What is Triesence, and how does it work?
Generic drug: triamcinolone acetonide
Brand name: Triesence
Triesence (triamcinolone acetonide) Injectable Suspension is a steroid injection used to treat inflammation of the joints or tendons to treat arthritis, bursitis, or epicondylitis (tennis elbow). Triesence is usually given in these conditions only as a short-term treatment of a severe or aggravated episode.
Triesence is also injected into soft tissues of the body to treat certain skin disorders caused by autoimmune conditions such as lupus, psoriasis, lichen planus, and others.
Ophthalmic Diseases
Triesence (triamcinolone acetonide) injectable suspension 40 mg/mL is indicated for:
- sympathetic ophthalmia,
- temporal arteritis,
- uveitis, and
- ocular inflammatory conditions unresponsive to topical corticosteroids.
Visualization During Vitrectomy
- Triesence suspension is indicated for visualization during vitrectomy.
What are the side effects of Triesence?
Common side effects of Triesence include:
- nausea
- bloating
- appetite changes
- stomach or side pain
- headache
- sleep problems (insomnia)
- acne
- scaling or other skin changes
- a wound that is slow to heal
- thinning hair
- bruising or swelling
- sweating more than usual, or
- irregular menstrual periods
What is the dosage for Triesence?
- The initial recommended dose of Triesence suspension is 4 mg (100 microliters of 40 mg/mL suspension) with subsequent dosage as needed over the course of treatment.
- The recommended dose of Triesence suspension is 1 to 4 mg (25 to 100 microliters of 40 mg/mL suspension) administered intravitreally.
What drugs interact with Triesence?
- There have been cases reported in which concomitant use of Amphotericin B and hydrocortisone was followed by cardiac enlargement and congestive heart failure. See Potassium depleting agents.
- Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. If possible, anticholinesterase agents should be withdrawn at least 24 hours before initiating corticosteroid therapy.
- Co-administration of corticosteroids and warfarin usually results in inhibition of response to warfarin, although there have been some conflicting reports. Therefore, coagulation indices should be monitored frequently to maintain the desired anticoagulant effect.
- Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required.
- Serum concentrations of isoniazid may be decreased.
- Drugs such as barbiturates, phenytoin, ephedrine, and rifampin, which induce hepatic microsomal drug metabolizing enzyme activity may enhance metabolism of corticosteroid and require that the dosage of corticosteroid be increased.
- Ketoconazole has been reported to decrease the metabolism of certain corticosteroids by up to 60% leading to an increased risk of corticosteroid side effects.
- Cholestyramine may increase the clearance of corticosteroids.
- Increased activity of both cyclosporine and corticosteroids may occur when the two are used concurrently. Convulsions have been reported with concurrent use.
- Patients on digitalis glycosides may be at increased risk of arrhythmias due to hypokalemia.
- Estrogens may decrease the hepatic metabolism of certain corticosteroids thereby increasing their effect.
- Concomitant use of aspirin or other non-steroidal antiinflammatory agents and corticosteroids increases the risk of gastrointestinal side effects. Aspirin should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia. The clearance of salicylates may be increased with concurrent use of corticosteroids.
- When corticosteroids are administered concomitantly with potassium-depleting agents, patients should be observed closely for development of hypokalemia.
- Corticosteroids may suppress reactions to skin tests.

QUESTION
The term arthritis refers to stiffness in the joints. See AnswerIs Triesence safe to use while pregnant or breastfeeding?
- Triamcinolone acetonide can cause fetal harm when administered to a pregnant woman.
- Human and animal studies suggest that the use of corticosteroids during the first trimester of pregnancy is associated with an increased risk of orofacial clefts, intrauterine growth restriction, and decreased birth weight.
- If this drug is used during pregnancy, or if the patient becomes pregnant while using this drug, the patient should be apprised of the potential hazard to the fetus.
- Corticosteroids are secreted in human milk. Reports suggest that steroid concentrations in human milk are 5 to 25% of maternal serum levels, and that total infant daily doses are small, less than 0.2% of the maternal daily dose. The risk of infant exposure to steroids through breast milk should be weighed against the known benefits of breastfeeding for both the mother and baby.
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Summary
Triesence (triamcinolone acetonide) Injectable Suspension is a steroid injection used to treat inflammation of the joints or tendons to treat arthritis, bursitis, or epicondylitis (tennis elbow). Triesence is also injected into soft tissues of the body to treat certain skin disorders caused by autoimmune conditions such as lupus, psoriasis, lichen planus, as well as ophthalmic diseases. Common side effects of Triesence include nausea, bloating, appetite changes, stomach or side pain, headache, sleep problems (insomnia), acne, scaling or other skin changes, slow-healing wounds, and others.
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Medications & Supplements
- triamcinolone acetonide - nasal, Nasacort
- triamcinolone acetonide 0.1% dental paste (Kenalog Orabase, Oralone)
- triamcinolone acetonide nasal inhaler (Nasacort)
- triamcinolone acetonide inhaler, Azmacort
- Trianex (triamcinolone acetonide)
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