Tri-

Tri- Uses, Dosage, Side Effects, Food Interaction and all others data.

Tri- Acetonide (a derivative of Tri-) in a compatible base. Topical steroids are primarily effective because of their anti-inflammatory, antipruritic & vasoconstrictive actions.

Tri- is a corticosteroid with anti-inflammatory properties. These properties are used to treat inflammation in conditions that affect various organs and tissues. Tri- should not be administered as an epidural injection.

Trade Name Tri-
Availability Prescription only
Generic Triamcinolone
Triamcinolone Other Names Fluoxyprednisolone, Tiamcinolonum, Triamcinolona, Triamcinolone, Triamcinolonum
Related Drugs Humira, Cosentyx, Promacta, Trelegy Ellipta, amlodipine, aspirin, lisinopril, metoprolol, prednisone, ibuprofen
Type
Formula C21H27FO6
Weight Average: 394.4339
Monoisotopic: 394.179166801
Protein binding

Triamcinolone is mostly bound to corticosteroid-binding globulin or serum albumin. Triamcinolone acetonide is approximately 68% protein bound in plasma.

Groups Approved, Vet approved
Therapeutic Class Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations
Manufacturer
Available Country United States
Last Updated: September 19, 2023 at 7:00 am
Tri-
Tri-

Uses

is used for the relief of the inflammatory and pruritic manifestations of corticosteroid responsive dermatoses including atopic dermatitis, contact dermatitis, eczematous dermatitis, neurodermatitis, seborrheic dermatitis, insect bites, lichen simplex chronicus, exfoliative dermatitis, stasis dermatitis, nummular eczema, psoriasis and pruritus ani and vulvae.

Tri- is also used to associated treatment for these conditions: Acne, Acne Vulgaris, Acute Gouty Arthritis, Allergic Contact Dermatitis, Allergic Rhinitis (AR), Allergy Skin, Alopecia Areata (AA), Ankylosing Spondylitis (AS), Asthma, Atopic Dermatitis (AD), Autoimmune Hemolytic Anemia, Berylliosis, Bullous dermatitis herpetiformis, Chapped skin, Chronic Eczema, Chronic Inflammatory Skin Diseases, Congenital Adrenal Hyperplasia (CAH), Congenital Hypoplastic Anemia, Crohn's Disease (CD), Dental Cavity, Dermatitis, Dermatitis, Contact, Dermatitis, Eczematous, Dermatomyositis, Diaper Rash, Discoid Lupus Erythematosus (DLE), Edema of the cerebrum, Epicondylitis, Erythroderma, Fungal infectious disorders of the Beard, Gingivitis, Hemangiomas, Hemorrhoids, Hypercalcemia, Infected Wound, Infections, Fungal, Inflammation of Mouth, Intertrigo, Itching of the Anus, Itching of the External Genitalia, Itching of the Foot, Itching of the genitals, Itching of the hand, Juvenile Idiopathic Arthritis (JIA), Keloid Scars, Leukemias, Lichen Planus (LP), Lichen simplex chronicus, Malignant Lymphomas, Mycosis Fungoides (MF), Mycotic Eczema, Necrobiosis lipoidica diabeticorum, Neurodermatitis, Nummular Dermatitis, Ocular Inflammation, Ophthalmia, Sympathetic, Oral Erosive Lichen Planus, Oral Infection, Otitis Externa, Pemphigus, Pericarditis, Polymyositis, Post-Herpetic Neuralgia (PHN), Primary adrenocortical insufficiency, Proteinuria, Psoriasis Vulgaris (Plaque Psoriasis), Psoriatic Arthritis, Psoriatic plaque, Pure Red Cell Aplasia, Purulent Wounds, Pyoderma caused by susceptible bacteria, Regional Enteritis, Rheumatoid Arthritis, Ringworm Folliculitis, Seborrheic Dermatitis, Seborrheic Dermatitis, Eczematous, Secondary Impetiginization, Secondary adrenocortical insufficiency, Secondary thrombocytopenia, Serum Sickness, Skin Mycoses, Stomatitis, Aphthous, Stomatitis, Denture, Synovitis, Systemic Lupus Erythematosus (SLE), Temporal Arteritis, Tinea Corporis, Transfusion Reactions, Trichinosis, Tuberculosis (TB), Ulcerative Colitis, Urticaria, Uveitis, Acute Bursitis, Acute Multiple sclerosis, Acute Rheumatic heart disease, unspecified, Acute Tenosynovitis, Corticosteroid-responsive dermatoses, Cutaneous candidiasis, Cystic tumour of the ganglia, Exfoliative erythroderma, Granuloma annulare lesions, Idiopathic eosinophilic pneumonias, Non-suppurative Thyroiditis, Oral infections, Oral lesions, Severe Erythema multiforme, Subacute Dermatitis, Eczematous, Symptomatic Sarcoidosis, Ulceration of the mouth, Ulcerative stomatitis

How Tri- works

Corticosteroids like triamcinolone inhibit phospholipase A2 on cell membranes, preventing the breakdown of lysosomal membranes of leukocytes, which in turn prevent the formation of arachidonic acid, which decrease expression of cyclooxygenase and lipoxygenase, inhibiting synthesis of prostaglandins and leukotrienes. Anti-inflammatory activity occurs via reversal of vascular dilation and reducing permeability, which prevents macrophage and leukocyte migration. Tri- also inhibits nuclear factor kappa-B, which decreases the production of pro-inflammatory signals such as interleukin-6, interleukin-8, and monocyte chemoattractant protein-1.

