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What is Triderm (triamcinolone topical)?
Triamcinolone is a topical steroid.
It reduces the actions of chemicals in the body that cause inflammation, redness, and swelling.
Triamcinolone topical is used to treat the inflammation caused by a number of conditions such as allergic reactions, eczema, and psoriasis.
The dental paste form of triamcinolone is used to treat mouth ulcers.
Triamcinolone topical may also be used for other purposes not listed in this medication guide.
What is the most important information I should know about Triderm (triamcinolone topical)?
Use this medication exactly as directed on the label, or as it has been prescribed by your doctor.
Do not use the medication in larger amounts or for longer than recommended.
Do not cover treated skin areas with a bandage or other covering unless your doctor has told you to.
If you are treating the diaper area of a baby, do not use plastic pants or tight-fitting diapers.
Covering the skin that is treated with triamcinolone topical can increase the amount of the drug your skin absorbs, which may lead to unwanted side effects.
Follow your doctor's instructions.
Avoid using this medication on your face, near your eyes, or on body areas where you have skin folds or thin skin.
Do not use this medication on a child without a doctor's advice.
Children are more sensitive to the effects of triamcinolone topical.
Triamcinolone topical will not treat a bacterial, fungal, or viral skin infection.
Contact your doctor if your condition does not improve or if it gets worse after using this medication for several days.
What should I discuss with my healthcare provider before using Triderm (triamcinolone topical)?
Do not use this medication if you are allergic to triamcinolone.
If you have any of these conditions, you may not be able to use triamcinolone topical, or you may need a dosage adjustment or special tests during treatment.
This medication may be harmful to an unborn baby.
Tell your doctor if you are pregnant or plan to become pregnant during treatment.
It is not known whether triamcinolone topical passes into breast milk or if it could harm a nursing baby.
Do not use this medication without telling your doctor if you are breast-feeding a baby.
How should I use Triderm (triamcinolone topical)?
Use this medication exactly as it was prescribed for you.
Do not use the medication in larger amounts, or use it for longer than recommended by your doctor.
Follow the instructions on your prescription label.
Wash your hands before and after each application, unless you are using triamcinolone topical to treat a hand condition.
Apply a small amount to the affected area and rub it gently into the skin.
Avoid using this medication on your face, near your eyes or mouth, or on body areas where you have skin folds or thin skin.
If you are using the dental paste, apply the medication in a thin layer, just enough to cover the mouth ulcer.
The paste may stick better if you dry the mouth ulcer before applying the medication.
It is important to use triamcinolone topical regularly to get the most benefit.
Store triamcinolone topical at room temperature away from moisture and heat.
Use the medication as soon as you remember.
If it is almost time for the next dose, skip the missed dose and use the medicine at the next regularly scheduled time.
Do not use extra medicine to make up the missed dose.
Seek emergency medical attention if you think you have used too much of this medicine, or if anyone has accidentally swallowed it.
An overdose of triamcinolone topical applied to the skin is not expected to produce life-threatening symptoms.
What should I avoid while using Triderm (triamcinolone topical)?
Avoid getting this medication in your eyes, mouth, and nose, or on your lips.
If it does get into any of these areas, wash with water.
Do not use triamcinolone topical on sunburned, windburned, irritated, or broken skin.
Also avoid using this medication in open wounds.
Avoid using skin products that can cause irritation, such as harsh soaps or shampoos or skin cleansers, hair coloring or permanent chemicals, hair removers or waxes, or skin products with alcohol, spices, astringents, or lime.
Do not use other medicated skin products unless your doctor has told you to.
This is not a complete list of side effects and others may occur.
Tell your doctor about any unusual or bothersome side effect.
You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Triderm (triamcinolone topical)?
It is not likely that other drugs you take orally or inject will have an effect on topically applied triamcinolone.
But many drugs can interact with each other.
Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors.
Do not start a new medication without telling your doctor.
Where can I get more information?
Your pharmacist can provide more information about triamcinolone topical.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc.
Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect.
Drug information contained herein may be time sensitive.
Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise.
Multum's drug information does not endorse drugs, diagnose patients or recommend therapy.
The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient.
Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides.
The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.
If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
This document has been reviewed by one or more clinical specialists.
See our editorial policy for more information.
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Generic Triderm (Triamcinolone) is a corticosteroid used to treat or prevent the symptoms of allergies.
Generic Triderm helps to reduce swelling, redness, itching, and allergic reactions on the skin.
Triderm can cause some side effects.
Generic Triderm cannot be anticipated.
Generic Triderm with other drugs?
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Products mentioned are trademarks, brands and patents of respective companies.
Triamcinolone-Topical - Drug Information and Side Effects on Drug3k.
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Triderm is used to treat swelling, inflammation, or itching of skin conditions such as eczema, dermatitis, rashes, insect bites, poison ivy, allergies and other irritations.
Store at room temperature away from sunlight.
If overdose is suspected, contact your local poison control center or emergency room immediately.
Triderm may be harmful if swallowed.
Clean and dry the affected area before applying the medication.
