Triacort, ointment 0.1%, 10g

Composition

Active ingredient:

triamcinolone acetonide 0.1 g;

Auxiliary substances:

glycerin,

propylene glycol,

dimexide,

petrolatum,

stearic acid,

emulsifying wax,

purified water.

Pharmacological action

of corticosteroids. Inhibits the functions of leukocytes and tissue macrophages. Restricts the migration of white blood cells to the area of inflammation. Interferes with the ability of macrophages to phagocytosis, as well as to form interleukin-1. It helps to stabilize lysosomal membranes, thereby reducing the concentration of proteolytic enzymes in the area of inflammation. Reduces capillary permeability due to histamine release. Inhibits fibroblast activity and collagen formation.

Inhibits the activity of phospholipase A2, which leads to suppression of prostaglandin and leukotriene synthesis. Inhibits the release of COX (mainly COX-2), which also helps to reduce the production of prostaglandins.

Reduces the number of circulating lymphocytes (T-and B-cells), monocytes, eosinophils and basophils due to their movement from the vascular bed to the lymphoid tissue; suppresses the formation of antibodies.

Inhibits pituitary release of ACTH and beta-lipotropin, but does not reduce the level of circulating beta-endorphin. Inhibits the secretion of TSH and FSH.

When applied directly to the vessels, it has a vasoconstrictor effect.

It has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. It stimulates gluconeogenesis, promotes the uptake of amino acids by the liver and kidneys, and increases the activity of gluconeogenesis enzymes. In the liver, it increases the deposition of glycogen, stimulating the activity of glycogen synthetase and glucose synthesis from protein metabolism products. An increase in blood glucose activates the release of insulin.

Inhibits the uptake of glucose by fat cells, which leads to the activation of lipolysis. However, due to an increase in insulin secretion, lipogenesis is stimulated, which contributes to fat accumulation.

It has a catabolic effect in lymphoid and connective tissue, muscles, adipose tissue, skin, and bone tissue.

Osteoporosis and Itsenko-Cushing syndrome are the main factors limiting long-term corticosteroid therapy. As a result of catabolic action, growth suppression in children is possible.

In high doses, it can increase the excitability of brain tissues and helps lower the threshold of convulsive readiness. It stimulates excessive production of hydrochloric acid and pepsin in the stomach, which contributes to the development of peptic ulcers.

When used systemically, therapeutic activity is due to anti-inflammatory, anti-allergic, immunosuppressive and antiproliferative effects.

When applied externally and topically, the therapeutic activity of triamcinolone acetonide is due to anti-inflammatory, anti-allergic and anti-exudative (due to the vasoconstrictor effect) action.

In terms of anti-inflammatory activity, triamcinolone acetonide is 6 times more active than hydrocortisone. Mineralocorticoid activity of triamcinolone acetonide is practically absent.

Indications

For systemic use: bronchial asthma, chronic bronchitis with bronchial obstructive syndrome, pemphigoid, psoriasis, dermatitis.

Intra-articular use: chronic inflammatory diseases of the joints, exudative arthritis, gout, dropsy of the joints, blockage of the shoulder joint, chronic inflammation of the inner layer of the joint capsule.

For external use: eczema, psoriasis, neurodermatitis, various types of dermatitis and other inflammatory and allergic skin diseases of non-microbial etiology (as part of complex therapy).

Contraindications

History of acute psychosis, active tuberculosis, myasthenia gravis, metastatic neoplasms, diverticulitis, gastric and duodenal ulcer, hypertension, Itsenko-Cushing syndrome, renal failure, thrombosis and embolism in the anamnesis, osteoporosis, diabetes mellitus, latent foci of infection, amyloidosis, syphilis, fungal diseases, viral infections (including those caused by Herpes simplex and Varicella zoster), amoebic infections, poliomyelitis (except for bulbar-encephalitis), gonococcal or tuberculous arthritis, vaccination period, lymphadenitis after BCG vaccination, glaucoma, infected skin lesions.

Side effects

From the endocrine system:  redistribution of adipose tissue, menstrual disorders, increased blood glucose levels, adrenal suppression, “moon-shaped face”, striae, hirsutism, acne.

