Class: Intranasal Adrenal Glucocorticosteroid
Dosage Forms. Nasal Spray: 55 mcg/actuation
Common FDA Label Indication, Dosing, and Titration.
1. Perennial or seasonal allergic rhinitis: Children 2-5 y of age, 1 spray/nostril daily, max of 110 mcg/d; Children 6-12 y of age, 1 spray/nostril daily, max of 220 mcg/d; Children over 12 y of age and Adults: Initial, 2 spray/nostril daily, max of 220 mcg/d; maintenance, 1 spray/nostril daily, max of 110 mcg/d
Off-Label Uses. None
MOA. Triamcinolone has anti-inflammatory, antipruritic, and vasoconstrictive properties. Corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
Drug Characteristics: Triamcinolone Nasal Inhaler
Medication Safety Issues: Triamcinolone Nasal Inhaler
Drug Interactions: Triamcinolone Nasal Inhaler. None known.
Adverse Reactions: Triamcinolone Nasal Inhaler
Efficacy Monitoring Parameters. Control of rhinitis signs and symptoms.
Toxicity Monitoring Parameters. While only small amounts of triamcinolone reach systemic circulation, bone mineral density and growth and development in children should be monitored. Routine ophthalmologic examinations should be performed. Monitor for signs and symptoms of adrenal suppression and infection.
Key Patient Counseling Points. Advise patients on the proper administration technique for this product. Instruct patients to monitor for signs of toxicity, especially adrenal insufficiency.
Clinical Pearls. Injectable, oral inhalation, and topical dosage forms of triamcinolone also available for treatment of other allergic disorders. While oral antihistamines (either over-the-counter or prescription) remain the mainstay for treatment of rhinitis, nasal steroids are a recommended option if symptoms are severe, unresolved with oral antihistamines, or if oral antihistamines cause undesirable adverse effects.