SKINCORT Tablet

Indication:

+Endocrine Disorders

Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone are the drugs of choice although synthetic analogs may be used in conjunction with mineralocorticoids where applicable; mineralocorticoid supplementation is of particular importance when treating this condition in infants); nonsuppurative thyroiditis, hypercalcemia associated with cancer.

+Rheumatic Disorders

As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in psoriatic arthritis; rheumatoid arthritis (selected cases may require low dose maintenance therapy): ankylosing spondylitis; acute and subacute bursitis; acute nonspecific tenosynovitis; and acute gouty arthritis, synovitis of osteoarthritis, epicondylitis.

+Collagen Diseases

For use during an exacerbation or as maintenance therapy in selected cases of systemic lumps erythematosus and acute rheumatic carditis.

+Dermatologic Diseases

Pemphigus, bullous dermatitis herpetiformis, severe erythema multiforme (Stevens-Johnson syndrome), exfoliative dermatitis, mycosis fungoides, and severe psoriasis. Severe seborrheic dermatitis.

Allergic States: control of seasonal or perennial allergic rhinitis, bronchial asthma, contact dermatitis, atopic dermatitis, serum sickness, drug hypersensitivity reactions and urticaria when they are severe or incapacitating, and intractable to adequate trials of conventional treatment.

+Ophthalmic Diseases

Severe acute and chronic allergic and inflammatory processes involving the eye and its associated anatomic parts such as allergic conjunctivitis, keratitis, allergic corneal marginal ulcers, herpes zoster ophthalmicus, iritis and iridocyclitis, chorioretinitis, anterior segment inflammation, diffuse posterior uveitis and choroiditis, optic neuritis, and sympathetic ophthalmia.

+Respiratory Diseases

Symptomatic sarcoidosis, Loffler’s syndrome not manageable by other means, berylliosis, fulminating or disseminated pulmonary tuberculosis when concurrently accompanied by appropriate antituberculous chemotherapy, aspiration pneumonitis.

+Hematologic Disorders

Idiopathic and secondary thrombocytopenia in adults, acquired (autoimmune) hemolytic anemia, erythroblasropenia (RBC anemia), and congeital (erythroid) hypoplastic anemia.

Neoplastic Diseases: palliative management of leukemias and lymphomas in adults and acute leukemia of childhood.

+Edematous States

To induce a diuresis or remission of proteinuria in the nephrotic syndrome (nonuremic, the idiopathic type, or that which is due to lupus erythematosus) and, in conjunction with diuretic agents, to induce a diuresis in refractory congestive heart failure and in cirrhosis of the liver with refractory ascites.

+Gastrointestinal Disorders

To tide the patient over a critical period of the disease in ulcerative colitis, regional enteritis.

+Nervous System

Exacerbations of multiple sclerosis.

+Miscellaneous

Tuberculous meningitis with subarachnoid block or impending block when concurrently accompanied by appropriate antituberculous chemotherapy. Trichinosis with neurologic or myocardial involvement.

Dosage and administration:

The physician should individualize the dosage for the patient and disease under treatment. In adults and children over 34kg with the common disease amenable to steroid therapy, the usual initial dose ranges 8-20mg/day divided into 3-4 doses. When a satisfactory response is obtained, the initial dose should be reduced gradually by decrements of 2mg over 2-3 days until the smallest dose is obtained which will adequately maintain the patient.

4mg of triamcinolone is approximately equivalent to:

cortisone 25mg

prednisolone 5mg

prednisone 5mg

methylprednisolone 4mg

hydrocortisone 20mg

dexamethasone 0.75mg

paramethasone 2mg

Acute psychosis; ocular herpes simplex, fungal or viral infections for which adequate anti-infective therapy is lacking;

Untreated acute or chronic infection, including tuberculosis.

+Fluid and Electrolyte Disturbances:

sodium retention, fluid retention, congestive heart failure in susceptible patients, potassium loss, cardiac arrhythmias or ECG changes due to potassium deficiency, hypokalemic alkalosis, hypertension.

+Musculoskeletal:

muscle weakness, fatigue, steroid myopathy, loss of muscle mass, osteoporosis, vertebral compression fractures, delayed healing of fractures, aseptic necrosis of femoral and humeral heads, pathologic fractures of long bones, spontaneous fractures.

+Gastrointestinal:

peptic ulcer with possible subsequent perforation and hemorrhage, pancreatitis, abdominal distention, ulcerative esophagitis

+Dermatologic:

impaired would healing, thin fragile skin, petechiae and ecchymoses, facial erythema, increased sweating, purpura, striae, hirsutism, acneiform eruptions, lupus erythematosus like lesions, suppressed reactions to skin tests.

+Neurological:

convulsions, increased intracranial pressure with papilledema (pseudotumor cerebri) usually after treatment, vertigo, headache, neuritis or paresthesias, aggravation of preexisting psychiatric conditions.

+Endocrine:

menstrual irregularities, development of the Cushingoid state, suppression of growth in children, secondary adreno-cortical and pituitary unresponsiveness, particularly in times of stress (e.g. trauma, surgery or illness), decreased carbohydrate tolerance, manifestations of latent diabetes mellitus, increased requirements for insulin or oral hypoglycemic agents in diabetics.

+Ophthalmic:

posterior subcapsular cataracts, increased intraocular pressure, glaucoma, exophthalmos.

+Metabolic:

hyperglycemia, glycosuria, negative nitrogen balance due to protein catabolism.

+Other:

necrotizing angiitis, thrombophlebitis, thromboembolism, aggravation or masking of infections, insomnia, syncopal episodes, anaphylactoid reactions.

Pregnancy

Weigh the potential hazards of corticosteroid therapy to the embryo or fetus carefully against possible benefits when using the drug during pregnancy.

See the package insert about the details.

When patients who are receiving corticosteroid therapy are subjected to unusual stress (trauma, surgery or severe illness), included dosage of rapidly acting corticosteroids is indicated before, during and after the stressful situation.

Corticosteroids may mask some signs of infection, and new infections may appear during their use. There may be decreased resistance and inability to localize infection when corticosteroids are used. If an infection occurs during corticosteroid therapy, it should be promptly controlled by suitable antimicrobial therapy.