Company:

Alcon

Glucocorticoid

Triamcinolone acetonide 40mg/mL; susp for intravitreal inj.

Sympathetic ophthalmia, temporal arteritis, uveitis, and ocular inflammatory conditions unresponsive to topical corticosteroids. Visualization during vitrectomy.

Triesence is a synthetic corticosteroid analog primarily used as an anti-inflammatory agent. It possesses glucocorticoid activity typical of this class of drug, but with little or no mineralocorticoid activity. Corticosteroids have been shown to depress the production of eosinophils and lymphocytes, while stimulating erythropoiesis and production of polymorphonuclear leukocytes. Inflammatory processes (eg, edema, fibrin deposition, capillary dilatation, migration of leukocytes, and phagocytosis) and the later stages of wound healing (eg, capillary proliferation, deposition of collagen, cicatrization) are inhibited.

Give anesthesia and broad-spectrum microbicide prior to use. Ophthalmic diseases: initially 4mg (100microliters); may repeat if needed. Visualization: 1–4mg (25–100microliters) intravitreally.

Systemic fungal infections. Live vaccination.

Not for IV administration. Ocular herpes simplex. Cerebral malaria: not recommended. Tuberculosis. If exposed to chickenpox or measles, consider prophylactic passive immune therapy. Strongyloides infestation. Latent amebiasis. Thyroid disorders. Diabetes. CHF. Hypertension. Recent MI. Renal insufficiency. GI perforation. Diverticulitis. Intestinal anastomoses. Peptic ulcer. Myasthenia gravis. Hypoprothrombinemia. Monitor for osteoporosis (esp. postmenopausal women) if on long-term therapy; do bone density tests. Supplement with additional steroids in physiologic stress. Monitor growth, weight, blood pressure, fluid and electrolyte balance. Avoid abrupt cessation. Pregnancy (Cat.D); (avoid in 1st trimester). Nursing mothers.

Potentiated by CYP3A4 inhibitors (eg, ketoconazole, macrolides), cyclosporine, estrogens. Antagonized by CYP3A4 inducers (eg, barbiturates, phenytoin, carbamazepine, rifampin), ephedrine, cholestyramine. May potentiate cyclosporine. May antagonize anticoagulants (monitor), isoniazid. Increased risk of arrhythmias with digitalis. May need to adjust dose of antidiabetic agents. Increased GI effects with aspirin, other NSAIDs. Monitor for hypokalemia with potassium-depleting drugs (eg, amphotericin B, diuretics). Withdraw anticholinesterase agents at least 24 hours before starting corticosteroid therapy. May suppress reactions to skin tests.

Elevated intraocular pressure (monitor), cataracts, endophthalmitis, hypopyon, inj site reactions, glaucoma, vitreous floaters, retinal pigment epithelium detachment, optic disc vascular disorder, eye inflammation, conjunctival hemorrhage, reduced visual acuity, HPA axis suppression, masks infection, increased susceptibility to infection, hypertension, hypokalemia, weight gain, osteoporosis, behavioral or mood disturbances, myopathy, Kaposi’s sarcoma.

Single-use vial (1mL)—1

3/28/08