Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Triamcinolone

Generic name
Triamcinolone
Brand name
ATC Code
H02AB08

Pharmacokinetics in children

No information

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dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

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Available formulations

No information is present at this moment.

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Dosages

Arthritis
  • Intra-articular
    • 1 year up to 18 years
      [2] [3] [4] [5] [6] [7] [8] [9] [10]

      • Triamcinolone hexacetonide:
        For larger joints (including the knee and hip): 1 mg/kg/dose. Maximum 40 mg per joint.
        For smaller joints (including ankle and wrist): 0.5-0.75 mg/kg/dose. Maximum 30 mg per joint.

        Triamcinolone acetonide:
        2 mg/kg/dose. The maximum dose for smaller joints is 40 mg per joint and for larger joints it is 80 mg per joint

      • Triamcinolone hexacetonide proved to be more effective than triamcinolone acetonide in juvenile rheumatism. 
Rheumatological, pulmonary, gastrointestinal, haematological, nephrological, endocrine, oncological, neurological, eye and skin conditions, severe allergic reactions, organ transplants and prophylaxis of nausea and vomiting in chemotherapy
  • Oral
    • < 35 kg
      [11]

      • Initial dose:  4-12 mg/day in 1 or more divided doses
        Maintenance: Decrease the initial dose every couple of days with dose decrements of 2 mg to a maintenance dose.

    • ≥ 35 kg
      [11]

      • Initial dose:  8-16 mg/day in 4 doses, sometimes up to 48 mg/day.
        Maintenance: Decrease the initial dose every couple of days with dose decrements of 2 mg to a maintenance dose.

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Renal impaiment in children > 3 months

GFR ≥10 ml/min/1.73m2: Dose adjustment not required.

GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.

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The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects in children

Benign intracranial hypertension (particularly in children during or shortly after rapid withdrawal).

Growth retardation [SmPC Volon]

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The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications

No information available on specific contra indications in children.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Monitor the growth and development of infants and children closely during prolonged use of corticosteroids; to prevent growth inhibition, aim for an alternating dose. The progression of chicken pox and measles can be more severe and even fatal in non-immune patients who are using corticosteroids; exposed patients should be given medical treatment immediately.
Do not use the liquid for injection intravenously.

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Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

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Mineralocorticoids
H02AA02
Glucocorticoids
H02AB02
H02AB09
H02AB04
H02AB06
H02AB07

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References

  1. Zulian F, et al, Triamcinolone acetonide and hexacetonide intra-articular treatment of symmetrical joints in juvenile idiopathic arthritis: a double-blind trial., Rheumatology (Oxford), 2004 , Oct;43(10), 1288-91
  2. Eberhard BA, et al, Comparison of the intraarticular effectiveness of triamcinolone hexacetonide and triamcinolone acetonide in treatment of juvenile rheumatoid arthritis, J Rheumatol, 2004, Dec;31(12), 2507-12
  3. Lanni S, et al, Outcome and predicting factors of single and multiple intra-articular corticosteroid injections in children with juvenile idiopathic arthritis, Rheumatology (Oxford), 2011 , Sep;50(9), 1627-34
  4. Zulian F, et al, Comparison of intra-articular triamcinolone hexacetonide and triamcinolone acetonide in oligoarticular juvenile idiopathic arthritis, Rheumatology (Oxford), 2003 , Oct;42(10), 1254-9
  5. Bloom BJ, et al, Intra-articular corticosteroid therapy for juvenile idiopathic arthritis: report of an experiential cohort and literature review, Rheumatol Int, 2011, Jun;31(6), 749-56
  6. Cleary AG, et al, Intra-articular corticosteroid injections in juvenile idiopathic arthritis, Arch Dis Child, 2003, Mar;88(3), 192-6
  7. Hertzberger-ten Cate R, Fiselier T. , Pauciarticulaire juveniele chronische arthritis. , Tijdschr Kindergeneeskd. , 1991, Oct;59(5), 148-52
  8. Kumar S, et al, Cushing's syndrome after intra-articular and intradermal administration of triamcinolone acetonide in three pediatric patients, Pediatrics, 2004, Jun;113(6), 1820-4
  9. Unsal E, , Intraarticular triamcinolone in juvenile idiopathic arthritis, Indian Pediatr, 2008, Dec;45(12), 995-7
  10. Verma S, et al, Feasibility and efficacy of intraarticular steroids (IAS) in juvenile idiopathic arthritis (JIA). , Indian Pediatr, 2009, Mar;46(3), 264-5
  11. Centrafarm BV, SmPC Triamcinolon tabletten (RVG 53166) 12-10-2015, www.geneesmiddeleninformatiebank.nl

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Changes

Changes