Triamcinolone Acetonide 0.1% Topical Cream (Triaderm)

1. Health Canada Drug Product Database -- Triaderm Cream 0.1% (DIN 00716960)

• Relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses -- eczema/atopic dermatitis, contact dermatitis, and other localized inflammatory skin conditions where itching has an inflammatory component.
• Not indicated for pruritus without an inflammatory skin finding -- a topical corticosteroid does not relieve itch that is not due to skin inflammation, and using one in that setting exposes the patient to corticosteroid adverse effects for no benefit.

• Topical corticosteroids are generally considered compatible with use in pregnancy when applied in moderate amounts for a limited duration; avoid large-quantity or prolonged use over extensive body-surface areas, which raises the theoretical risk of systemic absorption.

• Compatible with breastfeeding; avoid applying directly to the nipple/areola immediately before a feed.

• Older adults have thinner skin and may be more prone to local atrophy, purpura, and telangiectasia with prolonged use -- limit duration of use and monitor the treated area at follow-up.

• Use the lowest effective potency and the shortest effective duration in children, who have a higher surface-area-to-weight ratio and therefore greater systemic absorption risk from topical corticosteroids than adults. Moderate-potency products such as this one are generally reserved for short courses on non-facial, non-intertriginous skin.

• Apply a thin film to the affected area(s) once or twice daily.
• Limit continuous use to 2-3 weeks on thin-skinned areas (face, neck, skin folds, genitals) and reassess before continuing use on the trunk/limbs beyond several weeks, given the risk of skin atrophy and other local adverse effects with prolonged use.
• Do not use under occlusive dressings or diapers unless specifically directed, since occlusion significantly increases systemic absorption.

If overdose is suspected, seek emergency medical attention immediately or contact your regional Poison Control Centre without delay.

• Topical overdose from a single application is not expected to cause acute toxicity; chronic excessive use over large areas or under occlusion can lead to systemic corticosteroid effects, including hypothalamic-pituitary-adrenal axis suppression -- discontinue and seek medical assessment if this is suspected.

• Local burning or stinging on application, dryness, mild skin thinning with prolonged use.

Serious side effects require immediate discussion with the prescriber or emergency care.

• Skin atrophy, striae, telangiectasia, and purpura with prolonged or inappropriate use, particularly on the face or skin folds.
• Perioral dermatitis or acneiform eruptions with facial use.
• Systemic absorption sufficient to cause HPA-axis suppression or Cushingoid features -- rare with appropriate use, more likely with large-area or occluded use, especially in children.
• Masking or worsening of untreated cutaneous infection (fungal, bacterial, viral) -- a topical corticosteroid should not be applied to a skin infection without concurrent antimicrobial treatment.

• Use with caution on the face, groin, axillae, and other skin-fold areas, where absorption is highest and atrophy risk is greatest -- prefer a lower-potency agent for these sites when a corticosteroid is genuinely needed there.
• Use with caution in any condition where the skin barrier is already compromised (extensive dermatitis, skin infection) given increased absorption.

• Known hypersensitivity to triamcinolone acetonide or any product excipient.
• Untreated bacterial, fungal, or viral skin infection at the application site.
• Rosacea, perioral dermatitis, and acne -- topical corticosteroids can worsen these conditions.

• No clinically significant systemic drug interactions at recommended topical doses on limited body-surface areas; systemic corticosteroid drug-interaction principles apply only in the setting of significant systemic absorption (large-area or occluded use).

• None applicable -- topical product.

• Apply once or twice daily as directed; morning and evening dosing is a common, practical schedule for twice-daily use.

• Store at room temperature, tightly closed, and out of reach and sight of children.

• This is a moderate-strength steroid cream for red, inflamed, itchy patches of skin -- it treats the inflammation causing the itch, not itch on its own.
• Apply a thin film to the affected area as directed, usually once or twice a day, and rub in gently.
• Do not use on your face, groin, or armpits unless specifically told to, and do not use it for longer than directed -- prolonged use on thin skin can cause thinning, stretch marks, or visible blood vessels.
• Contact your pharmacist or prescriber if the treated area is not improving after 2-3 weeks, if it looks infected, or if you notice thinning or lightening of the skin where you have been applying it.