Dosing and uses of Azmacort (triamcinolone inhaled)
Adult dosage forms and strengths
inhaler
- 55mcg/inh
- 100mcg/inh
Asthma
Discontinued in the United States in 2010
Inhaler: 2 puffs (150 mcg) TID/QID; no more than 16 puffs/day
Discontinue if inadequate relief after 3 weeks
Pediatric dosage forms and strengths
inhaler
- 55mcg/inh
- 100mcg/inh
Asthma
6-12 years old: 1-2 puffs (75-150 mcg) TID/QId
No more than 12 puffs/day
Azmacort (triamcinolone inhaled) adverse (side) effects
>10%
Pharyngitis (25%)
Headache (21%)
1-10%
Flu syndrome (5%)
Sinusitis (4%)
Back pain (2%)
Frequency not defined
Bronchospasm
Cough
Dry throat/mouth
Oral candidiasis (rare)
Warnings
Contraindications
Acute bronchospasm
Hypersensitivity
(Nasal Spray): nasal injury/surgery (until healed)
Caution
TB, other serious infections, Glaucoma, incr IOP, cataracts, immunocompromised pts
Must be used regularly: NOT PRn
Chickenpox & measles: serious or fatal course in susceptible individuals
- Unvaccinated or immunologically unexposed children or adults should avoid exposure
Transferring pts from systemic corticosteroids; withdrawal of systemic corticosteroids may cause adrenal insufficiency, taper off gradually
Risk of infections of nose & pharynx, including Candida albicans
Excessive use may suppress HPA function
During periods of stress or severe status asthmaticus, may require supplementary systemic corticosteroids immediately
- Carry warning card to that effect
Metered-dose inhalers that contain chlorofluorocarbons (CFCs) are currently being phased out in the United States; alternate inhalers without CFCs are available
Inhaler: contents under pressure
Nasal spray: prime initially with 5 sprays
Pregnancy and lactation
Pregnancy category: C
Lactation: not known if excreted in breast milk
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 Azmacort (triamcinolone inhaled)
Half-Life: 88 min
Onset: 1-2 wk
Protein Bound: 68%
Vd: 99.5 L
Metabolites: 6 beta-hydroxytriamcinolone acetonide, 21-carboxytriamcinolone acetonide and 21-carboxy-6 beta-hydroxytriamcinolone acetonide
Clearance: 45.2 L/hr
Excretion: feces & urine
Mechanism of action
Glucocorticoid: anti-inflammatory, precise mechanism unknown
Effective local steroid activity with minimal systemic effects
