GENERIC NAME: triamcinolone acetonide inhaler
DRUG CLASS AND MECHANISM: Triamcinolone acetonide is a synthetic (man-made) steroid of the glucocorticoid family. The naturally-occurring glucocorticoid hormone is cortisol or hydrocortisone, and it is produced in the adrenal glands. Glucocorticoid steroids have potent anti-inflammatory actions. When used as an inhaler, the medication goes directly to the airways of the lungs, and very little is absorbed into the body.

PRESCRIPTION: yes

GENERIC AVAILABLE: no

PREPARATIONS: Inhaler 100 mcg/actuation.

STORAGE: Triamcinolone acetonide should be kept at room temperature, 15-30°C (59-86°F) and protected for direct light.

PRESCRIBED FOR: Triamcinolone acetonide is indicated for the control of bronchial asthma

in persons requiring continuous treatment. Such patients may include those with frequent asthmatic episodes requiring bronchodilators or those with asthmatic episodes at night.

DOSING: Triamcinolone acetonide is used for the prevention of asthmatic attacks and should not be used to treat acute (active) attacks. Doses vary widely. Two to four inhalations or more may be prescribed two to four times daily. The medication requires continuous (daily) use to be effective. Some benefit may be noted by the third day of use, but maximal benefit usually is not seen until the second or third week of use.

DRUG INTERACTIONS: No drug interactions have been described with inhaled triamcinolone acetonide.

PREGNANCY: When given orally, glucocorticoids such as triamcinolone have been shown to cause fetal abnormalities in animals; however, it is not known if there is an increased risk of malformation in children born to mothers exposed to triamcinolone acetonide during pregnancy.

NURSING MOTHERS: It is not known if triamcinolone acetonide is secreted in breast milk. Other medications in this class are secreted into breast milk, but it is not known whether the small amounts that may appear in the milk are of consequence to the infant.

SIDE EFFECTS: The most commonly noted side effects associated with inhaled triamcinolone acetonide are mild cough or wheezing; these effects may be minimized by using a bronchodilator inhaler (e.g. albuterol or Ventolin) prior to triamcinolone acetonide. Oral candidiasis or thrush (a fungal infection) may occur in 1 in 20 to 1 in 10 persons who use triamcinolone acetonide, the risk being higher with higher doses. The risk in children is lower than in adults. Hoarseness also may result from the use of triamcinolone acetonide. Using a spacer device and washing the mouth out with water following each use reduces the risk of thrush and hoarseness. Hoarseness also may occur.

High doses of other inhaled glucocorticoids may decrease bone formation and increase bone breakdown (resorption) leading to weak bones and fractures. Very high doses may cause suppression of the body's ability to make its own natural glucocorticoid in the adrenal glands. It is possible that patients with suppression of their adrenal glands may need increased amounts of glucocorticoids by the oral or intravenous route during periods of high physical stress.