Cenolon Injection

Cenolon Injection (Triamcinolone Acetonide)

Indications

Intramuscular Use:

• Rheumatic Disorders:
  • Acute gouty arthritis
  • Acute rheumatic carditis
  • Ankylosing spondylitis
  • Psoriatic arthritis
  • Rheumatoid arthritis (including juvenile)
• Allergic States:
  • Severe allergic conditions (asthma, atopic dermatitis, etc.)
• Dermatologic Diseases:
  • Bullous dermatitis herpetiformis
  • Pemphigus
  • Severe erythema multiforme
• Endocrine Disorders:
  • Adrenocortical insufficiency
  • Congenital adrenal hyperplasia
• Gastrointestinal Diseases:
  • Regional enteritis
  • Ulcerative colitis
• Hematologic Disorders:
  • Autoimmune hemolytic anemia
  • Diamond-Blackfan anemia
• Neoplastic Diseases:
  • Palliative management of leukemias and lymphomas
• Nervous System:
  • Acute exacerbations of multiple sclerosis
  • Cerebral edema from brain tumors
• Ophthalmic Diseases:
  • Sympathetic ophthalmia
  • Uveitis
• Renal Diseases:
  • Idiopathic nephrotic syndrome
• Respiratory Diseases:
  • Berylliosis
  • Symptomatic sarcoidosis
• Miscellaneous:
  • Tuberculous meningitis with appropriate therapy

Intra-articular Use:

• Adjunctive therapy for:
  • Acute gouty arthritis
  • Bursitis
  • Rheumatoid arthritis

Pharmacology

• Composition: Triamcinolone Acetonide is a synthetic glucocorticoid with anti-inflammatory properties.
• Absorption: Well absorbed from the gastrointestinal tract. Extended duration of effect (up to several weeks).
• Adrenal Suppression: Occurs within 24-48 hours post-injection, returning to normal in 30-40 days.

Dosage & Administration

• General: Initial doses range from 2.5 mg to 100 mg, adjusted based on response.
• Systemic Administration:
  • Adults: Initial dose of 60 mg into the gluteal muscle, with adjustments typically between 40-80 mg.
  • Pediatric: 0.11 to 1.6 mg/kg/day in 3-4 doses.
• Local Administration (Intra-articular):
  • Initial dose: 2.5 mg to 15 mg depending on joint size.
  • Up to 40 mg for larger areas may be sufficient.

Interactions

• Aminoglutethimide: May reduce corticosteroid-induced adrenal suppression.
• Anticoagulants (e.g., Warfarin): Monitor coagulation indices closely.
• Diuretics: Risk of hypokalemia when used with corticosteroids.
• Antidiabetics: Adjustments may be necessary due to increased blood glucose.

Contraindications

• Hypersensitivity to any components.
• Contraindicated in idiopathic thrombocytopenic purpura.

Side Effects

• Allergic Reactions: Anaphylaxis, angioedema.
• Cardiovascular: Hypertension, arrhythmias, congestive heart failure.
• Dermatologic: Acne, rash, skin thinning.
• Endocrine: Cushingoid state, menstrual irregularities.
• Fluid/Electrolyte Disturbances: Fluid retention, hypokalemia.
• Gastrointestinal: Nausea, pancreatitis, peptic ulcers.
• Musculoskeletal: Osteoporosis, muscle weakness.
• Neurologic/Psychiatric: Mood swings, insomnia, increased intracranial pressure.
• Ophthalmic: Glaucoma, cataracts.

Pregnancy & Lactation

• Category C: Use only if benefits justify potential risks. Appears in human milk; may affect growth and endogenous production.

Precautions & Warnings

• Use the lowest effective dose for the shortest duration necessary.
• Gradual reduction of dosage when applicable.
• Monitor for complications related to dose and treatment duration.

Consultation Note

Always follow the advice of a registered physician when administering this medication.