Generic Aristocort 4mg is taken orally after meals, administered intramuscularly, intra-articularly and externally. Patients over 12 years of age with adrenal insufficiency should take 4-12 mg per day in 2 doses (in the morning and at lunch) or once (in the morning). For other conditions, 4-48 mg per day in 2 doses or once are recommended. You should enter the dose of 40-80 mg and, if necessary, re-enter it after 4 weeks.
The dose of 2.5 – 15 mg is injected into the vagina of the tendon or in the joint cavity. The injections are repeated, if necessary. Children from 6 to 12 years of age with adrenal insufficiency are prescribed 0.117 mg/kg in 2 doses or once in the morning. In other cases, one should take 0.416-1.7 mg/kg; for children weighing up to 25 kg, the maximum daily dose is 12-14 mg. You should enter either the dose of 0.03-0.2 mg/kg (repeat it after 1-7 days) or 40 mg intramuscularly. If necessary, the injection is repeated after 4 weeks.
Generic Aristocort 4mg is not intended for intravenous administration. During therapy, it is recommended to take vitamin D and foods rich in calcium. With a single intramuscular injection of 60-100 mg of the drug for 1 to 2 days, adrenal function may be inhibited, which usually recovers after 30 to 40 days.
Application and prevention of treatment
For external use, it is recommended to combine Generic Aristocort 4mg with antimicrobial drugs to prevent local infectious complications.
Parenteral use in children under 6 years of age is not recommended; in children 6-12 years of age, parenteral administration is possible only for strict indications. Prolonged external use of Generic Aristocort 4mg should be avoided in patients under 18 years of age. In children during the growth period, glucocorticosteroids should only be used for absolute indications and under the careful supervision of the attending physician.
Before and during the administration of glucocorticosteroids, it is necessary to monitor the level of sugar, general blood analysis, and the content of electrolytes in the blood serum. In the treatment of septic conditions, intercurrent infections, and tuberculosis, antibiotic therapy is performed together. When treating with glucocorticosteroids, vaccination with live viral vaccines is contraindicated.
Immunization with bacterial vaccines or inactivated viral ones against the background of the use of glucocorticosteroids does not give the expected protective effect, since it does not provide the expected increase in the number of antibodies. Therefore, glucocorticosteroids should not be used for 2 weeks after and 8 weeks before vaccination. Caution is necessary when a patient who receives glucocorticosteroids comes into contact with patients with measles, chickenpox and other contagious diseases as the risk of developing the above diseases increases if they accidentally come into contact with infected people.
In these cases, passive immunization is recommended. Caution is necessary in patients after bone fractures and operations as glucocorticosteroids can slow the healing of fractures and wounds. In patients with hypothyroidism or cirrhosis of the liver, the effect of glucocorticosteroids increases. The use of Triamcinolone 4mg can change the indicators of skin allergies during hypersensitivity tests. When taking Generic Aristocort 4mg, care should be taken in patients whose activities are associated with increased attention and speed of psychomotor reactions (including driving vehicles), and in the development of adverse reactions from the nervous system (for example, disorientation, lethargy, depression, convulsions, personality changes, headache, mania, psychosis, hallucinations, and others). Such activities should be abandoned.
Bradycardia (up to cardiac arrest), arrhythmias, the development or increase in the severity of heart failure, ECG changes that are characteristic of hypokalemia, hypercoagulation, increased blood pressure, thrombosis; in patients with acute and subacute myocardial infarction — slowing the formation of scar tissue, the spread of the focus of necrosis, rupture of the heart muscle.
Also, increased intraocular pressure (ophthalmic hypertension, glaucoma), posterior subcapsular cataract, trophic changes in the cornea, a tendency to develop secondary fungal, bacterial or viral eye infections, sudden loss of vision (due to deposition of Triamcinolone 4mg crystals in the eye chambers), exophthalmos, menstrual disorders and anaphylactic shock, itching, skin rash, urticaria, bronchospasm, angioedema, respiratory arrest are possible.
Interaction with other drugs
When used together, the effect of insulin and oral hypoglycemic drugs is weakened; with cardiac glycosides, the risk of heart rhythm disorders and other toxic effects of glycosides increases; with laxatives, hypokalemia may develop.
When Generic Aristocort 4mg is used together with live viral vaccines as well as against the background of other types of immunization, the risk of virus activation and infection increases. Triamcinolone 4mg increases (with prolonged use) the folic acid content. High doses of the drug reduce the effects of somatropin. Triamcinolone 4mg weakens the effect of vitamin D on the absorption of calcium ions in the intestinal lumen. Cyclosporine (by inhibiting metabolism) and ketoconazole (by reducing clearance) increase the toxicity of Triamcinolone 4mg. Indomethacin increases the risk of Generic Aristocort 4mg adverse reactions by forcing it out of the association with albumins.
Restrictions on use
The restrictions include: chronic renal failure, chronic hepatitis, cirrhosis of the liver, hypothyroidism, esophagitis, hyperthyroidism, gastritis, psychosis or psychoneurosis, ulcerative colitis, immunodeficiency conditions (including AIDS or HIV infection), diseases of the cardiovascular system, hyperlipidemia, hypoalbuminemia and conditions that predispose to its development (necrotic syndrome); nephrourolithiasis, obesity (grade III-IV), old age.
Use during pregnancy and lactation
The use of Generic Aristocort 4mg is contraindicated during pregnancy. During therapy, it is necessary to stop breastfeeding (excreted in breast milk). Animal studies have shown the teratogenic effect of Triamcinolone 4mg (in the first trimester). When using Triamcinolone 4mg in the third trimester of pregnancy, it is possible to develop atrophy of the fetal adrenal glands. There are no data on the safety of using the drug in pregnant women.
An overdose of Generic Aristocort 4mg develops in case of nausea, vomiting, euphoria, depression, sleep disorders, agitation, hyperglycemia, Itsenko-Cushing syndrome, glucosuria; skin irritation at the site of application, burning, itching. Treatment comprises symptomatic and supportive stages with gradual withdrawal of the drug; hemodialysis is not effective; there is no specific antidote.