This medication is to be used as directed by the physician. Patients using topical corticosteroids should receive the following information and instructions.ġ. These preparations are not for ophthalmic use. If a favorable response does not occur promptly, the corticosteroid should be discontinued until the infection has been adequately controlled. In the presence of dermatological infections, the use of an appropriate antifungal or antibacterial agent should be instituted. If irritation develops, topical corticosteroids should be discontinued and appropriate therapy instituted. Occasionally, a patient may develop a sensitivity reaction to a particular occlusive dressing material or adhesive and a substitute material may be necessary.Ĭhildren may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity (see PRECAUTIONS, Pediatric Use). Infrequently, signs and symptoms of steroid withdrawal may occur, requiring supplemental systemic corticosteroids. Recovery of HPA axis function and thermal homeostasis are generally prompt and complete upon discontinuation of the drug. If HPA axis suppression or elevation of the body temperature occurs, an attempt should be made to withdraw the drug, to reduce the frequency of application, substitute a less potent steroid, or use a sequential approach when utilizing the occlusive technique. Therefore, patients receiving a large dose of any potent topical steroid applied to a large surface area or under an occlusive dressing should be evaluated periodically for evidence of HPA axis suppression by using the urinary free cortisol and ACTH stimulation tests, and for impairment of thermal homeostasis. Systemic absorption of topical corticosteroids has produced reversible hypothalamic pituitary-adrenal (HPA) axis suppression, manifestations of Cushing’s syndrome, hyperglycemia, and glucosuria in some patients.Ĭonditions which augment systemic absorption include the application of the more potent steroids, use over large surface areas, prolonged use, and the addition of occlusive dressings. Topical corticosteroids are contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation. Triamcinolone Acetonide Cream is indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses. Some of the topical corticosteroids and their metabolites are also excreted into the bile. Corticosteroids are metabolized primarily in the liver and are then excreted by the kidneys. Corticosteroids are bound to plasma proteins in varying degrees. Once absorbed through the skin, topical corticosteroids are handled through pharmacokinetic pathways similar to systemically administered corticosteroids. Thus, occlusive dressings may be a valuable therapeutic adjunct for treatment of resistant dermatoses (See DOSAGE AND ADMINISTRATION). Occlusive dressings substantially increase the percutaneous absorption of topical corticosteroids. Inflammation and/or other disease processes in the skin increase percutaneous absorption. Topical corticosteroids can be absorbed from normal intact skin. The extent of percutaneous absorption of topical corticosteroids is determined by many factors including the vehicle, the integrity of the epidermal barrier, and the use of occlusive dressings. There is some evidence to suggest that a recognizable correlation exists between vasoconstrictor potency and therapeutic efficacy in man. Various laboratory methods, including vasoconstrictor assays, are used to compare and predict potencies and/or clinical efficacies of the topical corticosteroids. The mechanism of anti-inflammatory activity of the topical corticosteroids is unclear. Topical corticosteroids share anti-inflammatory, anti-pruritic and vasoconstrictive actions. Triamcinolone Acetonide Cream USP, 0.5% contains: 5 mg of Triamcinolone Acetonide, USP per gram in a base containing Emulsifying Wax, Cetyl Alcohol, Isopropyl Palmitate, Sorbitol Solution, Glycerin, Lactic Acid, Benzyl Alcohol and Purified Water. Triamcinolone Acetonide Cream USP, 0.1% contains: 1 mg of Triamcinolone Acetonide, USP per gram in a base containing Emulsifying Wax, Cetyl Alcohol, Isopropyl Palmitate, Sorbitol Solution, Glycerin, Lactic Acid, Benzyl Alcohol and Purified Water. Triamcinolone Acetonide Cream USP, 0.025% contains: 0.25 mg of Triamcinolone Acetonide, USP per gram in a base containing Emulsifying Wax, Cetyl Alcohol, Isopropyl Palmitate, Sorbitol Solution, Glycerin, Lactic Acid, Benzyl Alcohol and Purified Water.
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