Trispan

Trispan

triamcinolone

Manufacturer:

Stada

Distributor:

HK Medical Supplies
/
Health Express
Concise Prescribing Info
Contents
Triamcinolone hexacetonide
Indications/Uses
lntraarticular inj: Persistent inflammation in 1 or several joints after general treatment of chronic inflammatory joint diseases; arthritis in pseudogout/chondrocalcinosis; active OA; post-traumatic, non-bacterial arthritis. Infiltration therapy: Non-bacterial tendovaginitis (only when strictly indicated) & bursitis; periathropathy; insertional tendinopathy; enthesopathy in systemic, inflammatory rheumatic disease. Sub- & intralesional inj: Isolated foci of psoriasis; Lichen ruber planus; Lichen simplex chronicus (neurodermatitis circumscripta); alopecia areata; chronic discoid lupus erythematosus; keloids.
Dosage/Direction for Use
lntraarticular inj Adult Large joints: 10-20 mg. Medium-sized joints: 5-10 mg. Small joints: 2-5 mg. Given as a single inj. If another inj is necessary, do not give for at least another 3-4 wk. Max number of inj per joint: 3-4. Childn Juvenile idiopathic arthritis Large joints: 0.5-1 mg/kg. Smaller joints: Reduce dose accordingly. Sub- & intralesional inj Adult Single inj not exceeding 0.1 mg/cm2 of the skin surface area. Should be generally diluted at a ratio of at least 1:1. Infiltration therapy Adult 2-20 mg.
Contraindications
Hypersensitivity. Preterm or newborn infants (due to benzyl alcohol content). Intraarticular inj: Infections w/in or in the immediate vicinity of the joint to be treated; bacterial arthritis; instability of the joint to be treated; bleeding diathesis (spontaneous or caused by anticoagulants); periarticular calcification; non-vascularised osteonecrosis; tendon rupture; Charcot's joint. Prolonged therapy: GI ulcers; severe osteoporosis; psychiatric history; acute viral infections (HZV, HSV, varicella); HBsAG-positive chronic active hepatitis; about 8 wk before & up to 2 wk after prophylactic vaccinations; systemic mycoses & parasitoses; poliomyelitis; lymphadenitis after BCG vaccination; narrow & open-angle glaucoma.
Special Precautions
Serious neurologic events. Increase in joint infection risk. Post-inj flare. Worsening of degenerative changes w/in the joint. In patients w/ history of TB, use only w/ tuberculostatic protection. Severe course of specific viral diseases (chickenpox, measles). Risk of intestinal perforation. Regular medical check-ups (including ophthalmological at 3-mthly intervals) during long-term therapy. Adequate K intake & Na restriction should be ensured & serum K levels monitored in high-dose therapy. Exacerbation or relapse of underlying disease, acute adrenocortical insufficiency & cortisone w/drawal syndrome as risks in discontinuing long-term therapy. Potentially increased need for insulin or oral antidiabetics in patients w/ diabetes. Monitor BP regularly in patients w/ difficult to control HTN. Carefully monitoring in patients w/ severe heart failure. Rare hereditary problems of fructose intolerance. Skin reactions to allergy tests may be suppressed. Can lead to positive doping test results. Should not be used in the 1st 5 mth of pregnancy. Discontinue breast-feeding if treatment w/ higher doses or long-term treatment is required. Childn & elderly.
Adverse Reactions
Local irritation; adrenal suppression (in long-term therapy), disturbances in sex hormone, reduced glucose tolerane, DM; Na retention w/ oedema, increased K excretion; muscle atrophy, osteoporosis, aseptic osteonecrosis, peri- & intraarticular calcification, tendon damage; depression, irritability, euphoria, increased drive & appetite; pseudotumor cerebri, manifestation of latent epilepsy; GI ulcers, GI bleeding, pancreatitis; HTN, increased risk of atherosclerosis & thrombosis, vasculitis; moderate leukocytosis, lymphopenia, eosinopenia, polycythemia; weakened immune defense, masking of infections; cataract, glaucoma.
Drug Interactions
Reduced glucocorticoid effect w/ enzyme inducers eg, barbiturates, phenytoin, primidone, rifampicin. Enhanced clinical effect w/ oestrogens (eg, ovulation inhibitors). Increased risk of GI ulcerations & bleeding w/ NSAIDs (eg, salicylates, indomethacin). Reduced hypoglycaemic effect of oral antidiabetics & insulin. Attenuated effect of oral anticoagulants. Increased risk of blood count changes w/ ACE inhibitors. Further increase in IOP w/ atropine & other anticholinergics. K deficiency may potentiate effect of cardiac glycosides. Further K excretion w/ saluretics. Accentuated K loss w/ laxatives. Decreased blood conc of praziquantel. Increased risk of myopathies & cardiomyopathies w/ chloroquine, hydroxychloroquine, mefloquine. Reduced effect of somatropin during long-term administration. Reduced rise in TSH w/ protirelin. Increased blood levels of ciclosporin.
MIMS Class
Corticosteroid Hormones
ATC Classification
H02AB08 - triamcinolone ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations.
Presentation/Packing
Form
Trispan susp for inj 20 mg/mL
Packing/Price
10 × 1's
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