Triamsic Ointment

Indications

Triamcinolone acetonide is a steroid used in several forms:

• Injection into a joint or soft tissue: painful, swollen joints in arthritis, bursitis and tendon inflammation
• Injection into muscle: severe allergies, asthma, skin conditions and other inflammatory conditions when tablets are not suitable
• Injection into the skin: keloid scars, patches of hair loss (alopecia areata) and some thick skin patches
• Cream or ointment: eczema, dermatitis and psoriasis
• Oral paste: mouth ulcers
• Nasal spray: allergic rhinitis (hay fever)

How It Works

Triamcinolone is a long-acting corticosteroid. It calms an overactive immune response and reduces inflammation, swelling, redness and itching where it is applied or injected.

Dosage and Administration

• Injections: given by a doctor or nurse, as prescribed. Injections into muscle are spaced weeks apart, and joint injections are not repeated too often.
• Cream or ointment: apply a thin layer to the affected skin two or three times a day, for the shortest time needed.
• Oral paste: dab a small amount onto the ulcer without rubbing, usually at bedtime and, if needed, two or three times a day after meals. See a doctor if the ulcer has not healed in about a week.
• Nasal spray: as on the label or as advised.

Interactions

• Ketoconazole, Itraconazole, Clarithromycin and Ritonavir can raise steroid levels and side effects.
• Painkillers such as Ibuprofen and Aspirin increase the risk of stomach ulcers with injected steroid.
• It can raise blood sugar, so diabetes medicines may need adjusting.
• Diuretics (water tablets) may increase the risk of low potassium.
• Live vaccines should be avoided after high-dose injections unless the doctor agrees.

Contraindications

• Allergy to triamcinolone or any ingredient of the product
• Injection: untreated serious infection, or an infected joint or skin at the injection site; it must never be given into a vein
• Cream: untreated bacterial, fungal or viral skin infections such as cold sores, chickenpox or ringworm, and acne or rosacea
• Oral paste: fungal, viral or bacterial infections of the mouth or throat

Side Effects

Injection: pain at the site, thinning, dimpling or lighter colour of the skin where injected, facial flushing, a short flare of joint pain, raised blood sugar, trouble sleeping, mood changes and period changes. Repeated or long-term use can cause weight gain, thinning bones and eye problems. Cream: thinning skin, stretch marks and visible small blood vessels with long use.

Get urgent medical help if there is swelling of the face, lips or throat, difficulty breathing, a hot, red and very painful joint or fever after an injection, severe stomach pain or black stools, sudden vision changes, or severe mood changes.

Pregnancy and Lactation

Injections should be used in pregnancy only if the doctor decides they are needed. Short-term use of cream on small areas is generally acceptable. Small amounts may pass into breast milk; injections while breastfeeding need a doctor's advice, and cream should not be applied to the breast.

Precautions and Warnings

• Tell the doctor about diabetes, high blood pressure, stomach ulcer, thin bones, glaucoma, tuberculosis or any current infection.
• Do not use the cream on the face, under bandages or on large areas for long unless the doctor advises.
• Use in children only as prescribed, as growth can be affected.
• After high doses, avoid contact with chickenpox or measles if not immune, and see a doctor if exposed.

Overdose

A single extra dose of cream, paste or injection is unlikely to cause serious harm. Too much over a long time can cause steroid side effects such as high blood sugar, high blood pressure, swelling and weakness, and can reduce the body's own steroid production. Seek medical advice.

Therapeutic Class

Corticosteroid (glucocorticoid).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Do not freeze the injection.