To apply, gently massage a small amount of the medication into the affected area and surrounding skin.
Do not bandage, wrap or cover the area treated unless you are instructed to do so by your doctor.
Do not use plastic pants or tight fitting diapers on children being treated with Triderm in the diaper area.
Avoid using Triderm around the eyes unless directed to do so by your doctor.
Triderm may cause burning, stinging, itching, or redness when first applied to the skin.
This should disappear in a few days as your body adjusts to the medication.
Triderm may also cause skin thinning and discoloration.
If any of these effects persist or worsen, inform your doctor.
Skin infections can become worse when using Triderm.
Notify your doctor if redness, swelling or irritation does not improve.
If you notice other effects not listed above, contact your doctor or pharmacist.
Do not use Triderm near the eyes if you have glaucoma.
Treatment with clobetasol, halobetasol propionate and augmented betamethasone dipropionate beyond two weeks consecutively is not recommended.
Do not use if there is an infection or sores present on the area to be treated.
Though very unlikely, it is possible Triderm will be absorbed into your bloodstream.
This may have undesirable consequences that may require additional corticosteroid treatment.
This is especially true for children and for those who have used this for an extended period if they also have serious medical problems such as serious infections, injuries or surgeries.
This precaution applies for up to one year after stopping use of Triderm.
Consult your doctor or pharmacist for more details.
Triderm should be used cautiously during pregnancy and only if clearly needed.
Discuss the benefits and risks with your doctor.
Small amounts of Triderm may appear in breast milk.
Consult with your doctor before breast-feeding.
Do not "double-up the dose to catch up.
Tell your doctor of all medications you may use, (both prescription and nonprescription), especially of: prednisone (or similar drugs), other skin medicines.
Do not start or stop any medicine without doctor or pharmacist approval.
If you don't follow the above rules, your post will be probably deleted.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals.
The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else.
A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
Drug3k does not provide medical advice, diagnosis or treatment.
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Therapeutic actions: Bethametasone is a synthetic corticosteroid and is used to decrease inflammation in the skin.
When applied to the skin it is absorbed into the skin cells.
Here it works by preventing the release of certain chemicals from the cells.
Clotrimazole is an antifungal medicine used to treat infections with fungi and yeasts.
Clotrimazole kills fungi and yeasts by interfering with their cell membranes.
It works by stopping the fungi from producing a substance called ergosterol, which is an essential component of fungal cell membranes.
The disruption in production of ergosterol causes holes to appear in the fungal cell membrane.
Gentamicin belongs to a class of antibiotics known as the aminoglycosides.
Gentamicin is bactericidal in action (kills bacteria).
It does this by causing the bacteria to produce defective proteins which are essential for their growth.
Dermatomycosis ((Tinea ðådis, Tinea ciuris, Tinea corporis) caused by Trichophyton rubrum, Trichophyton mentagrophyles, Epidermophyton floccosum è Microsporum canis and superficial skin candidosis.
This preparation is for external use only.
This medicine should be applied thinly and evenly to the affected area(s).
Adverse effects: Medicines and their possible side effects can affect individual people in different ways.
The following are some of the side effects that are known to be associated with this medicine.
Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
Interactions: It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine.
Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
Especially pay attention to cancer chemotherapy agents, other topical medications, and vitamins.
Additional Information: DO NOT SHARE THIS MEDICINE with others.
DO NOT USE THIS MEDICINE for other health conditions.
KEEP THIS PRODUCT, as well as syringes and needles, if needed during treatment, out of the reach of children.
Do not reuse needles, syringes, or other materials.
We do not claim to be affiliated with the manufactures of drugs which are presented on our web site.
We simply sell branded drugs and are not associating with the manufacturers.
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TRIAMCINOLONE is a corticosteroid.
It helps to reduce swelling, redness, itching, and allergic reactions.
This medicine is used to treat allergies, arthritis, asthma, skin problems, and many other conditions.
What should I tell my health care providers before I take this medicine?
They need to know if you have any of these conditions:depression, anxiety, or psychotic disturbances diabetes infection, like tuberculosis, herpes, or fungal infection liver disease osteoporosis previous heart attack seizures stomach or intestine disease thyroid disease an unusual or allergic reaction to triamcinolone, corticosteroids, other medicines, foods, dyes, or preservatives pregnant or trying to get pregnant breast-feedingHow should I use this medicine?
Take this medicine by mouth with a glass of water.
Follow the directions on the prescription label.
Take with milk or food to avoid stomach upset.
For best results, take this medicine at or about 8:00 in the morning.
Take your medicine at regular intervals.
Do not take your medicine more often than directed.
Do not stop taking except on your doctor's advice.
You may need to gradually reduce the dose.
Talk to your pediatrician regarding the use of this medicine in children.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
Note: This medicine is only for you.
Do not share this medicine with others.
If you miss a dose, take it as soon as you can.
If it is almost time for your next dose, take only that dose.
Do not take double or extra doses.
What may interact with this medicine?
