II. Indications

  1. Antiinflammatory and Immunosuppressant

III. Mechanism

  1. See Systemic Corticosteroid
  2. Triamcinolone is an intermediate duration Glucocorticoid
  3. Intermediate Glucocorticoid potency
  4. No mineralcorticoid activity

IV. Medications

  1. Non-Systemic Use (common)
    1. See Intra-articular Corticosteroid
    2. Topical Corticosteroid (Triamcinolone Acetonide, Kenalog)
    3. Intranasal Inhaler (Intranasal Triamcinolone)
    4. Inhaled Corticosteroid (Inhaled Triamcinolone, Azmacort)
      1. Azmacort was discontinued in the U.S. in 2016 with the CFC ban
  2. Systemic (rare systemic use in U.S)
    1. Triamcinolone (Aristocort, Kenalog)

V. Dosing: Adult

  1. General
    1. Systemic doses are listed for historical purposes (but has rare if any systemic use in the U.S.)
    2. In contrast, Triamcinolone is among the most commonly prescribed topical and intraarticular Corticosteroids
  2. Triamcinolone Oral: 4 to 48 mg orally daily
  3. Triamcinolone IM: 2.5 to 60 mg IM daily

VI. Adverse Effects

VII. Safety

  1. See Systemic Corticosteroid
  2. In pregnancy, use only if benefits outweigh risks to fetus
  3. Avoid in Lactation

VIII. Pharmacokinetics

  1. Intermediate Glucocorticoid potency
  2. Intermediate anti-inflammatory potency
  3. No Mineralocorticoid Activity
  4. Medium Half-Life

X. References

  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  2. Swadron and Hope in Herbert (2018) EM:Rap 18(9):16-8
  3. Dvorin (2020) Am Fam Physician 101(2): 89-94 [PubMed]
  4. Lane (1998) Endocrinol Metab Clin North Am 27:465-83 [PubMed]

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Related Studies

Cost: Medications

triamcinolone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
TRIAMCINOLONE 0.025% CREAM Generic $0.15 per gram
TRIAMCINOLONE 0.025% LOTION Generic $0.37 per ml
TRIAMCINOLONE 0.025% OINT Generic $0.07 per gram
TRIAMCINOLONE 0.05% OINTMENT Generic $0.53 per gram
TRIAMCINOLONE 0.1% CREAM Generic $0.15 per gram
TRIAMCINOLONE 0.1% LOTION Generic $0.33 per ml
TRIAMCINOLONE 0.1% OINTMENT Generic $0.12 per gram
TRIAMCINOLONE 0.1% PASTE Generic $3.81 per gram
TRIAMCINOLONE 0.147 MG/G SPRAY Generic $2.44 per gram
TRIAMCINOLONE 0.5% CREAM Generic $0.24 per gram
TRIAMCINOLONE 0.5% OINTMENT Generic $0.34 per gram
TRIAMCINOLONE 55 MCG NASAL SPR Generic OTC $0.78 per ml
TRIAMCINOLONE ACET 200 MG/5 ML Generic $6.67 per ml
TRIAMCINOLONE ACET 40 MG/ML VL Generic $5.86 per ml
TRIAMCINOLONE ACET 400 MG/10 ML Generic $4.40 per ml

Ontology: Triamcinolone (C0040864)

Definition (CHV) a kind of anti-inflammatory drug
Definition (NCI_NCI-GLOSS) A substance that is being studied for the prevention of nonmelanoma skin cancer. It is an anti-inflammatory drug that is applied to the skin to relieve irritation, rashes, and infections. It belongs to the family of drugs called topical corticosteroids.
Definition (NCI) A synthetic glucocorticoid with anti-inflammatory and immunomodulating properties. Upon cell entry, triamcinolone binds to and activates the glucocorticoid receptor, which leads to translocation of the ligand-receptor complex to the nucleus and induces expression of glucocorticoid-responsive genes such as lipocortins. Lipocortins inhibit phospholipase A2, thereby blocking the release of arachidonic acid from membrane phospholipids and preventing the synthesis of prostaglandins and leukotrienes, both mediators of inflammation. In addition, pro-inflammatory cytokine production, including interleukin (IL)-1and IL-6, and the activation of cytotoxic T-lymphocytes is also inhibited. T-cells are prevented from making IL-2 and proliferating. This agent also decreases the number of circulating lymphocytes, induces cell differentiation, and stimulates apoptosis through increasing Ikappa-B expression and curtailing activation of nuclear factor (NF)kappa-B.
Definition (MSH) A glucocorticoid given, as the free alcohol or in esterified form, orally, intramuscularly, by local injection, by inhalation, or applied topically in the management of various disorders in which corticosteroids are indicated. (From Martindale, The Extra Pharmacopoeia, 30th ed, p739)
Definition (CSP) synthetic glucocorticoid used in replacement therapy for adrenal insufficiency and as an anti-inflammatory and immunosuppressant in a variety of disorders.
Definition (PDQ) A synthetic glucocorticoid with anti-inflammatory and immunomodulating properties. Upon cell entry, triamcinolone binds to and activates the glucocorticoid receptor, which leads to translocation of the ligand-receptor complex to the nucleus and induces expression of glucocorticoid-responsive genes such as lipocortins. Lipocortins inhibit phospholipase A2, thereby blocking the release of arachidonic acid from membrane phospholipids and preventing the synthesis of prostaglandins and leukotrienes, both mediators of inflammation. In addition, pro-inflammatory cytokine production, including interleukin (IL)-1and IL-6, and the activation of cytotoxic T-lymphocytes is also inhibited. T-cells are prevented from making IL-2 and proliferating. This agent also decreases the number of circulating lymphocytes, induces cell differentiation, and stimulates apoptosis through increasing Ikappa-B expression and curtailing activation of nuclear factor (NF)kappa-B. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39275&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39275&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C901" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Steroid (T110)
MSH D014221
SnomedCT 325457006, 116594009, 6028009
LNC LP35873-6, MTHU018764
English Triamcinolone, Pregna-1,4-diene-3,20-dione, 9-fluoro-11,16,17,21-tetrahydroxy-, (11beta,16alpha)-, (11beta,16alpha)-9-Fluoro-11,16,17,21-tetrahydroxypregna-1,4-diene-3,20-dione, Triamcinolone [endocrine use], triamcinolone (medication), Triamcinolone [Chemical/Ingredient], Triamcinolone [endocrine use] (product), TRIAMCINOLONE, triamcinolone, Triamcinolone preparation, Triamcinolone (substance), Triamcinolone preparation (product), Triamcinolone [endocrine use] (substance), Triamcinolone preparation (substance)
Swedish Triamcinolon
Czech triamcinolon
Finnish Triamsinoloni
Russian KENAKORT, POL'KORTOLON, TRIAMTSINOLON, КЕНАКОРТ, ПОЛЬКОРТОЛОН, ТРИАМЦИНОЛОН
Japanese トリアムシノロン
Spanish triamcinolona (producto), preparado con triamcinolona (producto), preparado con triamcinolona, triamcinolona (uso endocrino) (producto), triamcinolona (uso endocrino), preparado de triamcinolona (producto), preparado de triamcinolona (sustancia), preparado de triamcinolona, triamcinolona (sustancia), triamcinolona, Triamcinolona
Polish Triamcynolon
Norwegian Triamcinolon
French Triamcinolone
German Triamcinolon
Italian Triamcinolone
Portuguese Triancinolona