Main physical and chemical properties: white round, oboyevypukly tablets with a groove on one party;
Structure. 1 tablet contains 4 mg of Triamcinolonum;
other components: lactose, povidone, talc, magnesium stearate, starch corn.
Release form. Tablets.
Farmakoterapevtichesky group. Corticosteroids for system use. Glucocorticoids. Code of automatic telephone exchange H02A B08.
Effect of the medicine. Pharmacodynamics. Triamcinolonum - a synthetic corticosteroid with active antiinflammatory, antiallergenic, a sedative and immunodepressive effect. It does not make a delay of sodium and water, and even has small diuretic effect. At use it does not stimulate the central nervous system in ordinary therapeutic doses. Its diabetogenic effect expressed by two-three times less than at dexamethasone. Its overwhelming influence on a hypophysis is a little less, than other corticosteroids in identical doses. Removal of Triamcinolonum results more slowly therefore it can be accepted only once a day.
Pharmacokinetics. At intake it is quickly soaked up in a digestive tract. The maximum concentration of Triamcinolonum in a blood plasma is defined in 8 – 12 hours after reception. The elimination half-life makes 200 minutes.
It is metabolized generally in a liver, less – in kidneys, about 15% of drug are removed with urine in an invariable look.
Indications for use. Kenalogum is applied at all indications to system corticosteroid therapy, including such as allergic diseases (allergic rhinitis and conjunctivitis, the small tortoiseshell), skin diseases (a violent dermatosis, neurodermatitis, psoriasis, especially — psoriasis arthritis).
Way of use and dose. Doses and duration of treatment are defined by the doctor individually.
Drug is appointed once a day (better in the morning) or several separate doses, especially if the general dose exceeds 16 mg.
The usual daily dose for adults makes from 4 to 32 mg. In the presence of undesirable effects the dose needs to be lowered gradually (by 4 mg each 2-3 days) before achievement of an adequate dose (ordinary about 4 mg a day).
Children whose body weight exceeds 25 kg have to receive the dose recommended for adults.
Children with body weight to 25 kg have to receive an initial dose of 12 mg a day, and the following doses depend on type of a disease and reaction of an organism.
Side effect. Side reactions similar to effects of other corticosteroids.
Skin reactions: striya, eels, petechias, ecchymomas, telangiektaziya, pigmentation, bad healing of wounds.
From muscles and bones: weakness of muscles and also atrophy, osteoporosis.
From sight: glaucoma, cataract.
From a digestive tract and a liver: gastric disturbances, stomach ulcer, pancreatitis, nausea, anorexia.
From endocrine system: braking of epinephral glands, a syndrome of Kushinga, steroid diabetes, disturbance of secretion of sex hormones - an irregularity of periods, impotence, a hirsutism.
From immune system: the reduced mechanism of protection of an organism, the increased risk of an infection; corticosteroids can mask an infection.
From system of blood: tendency to thromboses is increased.
From the central nervous system: dizziness, headache.
Allergic reactions meet seldom.
Corticosteroids suppress growth of children and teenagers. Besides, cases of arterial hypertension, the increased intraocular and intracranial pressure, an avaskulyarny necrosis of bones, pathological changes, psychoses, depressions, fibrinferment of vessels and increase in body weight are described.
Contraindications. Kenalogum is contraindicated to patients with hypersensitivity to Triamcinolonum or to other components of drug, at active stomach ulcer, an anastomosis in intestines, a diverticulitis, glaucoma, diabetes, osteoporosis, tendency to psychoses, lymphadenitis after BTsZh inoculation, in two months after an inoculation a live virus, at a heavy myasthenia, tuberculosis, a viral infection, system mycosis, an infection, insensitive to antibiotics, an amebiasis and a syndrome of Kushinga.
It is necessary to avoid use of Kenalogum at heavy poraneniye and operations. It is impossible to appoint him the patient to thrombosis of vessels or with complications of a trombembmasl.
Overdose. Overdoses (after several weeks of reception) can entail, generally a syndrome of Kushinga, braking of bark of epinephral glands, weakness of muscles, osteoporosis and an erosive gastroduodenopatiya. Treatment has to be symptomatic. It is necessary to avoid sharp a treatment suspension. One-time reception of a large number of tablets does not make clinically significant intoxication. The hemodialysis ordinary does not accelerate removal of Triamcinolonum from an organism.
Features of use.
Preventions and cautions.
Long-term use of Triamcinolonum slows down secretion of hormones of epinephral glands therefore treatments need to be stopped gradually. Suppression of epinephral glands can continue several months after a treatment suspension.
Patients with tuberculosis have to be in the anamnesis under careful supervision because the risk of reactivation of process is; it concerns as well are sick with stomach ulcer.
At heavy infections Triamcinolonum can be used only in a combination with treatment by antibiotics.
There is also increased risk of a viral infection at the first contact with viruses of chicken pox or herpes.
It is necessary to appoint carefully drug sick with a serious illness of muscles (an atrophy of muscles).
Triamcinolonum use at treatment of children only for serious requirements because it can oppress growth and development.
It is necessary to appoint corticosteroids carefully the patient with epilepsy, arterial hypertension, to patients with heavy heart failure and serious violations of function of a liver.
Corticosteroids can influence indicators of allergic tests and increase risk of a hypopotassemia.
Pregnancy and feeding by a breast.
Safety of reception of corticosteroids is not established. Their uses it is shown only in separate acute cases if possible advantage for mother to perevazhit possible risk for a fruit. During treatment it is necessary to stop feeding by a breast. Newborns from mothers that was received by corticosteroids during pregnancy, have to be under careful supervision through a possibility of insufficiency of bark of epinephral glands.
Influence on ability to steer the car and other mechanisms.
Kenalogum does not influence significantly psychophysical ability to steer the car or to work with mechanisms.
Interaction with other medicines. Triamcinolonum strengthens or weakens effect of anticoagulants, reduces concentration of salicylates and increases glucose level in a blood plasma (it is necessary to modify doses of insulin and/or anti-diabetic means).
Parallel use of Triamcinolonum and diuretics can increase potassium loss (patients are more sensitive to a digitalis). Parallel use of antagonists of beta and adrenergic receptors increases risk of a hypopotassemia. Estrogen can reduce a metabolism of corticosteroids.
Parallel use of barbiturates, Phenytoinum or rifampicin reduces efficiency of Triamcinolonum.
Triamcinolonum, applied together with non-steroidal anti-inflammatory drugs, increases risk of gastrointestinal bleeding. Corticosteroids reduce efficiency of anti-hypertensive drugs.
Terms and storage conditions. To store at a temperature not above 25 °C. To store in the place, unavailable to children. A period of validity – 5 years.