What Is Triamcinolone Acetonide?
Triamcinolone acetonide is a synthetic corticosteroid used to treat various skin diseases or reduce the discomfort of mouth ulcers. It is more effective in removing anti-inflammatory pine, about eight times as strong as prednisone [1] .
- Chinese name
- Triamcinolone
- Foreign name
- Triamcinolone acetonide
- Alias
- Triamcinolone acetate; triamcinolone
- CAS number
- 76-25-5
- EINECS number
- 200-948-7
- Molecular formula
- C24H31FO6
- Molecular weight
- 434.5
- Content
- 99%
- Function
- Adrenal corticosteroids
- Triamcinolone acetonide is a synthetic corticosteroid used to treat various skin diseases or reduce the discomfort of mouth ulcers. It is more effective in removing anti-inflammatory pine, about eight times as strong as prednisone [1] .
Triamide Compounds
Triamcinolone Basic Information
- Chinese name:
- Chinese alias: triamcinolone acetate; Quyanshusong; acetone triamcinolone; Conaco-A; Corning Ketong-A; Kangning Lekou cream ointment; Quan Shusong-A; Quyanshusong; Quyansong-A; Quyanshusong-A
- English name: triamcinolone acetonide
- English name: Triamcinolone Acetonide; Triamcinolone acetonide; Adcortyl-A; Aristoderm;
- CAS number: 76-25-5
- Molecular formula: C 24 H 31 FO 6
- Molecular weight: 434.49800
- Exact mass: 434.21000
- PSA: 93.06000
- LogP: 2.41880
Triamcinolone
- Appearance and properties: white to off-white crystalline powder
- Density: 1.33 g / cm 3
- Melting point: 274-278ºC (dec.)
- Boiling point: 576.9ºC at 760 mmHg
- Flash point: 302.7ºC
- Refractive index: 1.588
- Stability: Flammable. Incompatible with strong oxidants.
- Storage conditions: storeroom is ventilated, low temperature and dry, stored separately from food ingredients
Triamcinolone Safety Information
- Customs Code: 2937229000
- WGK Germany: 3
- Danger category code: R61
- Safety instructions: S53-S45
- RTECS number: TU3920000
- Dangerous goods mark: T [1]
Triamcinolone use
- Adrenocortical drugs, which act on glucose metabolism, can reduce the pathological response of antibody tissues to harmful stimuli, and are used in active rheumatism and rheumatoid arthritis.
Triamcinolone method
- Method name: Triamcinolone API-Triamcinolone-High Performance Liquid Chromatography
- Scope of application: This method uses high performance liquid chromatography to determine the content of triamcinolone in triamcinolone API.
- This method is applicable to triamcinolone API.
- Principle of the method: The test product was dissolved in methanol and quantitatively diluted, and then subjected to chromatographic separation by high performance liquid chromatography. The peak area of triamcinolone was detected at a wavelength of 240 nm using an ultraviolet absorption detector, and the content was calculated.
- Reagent: Methanol
- Equipment: 1. Instrument
- 1.1 HPLC
- 1.2 Column
- Octadecylsilane-bonded silica gel is used as a filler, and the number of theoretical plates should not be less than 5,000 based on the calculation of the triamcinolone peak.
- 1.3 UV absorption detector
- 2.Chromatographic conditions
- 2.1 Mobile phase: methanol water = 525 475
- 2.2 Detection wavelength: 240nm
- 2.3 Column temperature: room temperature
- Sample preparation:
- Preparation of reference solution
- Accurately weigh the appropriate amount of triamcinolone reference substance, dissolve it with methanol and quantitatively dilute it into a solution containing about 30 g / micron per 1 mL, which is the reference solution.
- 2. Preparation of test solution
- Accurately weigh an appropriate amount of the test sample, dissolve it with methanol and quantitatively dilute it into a solution containing about 30 g of triamcinolone per 1 mL, which is the test solution.
