Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
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.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
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
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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