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Description
Composition Triamcinolone 4 mg GCS pharmacological action. Suppresses the function of leukocytes and tissue macrophages. Limits the migration of leukocytes to the area of inflammation. Violates the ability of macrophages to phagocytosis, as well as the formation of interleukin-1. It contributes to the stabilization of lysosomal membranes, thereby reducing the concentration of proteolytic enzymes in the area of inflammation. Reduces capillary permeability due to histamine release. Suppresses the activity of fibroblasts and the formation of collagen. Inhibits the activity of phospholipase A2, which leads to the suppression of the synthesis of prostaglandins and leukotrienes. Suppresses the release of COX (mainly COX-2), which also helps to reduce the production of prostaglandins. Reduces the number of circulating lymphocytes (T-and B-cells), monocytes, eosinophils and basophils due to their movement from the vascular bed to the lymphoid tissue. inhibits the formation of antibodies. Triamcinolone suppresses the release of pituitary ACTH and & # 946.-Lipotropin, but does not reduce the level of circulating & # 946.-Endorphin. It inhibits the secretion of TSH and FSH. With the direct application of the vessels has a vasoconstrictor effect. Triamcinolone has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. Stimulates gluconeogenesis, promotes the uptake of amino acids by the liver and kidneys and increases the activity of gluconeogenesis enzymes. In the liver, triamcinolone enhances the deposition of glycogen, stimulating the activity of glycogen synthetase and the synthesis of glucose from the products of protein metabolism. An increase in blood glucose activates insulin secretion. Triamcinolone inhibits glucose uptake by fat cells, which leads to activation of lipolysis. However, due to an increase in insulin secretion, lipogenesis is stimulated, which contributes to the accumulation of fat. It has a catabolic effect in the lymphoid and connective tissue, muscles, adipose tissue, skin, bone tissue. Osteoporosis and Itsenko-Cushing syndrome are the main factors limiting long-term therapy of corticosteroids. As a result of the catabolic effect, growth can be suppressed in children. In high doses, triamcinolone can increase the excitability of brain tissue and contributes to lowering the threshold of convulsive readiness.Stimulates excessive production of hydrochloric acid and pepsin in the stomach, which contributes to the development of peptic ulcers. With systemic use, the therapeutic activity of triamcinolone is due to anti-inflammatory, anti-allergic, immunosuppressive and anti-proliferative effects. When applied topically and locally, the therapeutic activity of triamcinolone is due to the anti-inflammatory, anti-allergic and anti-exudative (due to the vasoconstrictor effect) action. With inhalation use has an anti-inflammatory effect on the bronchial mucosa in patients with bronchial asthma. With continuous use, it reduces the number of mast cells, macrophages, T-lymphocytes and eosinophils in the epithelium and the submucosal layer of the bronchi, and suppresses airway hyperreactivity. Triamcinolone is close to hydrocortisone for anti-inflammatory activity, and triamcinolone acetonide is 6 times more active. The mineralocorticoid activity of triamcinolone and triamcinolone acetonide is practically absent.
