triamcinolone acetonide inhaler, Azmacort

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GENERIC NAME: triamcinolone inhaler

BRAND NAME: Azmacort

DRUG CLASS AND MECHANISM: Triamcinolone is a synthetic (man-made) steroid of the glucocorticoid family used for treating asthma. It is similar to beclomethasone (Vanceril, QVAR) and fluticasone (Flovent). The naturally-occurring glucocorticoid hormone is cortisol or hydrocortisone produced in the adrenal glands. Glucocorticoids have potent anti-inflammatory actions. Some symptoms of asthma are caused by chronic inflammation in the airways within the lungs that obstruct the flow of air into and out of the lungs. Triamcinolone reduces inflammation in the lungs and airways and thereby improves breathing in individuals with asthma. When used as an inhaler, triamcinolone goes directly to the airways of the lungs, and very little is absorbed into the body. The FDA approved the triamcinolone inhaler in April 1982.



PREPARATIONS: Metered Dose Inhaler: 60 mg (75 mcg/actuation)

STORAGE: Triamcinolone inhaler should be kept at room temperature, 20-25 C (68-77 F) and protected from direct light. Exposure to temperatures above 38.8 C (120 F) may cause bursting of the canister. The canister should never be thrown into a fire or incinerator.

PRESCRIBED FOR: The triamcinolone inhaler is used for preventing episodes of asthma. It should not be used for acute attacks of asthma because it does not work quickly enough. A triamcinolone inhaler may reduce or eliminate the need for oral glucocorticoids to control asthma.

DOSING: The usual recommended dosage for adults is two inhalations (150 mcg) given 3-4 times daily or 4 inhalations (300 mcg) given twice daily. The maximum daily dose is 16 inhalations (1200 mcg) in adults. Higher initial doses (12 to 16 inhalations per day) may be considered in patients with more severe asthma.

The usual recommended dosage for children (6-12 years old) is 1 or 2 inhalations.

(75 to 150 mcg) given 3-4 times daily or 2-4 inhalations (150 to 300 mcg) twice daily. The maximum daily dose is 12 inhalations (900 mcg).

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

PREGNANCY: There are no adequate studies of the triamcinolone inhaler in pregnant women.

NURSING MOTHERS: It is not known if triamcinolone is secreted in breast milk. Other medications in its family are secreted into breast milk, but it is not known whether the small amounts that may appear in milk affect the infant.

SIDE EFFECTS: Common side effects include headache, pharyngitis (inflammation of the throat), vomiting, dry mouth, and cough. Mild cough or wheezing due to chemical irritation may be minimized by using an inhaled bronchodilator, for example, albuterol (Ventolin), prior to using the triamcinolone. Oral candidiasis or thrush (a fungal infection) may occur in 1 in 20 to 1 in 10 persons who use triamcinolone, the risk being higher with higher doses. The risk of thrush in children is lower than in adults. Hoarseness also may result from the use of triamcinolone inhaler. Using a spacer (a device that is attached to the inhaler) and washing the mouth out with water following each use reduces the risk of thrush and hoarseness.

High doses of inhaled glucocorticoids may decrease the formation of bone and increase the breakdown (resorption) of bone 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 such as illnesses when increased amounts of glucocorticoids are needed by the body.

Reference: FDA Prescribing Information

Last Editorial Review: 7/31/2009

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