Triamcinolone: What Is It? Uses, Side Effects, and Dosage
Allergies and autoimmune disorders are widespread in the United States, with approximately 50 million Americans suffering from some type of allergic reaction each year and 23.5 million people suffering from an autoimmune disorder. Unfortunately, incidences of both disorders are rising. Reactions to these disorders vary widely in severity and symptoms, but many can effectively be treated with steroid medications like triamcinolone. This widely-used, inexpensive medication is available in a variety of different forms that make it suitable for treating a huge range of conditions occurring on both an acute and chronic basis. With manufacturers producing numerous forms of the drug under both generic and brand names, triamcinolone is highly accessible and affordable for the majority of the population.
What Is Triamcinolone?
Triamcinolone is a synthetic glucocorticoid belonging to a class of drugs called corticosteroids, which imitates the natural steroid hormones your body produces. Triamcinolone comes in many different forms, including three topical forms (cream, lotion, and ointment), a nasal spray, a dental paste, and an injectable form. This medication is available in a wide variety of strengths and is sold under both generic and brand-name versions of the medication depending on the form of the drug used. Triamcinolone works by preventing the release of substances that cause inflammation, controlling inflammation, and calming overactive immune systems -- acting as an anti-inflammatory substance. The medication is commonly used to treat redness, itching, and swelling associated with allergic and autoimmune disorders and is FDA-approved.
What Is Triamcinolone Used to Treat?
Triamcinolone is considered a medium-to-high strength corticosteroid, so it is used for the treatment of persistent inflammation. The topical form of the medication is commonly used to treat redness, itching, skin infection, and swelling associated with allergic and autoimmune skin conditions, including:
- Seborrheic dermatitis
- Itching of the genital area
Triamcinolone can also be taken as a nasal spray, in an injectable form, or as a dental paste. When used internally, triamcinolone is used to treat the following:
- Rheumatoid arthritis
- Keloid scars
- Mouth injury and inflammation, including swelling and ulcers
- Cutaneous T-cell lymphoma
- Ulcerative colitis
- Breathing disorders
What Are Autoimmune Disorders?
Although triamcinolone is used to treat many different conditions, one of the most common applications of the medication is in the treatment of autoimmune disorders. Autoimmune disorders cause the body to unintentionally attack itself instead of fighting infections with the production of antibodies. Rather than attacking foreign diseases and infections, the antibodies attack their host body instead. More than 80 different autoimmune disorders have been identified, including Type 1 diabetes, rheumatoid arthritis, multiple sclerosis, and lupus. Autoimmune disorders have a variety of causes, but it is estimated that about one-third of the risk of developing an autoimmune disorder is genetic. Autoimmune disorders can also be caused by environmental triggers, like viruses and bacteria. People with one autoimmune disorder are statistically more likely to be diagnosed with another autoimmune disorder, and these conditions can affect just one part of the body, such as the skin or joints, or the entire body.
What Is the Cost of Triamcinolone?
Because triamcinolone is produced by a variety of manufacturers in both brand-name and generic forms and in a variety of strengths, it is relatively inexpensive. A 15-gram tube of cream ranges in price from about 3.29 dollars for 0.1 percent strength, while a tube of the same size at 0.5 percent strength would cost approximately 10 dollars. The triamcinolone ointment is similarly priced at the same amount and strength. A tube of triamcinolone paste is substantially more expensive, with five grams at 0.1 percent strength sold for approximately 27.88 dollars. Nasal spray costs approximately 15 dollars. Extremely large quantities of the medication at a very high strength can be expensive, but the medication is generally considered highly affordable. It is covered by many insurance plans.
What Are the Benefits of Using Triamcinolone?
There are many benefits of using triamcinolone, many of which are a direct result of the medication’s ability to treat many conditions. Triamcinolone is well-known by both medical professionals and patients because it has been in use for decades, so it is prescribed often and people are comfortable using it. The medication is used to treat many different conditions in a wide variety of forms and strengths, which has resulted in the drug being inexpensive. Many manufacturers produce both generic and brand-name forms of the drug, so you are likely to have one of the forms of the medication covered by your insurance company. If you do not have health insurance, triamcinolone is eligible for discounts under any pharmacy discount card program and is also affordable on a cash basis for most people.
How Do I Know What Dose of Triamcinolone to Take?
As with any medication, your doctor should direct you regarding the specific dosage of triamcinolone that is appropriate for the treatment of your medical condition. You should also read the drug information on any product before you use it. However, in general, the dosage of triamcinolone that is most commonly recommended depends on the form of the medication.
- Topical cream: Topical triamcinolone is typically applied between two and four times daily to the affected area and is most effective when applied to wet skin. The strength of topical triamcinolone ranges from 0.025 percent to 0.5 percent. Topical spray only comes in one strength, 0.147 mg/g.
- Dental paste: When used as a dental paste, triamcinolone is applied two to three times a day as a thin film on the injured area. However, the paste should not be rubbed in, as it will begin to crumble. Dental triamcinolone is most effective when used at bedtime.
- Injectable: The injectable form of triamcinolone comes in intramuscular, intra-articular, and intravitreal forms, all of which are given in a doctor’s office. Intramuscular injections are usually given as treatment for severe allergies, arthritis, or skin conditions that have not responded to topical treatment. A typical starting dose is between 40 and 80 mg. Intravitreal injections are given into the eye to treat eye inflammation at a starting dose of four mg. Intra-articular injections of triamcinolone are given into the joint and are typically used for osteoarthritis knee pain under the brand-name Zilretta. This dose is given as a 32 mg one-time dose.
