Dosing & Uses
Dosage Forms & Strengths
Treatment of rheumatic or arthritic disorders
60 mg IM every 6 weeks; may be supplemented by additional 20-100 mg IM PRN
Intralesional injection (10 mg/mL suspension): 1 mg per injection site 1 or more times weekly; not to exceed 30 mg/day
Intra-articular/intrasynovial/soft-tissue injection: Large joints, 15-40 mg; small joints/tendon sheath inflammation, 2.5-10 mg
Treatment of rheumatic or arthritic disorders
Intralesional injection: 0.5 mg/²; repeated PRN
Intra-articular injection (20 mg/mL suspension): 10-20 mg (large joint) ; 2-6 mg (small joints); repeated every 3-4 weeks PRN
Dilute with local anesthetic (1% or 2% lidocaine without parabens) before intra-articular or intralesional injection
Dilute with D5/NS or D10/NS or NS or SWI before intralesional injection
Avoid diluents containing parabens or phenols
Dosage Forms & Strengths
Treatment of rheumatic conditions
6-12 years: 0.03-0.2 mg/kg IM every 1-7 days
>12 years: 60 mg IM every 6 weeks; may be supplemented by additional 20-100 mg IM PRN
>12 years, intralesional injection (10 mg/mL suspension): 1 mg per injection site 1 or more times weekly; not to exceed 30 mg/day
Serious - Use Alternative
Significant - Monitor Closely
Frequency Not Defined
Increased intracranial pressure
Joint tissues damage
Lupus erythematosus-like lesions
Delayed wound healing
Pseudotumor cerebri (on withdrawal)
Systemic fungal infection, except as intra-articular injection for localized joint conditions
IM corticosteroids contraindicated for idiopathic thrombocytopenic purpura (ITP)
Triamcinolone diacetate injectable suspension contraindicated for intrathecal administration
Benzyl alcohol-containing formulations associated with potentially fatal "gasping syndrome" in premature newborns
Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids
Triamcinolone acetonide injectable suspension is for intra-articular or intralesional use only, not for IV, IM, intraocular, epidural, or IT use
Not for use in neonates (contains benzyl alcohol)
Use caution in patients with cirrhosis, ocular herpes simplex, hypertension, diverticulitis, hypothyroidism, myasthenia gravis, peptic ulcer disease, osteoporosis, ulcerative colitis, psychotic tendencies, untreated systemic infections, renal insufficiency, pregnancy
May cause higher degree of muscle wasting
Psychiatric disorders including depression, personality changes, insomnia, euphoria, and mood swings, may occur
High doses of corticosteroids, including triamcinolone, may increase mortality in patients with traumatic brain injury
Ophthalmic effects: Cataracts, infections, glaucoma
Monitor patients for hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing syndrome, and hyperglycemia; decrease dose gradually
Increased susceptibility to infection and increased risk of exacerbation, dissemination, or reactivation of latent infection
Monitor blood pressure and serum sodium and potassium levels
Increased risk of gastrointestinal (GI) perforation with certain GI disorders
Monitor bone density in long-term use
Behavioral and mood disturbances
Pregnancy: Fetal harm can occur with use in 1st trimester
Rare instances of anaphylaxis reported
Prolonged corticosteroid use may result in elevated intraocular pressure, glaucoma, or cataracts
Acute myopathy, involving ocular and/or respiratory muscles, reported with high-dose corticosteroids, especially in patients with neuromuscular transmission disorders
Prolonged use of Kaposi's sarcoma reported to be associated with development of Kaposi's sarcoma
Killed or inactivated vaccines may be administered; however, the response to such vaccines cannot be predicted
Immunization procedures may be undertaken in patients who are receiving corticosteroids as replacement therapy in physiologic doses (eg, for Addison’s disease)
- Serious neurologic events, some resulting in death, have been reported with epidural injection
- Specific events reported include, but are not limited to, spinal cord infarction, paraplegia, quadriplegia, cortical blindness, and stroke
- These serious neurologic events have been reported with and without use of fluoroscopy
- Safety and effectiveness of epidural administration of corticosteroids have not been established, and corticosteroids are not approved for this use
Pregnancy & Lactation
Pregnancy category: C
Lactation: Excreted in breast milk; use caution
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.
Mechanism of Action
Potent glucocorticoid with minimal to no mineralocorticoid activity
Controls or prevents inflammation by suppressing migration of polymorphonuclear leukocytes and fibroblasts and reversing capillary permeability
Suppresses immune system by reducing volume and activity of lymphatic system
Bioavailability: Complete with intra-articular injection
Duration: 8-12 hr (PO)
Peak plasma time: 8-10 hr (IM)
Protein bound: 68%
Vd: 99.5 L
Metabolized in liver
Half-life: Plasma, 2-3 hr; biologic, 18-36 hr
Renal clearance: 9.5 mL/min
Excretion: Urine (40%), feces (60%)
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.