- Note: "Precision weighing" means that the weighed weight should be accurate to one thousandth of the weighed weight. "Precision measurement" means that the accuracy of measuring the volume should meet the accuracy requirements of the volume pipette in national standards.
- Operation steps: Precisely pipette 20 mL of the reference solution and the test solution into the high-performance liquid chromatograph, measure the peak area of triamcinolone (C 24 H 31 FO 6 ) with a UV absorption detector at a wavelength of 240 nm, and calculate Show its content [2] .
Triamcinolone Pharmacopoeia Standard
Triamcinolone source (name), content (potency)
- This product is 9-fluoro-11, 21-dihydroxy-16, 17 [(l-methylethylene) bis (oxy)]-progestin-1,4-diene-3,20-dione. Calculated on dry basis, containing C 24 H 31 FO 6 should be 97.0% to 102.0%.
Triamcinolone traits
- This product is white or off-white crystalline powder; odorless.
- This product is soluble in acetone, slightly soluble in chloroform, slightly soluble in methanol or ethanol, and very slightly soluble in water.
- Specific rotation
- Take this product, weigh it accurately, add dioxane to dissolve and quantitatively dilute it to make a solution containing about 10mg per 1ml, and measure it according to law (Appendix VIE of Part Two of the Pharmacopoeia, 2010 Edition). The specific rotation is + 101 ° to +107 °.
- Absorption coefficient
- Take this product, weigh it accurately, add ethanol to dissolve and quantitatively dilute it to make a solution containing about 10 g per 1 ml, and measure the absorbance at a wavelength of 239 nm according to the ultraviolet-visible spectrophotometry (Appendix IVA of the Pharmacopoeia Part II of the 2010 edition). The absorption coefficient () is 340 to 370.
Triamcinolone identification
- (1) In the chromatogram recorded under the content determination item, the retention time of the main peak of the test solution should be consistent with the retention time of the main peak of the reference solution.
- (2) The infrared light absorption spectrum of this product should be consistent with the control spectrum (Figure 603 of "Infrared Spectra of Drugs").
Triamcinolone
- fluorine
- Take this product and check it according to law (Appendix E of the second edition of the Pharmacopoeia, 2010 edition). The fluorine content should be 4.0% ~ 4.75%.
- relative substance
- Take about 25mg of this product, put it in a 50ml measuring flask, add 35ml of methanol, shake to dissolve, dilute with water to the mark, shake well, as the test solution; take 1ml of precise amount, put it in a 100ml measuring bottle, add 70% methanol The solution was diluted to the mark, and shaken as a control solution. According to the chromatographic conditions under the content determination item, take 20 l of the control solution and inject it into the liquid chromatograph, and adjust the detection sensitivity so that the peak height of the main component chromatographic peak is about 20% of the full scale. Then, 20 l of each of the test solution and the control solution was precisely measured and injected into the liquid chromatograph, and the chromatogram was recorded to 3.5 times the peak retention time of the main component. If there are impurity peaks in the chromatogram of the test solution, the area of a single impurity peak must not be greater than 0.3 times (0.3%) the area of the main peak of the control solution, and the sum of the area of each impurity peak must not be greater than 0.8 times (0.8%) of the main peak area of the control solution. Any peak less than 0.01 times the area of the main peak of the control solution in the chromatogram of the test solution can be ignored.
- Loss on drying
- Take this product and dry it at 105 ° C to constant weight, and the weight loss shall not exceed 1.5% (Appendix L of Pharmacopoeia Part II of 2010 Edition).
- Residue on ignition
- Must not exceed 0.2% (Appendix N of Part Two of the 2010 Pharmacopoeia).
- selenium
- Take 0.10g of this product and check it according to law (Appendix D of Part II of the Pharmacopoeia of 2010 Edition), and it should meet the requirements (0.005%).
Triamcinolone content determination
- It was determined by high performance liquid chromatography (Appendix VD of Part Two of the Pharmacopoeia, 2010 Edition).