From the side of metabolism:  edema, electrolyte imbalance, negative nitrogen balance, growth retardation in children.

From the digestive system:  steroid gastric ulcer, erosive and ulcerative lesions of the gastrointestinal tract, acute pancreatitis.

From the central nervous system:  seizures, sleep disorders, mental disorders, headaches and dizziness, weakness.

Musculoskeletal disorders:  myopathy, osteoporosis.

From the cardiovascular system:  arterial hypertension.

From the side of the blood coagulation system:  thromboembolism.

From the side of the visual organ:  visual disturbances, posterior subcapsular cataract, increased intraocular pressure or exophthalmos, anaphylactic reactions.

Reactions due to immunosuppressive effects:  exacerbation of infectious diseases.

With intra-articular insertion:  joint soreness, irritation at the needle insertion site, depigmentation, sterile abscess, skin atrophy are possible, and resorptive side effects are possible when administered in doses of more than 40 mg.

For external use:  possible itching, skin irritation, late reactions such as eczema, steroid acne, purpura. With prolonged use of the ointment, secondary infectious lesions and atrophic skin changes may develop.

Interaction

When used concomitantly with anabolic steroids and androgens, the risk of developing peripheral edema and acne increases.

When used concomitantly with antithyroid drugs and thyroid hormones, changes in thyroid function may occur.

When used concomitantly with histamine H1-receptor blockers, the effect of triamcinolone decreases; with hormonal contraceptives, the effect of triamcinolone is potentiated.

Hypocalcemia associated with the use of triamcinolone can lead to an increase in the duration of neuromuscular blockade caused by the action of depolarizing muscle relaxants when they are used simultaneously.

When used concomitantly with immunosuppressants, the risk of bacterial and viral infections increases.

Hypokalemia is possible when used concomitantly with potassium-sparing diuretics.

With simultaneous use, it is possible to reduce the effectiveness of indirect anticoagulants, heparin, streptokinase, urokinase, and increase the risk of erosive and ulcerative lesions and bleeding from the gastrointestinal tract.

Concomitant use with NSAIDs (including acetylsalicylic acid) increases the risk of erosive and ulcerative lesions and bleeding from the gastrointestinal tract.

With simultaneous use, the effect of oral hypoglycemic agents, insulin is weakened; with laxatives, hypokalemia is possible; with cardiac glycosides, the risk of developing cardiac arrhythmias and other toxic effects of glycosides increases.

When used concomitantly with tricyclic antidepressants, it is possible to increase the mental disorders associated with taking triamcinolone.

How to take, course of use and dosage

Triacort ointment is applied evenly in a thin layer on the affected areas of the skin 1-3 times a day. The duration of treatment depends on the nature of the disease and the effectiveness of therapy, usually 5-10 days. If the disease persists, the course of treatment can be extended up to 25 days. On limited lesions, Triacort ointment can be applied under an occlusal dressing to enhance the effect. Treatment begins with 0.1% ointment, and when the therapeutic effect is achieved, they switch to 0.025% ointment with its gradual cancellation. This tactic provides a longer-lasting effect and reduces the risk of exacerbation of the process after discontinuation of the drug.

Special instructions

It is not intended for intravenous use.

With caution and under strict medical supervision, it is used for edematous syndrome, obesity, mental illnesses and gastrointestinal diseases. During the treatment period, it is recommended to take vitamin D and eat foods rich in calcium.

When applied externally, it is recommended to use in combination with antimicrobial agents to prevent local infectious complications.

Parenteral use in children under 6 years of age is not recommended; at the age of 6-12 years – for strict indications.

Long-term external use in children should be avoided, regardless of age.

Form of production

Ointment for external use

Storage conditions

At a temperature of 12-15 °C

Shelf life

2 years

Active ingredient

Triamcinolone

Dosage form

ointment

Purpose

For adults as prescribed by a doctor, for children as prescribed by a doctor

Indications

Neurodermatitis, Dermatosis, Psoriasis, Allergies, Dermatitis, Diathesis, Insect Bites