triamcinolone (topical)

Absorption: Minimal Prolonged use on large surface areas or large amounts applied or use of occlusive dressings may increase systemic absorption.

Distribution: Remains primarily at site of action.

Metabolism/Excretion: Usually metabolized in skin.

Half-Life: 2–>5 hr (plasma), 18–36 hr (tissue); adrenal suppression lasts 2.25 days.

Time/Action Profile ⬆ ⬇

(response depends on condition being treated)

ROUTE	ONSET	PEAK	DURATION
Topical	min–hrs	hrs–days	hrs–days

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity or known intolerance to corticosteroids or components of vehicles (ointment or cream base, preservative, alcohol);
Untreated bacterial or viral infections.

Use Cautiously in:

Hepatic dysfunction;
Diabetes mellitus, cataracts, glaucoma, or tuberculosis (use of large amounts of high-potency agents may worsen condition);
Patients with pre-existing skin atrophy;
Pregnancy, lactation, or children (chronic high-dose usage may result in adrenal suppression in mother, growth suppression in children; children may be more susceptible to adrenal and growth suppression).

Adv. Reactions/Side Effects ⬆ ⬇

Derm: allergic contact dermatitis, atrophy, burning, dryness, edema, folliculitis, hypersensitivity reactions, hypertrichosis, hypopigmentation, irritation, maceration, miliaria, perioral dermatitis, secondary infection, striae

Misc: adrenal suppression (use of occlusive dressings, long-term therapy)

Interactions ⬆ ⬇

Drug-drug:

None significant.

Route/Dosage ⬆ ⬇

(Adults ): Apply to affected area(s) 3–4 times daily (depends on product, preparation, and condition being treated).
(Children ): Apply to affected area(s) 1–2 times daily (depends on product, preparation, and condition being treated).

Availability ⬆ ⬇

(Generic available)

Cream: 0.025%; 0.1%; 0.5%
Ointment: 0.025%; 0.1%; 0.5%
Lotion: 0.025%; 0.1%
Spray: 2 sec/sprayRx
In combination with: In combination with: acetic acid, antifungals, anti-infectives, antihistamines, urea, and benzoyl peroxide in various otic and topical preparations. See Appendix [not included in this PDA edition].

Assessment ⬆ ⬇

Assess affected skin prior to and daily during therapy. Note degree of inflammation and pruritus. Notify physician or other health care professional if symptoms of infection (increased pain, erythema, purulent exudate) develop.

Lab Test Considerations:

Periodic adrenal function tests may be ordered to assess degree of hypothalamic-pituitary-adrenal (HPA) axis suppression in chronic topical therapy if suspected. Children and patients with dose applied to a large area, using an occlusive dressing, or using high-potency products are at highest risk for HPA suppression.
- May cause increased serum and urine glucose concentrations if significant absorption occurs.

Implementation ⬆ ⬇

Choice of vehicle depends on site and type of lesion. Ointments are more occlusive and preferred for dry, scaly lesions. Creams should be used on oozing or intertriginous areas, where the occlusive action of ointments might cause folliculitis or maceration. Creams may be preferred for aesthetic reasons even though they may be more drying to skin than ointments. Lotion is useful in hairy areas.
Apply ointment or cream sparingly as a thin film to clean, slightly moist skin. Wash hands immediately after applicaiton. Apply occlusive dressing only if specified by physician or other health care professional.
- Apply lotion to scalp by parting hair and applying a small amount to affected area. Rub in gently. Protect area from washing, clothing, or rubbing until medication has dried. Hair may be washed as usual but not right after applying medication.
- Use aerosols by shaking well and spraying on affected area, holding container 3–6 in. away. Spray for about 2 sec to cover an area the size of a hand. Do not inhale. If spraying near face, cover eyes.

Patient/Family Teaching ⬆ ⬇

Instruct patient on correct technique of medication administration. Emphasize importance of avoiding the eyes. If a dose is missed, it should be applied as soon as remembered unless almost time for the next dose.
Caution patient to use only as directed. Avoid using cosmetics, bandages, dressings, or other skin products over the treated area unless directed by health care professional.
Advise parents of pediatric patients not to apply tight-fitting diapers or plastic pants on a child treated in the diaper area; these garments work like an occlusive dressing and may cause more of the drug to be absorbed.
Caution women that medication should not be used extensively, in large amounts, or for protracted periods in patients who are pregnant or planning to become pregnant.
Advise patient to consult health care professional before using medicine for condition other than indicated.
Instruct patient to inform health care professional if symptoms of underlying disease return or worsen or if symptoms of infection develop.

section name header

Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