acetonide may provide symptomatic control throughout the ease (see p. 1603.1). Triamcinolone Acetonide Sodium pollen season for hay fever sufferers (but see Rhinitis, Phosphate (BANM. USAN. rJNNMI ® p. 1650.1). The diacetate ester has also been given Eye disorders. Intravitreal injection of triamcinolone intramuscularly. acetonide has been tried in the management of eye disor CL-61 965; cL-106359; Fos�ato i.le sodio del ' atetol)ido de For intra-articular injection triamcinolone acetonide, ders characterised by oedema and the abnormal prolifera triamcinolona; triamcfnotona. acetonido de.fosfzitode sodio diacetate, and hexacetonide have all been used. Doses for tion of intra-ocular cells. Promising results have been del; Triamcinolone. Acetpnlde, . Phosphate Sodique de; these esters have typically been in the range of 2.5 to 40 mg, reported in diabetic macular oedema, L2 cystoid macular Triamcino!onl Acetonidi Natrici Phosphas; TpMaMu!'fHOnoHa depending upon the size of the joint injected. oedema, and oedema associated with retinal vein occlu 1\ceTOH�A& Ha;p11A Qoc<(>ar. For topical application in the treatment of various skin sion.2·5 It has also been used in age-related macular Triamcinokme aq;tooiel\';2hiispdium phosphThe symbol t denotes a preparation no longer actively marketed The symbol <8> denotes a substance whose use may be restricted in certain sports (see p. viii) 1650 Corticosteroids
3. van Kooij B, et at. The pros and cons of intravitreal triamcinolone 3. Dercndorf H, et al. Pharmacokinetics of triamcinolone acetonide after New Kenacombt; Irl. : Kenacombt; Ledennix; Israel: Derma injections for uveitis and inflammatory cystoid macular edema. Ocul intravenous, oraL and inhaled administration. J Clin Pharmacol 1995; 35: combin; Ledermix; Oracort E; Pevisonet; Ital. : Assocortt; lmmunol lnflamm 2006; 14: 73-85. 302-5. Aureocort; Dermomycin Cart; Dirahist; Kataval; Pevisone; 4. Jonas JB. Intra\itreal triamcinolone acetonide: a change in a paradigm. 4. Argenti D, et al. A mass balance study to evaluate the biotransformation 2006; 38: 218-45. and excretion of [14C]-triamcinolone acetonide following oral Malaysia: Aecoras; Ecocort; Econazine; Endix; Kenacomb; 5. S, et a!. Intravitreal steroids in the management of macular administration. J Clin Phannacol 2000; 40: 770-80. Kifugan; Oral�Aid; Mex. : Bidrozilt; Biotriamint; Kenacomb; 84: 722-33. Suitramc; Neth.: Mycologt; Trianal; Will-Anal; Norw.: Pevl� pressure alterations following intravitreal sane; NZ: Kenacomb; Viaderm-KC; Philipp.: Kenacombt; Nizo triamcinolone acetonidc. Br J Ophthalmol 2006; 90: 999-1003. Preparations ···············-·-····· lex; Oticorn; Pevisone; Pol. : Pevisone; Polcortolon TC; Tria 7. Jonas JB. Effects of triamcinolone acetonide injections with and without comb; Port.: Localone; Pevisone; S.Afr. : Kenacombt; Pevisone; preservative. Br J Ophthalmol 2007; 91: 1099-1101. Proprietary Preparations (details are given in Volume B) 8. Garcfa-ArurniJ, et a!. Comparison ofdifferent techniques fur purification Trialonet; Singapore: Ecocort; Econazine; Epiderm; Oracon E; of triamcinolone acetonide suspension for intravitreal use. Br J Single·ingredient Prepara6ons. Arg.: Fortcinolona; Glytop; Oral Aid; Pevisone; Spain: Aldoderma; Anasilpielt; Ansa; Ophtha!mol 