Do not take this medicine with any of the following:mifepristone This medicine may also interact with the following:aspirin other steroid medicines vaccines and other immunization productsThis list may not describe all possible interactions.
Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use.
Also tell them if you smoke, drink alcohol, or use illegal drugs.
Some items may interact with your medicine.
What side effects may I notice from this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue black, tarry stools breathing difficulty change in vision confusion, depression, excitement, mood swings dizziness fever, infection, sores that do not heal frequent passing of urine increased thirst high blood pressure menstrual problems pain in back, hips, shoulders, ribs rounding of face seizures stomach pain swelling of feet, hands unusual bruising or red pinpoint spots on the skin unusually weak or tired Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):headache increased sweating trouble sleeping unusual increased growth of hair on the face or body upset stomach, nauseaThis list may not describe all possible side effects.
What should I watch for while using this medicine?
Visit your doctor or health care professional for regular checks on your progress.
If you are diabetic, check your blood sugar as directed.
If you are taking this medicine for a long time, carry an identification card with your name, the type and dose of medicine, and your doctor's name and address.
You may need to be on a special diet while taking this medicine.
Do not come in contact with people who have chickenpox or the measles while you are taking this medicine.
If you do, call your doctor right away.
Where should I keep this medicine?
Keep out of the reach of children.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F).
Throw away any unused medicine after the expiration date.
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Pharmacy accept MasterCard and VISA payments.
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We take Triamcinolone from well known and trusted manufacturers that prove oneself with long time quality work.
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We offer to you the medicine Triamcinolone that have the same active ingredient as well know brand name medicine Triderm.
The Triamcinolone (also known as generic Triderm) is the same medicine as Triderm just from another manufacturer with absolutely the same main ingredient and difference in color and form only.
From 14 October we start to offer quick delivery to US within 2-5 days for selected medicines.
From 1 October 2009 all our prices are based on US dollars.
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From 26 March 2009 we ensure success delivery within 13 days to UK, Scotland, Ireland, Sweden, Australia.
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In braces shown the brand name of medicine.
The manufacturer of every kind of medicine stated at the upper string.
The real medicine that we offer you can see on images.
Sorry, this is out of stock temporary.
We do not have this pack currently and awaiting it within 1-2 weeks.
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This medicine package is available for quick delivery to the US within 2-5 days.
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The active ingredient of Triderm may be sold under several names like Aristocort, Aristospan, Azmacort, Berlicort, Delphicort, Fougera, Ipercortis, Kenacort, Kenalog, Ledercort, Nasacort, Nasacort AQ, Oracort, Polcortolon, Polcortolone, Rhinisan, Sedozolona, Shincort, Simacort, Sterocort, Tri-Nasal, Triaderm, Triam Oral, Triamcinolona, Triamcinolone, Triamcort, Triampoen, Triamsicort, Tricort, Tricortone, Triderm, Triesence, Trilone, Trinasal, Tristoject, Volon A.
Due to licensing agreements in different countries of the world, sometimes drug manufacturers market the same drug under different names in different countries.
These are different trade names for the same medication.
Another reason of different name is selling of generic equivalent that for 50 percent to 80 percent less than the cost of the brand name.
Exactly due this fact you may find Triderm under different names in different pharmacies.
Special Disclaimer : Trademark names on this site include Triderm are the property of each trademark holder.
We do not claim we are affiliated some way with the manufacturer of Triderm as well as with holder of Trademark Triderm.
Brand name product Triderm is made by Triderm trademark holder.
We advertising approved generic medicines.
The manufacturer (manufacturers) of every product offered on this page is clearly visible as well as image (images) (if exist).
Generally, you will find generic alternatives to Triderm at this page but we are not affiliated with Triderm manufacturer.
This page "Triderm: where to buy online cheap Triderm medicine.
Eurodrugstore company that want as much as possible to help customers correct understand Triderm market and Allergy medicines.
This information related to Allergy and Triderm is for your information purposes only, it is not intended that this information about Triderm and Allergy covers all uses, directions, drug interactions, precautions, or adverse effects of your medication.
This is only general information about Triderm and Allergy, and should not be relied on for any purpose.
It should not be construed as containing specific instructions for any particular patient.
No warranty, either expressed or implied, is made in regards to this information.
How should I use this medicine?
This list may not describe all possible interactions.
This list may not describe all possible side effects.
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Serge Lefebvre, President of the Association.
New projects in Canada, Spain, Belgium and in France are always being worked on.
Effective immediately, AIST encourages all organizations and associations involved in the field of youth transportation to block off this day on their agendas.
AIST favours the exchange of information and experiences between the various organizations which contributes worldwide to the improvement in safe transportation for the benefit of youth.
For the founders of AIST and its members, safety in transportation of youth is so important that it calls for a general sharing of ideas and actions which promote quality and safety in school and related transportation of youth.
Lefebvre, this is what has motivated the decision taken by AIST to designate an International Day for Safety in the Transportation of Youth.
AIST is a non-profit organization created in 1994 by five founding members from various countries in America and Europe.