- Chromatographic conditions and system suitability tests
- Octadecylsilane-bonded silica gel was used as the filler; methanol-water (525: 475) was used as the mobile phase; the detection wavelength was 240 nm. Take QuAnide and Triamcinolone, dissolve and dilute with 70% methanol solution to make a solution containing about 5g per 1ml, take 20l into the liquid chromatograph, record the chromatogram, and calculate the number of theoretical plates based on the QuAnide peak Not less than 5000, the resolution of Qu'anide peak and Qu'anxi dragon peak should be greater than 15.
- Assay
- Take this product, accurately weigh it, add methanol to dissolve and quantitatively dilute it to make a solution containing about 30g per 1ml. Precisely take 20l into the liquid chromatograph and record the chromatogram; take another triamcinolone reference substance and measure it in the same way . Calculate the peak area according to the external standard method, and get [3] .
Triamide Categories
- Adrenal corticosteroids.
Triamide storage
- Shaded and sealed.
Triamcinolone
- (1) Triamide injection (2) Triamide econazole cream
Triamcinolone Drug Description
Triamcinolone
- 1. Injection: 50mg (5ml), 200mg (5ml).
- 2. Aerosol: 0.147mg per gram of medicine.
- 3. Ointment: 0.025%.
- 4. Cream: 0.1%.
- 5. Eye drops: 0.5%.
- 6. Lotion: 0.025%; 0.1%.
- 7. Cream: 5g, 15g.
Triamcinolone pharmacological action
- Triamcinolone is an acetate derivative of triamcinolone A. Is a medium-acting glucocorticoid. The effect is similar to that of Triamcinolone. It has anti-inflammatory, anti-pruritic, and vasoconstrictor effects. The retention of water and sodium is weak, and the anti-inflammatory effect is strong and durable. The anti-inflammatory activity of triamcinolone 4 mg is equivalent to approximately 5 mg of prednisolone or 20 mg of hydrocortisone. Triamcinolone is a long-acting adrenal corticosteroid. Its mechanism of action is similar to that of Triamcinolone. It has anti-inflammatory, anti-pruritic, and vasoconstrictive effects. Its anti-inflammatory and anti-allergic effect is strong and long-lasting, and its efficacy is 20-30 times greater than that of cortisone. Triamcinolone has anti-inflammatory, anti-pruritic and vasoconstrictive effects. Its anti-inflammatory and anti-allergic effects are strong and long-lasting. For dermatitis and other skin diseases, it can be absorbed by the skin through skin rubbing and closed dressing therapy. Triamcinolone is extremely well tolerated when applied topically.
Triamcinolone pharmacokinetics
- Triamcinolone is easily absorbed orally, 5mg orally, bioavailability is about 23%, blood concentration reaches 10.5ng / ml peak in 1h, and half-life is 2.0h; intramuscular injection is slow to absorb, and takes effect within a few hours, reaching 1-2 days Maximum effect. The effect can be maintained for 2 to 3 weeks; local injection in the skin and joint cavity is slow in absorption and long-lasting. Generally, the effect of one injection can be maintained for more than 1 to 2 weeks. Less binding to plasma albumin. After absorption, it is metabolized into inactive metabolites in the liver, kidneys and tissues and excreted through the kidneys.
Triamcinolone contraindications
- 1. Those who are allergic to adrenal corticosteroids.
- 2. Patients with mental illness may have a serious history of mental illness.
- 3. Active gastroduodenal ulcer.
- 4. After recent gastrointestinal anastomosis.
- 5. Heavier osteoporosis.
- 6. Obvious diabetes.
- 7. Viral, bacterial, and fungal infections that cannot be controlled with antimicrobials.
- 8. Neisseria gonorrhoeae infection.
- 9. Systemic fungal infection.
- 10. Accompanying infectious active arthritis or dermatitis.
- 11. Alcoholic cirrhosis with ascites.