2005; 89: 1112-14. Kenacort-A; Kenacort; Ledercort; Nasacort; Triamciterap; Cemalyt; Cremsolt; Flutenal Gentamidnat; Flutenal Salit; Triampoen; Austral.: Aristocort; Kenacort-A; Kenalog in Interderm; Nesfare; Positon; Swed. : Kenacombin Novumt; Haemangioma. For reference to the use of a mixture of Orabase; Telnase; Tricortone; Austria: Nasacort; Solu-Volon A; Kenacort-T compt; Pevisone; Switz.: Kenacort-A; Ledermix; triamcinolone and betamethasone for intralesional injec Volon A; Volon; Belg. : Albicort; Delphi; Kenacort-A; Braz. : Air Pevisone; Thai. : Dennacombin; Ecocort; Ecoderm; Econazine; tion of haemangioma, see p. 1605.3. din; Azmacortt; Nasacort; Omcilon-A Orabase; Ondcrem-A; Fungisil-T; KA-Cilonet; Kelaplus; Kenacombt; Lymarin; Tara� Oncileg A; Theracort; Triancii; Canad.: Aristocort; Aristospan; Plus; Timi; Tricozole; Trimicon; Turk.: Aftogel; Ekze-Mant; Rhinitis. Triamcinolone is usedu in the management of Kenalog; Nasacort; Oracort; Triaderm; Chile: Kenacon�At; UAE: Panderrn; UK: Aureocort; Ledennix; Ukr. : Trimistin ('iiJJ'f'l); }jjt'f'5/:i!i allergic rhinitis (p. 612.1). However, the use of depot Nasacort; China: A Sai Song Kenacort-A ( (TpHMHCTHH); USA : Myco�Biotic II; Myco-Triacet II; Mycogen II; Jiffl5/: injections of triamcinolone to n1anage seasonal allergic A); Kenalog (}jfti'JJ'); Nincort (i'!Ji); Xing Rui Ke (l!!. ); Mycolog-Il; Myconel; NGT; Tri-Statin II; Venez. : Kenacomb; Zhen De Cz.: Nasacortt; Triamdnolon; Denm.: Kenalog; rhinitis has been deemed unacceptable by some. 3 (Ii{�); Kenalog. Lederspan; Nasacort; Fin.: Aftab; Kenacort-Tt; Lederspan; I. Jeal W, Faulds D. Triamcinolone acetonide: a review of its pharmacol Nasacort; Fr.: Hexatrione; Kenacort; Nasacort; Ger.: Aftab; Del Used as an adjunct in:. Rus.: Prodetoxon (ITpo.ueToKcoH). ogical properties and therapeutic efficacy in the management of allergic phicort; Kortikoid�ratiopharm; Lederlon; Linolacort Triam; rhinitis. Drugs 1997; 53: 257-80. Pharmacopoeial Preparations Nasacortt; Polconolon N; Rhinisan; Triam; TriamCreme; Triam 2. Gawchik SM, Saccar CL. A risk-benefit assessment of intranasal BP 2014: Triamcinolone Acetonide Injection; Triamcinolone triamcinolone acetonide in allergic rhinilis. Drng Safety 2000; 23: 309- galen; Triamhexalt; TriamSalbet; Volon A; Volon; Volonimat Acetonide Nasal Spray; Triamcinolone Cream; Triamcinolone 22. N; Volonimat; Gr.: Forlion; Kenacort-A; Kenacort; Nasacort; Hexacetonide Injeaion; Triamcinolone Ointment; Triamcino 3. Anonymous. Any place for depot triamcinolone in hay fever? Drng Ther Nasatrim; Senciderm; Triamcinal; Hong Kong: Aftach; Aristo; lone Oromucosal Paste; Triamcinolone Tablets; Bull 1999; 37: l7-18. Dermacort; IUlobetasol Propionate (r!NNMJ associated with intravitreal use of triamcinolone see under ® Tricort; Pol. : Polcortolon; Port. : Aftach; Nasacort; Rus.: Berlicort .BMY-30056; . CGF'; Eye Disorders, p. 1649.3. (EepJIMKOpT)f; Ftorocort (TopoKopT); Kenalog (Kemmor); Pol J 4A 58; 6-a'fluotoclobetasol cortolon (llolThKOpToJioH); Polcortolon (IIonnKopToJioH); Polcorto Ha.lobetasot · Propior;ate . ltiSANl; Propionato .de uic>bEota;;o!; Hypersensitivity. Local reactions to topical triamcinolone lon TC (llonnKopToJioH TC); Triacon (TpMaKopT); S.Afr.: Kenalog L.Jiogetasol, propiona:e