Last update: Oct. 11, 2017

Triamcinolone Sistemic Use

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

A corticosteroid with a mainly glucocorticoid action and anti-inflammatory effects of similar strength to that of prednisolone.
Systemic administration (oral, injection), inhaled (bronchial, nasal), intra-articular, intravitreous and topical.
Indicated in the treatment of rheumatic diseases and collagen, inflammatory bowel disease, dermatitis, asthma, rhinitis, etc.

This comment is about systemic, intra-articular and ophthalmic triamcinolone.

Since the last update we have not found published data about its excretion in breast milk.

Administration of intra-articular triamcinolone in the wrist (Smuin 2016) or via an epidural in the cervical area (McGuire 2012) caused a temporary decrease in the production of milk lasting between one and four weeks that was resolved in both cases via the continuation and stimulation of breastfeeding.

The same has occurred, with a shorter duration, following the intra-articular administration of methylprednisolone (Babwah 2013).

Although after the administration of triamcinolone, both intraocular (Shen 2010, Degenring 2004), and epidural (Hooten 2016), elimination half-life is about 22-25 days, plasma levels are indetectable or very low, not clinically significant. The maximum concentration peak after these types of administration occurs at 24 hours (Hooten 2016, Shen 2010, Degenring 2004).

There is consensus among experts that, in general, neither systemic corticoids nor inhaled ones present a breastfeeding contraindication (National Asthma Education 2004).

The low plasma levels obtained after ophthalmic administration suggest a very low risk during breastfeeding.

Corticoids are of commonally used in pediatrics and have no side effects when they are used in isolation or in short-term treatments.

Until there is more published data about this drug in relation to breastfeeding, alternatives with a safer known pharmacokinetic profile for breastfeeding may be preferable (greater protein binding, lesser half-life and less oral bioavailability), especially during the neonatal period and in case of prematurity.

If used during breastfeeding it is advisable to monitor milk production.


See below the information of these related products:

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Triamcinolone Sistemic Use is also known as


Triamcinolone Sistemic Use in other languages or writings:

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Tradenames

Main tradenames from several countries containing Triamcinolone Sistemic Use in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 394 daltons
Protein Binding 68 %
VD 1,4 l/Kg
pKa 13,4 -
Tmax 8 - 10 hours
T1/2 1,5 hours

References

  1. Hooten WM, Nicholson WT, Gazelka HM, Reid JM, Moeschler SM, Lamer TJ. Serum Triamcinolone Levels Following Interlaminar Epidural Injection. Reg Anesth Pain Med. 2016 Abstract
  2. Smuin DM, Seidenberg PH, Sirlin EA, Phillips SF, Silvis ML. Rare Adverse Events Associated with Corticosteroid Injections: A Case Series and Literature Review. Curr Sports Med Rep. 2016 Abstract
  3. Babwah TJ, Nunes P, Maharaj RG. An unexpected temporary suppression of lactation after a local corticosteroid injection for tenosynovitis. Eur J Gen Pract. 2013 Abstract
  4. McGuire E. Sudden loss of milk supply following high-dose triamcinolone (Kenacort) injection. Breastfeed Rev. 2012 Abstract
  5. Shen L, You Y, Sun S, Chen Y, Qu J, Cheng L. Intraocular and systemic pharmacokinetics of triamcinolone acetonide after a single 40-mg posterior subtenon application. Ophthalmology. 2010 Abstract
  6. Degenring RF, Jonas JB. Serum levels of triamcinolone acetonide after intravitreal injection. Am J Ophthalmol. 2004 Abstract
  7. National Asthma Education and Prevention Program Asthma and Pregnancy Working Group. Quick Reference from the Working Group Report on Managing asthma during pregnancy: recommendations for pharmacologic treatment-2004 update. 2004;1-12. 2004 Full text (link to original source) Full text (in our servers)
  8. National Asthma Education and Prevention Program Asthma and Pregnancy Working Group. Managing asthma during pregnancy: recommendations for pharmacologic treatment-2004 update. 2004;1-57. 2004 Full text (link to original source) Full text (in our servers)

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