- 12. Children.
- 13. Pregnant and lactating women.
Triamcinolone dosage
- 1. For bronchial asthma: 40mg each time, once every 3 weeks, for 5 consecutive sessions as a course of treatment, 80mg each time for severe symptoms; halved for children 6-12 years old, and adults for children 3-6 years old when necessary 1/3 of the dose. For allergic rhinitis: 40mg each time, once every 3 weeks, 5 consecutive sessions for 1 course, or inferior turbinate injection, first spray 1% lidocaine solution on the nasal cavity after surface anesthesia, and inject into the front ends of both inferior turbinates Triamcinolone 5-20mg, once a week, 5 consecutive times for a course of treatment.
- 2. Joint or local injection: (1) For various osteoarthritis: 2.5 20mg each time, dissolved in 10 20ml of 0.25% lidocaine, with a 5 gauge needle, once into the lesion until 2 times a week 3 times or once every other day, once or twice every week after the symptoms improve; every 4 to 5 times is a course of treatment; (2) For skin diseases: direct injection into the skin lesions, usually 0.2 to 0.3 for each part mg, depending on the size of the affected area, no more than 0.5mg each time, repeated if necessary every 1 to 2 weeks.
- 3. External use: Apply ointment, cream, eye drops to the affected area 1 to 4 times a day. Aerosol spray cloth, 3 to 4 times a day. Squamous epithelial hyperplasia of the vulva: Rub the area 3 to 4 times a day. Itching stubborn, ineffective sclerosing moss can be injected subcutaneously with triamcinolone suspension.
- 4. Oral: Initially 4 mg, 2 to 4 times a day, maintenance amount 1 to 4 mg each time, 1 to 2 times a day.
- 5. Subcutaneous injection: 5-25mg each time, 1 or 2 times a week.
Triamcinol note
- 1. During local injection, patients with hypertension, heart disease, diabetes, osteoporosis, glaucoma, liver and kidney dysfunction, etc. should be used with caution and even banned depending on the condition.
- 2. Triamcinolone should be thoroughly shaken before use. Make the solution into a uniform suspension.
- 3. Should not be used for intravenous injection, local injection should not be too shallow, the total amount of each administration should not be too much.
- 4. Long-term external use can cause drug resistance.
- 5. For skin diseases complicated by bacterial or fungal infections, they should be combined with corresponding antibacterial or antifungal drugs.
- 6. Triamcinolone sodium has a weak effect and should not be used as an alternative treatment for adrenal insufficiency.
- 7. Pregnant women should not use it for a long time.
- 8. Triamcinolone is for external use only and avoid contact with eyes.
- 9. Disable those with viral skin diseases.
Triamcinolone adverse reactions
- Triamcinolone econazole cream
- 1. Long-term use of large doses of corticosteroids can cause disorders of water, salt, sugar, protein and fat metabolism: manifested as concentric obesity, full moon face, hairy, weak, hypokalemia, edema, hypertension, diabetes, etc. It is clinically called Cushing's syndrome. These symptoms can be treated without special treatment, and will usually gradually resolve on their own after stopping the medicine, and can return to normal after a few months or a long time. Antihypertensive and hypoglycemic drugs can be used when necessary, and symptomatic treatment such as low pressure, low sugar, high protein diet and potassium supplementation can be given. Therefore, patients with hypertension, arteriosclerosis, renal insufficiency, and diabetes should be appropriately supplemented with vitamin D and calcium, and corticosteroids should be used with caution.
- 2. Induction or exacerbation of infection: Corticosteroids have anti-inflammatory effects, but do not have antibacterial effects, and can reduce the body's ability to resist infection, reduce the body's ability to resist disease, and help bacteria grow, reproduce and spread. Therefore, long-term application of corticosteroids can induce infection or enlarge or spread potential infections in the body, and can also spread the original still nodules. In the course of medication, attention should be paid to changes in the condition and whether there is an induced infection, and anti-infective treatment should be given at the same time.