Dosage and administration
Inside adults - 4-20 mg per day in 2-3 doses. After improving the state, the daily dose is gradually reduced by 1-2 mg every 2-3 days to the minimum maintenance dose of 1 mg and the full abolition of therapy. V / m at the beginning of treatment - 40 mg 1 time in 4 weeks. Then, depending on the indications and the patient's response to treatment, you can enter 40-80 mg every 2-4 weeks. If necessary, a single dose can be increased to 100 mg. To avoid subcutaneous atrophy injected deep into the muscle. With intra-articular injection, as well as with the introduction in the area of the lesion, the dose is 10-40 mg. The interval between injections of at least 1 week. For use in the form of inhalation, the dose depends on the dosage form used and the age of the patient. Externally used 1-3 times / day. The duration of treatment is determined individually and is usually 5-10 days. With a persistent course of the disease, the course of treatment can be extended to 25 days. Do not use more than 4 weeks. Precautions During the period of treatment may worsen psoriasis. With pheochromocytoma, propranolol can be used only after taking an alpha blocker. After a long course of treatment, propranolol should be discontinued gradually, under the supervision of a physician.Against the background of treatment with propranolol, IV administration of verapamil, diltiazem should be avoided. A few days before anesthesia, you must stop taking propranolol or pick up a remedy for anesthesia with minimal negative inotropic effects. Influence on the ability to drive vehicles and control mechanisms In patients whose activities require increased attention, the question of the use of propranolol on an outpatient basis should be addressed only after evaluating the individual response of the patient. Side Effects On the part of the endocrine system: redistribution of adipose tissue, menstrual disorders, increased blood glucose levels, suppression of adrenal function, "moon-shaped face", stretch marks, hirsutism, acne. Metabolism: edema, electrolyte imbalance, negative nitrogen balance, growth retardation in children. On the part of the digestive system: steroid gastric ulcer, erosive and ulcerative lesions of the gastrointestinal tract, acute pancreatitis. On the part of the central nervous system: convulsions, sleep disorders, mental disorders, headaches and dizziness, weakness. From the musculoskeletal system: myopathy, osteoporosis. Since the cardiovascular system: arterial hypertension. On the part of the blood coagulation system: thromboembolism. On the part of the organ of vision: visual impairment, posterior subcapsular cataract, increased intraocular pressure or exophthalmos, anaphylactic reactions. Reactions due to immunosuppressive effects: exacerbation of infectious diseases. When intra-articular injection: possible joint pain, irritation at the injection site, depigmentation, sterile abscess, atrophy of the skin, with the introduction of doses of more than 40 mg, resorptive side effects are possible. Inhalation use: possible headache, sneezing, cough, dryness of the mucous membrane of the mouth or nose, a feeling of irritation in the nose, hoarseness, rarely - fungal infection of the nasopharynx caused by Candida albicans. When applied topically: itching, skin irritation, late reactions like eczema, steroid acne, purpura are possible. With prolonged use of the ointment may develop secondary infectious lesions and atrophic changes in the skin. Specific guidance Not intended for on / in the introduction.With caution and under strict medical supervision used for edematous syndrome, obesity, mental illness and diseases of the gastrointestinal tract. During the period of treatment, it is recommended to take vitamin D and eat foods rich in calcium. After a single intramuscular injection at a dose of 60-100 mg for 24-48 hours, an inhibition of adrenal function can be observed, which usually recovers after 30-40 days. When applied topically to prevent local infectious complications, it is recommended to be used in combination with antimicrobial agents. Parenteral administration in children under the age of 6 is not recommended. at the age of 6-12 years - according to strict indications. Avoid prolonged external use in children, regardless of age. Use during pregnancy and lactation If necessary, use during pregnancy (especially in the first trimester) and during lactation should assess the intended benefits to the mother and the risk of side effects in the fetus or child. Type: Drug Quantity in the package, pcs: 50 Shelf life: 60 months Active ingredient: Triamcinolone. Route of administration: Oral Vacation procedure: Prescription Release form: Prescription Storage conditions: In a dry place, In a dark place, Keep out of reach of children Maximum storage temperature, ° С: 30 Pharmacological group: H02AB Glucocorticoids Minimum age: 6 yearsActive ingredients
Release form
Pills
Composition
