Last update April 1, 2024

トリアムシノロン

Low Risk

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

Corticosteroid with main glucocorticoid action and anti-inflammatory effect of similar potency to prednisolone. Systemic (oral, injectable), inhaled (bronchial, nasal), intra-articular, intravitreal, intramammary and topical dermal administration. Indicated in the treatment of rheumatic and collagen diseases, inflammatory bowel disease, granulomatous mastitis, dermatitis, asthma, rhinitis, etc.

This commentary is about systemic, intra-articular, intramammary and ophthalmic Triamcinolone; for inhaled or topical dermatological use, see Inhaled Triamcinolone, Topical Triamcinolone.

At the time of last update, we found no published data on the excretion in breast milk of injected, intra-articular or ophthalmic triamcinolone.

After intramammammary injection of triamcinolone to treat granulomatous mastitis, triamcinolone levels in the milk of the affected breast were undetectable (Rosen 2023) or extremely low: relative infant dose 0.23% (Mitchell 2024), the authors considering that it is not necessary to withdraw lactation or wait any time to breastfeed in case of intramammammary injection of triamcinolone. In one mother, milk production decreased in the diseased breast, but not in the unaffected breast, recovering after 15 days. (Rosen 2023)

Intra-articular Triamcinolone administration at the wrist (Smuin 2016) or epidural in cervical area (McGuire 2012) caused temporary decrease in milk production of one to four weeks duration that resolved in both cases with maintenance and stimulation of lactation and use of galactogogues (domperidone, fenugreek).

Although after both intraocular (Shen 2010, Degenring 2004) and epidural (Hooten 2016) administration of triamcinolone, the elimination half-life is about 22 - 25 days, plasma levels are undetectable or very low, not clinically significant. The maximum peak concentration 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 corticosteroids (National Asthma Education 2004), nor inhaled corticosteroids (Middleton 2020, National Asthma Education 2004) pose a contraindication to breastfeeding.

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

Corticosteroids are commonly used in pediatrics and have no side effects when used alone or in short treatments.

Until more data are published on this drug in relation to lactation, alternatives with a known pharmacokinetic profile that is safer for lactation (greater protein binding, shorter half-life and lower oral bioavailability) may be preferable, especially during the neonatal period and in case of prematurity.

If used during lactation, milk production should be monitored.

Translated with DeepL.com (free version)


See below the information of these related products:

Alternatives

  • Methylprednisolone ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Prednisolone ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Prednisone ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Groups

トリアムシノロン belongs to these groups or families:

Tradenames

Main tradenames from several countries containing トリアムシノロン 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
1.5 hours

References

  1. Mitchell K, Krutsch K, Datta P, Hale TW. Evaluating the Transfer of Injected Triamcinolone Acetonide into Human Milk: Confirmatory Results. Breastfeed Med. 2024 Mar 19. Consulted on April 1, 2024 Abstract
  2. Rosen-Carole C, Datta P, Palmiter K, Starks K, Hale TW. Transfer of Injected Triamcinolone into Human Milk of a Lactating Patient Suffering from Idiopathic Granulomatous Mastitis. Breastfeed Med. 2023 Jan;18(1):74-77. Abstract
  3. Middleton PG, Gade EJ, Aguilera C, MacKillop L, Button BM, Coleman C, Johnson B, Albrechtsen C, Edenborough F, Rigau D, Gibson PG, Backer V. ERS/TSANZ Task Force Statement on the management of reproduction and pregnancy in women with airways diseases. Eur Respir J. 2020 Feb 6;55(2). pii: 1901208. Abstract Full text (link to original source) Full text (in our servers)
  4. 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
  5. 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 May-Jun;15(3):171-6. Abstract Full text (link to original source)
  6. McGuire E. Sudden loss of milk supply following high-dose triamcinolone (Kenacort) injection. Breastfeed Rev. 2012 Mar;20(1):32-4. Review. Abstract
  7. 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
  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. None 2004 Full text (link to original source) Full text (in our servers)
  9. Degenring RF, Jonas JB. Serum levels of triamcinolone acetonide after intravitreal injection. Am J Ophthalmol. 2004 Abstract

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