Kenalog Orabase (triamcinolone topical) dosing, indications, interactions, adverse effects, and more

Sections

Sections triamcinolone topical
Dosing & Uses
Adverse Effects
Warnings
Pregnancy
Pharmacology
Images
Patient Handout
Formulary

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

cream/ointment

0.025%
0.1%
0.5%

lotion

0.025%
0.1%

dental paste

0.1%

aerosol solution

0.0147%

therapy pack

0.1% (contains cetyl alcohol, methylparaben, propylene glycol)

kit

0.1% (contains propylene glycol)

Topical Inflammatory Dermatoses

Cream/ointment: Apply thin film to affected areas bid/qid

Lotion (0.025%): Apply thin film to affected area tid/qid

Lotion (0.1%): Apply thin film to affected area bid/qid

Aerosol solution: Apply to affected area tid/qid

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

Dosage Forms & Strengths

cream/ointment

0.025%
0.1%
0.5%

lotion

0.025%
0.1%

dental paste

0.1%

topical spray

0.0147%

therapy pack

0.1% (contains cetyl alcohol, methylparaben, propylene glycol)

kit

0.1% (contains propylene glycol)

Topical Inflammatory Dermatoses

Cream/ointment: Apply thin film to affected areas bid/qid

Lotion (0.025%): Apply thin film to affected area tid/qid

Lotion (0.1%): Apply thin film to affected area bid/qid

Aerosol solution: Apply to affected area tid/qid

Dosing considerations

Base frequency on severity of condition
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

Frequency Not Defined

Skin atrophy

Striae

Acneform lesions

Pigmentation changes

HPA suppression (with higher potency used >2 weeks)

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

May cause hypercorticism or suppression of hypothalamic-pituitary-adrenal (HPA) axis, especially in younger children or patients receiving high doses for prolonged periods; HPA axis suppression may lead to adrenal crisis

Absorption may be increased by use of occlusive dressings, application to denuded skin or to large surface areas; percutaneous absorption may cause manifestations of Cushing’s syndrome, hyperglycemia, or glycosuria

Pregnancy & 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.

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%)

Images

No images available for this drug.

Patient Handout

A Patient Handout is not currently available for this monograph.

Formulary

FormularyPatient Discounts

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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.

View explanations for tiers and restrictions

Tier	Description
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.
4	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC	NOT COVERED – Drugs that are not covered by the plan.

Code	Definition
PA	Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL	Quantity Limits Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST	Step Therapy Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR	Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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