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Generic Tamiflu is used to treat flu symptoms caused by influenza virus types A and B in patients who have had symptoms for less than 2 days.
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They need to know if you have any of these conditions: depression, anxiety, or psychotic disturbances diabetes infection, like tuberculosis, herpes, or fungal infection liver disease osteoporosis previous heart attack seizures stomach or intestine disease thyroid disease an unusual or allergic reaction to triamcinolone, corticosteroids, other medicines, foods, dyes, or preservatives pregnant or trying to get pregnant breast-feedingHow should I use this medicine?
Do not take this medicine with any of the following: mifepristone This medicine may also interact with the following: aspirin other steroid medicines vaccines and other immunization products This list may not describe all possible interactions.
Give your health care providers a list of all the medicines, herbs, nonprescription drugs, or dietary supplements you use.
Side effects that you should report to your doctor or health care professional as soon as possible: allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue black, tarry stools breathing difficulty change in vision confusion, depression, excitement, mood swings dizziness fever, infection, sores that do not heal frequent passing of urine increased thirst high blood pressure menstrual problems pain in back, hips, shoulders, ribs rounding of face seizures stomach pain swelling of feet, hands unusual bruising or red pinpoint spots on the skin unusually weak or tired Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome): headache increased sweating trouble sleeping unusual increased growth of hair on the face or body upset stomach, nausea This list may not describe all possible side effects.
If you are taking this medicine for a long time, carry an identification card with your name, the type and dose ofmedicine, and your doctor's name and address.
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In 1995, Jen's Dad, Louie, was 47 years old and in great shape.
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Emergency Room of The Queen's Hospital in Honolulu.
At the emergency room of a hospital she was pronounced dead.
An autopsy revealed that she too had died from TAAD.
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Sonny, Louie's mother's brother.
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Jen was living in the Washington, D.
Monday morning, but not feeling well.
Jen was on her way to George Washington University Hospital (GWUH).
CT scan with contrast was ordered.
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There was no blood flow in the anterior descending portion of the artery.
Terry traveled to southern California in September 2006.
TAAD Awareness 2006, Jen also had follow up tests and appointments.
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They are women of tremendous courage.
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Side effects that you should report to your doctor or health care professional as soon as possible:eye pain, decreased or blurred vision, or bulging eyes fever, sore throat, sneezing, cough, or other signs of infection, wounds that will not heal frequent passing of urine increased thirst mental depression, mood swings, mistaken feelings of self-importance or of being mistreated pain in hips, back, ribs, arms, shoulders, or legs swelling of feet or lower legs Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):confusion, excitement, restlessness headache nausea, vomiting skin problems, acne, thin and shiny skin weight gainThis list may not describe all possible side effects.
If you are taking this medicine over a prolonged period, carry an identification card with your name and address, the type and dose of your medicine, and your doctor's name and address.
This medicine may increase your risk of getting an infection.
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Source: Classified according to the MIMS Database.
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Oberhausen geboren und lebte ab 1929 in Berlin.
Nach einem gescheiterten Fluchtversuch an der Schweizer Grenze 1942 wurde er von der Gestapo verhaftet und in das Konzentrationslager Auschwitz deportiert.
Bundesverdienstkreuz verliehen.
Christian Ender studierte Philosophie, Kultur- und Musikwissenschaften.
Der ausschließlich privat finanzierte Film, welcher mit dem 2.
Sprachen untertitelt hier (1) online zu sehen.
Veranstaltungen sind hier (3) einsehbar.
Mehr Informationen zu dieser Problematik sind unter den Presseartikeln auf unserer Homepage, z.
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Werner Bab in der Kinemathek Hamburg e.
Steindamm 52-54 D-20099 Hamburg 28.
Helene-Lange-Schule Rendsburg 27.
Zeitabschnitte" im Landestheater in Rendsburg.
Politische Bildung Schleswig-Holstein.
Werner Bab und der gesamten 10.
AnjaFr, 13 Nov 2009, 05:46Sehr geehrter Herr Bab!
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Pronunciation:(trye am SIN oh lone)U.
Increased incidence of cleft palate, neonatal adrenal suppression, low birth weight, and cataracts in the infant has been reported following corticosteroid use during pregnancy.
In general, the use of large amounts, or prolonged use, of topical corticosteroids during pregnancy should be avoided.
In the mother, corticosteroids may increase calcium and potassium excretion, elevate blood pressure, and cause salt and water retention.
Precautions:May cause suppression of hypothalamic-pituitary-adrenal (HPA) axis, particularly in younger children or in patients receiving high doses for prolonged periods.
Particular care is required when patients are transferred from systemic corticosteroids to inhaled products due to possible adrenal insufficiency or withdrawal from steroids, including an increase in allergic symptoms.
Patients receiving 20 mg per day of prednisone (or equivalent) may be most susceptible.
Withdrawal and discontinuation of the corticosteroid should be done slowly and carefully Use with caution in patients with hypothyroidism, cirrhosis, nonspecific ulcerative colitis and patients at increased risk for peptic ulcer disease.
