See Supplemental Patient Information
- Deaths due to adrenal insufficiency have occurred in asthmatic patients during and after transfer from systemic corticosteroids to aerosolized steroids in recommended doses. Administer cautiously in patients who are transferred from systemically active corticosteroids to triamcinolone inhalation therapy
- Immediately resume systemic steroids during periods of stress or a severe asthmatic attack in patients who have been recently withdrawn from systemic corticosteroids
- Localized infections with Candida albicans have occurred infrequently in the mouth and pharynx during therapy. Suspend therapy and institute appropriate antifungal therapy in such conditions
- Children who are on immunosuppressant drugs are more susceptible to infections than healthy children. Chickenpox and measles can have a more serious or even fatal course in children receiving immunosuppressant doses of corticosteroids. If chickenpox develops, treatment with antiviral agents may be considered
- Therapy is not indicated for rapid relief of bronchospasm
- Bronchospasm may occur with an immediate increase in wheezing following therapy. If bronchospasm occurs during therapy, treat immediately with a fast-acting inhaled bronchodilator and discontinue triamcinolone
- Use with caution in patients already receiving prednisone treatment for any disease to avoid increase in HPA suppression
- Allergic conditions may get unmasked when patients are transferred from systemic steroid therapy to triamcinolone inhalation therapy
- Therapy may cause a reduction in growth velocity if used in pediatric patients
- During withdrawal from oral steroids, some patients may experience symptoms of systemically active steroid withdrawal such as joint/muscular pain, lassitude, and depression
- Suppression of HPA function has been reported in patients who received 4000 mcg/day of triamcinolone by oral inhalation and in certain patients who received recommended doses for as little as 6-12 wks
- Overdosage may cause hypercorticoidism and adrenal suppression
- Use with caution in patients with active or quiescent tuberculosis infection of the respiratory tract; untreated systemic fungal, bacterial, parasitic, or viral infections; or ocular herpes simplex
Cautions: Use cautiously in
- Diabetes or glaucoma
- Underlying immunosuppression
- Systemic corticosteroid therapy
Supplemental Patient Information
- Advise patients to promptly contact their physician if episodes of asthma which are not responsive to bronchodilators occur during the course of treatment
- Instruct patients to track their use of triamcinolone inhalation spray and to dispose of the canister after 240 actuations because effective dose delivery cannot be assured after 240 doses
- Caution patients receiving immunosuppressant doses of corticosteroids to avoid exposure to chickenpox or measles and to seek medical advice if exposed
Pregnancy Category:C
Breastfeeding: Safety unknown. The amounts of inhaled triamcinolone absorbed into the maternal bloodstream and excreted into breastmilk are probably too small to affect a breastfed infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 20 June 2011). Manufacturer advises caution.
