Triamcinolone Nasal Spray is indicated for the treatment and prevention of nasal symptoms associated with seasonal and perennial allergic rhinitis in adults and children aged 6 years and older.

The anti-inflammatory effects of corticosteroids are believed to involve the induction of lipocortins, which are phospholipase A₂ inhibitory proteins. By inhibiting phospholipase A₂, these proteins reduce the release of arachidonic acid, thereby limiting the synthesis of inflammatory mediators such as prostaglandins and leukotrienes.

Corticosteroids exert their action by binding to intracellular glucocorticoid receptors, which then translocate to the nucleus and interact with glucocorticoid response elements (GREs) on DNA. This interaction modulates gene expression, resulting in both upregulation and downregulation of specific proteins involved in inflammatory and immune responses.

The immunosuppressive effects of corticosteroids are associated with decreased lymphatic system activity, reduced levels of immunoglobulins and complement proteins, induction of lymphocytopenia, and interference with antigen–antibody interactions.

Triamcinolone Acetonide is a more potent derivative of triamcinolone and is approximately eight times more potent than prednisone. Corticosteroids are highly effective in managing allergic conditions. When administered intranasally, Triamcinolone Acetonide relieves allergy-related symptoms including rhinorrhea (watery nasal discharge), nasal congestion, postnasal drip, sneezing, and itching of the throat.

Adults and children 12 years of age and older: The recommended dose is 220 µgm as 2 sprays in each nostril once daily. Once symptoms are controlled patients can be maintained on 110 µgm (1 spray in each nostril once daily). The minimum effective dose should be used to ensure continued control of symptoms.

Pediatric Patients aged 6 to 12 years: The recommended dose is 110 µgm as 1 spray in each nostril once daily. Triamcinolone spray is not recommended for children under 6 years of age.

How to use the Nasal Spray

• Shake the bottle gently and remove the dust cover.
• Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath
• the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or
• more, press the nasal applicator several times until a fine moist comes out from the container.
• Gently blow the nose to clear the nostrils.
• Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly
• and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal
• applicator firmly down once to release a spray.
• Breathe out through your mouth.
• Repeat the above steps in the same/ other nostril for consecutive doses.

Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows

• Remove the dust cover.
• Gently pull off the nasal applicator.
• Wash the applicator and dust cover in warm water.
• Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.
• Gently push the applicator back on the top of the bottle and re-fix the dust cover.

There are no specific contraindications; however, caution should be exercised in patients with known hypersensitivity to any component of the formulation.

In clinical trials, the most commonly reported adverse reactions with Triamcinolone involved the nasal and throat mucosa. The most frequently observed reactions were rhinitis, headache, and pharyngitis.

Nasopharyngeal adverse effects included epistaxis, nasal irritation, dryness of the nasal mucosa, nasal or sinus congestion, and sneezing; however, these events occurred at rates comparable to placebo. As with other intranasal corticosteroids, rare cases of nasal septal perforation have been reported.

There are no adequate and well-controlled studies of Triamcinolone in pregnant women. Animal studies have demonstrated teratogenic effects; therefore, Triamcinolone should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Triamcinolone is excreted in human breast milk.

If adrenal function impairment is suspected, caution should be exercised when transitioning patients from systemic corticosteroid therapy to intranasal Triamcinolone.

In clinical studies of intranasal Triamcinolone, localized infections of the nose and pharynx with Candida albicans have been reported rarely. If such infections occur, appropriate local antifungal treatment may be required, and discontinuation of Triamcinolone should be considered.

Due to the inhibitory effects of corticosteroids on wound healing, Triamcinolone should be used cautiously in patients with recent nasal septal ulcers, nasal surgery, or nasal trauma until adequate healing has taken place.

As with other intranasal corticosteroids, acute overdosage with Triamcinolone is unlikely due to the limited total amount of active ingredient contained in the formulation.

Corticosteroid, Glucocorticoids, Nasal Steroid Preparations.

Store at a temperature not exceeding 25°C. Protect from light and moisture. Keep out of reach of children.