Triamcinolone acetonide

Author: Prof. Dr. med. Peter Altmeyer

Co-Autor: Dr. med. hans-werner momberger

Last updated on: 29.10.2020

Synonym(s)

Head tincture triamcinolone acetonide-containing 05%.; Hydrophilic triamcinolone acetonide cream 01% (NRF 11.38.); Triamcinolone acetonide hair alcohol 02% (nach ICHTHYOL); Triamcinolone acetonide ointment low in water (nach Gloor); Triamcinolone acetonide skin spirit 02% with salicylic acid 2% (NRF 11.39.)

Definition
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Moderately effective (class II) glucocorticoid halogenated with fluorine which is suitable as a topical agent for short-term skin therapy.

Half-life
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3-5 hours or 3 weeks (metabolites).

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Pharmacodynamics (Effect)
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Like other glucocorticoids, trimacinolone acetonide has anti-inflammatory, immunosuppressive, antipruriginous and antiproliferative effects.

Indication
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Systemic glucocorticoid therapy. Topical for eczema, allergic reactions, psoriasis vulgaris.

Limited indication
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Pregnancy.

Dosage and method of use
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Topical: Cream/Ointment/Spray/Lotion: Apply 1-2 times/day thinly to the affected skin areas.
Remember!
Duration of application max. 4 weeks!
Injection: 0,5-1 ml intrafocal, intraarticular, sublesional.

Standard concentration
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Creams/ointments: 0.025-0.1%, solutions: 0.1%.

Undesirable effects
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Side effects on triamcinolone acetonide are very rare. The DKG has tested triamcinolone acetonide 0.1% in Vasline so far. This application form is no longer available as a test substance in Germany. Therefore, a 1% concentration of triamcinolone acetonide in Vaseline is now (as of 2016) recommended.

Contraindication
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Topical application > 4 weeks.

Recipe(s)
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R262 R263 R259 R260 R261

Preparations
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Delphicort, Volon, Volonimat, Triamgalen, Corticoid-ratiopharm, Polcortolon N Spray

Note(s)
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The optimum pH stability is pH7 and harmonizes with that of Clotrimazole, for example. Triamcinolone acetonide is insoluble in water and moderately soluble in ethanol (5 in 100). Alkaline and acidic active ingredients and auxiliaries lead to hydrolytic cleavage (acetonide residue is split off = 90% loss of effectiveness). Combinations with (weakly basic) zinc oxide lead to slow hydrolytic and oxidative decomposition (shelf life must be limited to 4 months).
For the treatment of skin diseases at difficult locations the active ingredient is available as a spray (Polcortolon N Spray).
According to recent extensive studies, intramuscular administration can no longer be considered obsolete. It is a properly performed alternative for severe inflammatory skin diseases or allergies (Østergaard MS et al. 2005).

Literature
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Geier J et al (2016) News on the epicutaneous test series of the German Contact Allergy Group. Dermatology at work and in the environment 64: 70-75
Østergaard MS (2005) Hay fever and a single intramuscular injection of corticosteroid: A systematic review. Primary Care Respiratory Journal 14:124-30