Triamcinolone (Systemic)

• If you need to store this medicine at home, talk with your doctor, nurse, or pharmacist about how to store it.

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else's drugs.
• Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
• Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Check with your pharmacist about how to throw out unused drugs.
• Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about triamcinolone, please talk with your doctor, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about triamcinolone. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using triamcinolone.

Review Date: October 4, 2017

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Kit, Injection, as acetonide:

Arze-Ject-A: 40 mg/mL (3 x 1 mL) [contains benzyl alcohol, polysorbate 80]

P-Care K40: 40 mg/mL (1 x 1 mL) [contains benzyl alcohol, polysorbate 80]

P-Care K80: 40 mg/mL (2 x 1 mL) [contains benzyl alcohol, polysorbate 80]

Pod-Care 100K: 40 mg/mL (1 x 1 mL) [contains benzyl alcohol, polysorbate 80]

Pro-C-Dure 5: 40 mg/mL (2 x 1 mL) [contains benzyl alcohol, polysorbate 80]

Pro-C-Dure 6: 40 mg/mL (3 x 1 mL) [contains benzyl alcohol, polysorbate 80]

ReadySharp Triamcinolone: 40 mg/mL (1 x 1 mL) [contains benzyl alcohol, polysorbate 80]

Suspension, Injection, as acetonide:

Kenalog: 10 mg/mL (5 mL); 40 mg/mL (1 mL, 5 mL, 10 mL) [contains benzyl alcohol, polysorbate 80]

Suspension, Injection, as hexacetonide:

Aristospan Intra-Articular: 20 mg/mL (1 mL [DSC], 5 mL [DSC]) [contains benzyl alcohol]

Aristospan Intralesional: 5 mg/mL (5 mL [DSC]) [contains benzyl alcohol]

• Corticosteroid, Systemic

A long acting corticosteroid with minimal sodium-retaining potential. Decreases inflammation by suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability; suppresses the immune system by reducing activity and volume of the lymphatic system; suppresses adrenal function at high doses

Distribution

Vd: IV (acetonide): 99.5 L

Metabolism

Hepatic (Asare 2007)

Excretion

Urine (75% primarily); bile and feces (25%) (Asare 2007)

Pericarditis

The use of corticosteroids in the treatment of pericarditis remains controversial and dependent on the choice of steroid, dosing regimen, and route of administration. Current guidelines state that the use of intrapericardially administered corticosteroids is highly effective and circumvents common systemic adverse effects. Guidelines suggest this treatment should be restricted to certain types of pericarditis. At this time, intrapericardial administration of triamcinolone for autoreactive pericarditis has been shown to be an effective treatment in the prevention of recurrent symptoms and/or relapse of pericardial effusion. More clinical trials need to be conducted to determine whether intrapericardial administration of triamcinolone is effective for multiple types of pericarditis and to establish the best dose and/or dosing regimen for each type of pericarditis.

Refer to adult dosing.

Shake well before use to ensure suspension is uniform. Inspect visually to ensure no clumping; administer immediately after withdrawal so settling does not occur in the syringe. Do not administer any product IV or via the epidural or intrathecal route.

Acetonide:

Kenalog-10 injection: For intra-articular or intralesional administration only. When administered intralesionally, inject directly into the lesion (ie, intradermally or subcutaneously). One mL syringes with a 23- to 25-gauge needle are preferable for intralesional injections.

Kenalog-40 injection: For intra-articular, soft tissue or IM administration. When administered IM, inject deep into the gluteal muscle using a minimum needle length of 11/2 inches for adults. Obese patients may require a longer needle. Alternate sites for subsequent injections. Avoid IM injections into deltoid area.

Intrapericardial (off-label route): Triamcinolone hexacetonide: Instillation of triamcinolone suspension (diluted in 100 mL of warm [37°C] NS) may be administered as a slow injection over a 7F pigtail catheter introduced after periocardiocentesis; may be painful and appropriate analgesic premedication (eg, morphine) should be administered (Frasiolas 2010; Maisch 2002).

Hexacetonide: Dilute with a compatible solution prior to administration.

Aristospan (5 mg/mL): For intralesional or sublesional administration only; use a ≥23-gauge needle

Aristospan (20 mg/mL): For intra-articular and soft tissue administration only; use a ≥23-gauge needle

Ensure adequate intake of calcium and vitamins (or consider supplementation) in patients on medium-to-high doses of systemic corticosteroids.