Triacort, ointment 0.1% 10 g

GCS. Suppresses functions of leukocytes and tissue macrophages. Restricts the migration of leukocytes to the area of inflammation. Disrupts the ability of macrophages to phagocytosis, as well as the formation of interleukin-1. Promotes stabilization of lysosomal membranes, thus reducing the concentration of proteolytic enzymes in the area of inflammation. Reduces capillary permeability, caused by the release of histamine. It suppresses fibroblast activity and collagen formation.

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

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

It suppresses release of ACTH and β-lipotropin by pituitary, but does not decrease circulating β-endorphin. It suppresses the secretion of TSH and FSH.

It has a vasoconstrictor effect when directly applied to the blood vessels.

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

Suppresses glucose uptake 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 the lymphoid and connective tissue, muscles, adipose tissue, skin, bone tissue.

Osteoporosis and Itzenko-Cushing’s syndrome are the main factors limiting long-term GCS therapy. Growth suppression in children may occur as a result of catabolic action.

In high doses, it may increase brain tissue excitability and contribute to lowering the seizure threshold. It stimulates excessive production of hydrochloric acid and pepsin in the stomach, which promotes development of peptic ulcer.

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

Triamcinolone acetonide has therapeutic activity when used topically and topically due to its anti-inflammatory, anti-allergic and anti-exudative (due to its 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 bronchoobstructive syndrome, pemphigoid, psoriasis, dermatitis.

Intra-articular administration: chronic inflammatory joint diseases, exudative arthritis, gout, joint drops, shoulder joint blockage, 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 (in combination therapy).

Active ingredient

Composition

Active substance:

Triamcinolone acetonide 0.1 g;

Auxiliary substances:

glycerin,

propylene glycol,

dimexide,

vaseline,

How to take, the dosage

Triacort ointment is applied evenly in a thin layer to the affected skin areas 1-3 times a day. The duration of treatment depends on the nature of the disease and the effectiveness of therapy, usually amounting to 5-10 days. With a persistent course of the disease the treatment course may be prolonged up to 25 days. In limited lesions the Triacort ointment may be applied under an occlusive dressing to intensify the effect.
The treatment is started with 0.1% ointment and is gradually being replaced with 0.025% ointment after the therapeutic effect is achieved.
Such tactics provides a more prolonged effect and reduces the risk of relapse of the process after cancellation of the drug.

Interaction

Concomitant use with anabolic steroids, androgens increases the risk of peripheral edema, acne.

In concomitant use with antithyroid drugs and thyroid hormones may change thyroid function.

Concomitant use with histamine H1-receptor blockers decreases the effect of triamcinolone; with hormonal contraceptives – potentiates the effect of triamcinolone.

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

Concomitant use with immunosuppressants increases the risk of bacterial and viral infections.

Concomitant use with potassium-saving diuretics may cause hypokalemia.

Concomitant use may decrease the effectiveness of indirect anticoagulants, heparin, streptokinase, urokinase, increased risk of erosive ulcerative lesions and gastrointestinal bleeding.

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

When concomitant use weaken the effect of oral hypoglycemic agents and insulin; with laxatives – possible hypokalemia; with cardiac glycosides – increased risk of cardiac arrhythmias and other toxic effects of glycosides.

Concomitant use with tricyclic antidepressants may increase psychiatric disorders associated with taking triamcinolone.

Special Instructions

It is not intended for intravenous administration.

With caution and under close medical supervision, use with edema syndrome, obesity, mental illness and gastrointestinal diseases. It is recommended that vitamin D and calcium-rich foods be taken during treatment.

When used topically, it is recommended to use in combination with antimicrobials to prevent local infectious complications.

Parenteral use in children under 6 years of age is not recommended; 6-12 years of age with strict indications.

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

Contraindications

A history of acute psychosis, active tuberculosis, myasthenia gravis, neoplasms with metastases, diverticulitis, gastric and duodenal ulcer, arterial hypertension, Icenko-Cushing’s syndrome, renal failure, history of thrombosis and embolism, osteoporosis, diabetes mellitus, latent foci of infection, amyloidosis, syphilis, fungal diseases, viral infections (incl.Viral infections (including those caused by Herpes simplex and Varicella zoster), amebic infections, polio (except bulbar encephalitis), gonococcal or tuberculous arthritis, vaccination period, lymphadenitis after BCG vaccination, glaucoma, infected skin lesions.

Side effects

Endocrine system disorders: redistribution of adipose tissue, menstrual disorders, increased blood glucose levels, inhibition of adrenal function, “moon-shaped face”, stretch marks, hirsutism, acne.

Metabolism disorders: edema, electrolyte imbalance, negative nitrogen balance, growth retardation in children.

Digestive system disorders: steroid gastric ulcer, gastrointestinal erosive ulcers, acute pancreatitis.

CNS disorders: seizures, sleep disorders, mental disorders, headaches and dizziness, weakness.

Muscular system disorders: myopathy, osteoporosis.

Cardiovascular system: arterial hypertension.

With regard to the blood coagulation system: thromboembolism.

An organ of vision: visual disturbances, posterior subcapsular cataract, increased intraocular pressure or exophthalmos, anaphylactic reactions.

Reactions due to immunosuppressive action: exacerbation of infectious diseases.

In intra-articular administration: joint soreness, irritation at the place of needle insertion, depigmentation, sterile abscess, skin atrophy are possible; resorptive side effects are possible when administered in doses over 40 mg.

In external use: itching, skin irritation, late reactions such as eczema, steroid acne, purpura are possible. Prolonged use of the ointment may result in secondary infectious lesions and atrophic skin changes.

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