Triamcinolone + Nystatin + Neomycin + Gramicidin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : Topical Corticosteroid-responsive dermatoses w/ secondary infection As cream/oint containing triamcinolone acetonide 0.1%, neomycin (as sulfate) 0.25%, gramicidin 0.025%, nystatin 100,000 u/g: Apply 2-3 times/day. Otic Otitis externa As oint containing triamcinolone acetonide 0.1%, neomycin (as sulfate) 0.25%, gramicidin 0.025%, nystatin 100,000 u/g: Apply 2-3 times/day.
Dosage Details
Otic/Aural
Otitis externa
Adult: As otic ointment containing triamcinolone acetonide 0.1%, neomycin (as sulphate) 0.25%, gramicidin 0.025%, nystatin 100,000 units/g: Apply a small amount directly into the aural canal 2-3 times daily.
Child: As otic ointment containing triamcinolone acetonide 0.1%, neomycin (as sulphate) 0.25%, gramicidin 0.025%, nystatin 100,000 units/g: Apply a small amount directly into the aural canal 2-3 times daily.
Elderly: Use sparingly for short periods of time.

Topical/Cutaneous
Corticosteroid-responsive dermatoses with secondary infection
Adult: As cream/ointment containing triamcinolone acetonide 0.1%, neomycin (as sulphate) 0.25%, gramicidin 0.025%, nystatin 100,000 units/g: Apply sparingly to the affected area 2-3 times daily.
Child: As cream/ointment containing triamcinolone acetonide 0.1%, neomycin (as sulphate) 0.25%, gramicidin 0.025%, nystatin 100,000 units/g: Apply sparingly to the affected area 2-3 times daily.
Elderly: Use sparingly for short periods of time.
Contraindications
Tuberculous, viral lesions of the skin (e.g. herpes simplex and varicella); fungal lesions not susceptible to nystatin, facial rosacea, acne vulgaris or perioral dermatitis. Not to be applied to the external auditory canal in patients with perforated tympanic membranes. Do not use on extensive areas to reduce risk of systemic absorption and neomycin-induced ototoxicity. Not recommended for <1 yr.
Special Precautions
Patients with established hearing loss. Avoid occlusive dressing and prolonged or recurrent use. Avoid contact with eyes or mucous membranes. If there is no clinical improvement after 7 days, discontinue use as the infection may be masked by the steroid. Limit use to 5 days if used on the face or on children ≥1 yr. Use with caution and sparingly on inflamed or damaged skin (e.g extensive burns, trophic ulceration). Pregnancy.
Adverse Reactions
Prolonged use may cause sensitivity reactions, impaired wound healing, thinning of skin, striae, telangiectasia, hirsutism, hypothalamic-pituitary-adrenal axis suppression, Cushing's syndrome. Ototoxicity and nephrotoxicity.
Action
Description: Triamcinolone is a fluorinated corticosteroid with anti-inflammatory, antipruritic and anti-allergic actions. Nystatin, a polyene antifungal antibiotic, binds to ergosterol and interferes with the permeability of cell membrane of susceptible fungi e.g Candida spp. Neomycin is an aminoglycoside, often used topically in the infections against susceptible staphylococci and other organisms. Gramicidin, an antibacterial substance extracted from tyrothricin, is active against many Gram-positive bacteria. Used together, this combination provides a wide coverage against gram-positive, gram-negative bacteria and yeast which are responsible for most of the skin infections.
Pharmacokinetics:
Absorption: Nystatin: Poorly absorbed from GI tract; not absorbed from skin and mucous membranes when applied topically. Neomycin: Poorly absorbed from GI tract, absorption increased in damaged or inflamed mucosa or skin.
Distribution: Triamcinolone: Crosses placenta
Excretion: Triamcinolone: Plasma half life: 2- >5 hr. Neomycin: Rapidly excreted by kidneys; half life: 2-3 hr.
Storage
Otic/Aural:
Do not store above 25°C.
Topical/Cutaneous:
Ointment: Do not store above 25°C. Cream: Do not store above 25°C. Do not freeze.
Disclaimer: This information is independently developed by MIMS based on Triamcinolone + Nystatin + Neomycin + Gramicidin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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