xerosis
† non-FDA-approved indication
Triamcinolone (Nasacort® AQ; Kenalog®) Indications and Dosage
Equivalent Glucocorticoid dosages. These are general approximations and may not apply to all diseases or routes of administration.
Equivalent glucocorticoid dosages:
Cortisone--25 mg
Hydrocortisone--20 mg
Prednisolone--5 mg
Prednisone--5 mg
Methylprednisolone--4 mg
Triamcinolone--4 mg
Dexamethasone--0.75 mg
Betamethasone--0.6 mg
General Comparative Topical Corticosteroid Potency:
NOTE: The following is a general representation. Check specific product formulations prior to making potency decisions.
Very High Potency
Betamethasone dipropionate (augmented)
Clobetasol
Diflorasone diacetate ointment
Halobetasol
High Potency
Amcinonide
Betamethasone dipropionate
Desoximetasone gel or ointment, or cream >= 0.25%
Diflorasone diacetate cream
Fluocinolone cream >= 0.2%
Fluocinonide
Halcinonide
Triamcinolone >= 0.5%
Medium Potency
Beclomethasone
Betamethasone benzoate
Betamethasone valerate
Clobetasone
Desoximetasone cream < 0.25%
Diflucortolone
Fluocinolone ointment or topical solution or cream < 0.2%
Flurandrenolide >= 0.025%
Fluticasone
Hydrocortisone butyrate
Hydrocortisone valerate
Mometasone
Triamcinolone < 0.5%
Low Potency
Alclometasone
Clocortolone
Desonide
Dexamethasone
Flumethasone
Flurandrenolide < 0.025%
Hydrocortisone base
Hydrocortisone acetate
For bronchospasm prophylaxis or maintenance therapy in patients who require chronic treatment with corticosteroids for control of bronchial asthma:
Oral inhalation dosage (triamcinolone acetonide):
Adults: Initially, 200 mcg (2 metered sprays) PO 3 - 4 times a day. Severe asthma may require up to 16 oral inhalations/day in divided doses. Maintenance dosage must be individually determined, reduced according to patient response and may be given in two daily doses.
Children 6 - 12 years: 200 - 400 mcg (2 - 4 metered sprays) 2 - 4 times per day. Do not exceed 12 oral inhalations/day.
Children < 6 years: Safe dosage has not been established.
For the treatment of symptoms of seasonal and perennial allergic rhinitis:
Nasal inhalation dosage (Nasacort® HFA):
Adults and adolescents >= 12 years: Initially, 2 sprays in each nostril once daily (total dose 220 mcg); if needed, increase to 4 sprays in each nostril once daily. Once the maximal effect is achieved, titrate to the minimum effective dose.
Children 6 - 11 years: 2 sprays in each nostril once per day (total dose 220 mcg). Once the maximal effect is achieved, titrate to the minimum effective dose.
Nasal inhalation dosage (Nasacort® AQ nasal spray):
Adults and adolescents >= 12 years: Each spray delivers 55 mcg. The recommended starting dose is 2 sprays into each nostril once per day (total dose of 220 mcg). Dosage should be reduced to the minimum effective dose. Maximum effects usually occur within 1 week of initiation of therapy. If adequate relief of symptoms is not achieved after 3 weeks of treatment, the drug should be discontinued.
Children 6 - 11 years: 1 - 2 sprays (55 - 110 mcg) into each nostril once per day. Dosage should be reduced to the minimum effective dose once the maximal effect is achieved.
Nasal inhalation dosage (Tri-Nasal® nasal spray):
Adults and adolescents >= 12 years: Each spray delivers 50 mcg. The recommended starting dose is 2 sprays into each nostril once daily (total dose of 200 mcg). The dose may be increased to 400 mcg/day given as 4 sprays/nostril once daily or 2 sprays/nostril twice daily. Do not exceed 400 mcg/day. Dosage should be reduced to the minimum effective dose.
For the treatment of acute rheumatic carditis, berylliosis, temporal arteritis † , or systemic lupus erythematosus (SLE):
NOTE: For many conditions, the dosing of corticosteroids is highly variable; the following general dosing recommendations apply.
Oral dosage (triamcinolone tablets or triamcinolone diacetate syrup):
Adults: 4 - 48 mg (base) PO per day as a single dose or in divided doses. Certain cases may require up to 60 mg as an initial dose.
Children: 416 mcg - 1.7 mg (base)/kg PO per day, or 12.5 - 50 mg (base)/m2 PO per day as a single dose or in divided doses.
Intramuscular dosage (triamcinolone acetonide):
Adults: 40 - 80 mg IM. Repeat every four weeks, if needed.
Children >= 6 years: 40 mg IM. Repeat every four weeks, if needed. Alternatively, 30 - 200 mcg/kg or 1 - 6.25 mg/m2 repeated at 1 - 7 day intervals.
Intramuscular dosage (triamcinolone diacetate):
Adults: 40 mg IM once a week. The dose may also be calculated as 4 - 7 times the daily oral dose given as a single IM injection and repeated at four-day to four-week intervals as needed.
Children >= 6 years: 40 mg IM once a week.
Children < 6 years: Safe dosage has not been established.
For the treatment of fulminating or disseminated pulmonary tuberculosis in conjunction with appropriate antituberculosis therapy:
Oral dosage (triamcinolone tablets or triamcinolone diacetate syrup):
Adults: 4 - 48 mg (base) PO per day as a single dose or in divided doses. Certain cases may require up to 60 mg as an initial dose.
Children: 416 mcg - 1.7 mg (base)/kg/day PO or 12.5 - 50 mg (base)/m2/day PO as a single dose or in divided doses.
