triamcinolone intravitreal

Triamcinolone intravitreal is a medication injected into the vitreous of the eye to treat inflammatory eye conditions, including those that don’t respond to topical ophthalmic application of corticosteroids. Triamcinolone is also used to visualize during vitrectomy, a surgical procedure to remove the vitreous. Vitreous is a transparent gel-like substance that fills the eyeball space between the lens and retina.

Triamcinolone is a synthetic corticosteroid that has potent anti-inflammatory properties. Triamcinolone inhibits inflammatory signals, and the synthesis and release of inflammatory substances. Triamcinolone binds to and activates glucocorticoid receptors on cell membranes and produces multiple anti-inflammatory processes:

• Depresses the production of eosinophils and lymphocytes, immune cells that promote inflammation.
• Reduces capillary permeability to prevent the leakage of inflammatory cells and proteins (cytokines) into the inflammation site.
• Prevents migration of leukocytes, types of white cells, to the inflammation site.
• Inhibits fibrin deposition and swelling (edema).
• Inhibits later stages of wound healing such as capillary proliferation, collagen deposition and scar formation.

The uses of triamcinolone intravitreal include ocular inflammatory conditions including:

• Macular edema associated with uveitis
• Sympathetic ophthalmia
• Temporal arteritis
• Uveitis
• Ocular inflammatory conditions that don’t respond to topical corticosteroids
• Visualization during vitrectomy

• Do not use triamcinolone intravitreal in patients with:
  • Hypersensitivity to any component of the formulation
  • Systemic fungal infections
  • Cerebral malaria
• Corticosteroids, including triamcinolone intravitreal, can increase the risk for secondary fungal or viral ocular infections and also mask signs of infection. Monitor patients for secondary infections and provide appropriate treatment should infection develop.
• Triamcinolone intravitreal can cause new onset or exacerbation of increased intraocular pressure. Monitor patients for signs and symptoms and treat appropriately.
• Triamcinolone can cause infectious or non-infectious inflammations in the inner layer and fluid of the eye (endophthalmitis). Monitor patients and treat appropriately.
• Corticosteroids, including triamcinolone, can cause cataracts to form.
• Use triamcinolone intravitreal with caution in patients with ocular herpes simplex because of possible corneal perforation. Do not use in patients with active ocular herpes simplex infection.
• Chronic use of corticosteroids can cause reversible suppression of hypothalamic-pituitary-adrenal axis, Cushing’s syndrome, hyperglycemia, and potential for adrenal insufficiency after discontinuation, lasting for months. Monitor patients and institute corticosteroid replacement therapy in situations of stress during that period.
• Changes in thyroid status may necessitate dosage adjustments.

Common side effects of triamcinolone intravitreal include:

• Cataract including:
  • Cortical cataract
  • Nuclear cataract
  • Subcapsular cataract
• Progression of cataract
• Injection site reactions such as:
  • Blurring of vision
  • Transient discomfort
• Acute eye pain
• Eye irritation
• Foreign body sensation in the eyes
• Itchy eyes
• Increased intraocular pressure
• Headache
• Infectious or non-infectious inflammation of the inner layers of the eye (endophthalmitis)
• Deposition of cells and fibrin in the anterior eye chamber (hypopyon)
• Glaucoma, an ocular condition that progressively damages the optic nerve
• Vitreous floaters
• Vitreous opacity
• Vitreous detachment
• Retinal detachment
• Detachment of retinal pigment epithelium
• Optic disc vascular disorder
• Eye inflammation
• Inflammation of the uvea layer in the eye (uveitis)
• Red eye (conjunctival hyperemia)
• Bleeding in the eye’s outer membrane (conjunctival hemorrhage)
• Conjunctival edema
• Reduced visual acuity
• Drooping of upper eyelid (blepharoptosis)
• Blurred vision
• Inflammatory lump in the eyelid (chalazion)
• Inflammation of meibomian glands in the eye (meibomianitis)
• Light flashes in the field of vision (photopsia)
• Light sensitivity (photophobia)
• Corneal inflammation with pinpoint lesions (punctate keratitis)
• Dry eyes (xerophthalmia)
• Bulging eyes (exophthalmos)

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Injectable suspension, intravitreal (as acetonide salt)

• 4 mg/0.1 mL

Adult:

Ophthalmic Disease

• Indicated for sympathetic ophthalmia, temporal arteritis, uveitis, and ocular inflammatory conditions unresponsive to ophthalmic corticosteroids
• Initial: 4 mg intravitreal once; may administer additional doses as needed

Visualization During Vitrectomy (Triesence)

• 1-4 mg intravitreal

Pediatric:

Safety and efficacy not established

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Triamcinolone intravitreal has no listed severe or serious interactions with other drugs.
• Moderate interactions of triamcinolone intravitreal include:
  • strong CYP3A4 inhibitors
  • nirmatrelvir
  • ritonavir
  • ophthalmic non-steroidal anti-inflammatory agents
  • anticoagulant agents
  • antidiabetic agents
• Triamcinolone intravitreal has no listed mild interactions with other drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• Triamcinolone intravitreal can cause fetal harm. Do not use triamcinolone intravitreal during pregnancy except when clearly needed and potential benefits outweigh potential risks to the fetus. If administered during pregnancy, monitor the newborn carefully for signs of hypoadrenalism.
• Corticosteroids including triamcinolone are excreted in breastmilk. The amount systemically absorbed following intravitreal administration and consequent excretion in breastmilk is not known. Decision to breastfeed during treatment with triamcinolone intravitreal should be based on the benefits of breastfeeding and the risk of steroid exposure to the breastfed infant.

• Corticosteroids, including triamcinolone intravitreal, can increase susceptibility to secondary infections. Take precautions to avoid exposure to infections.
• Report to your physician if you develop infections or severe allergic reactions.
• Notify your ophthalmologist if you experience any persistent symptoms of eye infection or other reactions to triamcinolone intravitreal such as redness, pain, swelling or irritation of the eyes.