Triesence (triamcinolone acetonide): Uses, Side Effects & Warnings

What is Triesence, and how does it work?

Generic drug: triamcinolone acetonide

Brand name: Triesence

Triesence (triamcinolone acetonide) Injectable Suspension is a steroid injection used to treat inflammation of the joints or tendons to treat arthritis, bursitis, or epicondylitis (tennis elbow). Triesence is usually given in these conditions only as a short-term treatment of a severe or aggravated episode.

Triesence is also injected into soft tissues of the body to treat certain skin disorders caused by autoimmune conditions such as lupus, psoriasis, lichen planus, and others.

Ophthalmic Diseases

Triesence (triamcinolone acetonide) injectable suspension 40 mg/mL is indicated for:

sympathetic ophthalmia,
temporal arteritis,
uveitis, and
ocular inflammatory conditions unresponsive to topical corticosteroids.

Visualization During Vitrectomy

Triesence suspension is indicated for visualization during vitrectomy.

What are the side effects of Triesence?

Common side effects of Triesence include:

nausea
bloating
appetite changes
stomach or side pain
headache
sleep problems (insomnia)
acne
scaling or other skin changes
a wound that is slow to heal
thinning hair
bruising or swelling
sweating more than usual, or
irregular menstrual periods

What is the dosage for Triesence?

Dosage For Treatment Of Ophthalmic Diseases

The initial recommended dose of Triesence suspension is 4 mg (100 microliters of 40 mg/mL suspension) with subsequent dosage as needed over the course of treatment.

Dosage For Visualization During Vitrectomy

The recommended dose of Triesence suspension is 1 to 4 mg (25 to 100 microliters of 40 mg/mL suspension) administered intravitreally.

What drugs interact with Triesence?

Amphotericin B

There have been cases reported in which concomitant use of Amphotericin B and hydrocortisone was followed by cardiac enlargement and congestive heart failure. See Potassium depleting agents.

Anticholinesterase Agents

Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. If possible, anticholinesterase agents should be withdrawn at least 24 hours before initiating corticosteroid therapy.

Anticoagulant Agents

Co-administration of corticosteroids and warfarin usually results in inhibition of response to warfarin, although there have been some conflicting reports. Therefore, coagulation indices should be monitored frequently to maintain the desired anticoagulant effect.

Antidiabetic Agents

Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required.

Antitubercular Drugs

Serum concentrations of isoniazid may be decreased.

CYP 3A4 Inducers (e.g., barbiturates, phenytoin, carbamazepine, and rifampin)

Drugs such as barbiturates, phenytoin, ephedrine, and rifampin, which induce hepatic microsomal drug metabolizing enzyme activity may enhance metabolism of corticosteroid and require that the dosage of corticosteroid be increased.

CYP 3A4 Inhibitors (e.g., ketoconazole, macrolide antibiotics)

Ketoconazole has been reported to decrease the metabolism of certain corticosteroids by up to 60% leading to an increased risk of corticosteroid side effects.

Cholestyramine

Cholestyramine may increase the clearance of corticosteroids.

Cyclosporine

Increased activity of both cyclosporine and corticosteroids may occur when the two are used concurrently. Convulsions have been reported with concurrent use.

Digitalis

Patients on digitalis glycosides may be at increased risk of arrhythmias due to hypokalemia.

Estrogens, Including Oral Contraceptives

Estrogens may decrease the hepatic metabolism of certain corticosteroids thereby increasing their effect.

NSAIDS Including Aspirin And Salicylates

Concomitant use of aspirin or other non-steroidal antiinflammatory agents and corticosteroids increases the risk of gastrointestinal side effects. Aspirin should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia. The clearance of salicylates may be increased with concurrent use of corticosteroids.

Potassium Depleting Agents (e.g., diuretics, Amphotericin B)

When corticosteroids are administered concomitantly with potassium-depleting agents, patients should be observed closely for development of hypokalemia.

Skin Tests

Corticosteroids may suppress reactions to skin tests.

Toxoids And Live Or Inactivated Vaccines

Due to inhibition of antibody response, patients on prolonged corticosteroid therapy may exhibit a diminished response to toxoids and live or inactivated vaccines. Corticosteroids may also potentiate the replication of some organisms contained in live attenuated vaccines.

QUESTION

The term arthritis refers to stiffness in the joints.
See Answer

Is Triesence safe to use while pregnant or breastfeeding?

Triamcinolone acetonide can cause fetal harm when administered to a pregnant woman.
Human and animal studies suggest that the use of corticosteroids during the first trimester of pregnancy is associated with an increased risk of orofacial clefts, intrauterine growth restriction, and decreased birth weight.
If this drug is used during pregnancy, or if the patient becomes pregnant while using this drug, the patient should be apprised of the potential hazard to the fetus.
Corticosteroids are secreted in human milk. Reports suggest that steroid concentrations in human milk are 5 to 25% of maternal serum levels, and that total infant daily doses are small, less than 0.2% of the maternal daily dose. The risk of infant exposure to steroids through breast milk should be weighed against the known benefits of breastfeeding for both the mother and baby.