Generic Name and Formulations:
Triamcinolone hexacetonide 20mg/mL; susp for intra-articular inj; contains benzyl alcohol.
Adjunctive therapy for short-term administration in acute gouty arthritis, acute and subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, rheumatoid arthritis, synovitis of osteoarthritis.
Individualize. Average intra-articular dose: 2–20mg. Large joints: 10–20mg. Small joints: 2–6mg. Usual frequency of injection into a single joint is every 3–4 weeks.
See full labeling.
Idiopathic thrombocytopenic purpura (IM preparations).
Not for treatment of traumatic brain injury. Not for epidural use; serious neurologic events may occur. Concomitant systemic fungal infections, active ocular herpes simplex, cerebral malaria, live vaccines: not recommended. Latent or active amebiasis. Strongyloides infestation. Tuberculosis. If exposed to chickenpox or measles, consider prophylactic passive immune therapy. Recent MI. CHF. Hypertension. Renal insufficiency. Peptic ulcers. Diverticulitis. Intestinal anastomoses. Ulcerative colitis. Cirrhosis. Unstable or infected joints. Postmenopausal women (osteoporosis risk). Hypo- or hyperthyroidism. Supplement with additional steroids in physiologic stress. Emotional instability. Psychotic tendencies. Myasthenia gravis. Avoid abrupt cessation. Monitor thyroid, weight, growth, fluid, electrolyte balance and intraocular pressure (w. therapy >6 weeks). Infants (Gasping Syndrome). Pregnancy (Cat.C). Nursing mothers.
Potentiated by CYP3A4 inhibitors (eg, ketoconazole, macrolides), cyclosporine, estrogens. Antagonized by CYP3A4 inducers (eg, barbiturates, phenytoin, carbamazepine, rifampin), cholestyramine. May potentiate cyclosporine (seizure risk). May antagonize anticoagulants (monitor), isoniazid. Increased risk of arrhythmias with digitalis. May need to adjust dose of antidiabetic agents. Increased GI effects with aspirin, other NSAIDs. Monitor for hypokalemia with potassium-depleting drugs (eg, amphotericin B, diuretics). Concomitant neuromuscular blocking agents; increased risk of myopathy. Withdraw anticholinesterase agents at least 24hrs before initiating corticosteroid therapy. Aminoglutethimide may lead to loss of corticosteroid-induced adrenal suppression. May suppress reactions to skin tests.
HPA axis suppression, masks infection, increased susceptibility to infection, glaucoma, cataracts, secondary infections, hypokalemia, hypocalcemia, hypernatremia, hypertension, psychic disorders, myopathy, osteoporosis, peptic ulcer, dermal atrophy, increased intracranial pressure, carbohydrate and glucose intolerance, inj site reactions; Kaposi's sarcoma, anaphylactoid reactions.
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