Dosage

Tri- dosage

A small amount of Tri- is gently rub to the affected area 1-2 times daily. Some cases of eczematised psoriasis may be treated more effectively by the application of Tri- under an occlusive dressing.

Occlusive dressing technique: Gently rub a small amount of Tri- on the lesion until it disappears. Then reapply, leaving a thin coating and cover with a pliable non porous film. For convenience apply Tri- intermittently (12 hour occlusion during the night) followed by reapplication without occlusion, during the day.

Pediatric use: Tri-should not be used in children under 8 years. Administration of topical corticosteroids to children should be limited to the least amount compatible with an effective therapeutic regimen. Chronic corticosteroid therapy may interfere with the growth and development of children. As children are more likely to get side effects, they should not normally be treated for longer than 5 days.

Side Effects

The following local side effects have been reported with topical corticosteroids, either with or without occlusive dressings: burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis and allergic contact dermatitis, maceration of the skin, secondary infection, skin atrophy, striae and miliaria.

Toxicity

The subcutaneous LD50 of triamcinolone acetonide in rats is 13,100µg/kg and in mice is 132mg/kg. The oral LD50 in rats is 1451mg/kg and in mice is 2168mg/kg.[LD50] The intraperitoneal LD50 in mice is 105mg/kg.[LD50]

Patients experiencing an overdose may develop Cushing's syndrome. This overdose may be treated with supportive therapy and mifepristone for its antiglucocorticoid activity.

Precaution

If reactions or idiosyncrasies are encountered, Tri- Acetonide should be discontinued. The use of topical steroids on infected areas should be attended with caution and careful observation, bearing in mind the potential spreading of infections by anti-inflammatory steroids and the possible advisability of discontinuing steroid therapy and/or initiating antibacterial measures.

Tri- Acetonide should not be used on healthy skin or over large areas of skin and not to be used in the eye as there is potential risk of glaucoma and cataract. When steroids are applied for long periods of time (more than 4 weeks) the occurrence of atrophic striae is likely. Prolonged use on flexures and intertriginous areas is undesirable. Children may absorb proportionately larger amounts of topical corticosteroids and thus may be more susceptible to systemic toxicity. In infants, long term continuous topical steroid therapy should be avoided. Adrenal suppression can occur even without occlusion.

Food Interaction

No interactions found.

Tri- Cholesterol interaction

[Moderate] Corticosteroids may elevate serum triglyceride and LDL cholesterol levels if used for longer than brief periods.

Patients with preexisting hyperlipidemia may require closer monitoring during prolonged corticosteroid therapy, and adjustments made accordingly in their lipid-lowering regimen.

Tri- Hypertension interaction

[Moderate] Corticosteroids may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure.

These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone.

The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities.

However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods.

Therapy with corticosteroids should be administered cautiously in patients with preexisting fluid retention, hypertension, congestive heart failure, and

Dietary sodium restriction and potassium supplementation may be advisable.

Volume of Distribution

The apparent volume of distribution of triamcinolone is 115.2±10L. The mean apparent volume of distribution of triamcinolone acetonide is 1.96L/kg. The apparent volume of distribution of triamcinolone diacetate is 119.7±33.14L.

Elimination Route

A 16mg oral dose of triamcinolone reaches a Cmax of 5.23±0.84ng/mL with a Tmax of 2.24±0.78h and an AUC of 36.0±6.2ng*h/mL.

A 2mg intravenous dose of triamcinolone acetonide has an AUC of 57.7ng*h/mL. The bioavailability of 800µg of inhaled triamcinolone acetonide is 25%, with 10.4% coming from pulmonary absorption and the rest being accounted for by deposition on the oral mucosa and other underlying factors. An inhaled dose of triamcinolone acetonide reaches a Cmax of 0.92ng/mL with a Tmax of 1.74h and an AUC of 5.12ng*h/mL. The fraction of an inhaled dose that is actually absorbed via the pulmonary route reaches a Cmax of 0.55ng/mL with a Tmax of 0.66h and an AUC of 2.15ng*h/mL.

A 16mg oral dose of triamcinolone diacetate reaches a Cmax of 5.33±1.55ng/mL with a Tmax of 1.86±0.47h and an AUC of 32.7±9.9ng*h/mL.

