Synonyms: Tramacin; Triam; Tricinolon; Vetalog; isopropylidenedioxy- 1,4-pregnadiene,3,20- dione; hydroxyprednisolone acetonide

OSHA IMIS Code Number: T360

Chemical Abstracts Service (CAS) Registry Number: 76-25-5

Chemical Description and Physical Properties:

white, odorless crystalline powder
molecular weight: 434.5
molecular formula: C₂₄H₃₁FO₆
solubility in water (g/L): partly miscible
melting point: 292-294°C

Incompatibilities: Water; oxidizing agents

Potential Symptoms: Redistribution of body fat ('buffalo hump'; 'moon face'); increase in blood granulocytes and blood glucose (hyperglycemia); decrease in blood lymphocytes and blood cortisol; increased susceptibility to infection; muscle weakness; psychological disturbances (emotional lability, insomnia); bone fragility; joint erosion and pain; skin bruising; telangiectasia on the cheeks and nose; acne in exposed areas of skin (face, neck, forearms)

Health Effects: Potential teratogen (HE5); Immunosuppression (HE-4); Chronic toxicity-osteoporosis, osteonecrosis, adrenocortical suppression (HE-3)

Affected Organs: Hypothalamic-pituitary-adrenal axis, reproductive system, bone, skin

Notes:

1. OSHA does not have a PEL for triamcinolone or any of its congeners.
2. The FDA regulates triamcinolone acetonide as a teratogen (Pregnancy Category C). In animal studies, it is associated with cleft palate and CNS malformations in the offspring.
3. It has been suggested that concentrations 3 to 4 orders of magnitude less than 1% be used in patch testing for allergic sensitivity or cross-sensitivity to triamcinolone acetonide.
4. Regardless of the route of exposure, the mean concentration of free triamcinolone acetonide in plasma causing 50% of the maximum decrease of lymphocytes in blood (E₅₀) was estimated to be 0.25 ng/mL, and a similar E₅₀ (0.23) was associated with the increase in blood granulocytes in healthy male volunteers; 29% of the drug in plasma was found to be free (i.e., not bound to plasma proteins).

Literature Basis:

• Furukawa, S., Usuda, K., Abe, M. and Ogawa, I.: Histopathological findings of cleft palate in rat embryos induced by triamcinolone acetonide. J. Vet. Med. Sci. 66(4): 397-402, 2004.
• Isaksson, M.: Skin reactions to inhaled corticosteroids. Drug Saf. 24(5): 369-373, 2001.
• Isaksson, M., Bruze, M., Lepoittevin, J.P. and Goossens, A.: Patch testing with serial dilutions of budesonide, its R and S diastereomers, and potentially cross-reacting substances. Am. J. Contact Dermat. 12(3): 170-176, 2001.
• Moroni, P., et al.: Skin pathology in industrial workers exposed to synthetic corticosteroids. Derm. Beruf Umwelt. 33(6): 220-222, 1985.
• Newton, R.W., Browning, M.C., Iqbal, J., Piercy, N. and Adamson, D.G.: Adrenocortical suppression in workers manufacturing synthetic glucocorticoids. Br. Med. J. 1(6105): 73-74, 1978.
• Park-Wyllie, L., et al.: Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. Teratology 62(6): 385-392, 2000.
• Rohatagi, S., et al.: Pharmacokinetic and pharmacodynamic evaluation of triamcinolone acetonide after intravenous, oral, and inhaled administration. J. Clin Pharmacol. 35(12): 1187-1193, 1995.
• Schimmer, B.P. and Parker, K.L.: Adrenocorticotropic hormone; adrenocortical steroids and their synthetic analogs; inhibitors of the synthesis and actions of adrenocortical hormones (Chapter 60). In, Goodman & Gilman's The Pharmacological Basis of Therapeutics, 10^th Ed., edited by J.G. Hardman, L.E. Limbird and A.G. Gilman. New York: McGraw-Hill, 2001, pp. 1649-1677.
• Tarara, R.P., Wheeldon, E.B. and Hendrickx, A.G.: Central nervous system malformations induced by triamcinolone acetonide in nonhuman primates: pathogenesis. Teratology 38(3): 259-270, 1988.

Date Last Revised: 05/16/2005

Wipe Sampling Method:

• sampling media: Glass Fiber Filter (37-mm diameter)
  analytical solvent: Methanol
  current analytical method: Liquid Chromatography; LC/UV
  method reference: OSHA Salt Lake Technical Center In-House File
  method classification: Not Validated

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