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|Jmol-3D images||Image 1|
|Molar mass||434.50 g mol−1|
|Except where noted otherwise, data are given for materials in their standard state (at 25 °C (77 °F), 100 kPa)|
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Triamcinolone acetonide is a synthetic corticosteroid used to treat various skin conditions, to relieve the discomfort of mouth sores, and in nasal spray form, to treat allergic rhinitis. It is a more potent derivative of triamcinolone, and is about eight times as potent as prednisone.
It is also known under the brand names Kenalog and Volon A as an injection to treat allergies, arthritis, eye diseases, intestinal problems, and skin diseases. In 2014, the FDA made triamcinolone acetonide an over-the-counter drug in the USA in nasal spray form under the brand name Nasacort.
Triamcinolone acetonide as an intra-articular injectable has been used to treat a variety of musculoskeletal conditions. When applied as a topical ointment, it is used for blistering from poison ivy, oak, and sumac, applied to the skin, avoiding eyes, mouth, and genital area. It provides immediate relief and is used before using oral prednisone. Oral/dental paste preparations are used for treating aphthous ulcers.
As an intravitreal injection, triamcinolone acetonide has been used to treat various eye diseases and has been found useful in reducing macular edema. Drug trials have found it to be as efficient as anti-VEGF drugs in eyes with artificial lenses over a two-year period.
Uncommonly, intramuscular injection of triamcinolone acetonide may be indicated for the control of severe or incapacitating allergic states for which conventional treatments have failed, such as asthma, atopic dermatitis, contact dermatitis, perennial or seasonal allergic rhinitis, serum sickness, and transfusion and drug hypersensitivity reactions.
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Common side effects of triamcinolone acetonide include sore throat, nosebleeds, increased coughing, headache, and runny nose. If these side effects occur, users are advised to consult their medical doctors where possible. Overuse or prolonged use of triamcinolone acetonide significantly increases the risk of side effects, as does dehydration.
Rarer, more serious side effects include opportunistic infections (due to suppression of immune responses) and anaphylaxis. If these life-threatening side effects occur, users must seek emergency medical services. Users should not attempt complex tasks (such as driving) while experiencing these side effects, and persons suffering from these effects should request transport to a hospital from acquaintances or emergency services using emergency telephone numbers.
Few serious adverse effects were noted in clinical trials with intranasal formulations; these include pharyngitis, rhinitis, headache, and epistaxis as the more common ones. Overdosage is unlikely. Uncommonly, systemic effects associated with corticosteroids can occur when triamcinolone acetonide is administered in large doses and/or over a long period of time.
As with all immunosuppressant drugs, triamcinolone acetonide should not be taken when sick or when illness has recently passed. Contact with sick persons should be avoided during the entire course of treatment. While using it, even minor illnesses (e.g. common cold) can be very serious, and may sometimes become life-threatening. Users who get sick during their regimen should contact their doctors to discuss whether to discontinue the prescription.
Triamcinolone acetonide should not be taken if the patient is also taking any other steroid or immunosuppressant, or if they have recently undergone any medical procedures involving the administration of steroids (e.g. nerve block).
Many drugs have been demonstrated to increase triamcinolone acetonide concentration in the blood to well above the intended level. Patients should inform doctors about any other drugs they are taking.
Triamcinolone acetonide is also used in veterinary medicine as an ingredient in topical ointments and in topical sprays for control of pruritus in dogs. A series of injections with triamcinolone acetonide or another corticosteroid may reduce keloid size and irritation. It is also used as a preinductor and/or inductor of birth in cows.
Conversion of the 17,20 double bond to a keto alcohol is accomplished in a single step with a special combination of reagents. NMO is acronym for N-methylmorpholine N-oxide, a cooxidant. See Upjohn dihydroxylation for details. It is sufficiently strong oxidant to oxidize the the hydroxyl at 20 to a ketone.
Thus, reaction under those conditions completes the formation of the dihydroxyacetone side chain and hydrocortisone acetate. Further oxidation of the 11 hydroxyl group with, for example, Jones’ reagent gives cortisone acetate.
- Triamcinolone Acetonide Drug information from MedLine Plus
- Nasacort medication leaflet
- GENESIS® (triamcinolone acetonide) Topical Spray Drug information
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