- 3. Inducing or aggravating peptic ulcer: In addition to hindering tissue repair and delaying tissue healing, glucocorticoids can increase gastric acid and pepsin secretion, reduce gastric mucus secretion, and reduce gastric mucosal resistance, which can induce or aggravate Gastric and duodenal ulcers can bleed and even cause perforation of the digestive tract.
- 4. Neurological symptoms: excitement, insomnia can occur, individual patients can induce psychosis, and epilepsy patients can induce seizures. Therefore, patients with psychotic tendencies, mental patients and epilepsy should be disabled.
- 5. Adrenal cortex atrophy or dysfunction: Long-term application of this class of drugs, because the glucocorticoid level in the body is higher than normal for a long time, can cause negative feedback, and affect the hypothalamus and the anterior pituitary gland to secrete adrenocorticotropic hormones, making the endogenous Reduced glucocorticoid secretion or cause adrenocortical insufficiency. Once stressed, such as bleeding or infection, dizziness, nausea, vomiting, hypotension, hypoglycemia, or hypoglycemia may occur.
- 6, rebound phenomenon and withdrawal symptoms: long-term application of hormonal drugs, if the symptoms are basically controlled, if the reduction is too large or the drug is stopped suddenly, the original symptoms can quickly appear or worsen, this phenomenon is called rebound phenomenon. This is caused by the patient's dependence on hormones or the symptoms have not been completely controlled. The treatment measures are to restore the dosage of hormones, and then slowly reduce them after the symptoms are controlled.
Triamcinolone Drug Interactions
- 1. Combined with hypokalemia drugs (such as amphotericin B, potassium excretion diuretics, irritant laxatives, digitalis), increase the risk of hypokalemia.
- 2. Combination with anticoagulants can affect the metabolism of oral anticoagulants and the role of coagulation factors, increasing the risk of bleeding.
- 3. When combined with insulin, metformin, and sulfonylurea hypoglycemic agents, it can reduce the effect of lowering blood sugar. The dosage of hypoglycemic agents should be adjusted.
- 4. Combined with magnesium, aluminum, calcium salts, oxides and hydroxides can reduce the absorption of triamcinolone.
- 5. Combination with -interferon may inhibit the effect of interferon.
- 6. Combined with acetylsalicylic acid can reduce the absorption of salicylic acid. The dosage of salicylic acid should be adjusted.
- 7. The enzyme inducer can reduce the efficacy of triamcinolone, and the dosage of triamcinolone should be adjusted when combined with it.
Triamcinolone for eczema
- The World Health Organization WHO clearly states in its guidance document on immunodesensitization treatment that "immunodesensitization treatment is the only fundamental treatment that can completely treat allergic eczema." The international authoritative organization for allergy research has also proposed that "the use of high-quality standardized desensitization preparations and the use of the best allergy treatment plan, including the elimination of eczema allergens, immune repair of patients, symptomatic drug treatment of allergic eczema with skin inflammation, standardization Desensitization immunotherapy, referred to as "four in one quadruple therapy" scheme.
- First, try to find allergens. Sometimes allergens are hard to find, and they are always unclear, because people are in contact with too many things. The illness comes from the mouth, you can record it yourself, what you have eaten in the past three days, if the rash is a few times because of eating something, remember to stop eating later. Also pay attention to environmental factors, do not go where there are many flowers and pollen, wear a mask when going out during the pollen season. There are also more common, such as allergies to the eye frame, allergies to the accessories of the belt, these should be avoided. Because it starts to feel itchy after using a certain kind of cosmetics, it generally means that you are allergic to the ingredients in the cosmetics, so you should not use this kind of cosmetics. This is prevention-oriented and try to find the cause. Can't find the reason to avoid some allergic factors in your life.
