Triamcinolone acetonide

Overview

Triamcinolone acetonide, sold under the brand name Kenalog among others, is a synthetic corticosteroid medication used topically to treat various skin conditions, to relieve the discomfort of mouth sores, and by injection into joints to treat various joint conditions. It is also injected into lesions to treat inflammation in some parts of the body, particularly the skin. In nasal spray form, it is used to treat allergic rhinitis. It is used for the treatment of macular edema associated with uveitis. It is a more potent derivative of triamcinolone, and is about eight times as potent as prednisone.[1][2][3] WP

Most forms of triamcinolone acetonide are prescription drugs. In 2014, the U.S. Food and Drug Administration (FDA) made triamcinolone acetonide an over-the-counter drug in the United States in nasal spray form under the brand name Nasacort. It is available as a generic medication.[3][4] WP

Uses, dosage and effects

Medical uses

Triamcinolone acetonide as an intra-articular injectable has been used to treat a variety of musculoskeletal conditions. When applied to the skin as a topical ointment, it is used to mitigate blistering from poison ivy, oak, and sumac. When combined with nystatin, it is used to treat skin infections with discomfort from fungus, though it should not be used on the eyes. It provides relatively immediate relief and is used before using oral prednisone. Oral and dental paste preparations are used for treating aphthous ulcers.[5] WP⚠ Wikipedia itself has flagged this text: citation needed.

As an intravitreal injection, triamcinolone acetonide has been used to treat various eye diseases and has been found useful in reducing macular edema. Drug trials have found it to be as efficient as anti-VEGF drugs in eyes with artificial lenses over a two-year period. A systematic review did not find any evidence of any benefit in preventing vision loss in eyes treated with triamcinolone acetonide over placebo, for patients with age-related macular degeneration.[6][7] WP

Triamcinolone acetonide is also administered via intralesional injection in the treatment of hypertrophic and keloid scars.[8][9] WP

Veterinary use

Triamcinolone acetonide is also used in veterinary medicine as an ingredient in topical ointments and in topical sprays for control of pruritus in dogs.[10] WP

It is used as a preinductor and/or inductor of birth in cows. It was also used in the horse racing industry, but it is now a banned substance if found in a horse's system on race day.[11] WP

Risks and side effects

Contraindications

Evidence suggests that usage of triamcinolone acetonide or other steroids to treat macular edema increases the risk of increasing intraocular pressure in patients.[12] WP

Pharmacology

Pharmacodynamics

Triamcinolone acetonide is a corticosteroid. It is specifically a glucocorticoid, or an agonist of the glucocorticoid receptor, that is about five times as potent as cortisol. It has very little mineralocorticoid effects. The affinities of triamcinolone acetonide for the androgen and estrogen receptors are both <0.1% (relative to testosterone and estradiol). However, triamcinolone acetonide has 15% of the affinity of progesterone for the progesterone receptor. In relation to this, triamcinolone acetonide can produce endocrine side effects like ovulation inhibition and menstrual irregularities.[13–17] WP

Chemistry

Formula

C24H31FO6 PC

CAS number

76-25-5 PC

Molar mass (g/mol)

434.5 PC

IUPAC name (computed by PubChem)

(1S,2S,4R,8S,9S,11S,12R,13S)-12-fluoro-11-hydroxy-8-(2-hydroxyacetyl)-6,6,9,13-tetramethyl-5,7-dioxapentacyclo[10.8.0.02,9.04,8.013,18]icosa-14,17-dien-16-one PC

SMILES

C[C@]12C[C@@H]([C@]3([C@H]([C@@H]1C[C@@H]4[C@]2(OC(O4)(C)C)C(=O)CO)CCC5=CC(=O)C=C[C@@]53C)F)O PC

InChIKey

YNDXUCZADRHECN-JNQJZLCISA-N PC

PubChem CID

6436

IUPAC name

(4aS,4bR,5S,6aS,6bS,9aR,10aS,10bS)-4b-fluoro-6b-glycoloyl-5-hydroxy-4a,6a,8,8-tetramethyl-4a,4b,5,6,6a,6b,9a,10,10a,10b,11,12-dodecahydro-2H-naphtho WP

Harm reduction information

No harm reduction data is on file for this compound yet. That means no dose, timing or combination data from PsychonautWiki or TripSit. Please don't guess a dose from similar compounds. If you have taken it and feel unwell, contact emergency services or a poison control center.

User reports

Pop culture

No references added yet.

Sources

1. Journal / agency Triamcinolone Topical
2. Journal / agency Xipere- triamcinolone acetonide injection, suspension
3. Journal / agency Nasacort Allergy 24HR- triamcinolone acetonide spray, metered. 3 February 2014
4. Journal / agency Competitive Generic Therapy Approvals. 3 March 2023
5. Other Nystatin And Triamcinolone (Topical Route)
6. Journal / agency Rittiphairoj T, Mir TA, Li T, Virgili G. Intravitreal steroids for macular edema in diabetes. The Cochrane Database of Systematic Reviews. November 2020. doi:10.1002/14651858.CD005656.pub3 · PMID 33206392 · PMC8095060
7. Journal / agency Geltzer A, Turalba A, Vedula SS. Surgical implantation of steroids with antiangiogenic characteristics for treating neovascular age-related macular degeneration. The Cochrane Database of Systematic Reviews. January 2013. doi:10.1002/14651858.CD005022.pub3 · PMID 23440797 · PMC4269233
8. Other Intralesional Steroid Therapy (Patient Information Leaflets). 2008
9. Journal / agency Griffith BH. The treatment of keloids with triamcinolone acetonide. Plastic and Reconstructive Surgery. September 1966. doi:10.1097/00006534-196609000-00004 · PMID 5919603
10. Other Genesis (triamcinolone acetonide) Topical Spray Drug information
11. Other Champion Hurdle favorite Yanworth failed drug test
12. Journal / agency Gewaily D, Muthuswamy K, Greenberg PB. Intravitreal steroids versus observation for macular edema secondary to central retinal vein occlusion. The Cochrane Database of Systematic Reviews. September 2015. doi:10.1002/14651858.CD007324.pub3 · PMID 26352007 · PMC4733851
13. Other Arzneistoff-Profile. 2004
14. Other Kavlock RJ, Daston GP. Drug Toxicity in Embryonic Development II: Advances in Understanding Mechanisms of Birth Defects: Mechanistics Understanding of Human Development Toxicants. 6 December 2012
15. Journal / agency Brook EM, Hu CH, Kingston KA, Matzkin EG. Corticosteroid Injections: A Review of Sex-Related Side Effects. Orthopedics. March 2017. doi:10.3928/01477447-20161116-07 · PMID 27874912
16. Journal / agency Cunningham GR, Goldzieher JW, de la Pena A, Oliver M. The mechanism of ovulation inhibition by triamcinolone acetonide. The Journal of Clinical Endocrinology and Metabolism. January 1978. doi:10.1210/jcem-46-1-8 · PMID 376542
17. Journal / agency Luzzani F, Gallico L, Glässer A. In vitro and ex vivo binding to uterine progestin receptors of the rat as a tool to assay progestational activity of glucocorticoids. Methods and Findings in Experimental and Clinical Pharmacology. 1982. PMID 7121132

Text and values on this page are quoted from Wikipedia (CC BY-SA 4.0), PubChem (public domain). Each value links to the exact revision it came from.