Dosing and uses of Nasacort Allergy 24HR (triamcinolone intranasal)
Adult dosage forms and strengths
nasal spray
- 55mcg/spray
- Note: Nasacort AQ (Rx) was phased out and replaced by Nasacort Allergy 24HR (OTC) in spring 2014
Allergic Rhinitis
2 sprays/nostril qDay (220 mcg/day); not to exceed 220 mcg/day
Dosing Considerations
Once maximum benefit has been achieved, reduce dose to 1 spray/nostril qDay (110 mcg/day) to minimize adverse effects while maintaining effectiveness
Administration
Suspension; shake well before use
Before using for first time, prime pump by releasing 5 sprays into air away from face
If not used for >2 weeks, repeat priming by releasing 1 spray into air before using
Pediatric dosage forms and strengths
nasal spray suspension
- 55mcg/spray
- Note: Nasacort AQ (Rx) was phased out and replaced by Nasacort Allergy 24HR (OTC) in spring 2014
Allergic Rhinitis
<2 years: Safety and efficacy not established
2-6 years: 1 spray/nostril qDay (110 mcg/day); not to exceed 110 mcg/day
6-12 years: 1 spray/nostril qDay; may increase to 2 sprays/nostril qDay (110 mcg/day); if inadequate response, may increase to 2 sprays/nostril qDay (ie, 220 mcg/day); not to exceed 220 mcg/day
≥12 years: 2 sprays/nostril qDay (220 mcg/day); not to exceed 220 mcg/day
Dosing Considerations
>6 years: Once maximum benefit has been achieved, reduce dose to 1 spray/nostril qDay (110 mcg/day) to minimize adverse effects while maintaining effectiveness
Administration
Suspension; shake well before use
Before using for first time, prime pump by releasing 5 sprays into air away from face
If not used for >2 weeks, repeat priming by releasing 1 spray into air before using
Nasacort Allergy 24HR (triamcinolone intranasal) adverse (side) effects
1-10%
Flu syndrome [children] (9%)
Pharyngitis (5-8%)
Headache [children] (6%)
Bronchitis [children] (3%)
Dyspepsia (3-5%)
Tooth disorder [children] (3%)
Epistaxis (3-5%)
Excoriation [children] (3%)
Increased cough (2- 8%)
Upper abdominal pain [children] (5%)
Diarrhea [children] (3%)
Rash [children] (3%)
Asthma [children] (3%)
Rhinorrhea [children] (2%)
Postmarketing Experience
Nasal discomfort/congestion
Sneezing
Alterations of taste and smelL
Nausea
Insomnia
Dizziness
Fatigue
Dyspnea
Decreased blood cortisoL
Cataract
Glaucoma
Increased IOp
Pruritus
Rash
Hypersensitivity
Warnings
Contraindications
Hypersensitivity
Cautions
Delay initiation of treatment in patients with recent nasal surgery, nasal trauma, nasal septum ulcers (until healing has occurred)
Prolonged use may increase incidence of secondary infection
Monitor for vision change, or with history of increased IOP, glaucoma, or cataracts
Potential worsening of existing tuberculosis, fungal, bacterial, viral, or parasitic infections, or ocular herpes simplex
More serious or fatal course of chickenpox or measles in susceptible patients
Risk for hypercorticism and adrenal suppression with higher than normal doses
Potential reduction of growth velocity in children
Pregnancy and lactation
Pregnancy category: C
Lactation: Unknown whether distributed in breast milk; exercise 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 Nasacort Allergy 24HR (triamcinolone intranasal)
Mechanism of action
Corticosteroid with potent anti-inflammatory properties; elicits effects on various cells, including mast cells and eosinophils; also elicits effects on inflammatory mediators (eg, histamine, eicosanoids, leukotrienes, cytokines)
Absorption
Minimal systemic absorption occurs, mostly by small amount swallowed during nasal administration
Distribution
Vd: 99.5 L
Peak plasma time: 1.5 hr
Peak plasma concentration: 0.5 ng/mL
Metabolism
Metabolites: 6β-hydroxytriamcinolone acetonide, 21-carboxytriamcinolone acetonide and 21-carboxy-6β-hydroxytriamcinolone acetonide (major)
Elimination
Half-life: 88 min
