triamcinolone topical (Kenalog Orabase, Kenalog topical, Pediaderm TA, Triacet, Trianex)

Dosing and uses of Kenalog Orabase (triamcinolone topical)

• Adult
• Pediatric

 

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%)