Triamcinolone NN
Triamcinolone is a fluorinated corticosteroid with anti-inflammatory, antipruritic and anti-allergic actions. Nystatin, a antifungal antibiotic, binds to ergosterol and interferes with the permeability of cell membrane of susceptible fungi e.g Candida spp. Neomycin is an aminoglycoside, often used topically in the infections against susceptible staphylococci and other organisms.
Mechanism of effect
Corticosteroid, antibacterial, and antifungal combination topical product with anti-inflammatory, antipruritic, and vasoconstrictive effects (triamcinolone); broad spectrum anti-bacterial activity (neomycin); anticandidal activity (nystatin).
Dosage
Tiamcinolone acetonide 0.1%, Neomycin (as sulphate) 0.25%, Nystatin 100,000 units/g:
Dermatoses: Topical (cream, ointment): Apply a small quantity 2 or 3 times/day.
Drug contraindications
Herpes SimplexAlerts
Concerns related to adverse effects:
Adrenal suppression: Corticosteroids may cause hypercortisolism or suppression of hypothalamic-pituitary-adrenal (HPA) axis, particularly in patients receiving high doses for prolonged periods. Steroid withdrawal may occur with discontinuation following prolonged therapy.
Immunosuppression: Prolonged use may result in fungal or bacterial superinfection; discontinue if dermatological infection persists despite appropriate antimicrobial therapy.
Local effects: Topical use of triamcinolone has been associated with local sensitivity reactions; skin atrophy, burning, itching, erythema, dryness, have been reported with use of topical corticosteroids. Discontinue use if local irritation or sensitization occur.
Systemic effects: May be absorbed percutaneously; absorption is increased by the use of occlusive dressings, application to large surface areas. Absorption of topical corticosteroids may cause manifestations of Cushing's syndrome, hyperglycemia, or glycosuria. Rarely, ototoxicity (eg, tinnitus and deafness) has been reported with topical corticosteroids or topical neomycin. Avoid prolonged use (may increase risk of systemic effects).
Disease-related concerns:
Cardiovascular disease: Use topical corticosteroids with caution in patients with skin disease associated with impaired circulation (eg, dermatitis); reassess patient.
Points of recommendation
For external use only; avoid contact with eyes. Treated area(s) should not be covered with occlusive dressings.
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