Half Life

The half life of triamcinolone is 2.7h. The mean terminal elimination half life following an inhaled dose of triamcinolone acetonide is 2.4h. The half life of triamcinolone diacetate is 2.8h.

Clearance

The clearance of triamcinolone is 28.6±5.6L/h. The mean total body clearance of triamcinolone acetonide is 0.57L/h. The clearance of triamcinolone diacetate is 34.4±10.6L/h.

Elimination Route

Approximately 20% of a dose of triamcinolone is recovered in the urine as the unchanged drug, 25% is recovered as 6-beta-hydroxy-triamcinolone, and 5% is recovered as unidentified metabolites.

Pregnancy & Breastfeeding use

There are no adequate and well-controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids. Therefore, topical corticosteroid should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether topical administration of corticosteroid could result in sufficient systemic absorption to produce detectable quantities in breast milk. Systemically administered corticosteroids are secreted into breast milk in quantities not likely to have a deleterious effect on the infant. Nevertheless, caution should be exercised when topical corticosteroids are administered to a nursing woman.

Contraindication

Tri- Acetonide is contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation. It is also contraindicated in tuberculosis of the skin, fungus infections and viral diseases of the skin (Herpes simplex, chickenpox and vaccinia), perioral dermatitis, rosacea and ulcerative conditions.

Acute Overdose

Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects e.g., mild, reversible suppression of adrenal function, ecchymoses of the skin, peptic ulceration, hypertension, aggravation of infection, hirsutism, acne, edema and muscle weakness

Storage Condition

Store in a cool & dry place. Protect from light.

Innovators Monograph

You find simplified version here Tri-

FAQ

What is Tri- used for?

Tri- used to treat the itching, redness, dryness, crusting, scaling, inflammation, and discomfort of various skin conditions, including psoriasis a skin disease in which red, scaly patches form on some areas of the body and eczema a skin disease that causes the skin to be dry and itchy and to sometimes develop red, scaly rashes. It is also used as a dental paste to relieve the discomfort of mouth sores.

How safe is Tri-?

Many people using this medication do not have serious side effects.Sometimes Tri- can cause a severe allergic reaction in some people.

What are the common side effects of Tri-?

Common side effects of Tri- are include:

  • skin redness,
  • burning,
  • itching,
  • irritation,
  • excessive dryness,
  • peeling,
  • thinning of your skin,
  • blistering skin,
  • stretch marks, and
  • acne.

Is Tri- safe during pregnancy?

Tri- should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.Topical corticosteroids should not be used extensively on pregnant patients, in large amounts or for extended periods of time.

Is Tri- safe during breastfeeding?

Tri- can be applied to the breast or nipple area, but should be wiped off thoroughly prior to nursing. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.

Can I drink alcohol with Tri-?

Tri- may not work as well during this time, and may not fully protect you from disease. Avoid drinking alcohol while you are taking Tri-.

Can I drive after taking Tri-?

Tri- can also cause dizziness. Do not drive or operate heavy machinery until you know how Tri- affects you.

How long does Tri- stay in my system?

Studies indicate that following a single intramuscular dose acetonide, adrenal suppression occurs within 24 to 48 hours and then gradually returns to normal, usually in 30 to 40 days.

Is Tri- a strong steroid?

Clobetasol is a potent steroid, Tri- is midstrength, and desonide is lower-potency.

What happens if I use Tri- for too long?

Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may cause unwanted side effects or skin irritation.

Does Tri- cause high blood sugar?

Tri- preparations had significantly increased blood glucose levels.

Is Tri- used for acne?

In acne, different volumes of Tri- injections have been recommended depending upon the size, location of the lesion, and depth of the lesions.

How long does it take Tri- to work?

Tri- treatment for seven days is usually sufficient. If your symptoms have not improved after this time , speak again with your doctor for further advice. Topical corticosteroids like Tri- should not be used for long periods of time or on large areas of the body.

How often does I apply Tri-?

It usually is applied two to four times a day. For mouth sores, it is applied at bedtime and, if necessary, two or three times daily, preferably after meals.

What happens if I miss a dose?

If you miss a dose of Tri-, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Where should I not take Tri-?

Use Tri- only on the skin. Do not use it on the face, groin, or underarms unless directed to do so by your doctor.

Can I overdose on Tri-?

An overdose of Tri- is not expected to produce life threatening symptoms.

Does Tri- thin the skin?

Other side effects of Tri- include thinning of your skin, blistering skin, or stretch marks.

Can Tri- worsen rash?

Skin infections can become worse when Tri- is used.

Can I use Tri- on my eczema?

Tri- reduces the swelling, itching, and redness that can occur in these types of conditions.

Who should not take Tri-?

You should not use if you are allergic to Tri- or if you have a fungal infection anywhere in your body.

How should I take Tri-?

You should Follow the directions on your prescription label.Do not take in larger or smaller amounts or for longer than recommended. Take Tri- with food to prevent stomach upset.

*** Taking medicines without doctor's advice can cause long-term problems.
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