- Second, eczema can be very itchy, and scratches often make skin lesions worse. In fact, the more the dermatitis gets, the more itchy it gets, the more itchy the more it gets, causing a vicious circle. Therefore, do not scratch when itching, it tends to get more and more itchy.
- Third, see a doctor. For rash, you can take some anti-allergic drugs. If you have a severe itch, you can take some chlorpheniramine and antihistamines. Your doctor will prescribe some topical medications, most commonly corticosteroids. There are more than 20 kinds of hormone drugs, and hormones have different strengths. We advocate not to use the strongest medicine at the beginning, and the strongest medicine is not suitable for long-term use, and long-term use has side effects. You can also use some topical ointments and potions.
Triamcinolone Toxicity
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3. Immune system toxicity-anaphylactic shock |
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2. Reproductive toxicity-abnormal development of the gastrointestinal system |
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3. Reproductive toxicity-reduced weight gain in newborns |
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2. Reproductive toxicity-affects the fetus |
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2. Reproductive toxicity-embryo or fetal death 3. Reproductive toxicity-abnormalities of the skull and face (including nose / tongue) |
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2. Reproductive toxicity-abnormal development of musculoskeletal system 3. Reproductive toxicity-abnormal development of blood and lymphatic system (including spleen and bone marrow) |
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2. Reproductive toxicity-embryo or fetal death |
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- [4-33]
Triamide expert review
- Domestic reports indicate that 7 cases of atopic dermatitis were treated with imported 0.1% acetic acid and anti-inflammatory pine cream for 21 consecutive days, and 6 cases of dermatitis improved over 50%; 21 cases of neurodermatitis improved over 50% 16 cases. No adverse reactions such as skin atrophy and telangiectasia were seen. The Peking Union Medical College Hospital of the Chinese Academy of Medical Sciences divided 57 randomized, double-blind patients with systemic lupus erythematosus (SIE) into two groups, taking triamcinolone 0.8 mg / kg or prednisone acetate 1 mg / kg orally. Results The total effective rate was 73.7% in both groups, but the weight gain and the incidence of full moon face adverse reactions were significantly lower in the triamcinolone-treated group. It is mainly used for the treatment of allergic diseases and the treatment of arthritis patients with hypertension or edema, with obvious curative effects. Triamcinolone A's acetate derivative is a medium-acting glucocorticoid. The effect is similar to that of Triamcinolone. Its anti-inflammatory and anti-allergic effects are strong and long-lasting. It is suitable for various skin diseases such as neurodermatitis and eczema. Domestic reports reported that 321 cases of various soft tissue strains were treated with triamcinolone. 5 to 20 mg each time, add 0.25% lidocaine solution as a local tenderness point closure. Once a week, 5 consecutive times is a course of treatment. Some patients recovered 8 times. If the symptoms are not improved after 3 injections, it will be invalid, and the closure will not be continued. In recent follow-up, 164 cases (51.1%) were cured after treatment with triamcinolone, 88 cases (27.4%) were markedly effective, 31 cases (9.7%) were effective, 38 cases (11.8%) were ineffective, and the total effective rate was 88.2%. Another report reported that 78 patients with bronchial asthma were treated with triamcinolone (40 males and 38 females) with a course of 1 to 25 years. Use Triamcinolone Suspension Injection for bilateral Feishu acupoint injection, 0.2ml (8mg) per acupoint, every 2 weeks for 1 to 3 months (7 cases in one month, 12 cases in 2 months) , 59 cases in 3 months). Results Initial results were obtained in 1 to 3 days, 54 cases were clinically cured and markedly effective, 22 cases were effective, and the total effective rate was 98.7%. 38 cases were followed up for more than 2 years and remained stable. It is a long-acting adrenal corticosteroid, with strong and long-lasting anti-inflammatory and anti-allergic effects, and an anhydrous sodium retention effect. There are many dosage forms, which are used for the treatment of allergic diseases such as respiratory, otolaryngology, dermatology, ophthalmology and other diseases in various professions.