triamcinolone topical (Kenalog Orabase, Kenalog topical, Pediaderm TA, Triacet, Trianex)
Classes: Corticosteroids, Topical
Dosing and uses of Kenalog Orabase (triamcinolone topical)
Adult dosage forms and strengths
cream/ointment
- 0.025%
- 0.05%
- 0.1%
- 0.5%
lotion
- 0.025%
- 0.1%
dental paste
- 0.1%
aerosol solution
- 0.0147%
Topical Inflammatory Dermatoses
Cream/ointment (0.025%): Apply BID-QId
Cream/ointment (0.1%, 0.5%): Apply BID-TId
Spray: Apply TID-QId
See also combination with nystatin
Oral Inflammatory or Ulcerative Lesions
Dental paste: Apply as thin film enough to cover the lesion qHS; may increase to BID/TID PC if lesions are severe
Pediatric dosage forms and strengths
cream/ointment
- 0.025%
- 0.05%
- 0.1%
- 0.5%
lotion
- 0.025%
- 0.1%
dental paste
- 0.1%
topical spray
- 0.0147%
Topical Inflammatory Dermatoses
Cream/ointment (0.025%): Apply BID-QId
Cream/ointment (0.1%, 0.5%): Apply BID-TId
Spray: Apply TID-QId
See also combo with nystatin
Dosing considerations
- Limit to the minimum amount necessary for therapeutic efficacy
Oral Inflammatory or Ulcerative Lesions (Off-label)
Dental paste: Apply as thin film qHS; may increase to BID/TID PC
Kenalog Orabase (triamcinolone topical) adverse (side) effects
Frequency not defined
Skin atrophy
Striae
Acneform lesions
Pigmentation changes
HPA suppression (with higher potency used >2 weeks)
Warnings
Contraindications
Underlying fungal, bacterial, or viral infection
Hypersensitivity
Ophthalmic use
Cautions
Chronic topical corticosteroid therapy may interfere with growth and development in children
Use medium to very high potency for <2 weeks to reduce local and systemic side effects
Use low potency for chronic therapy
Avoid medium to very high potency on face, folds, and groin because can increase steroid absorption
Use lower potency for children (ie, increase BSA/kg, therefore increase systemic absorption)
Prolonged use may result in bacterial or fungal superinferction; discontinue if dermatological infection persists despite antimicrobial therapy
Discontinue if local sensitization including irritation or redness occurs
Avoid use of high potency steroids in the face
Pregnancy and lactation
Pregnancy category: C
Lactation: Not known whether topical corticosteroids are distributed into milk; however, systemic corticosteroids are distributed into milk; use with caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Kenalog Orabase (triamcinolone topical)
Mechanism of action
Corticosteroids decrease inflammation by stabilizing leukocyte lysosomal membranes, preventing release of destructive acid hydrolases from leukocytes, inhibiting macrophage accumulation in inflamed areas, reducing leukocyte adhesion to capillary endothelium, reducing capillary wall permeability and edema formation, decreasing complement components, antagonizing histamine activity and release of kinin from substrates, and reducing fibroblast proliferation, collagen deposition, and subsequent scar tissue formation
Pharmacokinetics
Absorption: Absorptioni may occur percutaneously wiht topical steroids
Half-life: 18-36 hr
Excretion: Urine (40%); feces (60%)
