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Triamcinolone Acetonide       

Topical Corticosteroid

Indications: The relief of inflammatory manifestations of corticosteroid responsive dermatoses, including atopic dermatitis, contact dermatitis, eczematous dermatitis, neurodermatitis, seborrheic dermatitis, insect bites, lichen simplex chronicus, exfoliative dermatitis, stasis dermatitis, nummular eczema, psoriasis and pruritus ani and vulvae (creams only).

Contraindications: Tuberculous, fungal and most viral diseases of the skin  such as herpes simplex, vaccinia and varicella; hypersensitivity to any of the components of the preparation. Corticosteroid preparations are not intended for ophthalmic use, nor should they be applied in the external auditory canal of patients with perforated eardrums.

Precautions: Pregnancy and Lactation: Although topical steroids have not been reported to have an adverse effect on the fetus, the safety of topical steroid preparation during pregnancy and lactation has not been absolutely established. Weigh the potential benefits against possible hazard to the fetus or nursing infant.

            If irritation develops, discontinue the product and institute appropriate therary.

            If a symptomatic response is not noted within a week, discontinue the local application of corticosteroids and reevaluate the patient.

            In the presence of an infection, use appropriate antifungal or antibacterial agents. If a favorable response does not occur promptly, discontinue the corticosteroid until the infection has been adequately controlled.

Adverse Effects: The following  local adverse reactions have been reported with topical  corticosteroids, either with or without occlusive dressings:  burning sensation, itching, irritation, dryness, folliculitis, secondary  infection, skin atrophy, milliaria, hypertrichosis, acneiform  eruptions, laceration of the skin and hypopigmentation, pustules, pyoderma, atrophy of subcutaneous  tissue, telangiectasia, adrenal suppression and erythema. Contact sensitivity to a particular dressing material or adhesive may occur occasionally. When steroid preparations are used for long periods in intertriginous areas or under occlusive dressing, striae may occur.

            Posterior subcapsular cataracts have been reported following systemic use of corticosteroids.

Overdose: Symptoms: Mild, reversible suppression of adrenal function, ecchymoses of the skin, peptic ulceration, hypertension, aggravation of infection, hirsutism, acne, edema and muscle weakness.

Treatment:  discontinue corticosteroid and treat symptomatically.

Dosage: Kenalog Cream: Rub into affected area 2 or 3 times daily.

Kenalog Ointment: Apply lightly to the affected area 2 or 3 times daily.

            Kenalog Spray: Spray on affected area from a distance of 7 to 15 cm. To cover area about the size of the hand, a 2 second spray is suffcient. 3 or 4 applications daily are generally sufficient.

            The ointments are preferable for dry, scaly lesions; the creams for moist, weeping lesions.

            Occlusive Dressing Technique: Gently rub a small amount of Kenalog cream or ointment on the lesion until the cream or ointment disappears. Then reapply, leaving a thin coating and cover with a pliable non  porous film. For convenience apply the cream or ointment intermittently (12 hour occlusion during the day).

            Spray a small amount of Kenalog Spray into the lesion. Cover lesion with a dampened clean cotton cloth or briefly soak affected area in cold water if additional moisture is needed. Cover with a pliable non porous film.    

Supplied: Kenalog Cream contains: triamcinolone acetonide USP 0.1% in an aqueous vanishing cream base containing propylene glycol, polyoxyethylene fatty alcohol ether, white  petrolatum, sorbitol and water. Tubes of 30 g. Store at room temperature.

            Kenalog Ointment contains: 0.1% triamcinolone acetonide USP in Plastibase (Squibb plasticized hydrocarbon gel containing a polyethylene and mineral oil gel base.) Tubes of 30 g. Store at room temperature.

            Kenalog Spray: After spraying, the nonvolatile vehicle remaining on the skin contains approximately 0.25% triamcinolone acetonide. Aerosol cans of 23 g. each contaning 3.38 mg traimcinolone acetonide (147 mg/g of spray).   

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