Monograph
S01BA05 - Triamcinolone |
Not porphyrinogenic |
NP |
Rationale
Triamcinolone is administered locally in the eye and has minimal hepatic exposure. Triamcinolone is a substrate of CYP3A4 but is not suspected to be an inducer or a mechanism based inhibitor of CYP enzymes.
Chemical description
Corticosteroide
Therapeutic characteristics
Triamcinolone is an anti-inflammatory agent used in various disorders of the eye, or as a visualisation agent during vitrectomy. It may be administered as an intravitreal or subtenon injection.
Hepatic exposure
In a pharmacokinetic study performed on 36 patients, the highest measured plasma Cmax after a 40-mg posterior subtenon TA injection was 1,15 ng /ml which is equivalent to 2,9 nM. This is well below µM concentration and therefore regarded as insignificant.
Metabolism and pharmacokinetics
Triamcinolone is a substrate of CYP3A4 (Moore 2013) and interaction studies have shown increased glucocorticoid effects of triamcinolone when administered with the CYP 3A4 inhibitor ritonavir (Dort 2009).
Triamcinolone is not suspected to be an inducer or a mechanism based inhibitor of CYP enzymes, and is not observed to alter the metabolism of other CYP metabolized drugs.
References
| # | Citation details | PMID |
|---|---|---|
| * | Scientific articles | |
| 1. | Adrenal suppression due to an interaction between ritonavir and injected triamcinolone: a case report.
Dort K, Padia S et al. AIDS Res Ther. 2009 Jun 8;6:10. |
23758832 |
| 2. | Metabolic pathways of inhaled glucocorticoids by the CYP3A enzymes.
Moore CD, Roberts JK et al. Drug Metab Dispos. 2013 Feb;41(2):379-89. |
23143891 |
| 3. | Intraocular and systemic pharmacokinetics of triamcinolone acetonide after a single 40-mg posterior subtenon application.
Shen L, You Y et al. Ophthalmology. 2010 Dec;117(12):2365-71. |
20678801 |
| * | Summary of Product Characteristics | |
| 4. | Norwegian medicines agency. Summary of Product Characteristics (SPC). Triesence.
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