Composition
Inj 10 mg/40 mg: Triamcinolone acetonide 10 mg/40 mg.
Indications & Dosage
Suppression of inflammatory and allergic disor-ders, rheumatic disease: BY DEEP IM INJ: Adults: Initial: 60 mg. Dose given for depot effect, to be administered into gluteal muscle; repeated at intervals according to patients response, 2.5-100 mg/day. lowest possible dose to be used. When reduction possible, reduce gradually Children: Initial: 0.11-1.6 mg/ kg/day in 3-4 divided doses; 6-12 yrs: Initial: 40 mg: 12-18 yrs: Initial: 60 mg. Lowest possible dose to be used; when reduction possible, reduce gradually. Hay fever/pollen asthma: Adults & Children above 12 yrs: 40-100 mg as a single injection per season. Multiple sclerosis (acute exacerbation): Adults & Children above 12 yrs: 160 mg/day for 1 week, followed by 64 mg every other day for one month. Intra-articular, intrabursal, tendon sheaths: Adults: Smaller joints: Initially 2.5-5 mg, may require up to 10 mg; larger joints: Initially 5-15mg, may require up to 40 mg. Max dose/treatment (several joints at one time): 20-80 mg. INTRADERMAL: Adults: Initial: 1 mg.
Administration
Intra-articular: The usual intra-articular technique should be followed. Care should be taken to ensure that the injection is made into tendon sheath rather than the tendon substance. Epicondylitis may be treated by infiltrating the preparation into the area of greatest tenderness. Intralesional: For treatment of dermal lesions, it should be injected directly into the lesions. IM: Shake IM suspension thoroughly before drawing it into syringe. The injection should be made deeply into the gluteal muscle. The minimum needle length of 1.5 inch is recommended, may be diluted with D5NS, D1ONS, or SWFI to a 1:1, 1:2 or 1:4 conc.
Stability
Store at 20C-25C. Protect from light. Avoid freez-ing. Do not autoclave when it is desirable to sterilize the exterior of the vial.
Contraindications
Systemic fungal infections unless specific anti-infective therapy is used, head injury, stroke.
Precautions
Active infections not controlled by antibiotics, latent or active amoebiasis, history of TB, septicaemia, symptoms may be masked, avoid or maintain extreme cautions in chickenpox, measles, psychiatric disorders, renal impairment, hepatic failure, cirrhosis, active peptic ulcer, myasthenia gravis, previous steroid myopathy, osteoporosis, epilepsy, hypothyroidism, diabetes, adrenal suppres-sion, hypertension, recent MI, congestive heart failure, thromboembolic disorders, glaucoma, corneal perforation. Withdraw gradually, withdrawal symp-toms may include fever, myalgia, arthralgia, rhinitis, itchy skin nodules and weight loss.
Interactions
Live vaccines or other vaccines, anticoagulants, hypoglycaemia agents, antihypertensives, diuretics, erythromycin, rifamycin, amphotericin, azole antifungals, ritonavir, cyclosporin, cardiac glycosides,Oestrogens including oral contraceptives, somatropin, Carbamazepine, phenytoin, primicane, barbiturates. Muscle relaxants, NSAIDs, salicylates, sympathomimetics, mifepristone, methotrexate, theophylline, aprepitant.
Pregnancy
Caution advised
Lactation
Caution advised
Side Effects
Endocrine irregularities including menstrual problems, cushingoid state, adrenal suppression, growth suppression in children, increased susceptibility to infection, increased severity of infection, fluid/electrolyte disturbance, hypertension, negative protein, nitrogen and calcium balance, myopathy, tendon rupture, osteoporosis, osteonecrosis and fractures, impaired wound healing, sweating, hirsutism, striae, telangiectasia, acne, GI disturbance, peptic ulceration, acute pancreatitis, candidiasis, psychiatric effects, neurological effects, insomnia, diabetes, impaired glucose tolerance, weight gain, increased appetite, ocular disturbances including cataracts, raised in-traocular pressure, optic nerve damage, corneal changes, glaucoma, thromboembolism, leukocytosis.