Triamcinolone 4 mg
Pharmacological effect
GKS. Suppresses the function of leukocytes and tissue macrophages. Limits the migration of leukocytes to the area of inflammation. Violates the ability of macrophages to phagocytosis, as well as the formation of interleukin-1. It contributes to the stabilization of lysosomal membranes, thereby reducing the concentration of proteolytic enzymes in the area of inflammation. Reduces capillary permeability due to histamine release. Suppresses the activity of fibroblasts and the formation of collagen. Inhibits the activity of phospholipase A2, which leads to the suppression of the synthesis of prostaglandins and leukotrienes. Suppresses the release of COX (mainly COX-2), which also helps to reduce the production of prostaglandins.Reduces the number of circulating lymphocytes (T-and B-cells), monocytes, eosinophils and basophils due to their movement from the vascular bed to the lymphoid tissue. inhibits the formation of antibodies. Triamcinolone suppresses the release of pituitary ACTH and & # 946.-Lipotropin, but does not reduce the level of circulating & # 946.-Endorphin. It inhibits the secretion of TSH and FSH. With the direct application of the vessels has a vasoconstrictor effect. Triamcinolone has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. Stimulates gluconeogenesis, promotes the uptake of amino acids by the liver and kidneys and increases the activity of gluconeogenesis enzymes. In the liver, triamcinolone enhances the deposition of glycogen, stimulating the activity of glycogen synthetase and the synthesis of glucose from the products of protein metabolism. An increase in blood glucose activates insulin secretion. Triamcinolone inhibits glucose uptake by fat cells, which leads to activation of lipolysis. However, due to an increase in insulin secretion, lipogenesis is stimulated, which contributes to the accumulation of fat. It has a catabolic effect in the lymphoid and connective tissue, muscles, adipose tissue, skin, bone tissue. Osteoporosis and Itsenko-Cushing syndrome are the main factors limiting long-term therapy of corticosteroids. As a result of the catabolic effect, growth can be suppressed in children. In high doses, triamcinolone can increase the excitability of brain tissue and contributes to lowering the threshold of convulsive readiness. Stimulates excessive production of hydrochloric acid and pepsin in the stomach, which contributes to the development of peptic ulcers. With systemic use, the therapeutic activity of triamcinolone is due to anti-inflammatory, anti-allergic, immunosuppressive and anti-proliferative effects. When applied topically and locally, the therapeutic activity of triamcinolone is due to the anti-inflammatory, anti-allergic and anti-exudative (due to the vasoconstrictor effect) action. With inhalation use has an anti-inflammatory effect on the bronchial mucosa in patients with bronchial asthma. With continuous use reduces the number of mast cells, macrophages, T-lymphocytes and eosinophils in the epithelium and the submucosal layer of the bronchi,inhibits airway hyperreactivity. Triamcinolone is close to hydrocortisone for anti-inflammatory activity, and triamcinolone acetonide is 6 times more active. The mineralocorticoid activity of triamcinolone and triamcinolone acetonide is practically absent.
Indications
For oral administration: rheumatism, rheumatoid arthritis, systemic lupus erythematosus and other collagenoses, acute allergic reactions, allergic skin diseases, severe forms of bronchial asthma, erythema multiforme, hemorrhagic diathesis, hemolytic anemia, lymphoma, leukemia. For parenteral use: rheumatoid arthritis, connective tissue diseases, systemic lupus erythematosus, dermatosis, pulmonary emphysema and pulmonary fibrosis, lymphosarcoma, lymphoma, lymphatic leukemia, nephrotic syndrome, sprue. For inhalation use: bronchial asthma in the acute phase. Insufficient effectiveness of bronchodilators and / or mast cell membrane stabilizers in the treatment of bronchial asthma. Hormone-dependent bronchial asthma (in order to reduce the dose of GCS for oral administration). Allergic rhinitis. For external use: eczema, psoriasis, neurodermatitis, various types of dermatitis and other inflammatory and allergic skin diseases of non-microbial etiology (as part of complex therapy).
Contraindications
Acute psychosis in the history of active TB disease, myasthenia gravis, tumors with metastasis, diverticulitis, gastric ulcer and duodenal ulcer, hypertension, Cushing's syndrome, renal failure, thrombosis and embolism in history, osteoporosis, diabetes, hidden foci of infection, amyloidosis, syphilis, fungal diseases, viral infections (including those caused by Herpes simplex and Varicella zoster), amoebic infections, polio (with the exception of the bulbar-encephalitic form), gonococcal or tuberculosis arthritis, iodine vaccination, lymphadenitis after BCG vaccination, glaucoma, infected skin lesions.
