triamcinolone acetonide inhaler, Azmacort (cont.)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
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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