triamcinolone acetonide nasal inhaler-spray, Nasacort (discontinued brand in USA); Nasacort AQ

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Medical Author:

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.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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GENERIC NAME: triamcinolone acetonide nasal spray

BRAND NAME: Nasacort (discontinued brand in USA); Nasacort AQ

DRUG CLASS AND MECHANISM: Triamcinolone acetonide is a synthetic (man-made) corticosteroid. It is administered either as an oral metered-dose inhaler for the treatment of asthma (Azmacort), as a topical preparation for the skin (Kenalog; Aristocort) or as a nasal spray (Nasacort AQ) for relieving symptoms of rhinitis. Corticosteroids are naturally occurring hormones produced by the adrenal glands that prevent or suppress inflammation and immune responses. When given by intranasal spray, triamcinolone acetonide provides relief from allergy-induced watery nasal discharge (rhinorrhea), nasal congestion, postnasal drip, sneezing, and itching of the back of the throat which are symptoms associated with allergy. Approximately 50% of the triamcinolone acetonide is absorbed into the blood. A beneficial response usually is noted within a few days but can take as long as 4 weeks. The FDA approved Nasacort in July 1991.

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Nasal Spray: 16.5 g, 120 actuations. Each spray delivers 55 mcg triamcinolone acetonide.

STORAGE: Triamcinolone spray should be stored at room temperature, 59-86 F (15-30 C), and protected from heat, and direct light.

PRESCRIBED FOR: Triamcinolone acetonide nasal spray is used for relieving symptoms of rhinitis.

DOSING: The recommended dose is one or two sprays in each nostril once daily. Before use of the nasal spray, the nose should be blown gently, and the inhaler or spray should be shaken. The head should be tilted backwards, with the nozzle inserted into one nostril, the opening of the nozzle toward the swollen area. The other nostril should be closed. and the spray or inhaler activated while breathing in through the nose and out through the mouth. The inhaler or spray should be cleaned daily. The canister should be removed from the inhaler, rinsing the cap, nosepiece, and the inhaler with warm water and then drying them thoroughly.

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

PREGNANCY: Serious complications (including cleft palate and still births) have been reported when oral corticosteroids were administered during pregnancy. It is not known if the small amounts of corticosteroids that appear in the blood following intranasal use carry the same risk. Triamcinolone acetonide use during pregnancy should be avoided unless the physician feels that the potential therapeutic benefit justifies the potential risk to the fetus.

NURSING MOTHERS: It is unknown whether triamcinolone acetonide accumulates in breast milk. However, it is known that other corticosteroids are excreted in breast milk. The effects on the child, if any, are unknown.

SIDE EFFECTS: The most common side effects following nasal inhalation of triamcinolone acetonide are nasal irritation and itching, increased cough, nausea or vomiting, sore throat, nasal congestion, sneezing, nasal burning, bloody nasal discharge, and nasal dryness. Other adverse effects reported with intranasal triamcinolone acetonide include headache, dizziness, and watery eyes. All of these are either mild or uncommon. Nasal septal perforation, oral or nasal fungal infections, growth suppression in children, glaucoma, cataracts, and decreased production of cortisol by the adrenal glands also may occur.

Reference: FDA Prescribing Information

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