Corticosteroids should be used with caution in patients with diabetes, hypertension, osteoporosis, glaucoma, cataracts, or tuberculosis.
Use caution in hepatic impairment.
Because of the risk of adverse effects, systemic corticosteroids should be used cautiously in the elderly, in the smallest possible dose, and for the shortest possible time.
Controlled clinical studies have shown that orally-inhaled and intranasal corticosteroids may cause a reduction in growth velocity in pediatric patients.
The growth of pediatric patients receiving inhaled corticosteroids, should be monitored routinely (eg, via stadiometry).
To minimize the systemic effects of orally-inhaled and intranasal corticosteroids, each patient should be titrated to the lowest effective dose.
May suppress the immune system, patients may be more susceptible to infection.
Use with caution in patients with systemic infections or ocular herpes simplex.
Avoid exposure to chickenpox and measles.
Oral topical: Discontinue if local irritation or sensitization should develop.
If significant regeneration or repair of oral tissues has not occurred in seven days, re-evaluation of the etiology of the oral lesion is advised.
Toxicology:When consumed in high doses for prolonged periods, systemic hypercorticism and adrenal suppression may occur.
In those cases, discontinuation of the corticosteroid should be done judiciously.
Increased effect: Salmeterol: The addition of salmeterol has been demonstrated to improve response to inhaled corticosteroids (as compared to increasing steroid dosage).
Herb Interactions:Ethanol: Avoid ethanol (may enhance gastric mucosal irritation).
Food: Triamcinolone interferes with calcium absorption.
Nutraceutical: Avoid cat's claw, echinacea (have immunostimulant properties).
Injection, suspension: Shake well prior to use Diacetate suspension: May dilute prior to use using NS or equal parts of NS and procaine 1%.
Avoid diluents containing parabens or preservatives (may cause flocculation).
Suspensions for intralesional use may be diluted to 1:1 or 1:10 concentration.
Hexacetonide suspension: Avoid diluents containing parabens or preservatives (may cause flocculation).
Suspension for intralesional use, may be diluted with D5NS, D10NS or SWFI to a 1:1, 1:2, or 1:4 concentration.
Solutions for intra-articular use, may be diluted with lidocaine 1% or 2%.
Kinetics:Duration: Oral: 8-12 hours Absorption: Topical: Systemic Time to peak: I.
In life-threatening situations, parenteral doses larger than the oral dose may be needed.
Injection:Acetonide: Intra-articular, intrabursal, tendon sheaths: Adults: Initial: Smaller joints: 2.
Intradermal: Adults: Initial: 1 mg I.
Average dose: Knee: 25 mg, finger: 2-5 mg Intralesional, sublesional: Range: 5-48 mg, dependent upon size of lesion Maximum: 12.
Usual treatment course: 2-3 injections at 1- to 2-week intervals I.
Hexacetonide: Adults: Intralesional, sublesional: Up to 0.
AcetonideDiacetateHexacetonideIntrasynovial2.
A larger quantity may be required for coverage of some lesions.
Inject deep in large muscle mass, avoid deltoid.
SubQ: Avoid subcutaneous administration.
Nasal spray, inhalation: Shake well prior to use.
Gently blow nose to clear nostrils.
Oral inhalation: Shake well prior to use.
Rinse mouth and throat after using inhaler to prevent candidiasis.
Apply at bedtime or after meals if applications are needed throughout the day.
Tablet: Once-daily doses should be given in the morning.
Topical: Apply a thin film sparingly and avoid topical application on the face.
Do not use on open skin or wounds.
Do not occlude area unless directed.
Dietary Considerations:May be taken with food to decrease GI distress.
Take oral medication with or after meals.
Limit intake of caffeine or stimulants.
Prescriber may recommend increased dietary vitamins, minerals, or iron.
If you have diabetes, monitor glucose levels closely (antidiabetic medication may need to be adjusted).
Inform prescriber if you are experiencing greater than normal levels of stress (medication may need adjustment).
You may be more susceptible to infection (avoid crowds and exposure to infection).
Inform prescriber if you are or intend to become pregnant.
Consult prescriber if breast-feeding.
Aerosol: Shake gently before use.
Use at regular intervals, no more frequently than directed.
Not for use during acute asthmatic attack.
Follow directions that accompany product.
Rinse mouth and throat after use to prevent candidiasis.
Do not use intranasal product if you have a nasal infection, nasal injury, or recent nasal surgery.
If using two products, consult prescriber in which order to use the two products.
Take deep breaths for 3-5 minutes, and clear nasal passages before administration (use decongestant as needed).
Hold breath for 5-10 seconds after use, and wait 1-3 minutes between inhalations.
Follow package insert instructions for use.
If also using inhaled bronchodilator, use before triamcinolone.
Rinse mouth and throat after use to reduce aftertaste and prevent candidiasis.
Topical: For external use only.
Not for eyes or mucous membranes or open wounds.
Apply in very thin layer to occlusive dressing.
Apply dressing to area being treated.
Avoid prolonged or excessive use around sensitive tissues, genital, or rectal areas.