Use during pregnancy and lactation
If necessary, use during pregnancy (especially in the first trimester) and during lactation should assess the intended benefits to the mother and the risk of side effects in the fetus or child.
Dosage and administration
Inside adults - 4-20 mg per day in 2-3 doses.After improving the state, the daily dose is gradually reduced by 1-2 mg every 2-3 days to the minimum maintenance dose of 1 mg and the full abolition of therapy. V / m at the beginning of treatment - 40 mg 1 time in 4 weeks. Then, depending on the indications and the patient's response to treatment, you can enter 40-80 mg every 2-4 weeks. If necessary, a single dose can be increased to 100 mg. To avoid subcutaneous atrophy injected deep into the muscle. With intra-articular injection, as well as with the introduction in the area of the lesion, the dose is 10-40 mg. The interval between injections of at least 1 week. For use in the form of inhalation, the dose depends on the dosage form used and the age of the patient. Externally used 1-3 times / day. The duration of treatment is determined individually and is usually 5-10 days. With a persistent course of the disease, the course of treatment can be extended to 25 days. Do not use more than 4 weeks.
Side effects
On the part of the endocrine system: redistribution of adipose tissue, menstrual disorders, increased blood glucose levels, adrenal suppression, "moon face", striae, hirsutism, acne. Metabolism: edema, electrolyte imbalance, negative nitrogen balance, growth retardation in children. On the part of the digestive system: steroid gastric ulcer, erosive and ulcerative lesions of the gastrointestinal tract, acute pancreatitis. On the part of the central nervous system: convulsions, sleep disorders, mental disorders, headaches and dizziness, weakness. From the musculoskeletal system: myopathy, osteoporosis. Since the cardiovascular system: arterial hypertension. On the part of the blood coagulation system: thromboembolism. On the part of the organ of vision: visual impairment, posterior subcapsular cataract, increased intraocular pressure or exophthalmos, anaphylactic reactions. Reactions due to immunosuppressive effects: exacerbation of infectious diseases. When intra-articular injection: possible joint pain, irritation at the injection site, depigmentation, sterile abscess, atrophy of the skin, with the introduction of doses of more than 40 mg, resorptive side effects are possible. Inhalation use: possible headache, sneezing, cough, dryness of the mucous membrane of the mouth or nose, a feeling of irritation in the nose, hoarseness, rarely - fungal infection of the nasopharynx caused by Candida albicans. When applied topically: itching, skin irritation, late reactions like eczema, steroid acne, purpura are possible.With prolonged use of the ointment may develop secondary infectious lesions and atrophic changes in the skin.
special instructions
On the part of the endocrine system: redistribution of adipose tissue, menstrual disorders, increased blood glucose levels, adrenal suppression, "moon face", striae, hirsutism, acne. Metabolism: edema, electrolyte imbalance, negative nitrogen balance, growth retardation in children. On the part of the digestive system: steroid gastric ulcer, erosive and ulcerative lesions of the gastrointestinal tract, acute pancreatitis. On the part of the central nervous system: convulsions, sleep disorders, mental disorders, headaches and dizziness, weakness. From the musculoskeletal system: myopathy, osteoporosis. Since the cardiovascular system: arterial hypertension. On the part of the blood coagulation system: thromboembolism. On the part of the organ of vision: visual impairment, posterior subcapsular cataract, increased intraocular pressure or exophthalmos, anaphylactic reactions. Reactions due to immunosuppressive effects: exacerbation of infectious diseases. When intra-articular injection: possible joint pain, irritation at the injection site, depigmentation, sterile abscess, atrophy of the skin, with the introduction of doses of more than 40 mg, resorptive side effects are possible. Inhalation use: possible headache, sneezing, cough, dryness of the mucous membrane of the mouth or nose, a feeling of irritation in the nose, hoarseness, rarely - fungal infection of the nasopharynx caused by Candida albicans. When applied topically: itching, skin irritation, late reactions like eczema, steroid acne, purpura are possible. With prolonged use of the ointment may develop secondary infectious lesions and atrophic changes in the skin.