d"; \Jlob;;tasol, P'()Pit>nato preparations have been attributed to the content of ethyle in Orabase; Nasacor; Singapore: Dermacortt; Kenalog in Ul betascJii Propionas; Yno6era3ona flpomMUlobetasol propionate is a corticosteroid that is used Triesence; Trilog; Trivaris; Venez.: Kenacort; Nasacort. topically for its glucocorticoid activity (p. 1597.1) in the The interactions of corticosteroids in general are described treatment of various skin disorders. It is usually used as a on p. 1619.3. Multi-ingredient Preparations. Arg.: Bagovit A Plus; Biotaer cream or ointment containing 0.05%. Nasalt; Kenacomb; Mantus; Sorsis; Austral.: Kenacomb; Oto When applied topically, particularly to large areas, when Pharmacokinetics comb Otic; Austria: Aureocort; Pevisone; Volon A antibiotika the skin is broken, or under occlusive dressings, haltigt; Volon A Tinktur; Belg.: Mycolog; Pevisonet; Trianal; corticosteroids may be absorbed in sufficient amounts to For a brief outline of the pharmacokinetics of corticoster Braz.: Londerm-Nt; Mud; Neolon D; Omcilon-A M; Ondbel; cause systemic effects (p. 1615.3). The effects of topical oids, see p. 1620.3. Oncileg; Onciplust; Canad.: ratio-Triacomb; Viaderm�KC; corticosteroids on the skin are described on p. 1617.3. For Triamcinolone is reported to have a half-life in plasma of China: An Long (_��);Fu Yan Ning Ji Bai Fu (Effi recommendations concerning the correct use of corticoster about 2 to over 5 hours. It is bound to plasma albumin to a Kenacomb (:11::1J}jjtf1JJ5t:f\l); Pevisone YiFuQing �); oids on the skin, and a rough guide to the clinical potencies much smaller extent than hydrocortisone. Zhaohuile Cz.: Triadermt; Triamcinolon E; (.fia."/l';i]!l); (ljiJlifij:Jf,); of topical corticosteroids, see P- 1599.2. The acetonide, diacetate, and hexacetonide esters of Triamcinolon S; Triamcinolon; Denm.: Kenalog Camp med triamcinolone are only very slowly absorbed from injection Mycostatint; Pevison; Pevisonet; Fin.: Pevisone; Fr.: Cider sites. mext; Kenalcolt; Localone; Pevisone; Ger.: Epipevisone; Leder Preparations mix; Moronal Vt; Mykoproct sinet; Volon A Tinktur N; Volon Triamcinolone crosses the placenta. Proprietary Preparations (details are given in Volume B) References to the pharmacokinetics of triamcinolone and A-Schuttelmix; Volonimat Plus Nt; Gr.: Bioderm; Biofiloderm; Dermochrom; Kenacomb; Olamyc; Pevison; Hong Kong: Ansa; its esters. Single-ingredient Preparations. Canad.: Ultravate; India: Halobe Antidermt; Centacomb; Clotrinolon; Dermawellt; Ecocort; In ta; Halostrol; Halovate; Hobs; USA: Halonate; Ultravate. I. MOllmann H, et al. Pharmacokinetics of triamcinolone acetonide and its quadeicren; Kenacombt; Ledermix; Oragesic; Pevisone; Tri phosphate ester. Bur J Clin Pharmacal 1985; 29: 85-9. 2. Derendorf H, et al. Pharmacokinetics and pharmacodynamics of Gelt; Triacombt; Triamecon; Triconazole; Triditol-G; Hung. : Multi-ingredient Preparations. India: Halostrol-F; Halostrol-M; glucocorticoid suspensions after intra-articular administration. Clin Alkcema; Polcortolon TCt; India: Daktarin-T; Exsora; Kena Halovate-F; Halovate·S; Hobs-S; USA: Halac Kit. Pharmacal Ther 1986; 39: 313-17. cornb; Kenalog-S; Ledercort-N; Micolon; Indon.: Kenantistt;
All cross� references refer to entries in Volume A