Inform prescriber if condition worsens (swelling, redness, irritation, pain, open sores) or fails to improve.
Additional Information:16 mg triamcinolone is equivalent to 100 mg cortisone (no mineralocorticoid activity).
HPA axis suppression, suggesting that growth velocity is a more sensitive indicator of systemic corticosteroid exposure in pediatric patients than some commonly used tests of HPA axis function.
The long-term effects of this reduction in growth velocity associated with orally-inhaled and intranasal corticosteroids, including the impact on final adult height, are unknown.
The potential for "catch up" growth following discontinuation of treatment with inhaled corticosteroids has not been adequately studied.
Other Considerations:Triamcinolone is a long-acting corticosteroid with minimal sodium-retaining potential.
Neuromuscular Effects: ICU-acquired paresis was recently studied in 5 ICUs (3 medical and 2 surgical ICUs) at 4 French hospitals.
All ICU patients without pre-existing neuromuscular disease admitted from March 1999 through June 2000 were evaluated (De Jonghe B, 2002).
Each patient had to be mechanically ventilated for 7 days and was screened daily for awakening.
The first day the patient was considered awake was Study Day 1.
Patients with severe muscle weakness on Study Day 7 were considered to have ICU-acquired paresis.
Among the 95 patients who were evaluable, about 25% developed ICU-acquired paresis.
Independent predictors included female gender, the number of days with 2 organ dysfunction, and administration of corticosteroids.
Further studies may be required to verify and characterize the association between the development of ICU-acquired paresis and use of corticosteroids.
Adrenal Insufficiency: Patients will often have steroid-induced adverse effects on glucose tolerance and lipid profiles.
When discontinuing steroid therapy in patients on long-term steroid supplementation, it is important that the steroid therapy be discontinued gradually.
Abrupt withdrawal may result in adrenal insufficiency with hypotension and hyperkalemia.
Patients on long-term steroid supplementation will require higher corticosteroid doses when subject to stress (ie, trauma, surgery, severe infection).
Guidelines for glucocorticoid replacement during various surgical procedures have been published (Salem M, 1994, Coursin DB, 2002).
Septic Shock: A recent randomized, double-blind, placebo controlled trial assessed whether low dose corticosteroid administration could improve 28-day survival in patients with septic shock and relative adrenal insufficiency.
Cortisol levels were drawn immediately before corticotropin administration and 30 to 60 minutes afterwards.
Three hundred adult septic shock patients requiring mechanical ventilation and vasopressor support were randomized to either hydrocortisone (50 mg IVP every 6 hours) and fludrocortisone (50 mcg tablet daily via nasogastric tube) or matching placebos for 7 days.
In patients who did not appropriately respond to corticotropin (nonresponders), there were significantly fewer deaths in the active treatment group.
Vasopressor therapy was withdrawn more frequently in this subset of the active treatment group.
Adverse events were similar in both groups.
Patients who lack adrenal reserve and thus have relative adrenal insufficiency during the stress of septic shock may benefit from physiologic steroid replacement.
These patients may not benefit from physiologic steroid replacement.
Further study is required to better characterize the patient populations who may benefit.
Cardiovascular Considerations:Inhaled steroid therapy, usually used for chronic obstructive lung disease, has the important advantage of having minimal systemic effects.
The inhaled steroid, when administered appropriately, may be assumed to have pulmonary effects equivalent to about 10 mg of oral steroids but with minimal systemic consequences.
Oral and intravenous steroid therapy in patients with heart failure should be administered cautiously with special attention given to signs and symptoms of fluid retention.
Dental Health: Effects on Dental Treatment:Key adverse event(s) related to dental treatment: Ulcerative esophagitis, perioral dermatitis, atrophy of oral mucosa, burning, and irritation.
L) Ointment, topical, as acetonide: 0.
American Academy of Pediatrics Committee on Drugs: "Transfer of Drugs and Other Chemicals Into Human Milk,"Pediatrics, 2001, 108(3):776-89.
Annane D, Sebille V, Charpentier C, et al, "Effect of Treatment With Low Doses of Hydrocortisone and Fludrocortisone on Mortality in Patients With Septic Shock,"JAMA, 2002, 288(7):862-71.
Boot AM, Nauta J, Hokken-Koelega AC, et al, "Renal Transplantation and Osteoporosis,"Arch Dis Child, 1995, 72(6):502-6.
Bowman H and Lennard TW, "Immunosuppressive Drugs,"Br J Hosp Med, 1992, 48(9):570-3.
Cooper MS and Stewart PM, "Corticosteroid Insufficiency in Acutely Ill Patients,"N Engl J Med, 2003, 348(8):727-34.
Coursin DB and Wood KE, "Corticosteroid Supplementation for Adrenal Insufficiency,"JAMA, 2002, 287(2):236-40.
Jonghe B, Sharshar T, Lefaucheur JP, et al, "Paresis Acquired in the Intensive Care Unit.
A Prospective Multicenter Study,"JAMA, 2002, 288(22):2859-67.