Intramuscular dosage (triamcinolone acetonide):
Adults: 40 - 80 mg IM. Repeat every four weeks, if needed.
Children >= 6 years: 40 mg IM. Repeat every four weeks, if needed. Alternatively, 30 - 200 mcg/kg or 1 - 6.25 mg/m2 repeated at 1 - 7 day intervals.
Intramuscular dosage (triamcinolone diacetate):
Adults: 40 mg IM once a week. The dose may also be calculated as 4 - 7 times the daily oral dose given as a single IM injection and repeated at four-day to four-week intervals as needed.
Children >= 6 years: 40 mg IM once a week.
Children < 6 years: Safe dosage has not been established.
For the treatment of pruritus and topical inflammation associated with moderate to severe corticosteroid-responsive dermatoses (e.g., alopecia areata, atopic dermatitis, contact dermatitis including Rhus dermatitis due to poison ivy, poison oak, poison sumac, subacute cutaneous or discoid lupus erythematosus, eczema, exfoliative dermatitis, insect bites or stings, granuloma annulare, keloids, lichen striatus, lichen planus, lichen simplex chronicus, mycosis fungoides, necrobiosis lipoidica diabeticorum, pemphigus, pityriasis rosea, polymorphous light eruption, psoriasis, sarcoidosis, seborrheic dermatitis, sunburn, or xerosis):
Topical dosage (triamcinolone acetonide):
Adults: Apply 0.025 - 0.1% cream, ointment or lotion to the affected areas 2 - 4 times per day; or 0.015% topical aerosol 1 - 2 times per day.
Intralesional or sublesional dosage (triamcinolone diacetate):
Adults: 3 - 48 mg injected intralesionally or sublesionally. 25 mg per lesion is the average requirement. Two or three injections may be given at 1 - 2 week intervals. Maximum recommended weekly dose is 75 mg.
for the treatment of ulcerative or inflammatory oral lesions including aphthous ulcer, desquamative gingivitis † , and oral lichen planus † :
Topical oral dosage (0.1% triamcinolone acetonide paste):
Adults: Apply paste to oral mucous membranes 2 - 3 times per day after meals and at bedtime.
For the relief of inflammation associated with synovitis of osteoarthritis; rheumatoid arthritis; acute and subacute bursitis; gout with acute gouty arthritis; epicondylitis; acute non-specific tenosynovitis; polychondritis † ; posttraumatic osteoarthritis:
NOTE: For many conditions, the dosing of corticosteroids is highly variable; the following general dosing recommendations apply.
Oral dosage (triamcinolone tablets or triamcinolone diacetate syrup):
Adults: 4 - 48 mg (base)/day PO as a single dose or in divided doses. Certain cases may require up to 60 mg as an initial dose.
Children: 416 mcg - 1.7 mg (base)/kg/day PO or 12.5 - 50 mg (base)/m2/day PO as a single dose or in divided doses.
Intramuscular dosage (triamcinolone acetonide):
Adults: 40 - 80 mg IM. Repeat every four weeks.
Children: 40 mg IM. Repeat every four weeks.
Intramuscular dosage (triamcinolone diacetate):
Adults and children >= 6 years: 40 mg IM once a week. The dose may also be calculated as 4 - 7 times the daily oral dose given as a single IM injection and repeated at four-day to four-weekly intervals.
Children < 6 years: Safe dosage has not been established.
Intra-articular or intrabursal dosage (triamcinolone acetonide):
Adults and children >= 6 years: 2.5 - 15 mg at appropriate site. Repeat as needed.
Intra-articular or intrasynovial dosage (triamcinolone diacetate):
Adults: 5 - 40 mg at appropriate site. Repeat at 1 - 8 week intervals if necessary.
Intra-articular dosage (triamcinolone hexatonide):
Adults: 2 - 20 mg at appropriate site. Repeat at 3 - 4 week intervals as necessary.
For the treatment of primary (Addison’s disease) or secondary adrenocortical insufficiency:
NOTE: Hydrocortisone and cortisone are the preferred agents for these conditions.
Oral dosage (triamcinolone tablets or triamcinolone diacetate syrup):
Adults: 4 - 12 mg (base)/day PO as a single dose or in divided doses.
Children: 117 mcg (base)/kg/day PO or 3.3 mg (base)/m2/day PO as a single dose or in divided doses.
For the relief of inflammation and for immunosuppression associated with a variety of disorders, like Hodgkin’s disease:
NOTE: For many conditions, the dosing of corticosteroids is highly variable; the following general dosing recommendations apply.
Oral dosage (triamcinolone tablets or triamcinolone diacetate syrup):
Adults: 4 - 48 mg (base) PO per day as a single dose or in divided doses. Certain cases may require up to 60 mg as an initial dose.
Children: 416 mcg - 1.7 mg (base)/kg/day PO or 12.5 - 50 mg (base)/m2/day PO as a single dose or in divided doses.
For the treatment of chronic idiopathic thrombocytopenic purpura (ITP):
Oral dosage:
Adults and adolescents: Prednisone is usually preferred for this condition. The equivalent triamcinolone dosage would be 0.8 mg/kg/day PO.
Maximum Dosage Limits:
Corticosteroid dosage must be individualized and is highly variable depending on the nature and severity of the disease, route of administration, and on patient response.
Patients with hepatic impairment:
Systemic dosage may need adjustment depending on the degree of hepatic insufficiency, but quantitative recommendations are not available.
Patients with renal impairment:
Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.
† non-FDA-approved indication
[ Last revised: 7/19/2004 1:30:00 PM ]
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