- Nasal spray: Nasal spray doses of triamcinolone start with two sprays in each nostril once a day for adults and children twelve years of age and older. For children ages six to eleven, dosing begins with one spray in each nostril per day and can be raised to two times per day if needed. Children between the ages of two and five should use one spray in each nostril once per day.
Triamcinolone should be taken with food to prevent stomach upset, and patients should not stop using triamcinolone suddenly and avoid missed doses. Unpleasant withdrawal symptoms can occur. Your doctor should help you gradually reduce the dosage of your medication in order to prevent uncomfortable withdrawal symptoms. Patients taking triamcinolone or any steroid medication for long-term use should carry an ID card or wear a medical alert bracelet indicating that they receive steroid medications. It should be stored at room temperature.
Are There Any Side Effects I Should Be Aware of?
Because triamcinolone is available in a variety of different forms, side effects for the medication depend on how it is used. However, in general, common adverse effects associated with injectable triamcinolone include:
- Injection site reaction
- Joint swelling
- Blurred vision
- Diminished urination
- Irregular, fast, slow, or pounding heartbeat
- Mood changes
- Numbness or tingling in the extremities
- Pounding in the ears
- Shortness of breath
- Swelling of the extremities
- Trouble thinking, speaking or walking
- Troubled breathing at rest
- Weight gain
- Water retention
- Slow wound healing
- Changes in the shape or location of body fat
- Insomnia or trouble sleeping
Less frequently occurring serious side effects for injectable triamcinolone can occur. Seek medical attention immediately if you experience one or more of these side effects:
- Severe mood changes or depression
- Bloody or black, tarry stools
- Muscle weakness
- Very high blood pressure
- Fast heart rate
- Shortness of breath
- Blurred vision
- Severe headache
- Pancreatitis (inflammation of the pancreas) as indicated by symptoms including pain in the upper stomach area, nausea, or vomiting
- Low potassium (characterized by confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness, or a limp feeling)
- Side effects commonly associated with the topical form of triamcinolone may include the following:
- Blemishes on the skin
- Dry, scaly skin
- Increased hair growth
- Large, flat, blue, or purplish patches in the skin
- Redness of the skin
Are There Any Risks Associated with Triamcinolone?
In addition to the potential for side effects listed above, there are some risks associated with the use of triamcinolone. The medication as the potential to cause a life-threatening allergic reaction in some people, so you should call 911 immediately if you experience any of the following symptoms:
- Difficulty catching your breath or breathing
- Rash, hives, or swelling
- Difficulty swallowing or speaking
- Stomach pain, nausea, vomiting, or diarrhea
- Irregular heartbeat
- Cardiac arrest
If you have ever had a reaction to triamcinolone in the past, let your doctor know. Use of triamcinolone has been shown on occasion to delay growth in children when used for an extended period of time, so talk to your child’s doctor about the risks of using the medication.
Like other steroid medications, triamcinolone can weaken your immune system, making it more likely for you to get an infection or see an existing infection worsen. You should make your doctor aware of any recent illnesses or infections, and be sure to avoid exposure to people who are ill or who have infections when taking triamcinolone. While illnesses like chickenpox or the measles are typically mild in most people, those taking triamcinolone can experience serious and sometimes even fatal infections if exposed to these diseases. Call your doctor for preventative treatment right away if you believe you have been exposed to chickenpox or measles.
Because the medication can weaken your immune system, you should not receive a “live” vaccine while taking triamcinolone, as they may not work as well.
Who Should not Take Triamcinolone?
People who have recently been ill or had an infection or who have a current fungal infection should not take triamcinolone due to potential drug interactions. People with the following medical conditions should speak to their doctor before taking triamcinolone:
- Liver disease
- Kidney disease
- Thyroid disorder
- Previous incidence of malaria
- A muscle disorder such as myasthenia gravis
- Glaucoma or cataracts
- Herpes infection of the eyes
- Stomach ulcers, ulcerative colitis, or diverticulitis
- Depression or mental illness
- Congestive heart failure
- High blood pressure
Is Triamcinolone Safe for Pregnant and Nursing Women?
Triamcinolone is currently classified by the Food and Drug Administration as a Category C medication, meaning that it is not known whether triamcinolone will harm an unborn baby. Because the effects of triamcinolone on unborn babies are unknown, it’s important that women who are pregnant or planning to become pregnant speak with their doctors before taking triamcinolone. Triamcinolone has been shown to pass through breast milk and can harm a nursing baby; the drug can affect or delay growth in children so, therefore, you should not use it while you are breast-feeding.
How Do I Know if Triamcinolone Is Right for Me?
Triamcinolone is generally well-tolerated, but it is not right for everyone. Although the medication is widely considered safe, especially in its topical forms, any steroid medication is associated with potential risks due to the weakening of the immune system. Individuals with the health conditions mentioned above should not take triamcinolone, nor should nursing mothers. Triamcinolone is available in many forms and strengths to suit individuals' needs and treat a variety of conditions. While it is safe to use with some medications, steroid medications do interact with other medications and can diminish their effectiveness. You should get medical advice from your healthcare provider about any prescription drugs, over-the-counter medications, supplements, or herbs that you are taking prior to taking triamcinolone. Drugs known to interact with triamcinolone include:
- Aspirin, when taken daily or in high doses
- Diuretics, such as water pills
- Blood thinners
- Insulin or diabetes medications taken by mouth
- Seizure medications such as phenytoin or phenobarbital