Expert Panel Report 2, "Guidelines for the Diagnosis and Management of Asthma,"Clinical Practice Guidelines, National Institutes of Health, National Heart, Lung, and Blood Institute, NIH Publication No.
Expert Panel Report, National Asthma Education Program, National Heart, Lung, and Blood Institute, "Guidelines For the Diagnosis and Management of Asthma,"J Allergy Clin Immunol, 1991, 88(3 Pt 2):425-534.
Frey BM and Frey FJ, "Clinical Pharmacokinetics of Prednisone and Prednisolone,"Clin Pharmacokinet, 1990, 19(2):126-46.
Gamsu HR, Mullinger BM, Donnai P, et al, "Antenatal Administration of Betamethasone to Prevent Respiratory Distress Syndrome in Preterm Infants: Report of a UK Multicentre Trial,"Br J Obstet Gynaecol, 1989, 96(4):401-10.
Grotz WH, Mundinger FA, Gugel B, et al, "Bone Mineral Density After Kidney Transplantation: A Cross-Sectional Study in 190-Graft Recipients Up to 20 Years After Transplantation,"Transplantation, 1995, 59(7):982-6.
Gutin PH, "Corticosteroid Therapy in Patients With Brain Tumors,"Natl Cancer Inst Monogr, 1977, 46:151-6.
Hotchkiss RS and Karl IE, "The Pathophysiology and Treatment of Sepsis,"N Engl J Med, 2003, 348(2):138-50.
Kimberly RP, "Glucocorticoids,"Curr Opin Rheumatol, 1994, 6(3):273-80.
Liggins GC and Howie RN, "A Controlled Trial of Antepartum Glucocorticoid Treatment of Respiratory Distress Syndrome in Premature Infants,"Pediatrics, 1972, 50:515-25.
Lowenthal RM and Jestrimski KW, "Corticosteroid Drugs: Their Role in Oncological Practice,"Med J Aust, 1986, 144(2):81-5.
Murphy CM, Coonce SL, and Simon PA, "Treatment of Asthma in Children,"Clin Pharm, 1991, 10(9):685-703.
Reed B, "Dermatologic Drugs, Pregnancy, and Lactation.
A Conservative Guide,"Arch Dermatol, 1997, 133:894-8.
Report of a Workshop by the British Association for Paediatric Nephrology and Research Unit, Royal College of Physicians, "Consensus Statement on Management and Audit Potential for Steroid Responsive Nephrotic Syndrome,"Arch Dis Child, 1994, 70(2):151-7.
Salem M, Tainsh RE Jr, Bromberg J, et al, "Perioperative Glucocorticoid Coverage.
A Reassessment 42 Years After Emergence of a Problem,"Ann Surg, 1994, 219(4):416-25.
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University of Maryland Medical Center (UMMC).
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The following information is an educational aid only.
What key warnings should I know about before taking this medicine?
When switching from an oral steroid to an inhaled one, there can be problems.
Symptoms such as weakness, feeling tired, dizziness, nausea, vomiting, inability to think clearly, or low blood sugar may occur.
Call healthcare provider right away if you have any of these symptoms.
If you have a serious accident and are injured, have surgery, or any type of infection, you may need extra doses of oral steroids.
These extra steroids will help your body deal with these stresses.
Carry a warning card saying that you may need extra steroids at certain times.
This medicine does not mix well with many medicines.
Check all medicines with healthcare provider.
If you have an allergy to triamcinolone or any other part of this medicine.
Tell healthcare provider if you are allergic to any medicine.
Make sure to tell about the allergy and how it affected you.
If you have a severe infection.
If you are having a breathing attack.
What is this medicine used for?
This medicine is used to relieve allergy symptoms.
This medicine is used to treat poor adrenal function.
This medicine is used to treat asthma.
It may take 2 weeks to see the full effect.
This medicine is used to treat diseases where the anti-inflammatory or immunosuppressant properties are needed.
This medicine is used to treat nasal congestion.
This medicine is used to treat a variety of skin rashes.
This medicine is used to treat lupus.
Triamcinolone replaces an important chemical produced in the body.
It prevents or reduces irritation and swelling.
It blocks the allergic reaction by minimizing or preventing the body's reaction to the allergen.
It decreases the body's harmful response to diseases affecting the immune system.
A spacer can be used with the inhaler for easier delivery.
Children younger than 8 years of age should use a spacer.
Rinse out mouth after each use.
Check spray use with healthcare provider at each visit.
Read and follow all instructions provided with spray.
Using the spray the right way is very important.
Do not take this medicine by mouth.
Keep out of mouth, nose, and eyes (may burn).
Wash hands before and after use.
Clean affected area before use.
Apply a thin layer to the affected skin and rub in gently.
This medicine is given as a shot into a muscle.
Take a missed dose as soon as possible.
If it is almost time for the next dose, skip the missed dose and return to your regular schedule.
Do not take a double dose or extra doses.
Do not change dose or stop medicine.
What are the precautions when taking this medicine?
Wear disease medical alert identification.
Talk with healthcare provider before receiving any vaccinations.
Use with this medicine may either increase the risk of serious infection or make the vaccination less effective.
Check medicines with healthcare provider.
This medicine may not mix well with other medicines.
Tell healthcare provider if you are pregnant or plan on getting pregnant.
Tell healthcare provider if you are breast-feeding.
If you have been taking this medicine for several weeks, talk with healthcare provider before stopping.
You may want to gradually withdraw this medicine.
Do not run out of this medicine.
If you have diabetes, talk with healthcare provider.
This medicine can increase blood sugar.
If you have glaucoma or cataracts, talk with healthcare provider.
If you have high blood pressure, talk with healthcare provider.
If you are being treated for any infection, talk with healthcare provider.
If you have osteoporosis, talk with healthcare provider.
If you have stomach ulcers, talk with healthcare provider.
If you have tuberculosis, talk with healthcare provider.
If you have a weakened heart, talk with healthcare provider.
Tell dentists, surgeons, and other healthcare providers that you use this medicine.
Avoid alcohol (includes wine, beer, and liquor).
Do not use this medicine to treat an asthma attack.
Do not use tight-fitting diapers or plastic pants on a child treated in the diaper area.
This may cause more medicine to get into the child's system.
Do not put coverings (bandages, dressings, make-up) over the area unless told to do so by healthcare provider.
What are some possible side effects of this medicine?
Avoid people with infections, colds, or flu.
Small frequent meals, frequent mouth care, sucking hard, sugar-free candy, or chewing sugar-free gum may help.
Change in body fat distribution.
Weakened bones with long-term use.
Skin changes (acne, stretch marks, slow healing, hair growth).
Cataracts or glaucoma with long-term use.
Change in condition being treated.
Is it better, worse, or about the same?
Check blood sugar as directed by healthcare provider.
If a child is using this medicine, monitor growth carefully.
If using for asthma, the number of asthma attacks.
Follow up with healthcare provider.
If you suspect an overdose, call your local poison control center or emergency department immediately.
Signs of a life-threatening reaction.
Signs or symptoms of infection.
If exposure to chickenpox has occurred and you have not had chickenpox or been vaccinated against it.
No improvement in condition or feeling worse.
How should I store this medicine?
The injection will be given to you in a healthcare setting.
Store aerosol and powder at room temperature.
Throw away any unused powder after 2 months.
If you have a life-threatening allergy, wear allergy identification at all times.
Do not share your medicine with others and do not take anyone else's medicine.
Keep all medicine out of the reach of children and pets.
Keep a list of all your medicines (prescription, natural products, supplements, vitamins, over-the-counter) with you.
Give this list to healthcare provider (doctor, nurse, nurse practitioner, pharmacist, physician assistant).
Call your doctor for medical advice about side effects.
You may report side effects to FDA at 1-800-FDA-1088 or in Canada to Health Canada's Canada Vigilance Program at 1-866-234-2345.
Talk with healthcare provider before starting any new medicine, including over-the-counter, natural products, or vitamins.
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Adcortyl (Triamcinolone) is a corticosteroid used to treat severe allergies, arthritis, asthma, and skin conditions.
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It works by blocking the formation of ceratin blood clotting factors.
Some medical conditions may interact with Coumadin.
The starting dose is usually 2 to 5 milligrams (mg) per day for two to four days which may later be adjusted depending on the condition and blood test results.
While taking Coumadin, it is very important to avoid sports and activities that may cause injury.
Any falls, blows to the body or head or other injuries should be reported to the doctor immediately since serious internal bleeding may occur without the patient becoming aware of it.
Patients should also be careful to avoid cutting themselves.
This includes special care to be taken in brushing teeth and shaving.
It is better to use a soft brush and floss gently as well as to use an electric shave and avoid a blade.
Drinking too much alcohol may change the way this anticoagulant affects the body.
It is advisable to avoid drinking on a daily basis and also take no more than one or two drinks at any time.
INR is within therapeutic range should be diagnostically investigated since it could mean a previously unsuspected lesion like a tumor or ulcer.
The anticoagulant effect of the medication may also cause fatal or nonfatal hemorrhage from any tissue or organ.
The possibility of hemorrhage should be always considered in evaluating the condition of any anticoagulated patient with complaints which do not indicate an obvious diagnosis.
After the medicine is stopped, the body needs time to recover before it can return to its normal blood clotting ability.
It is necessary that the same care be taken during this period as during the treatment in order to ensure that no unexpected complications occur.
Tell your doctor or dentist that you take Coumadin before you receive any medical or dental care, emergency care, or surgery.
Carry an ID card at all times that says you take Coumadin.
Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
Contact your doctor right away if you may have taken too much of Coumadin.
Coumadin's side effects may be increased.
Do not change your eating habits without checking with your doctor.
Foods that have high levels of vitamin K in them (eg, green leafy vegetables, broccoli, liver, certain vegetable oils) may change the effect of Coumadin.
Ask your doctor for a list of foods that may affect this medicine.
Tell your doctor if any foods on the list are a part of your diet.
Do not eat cranberry products or drink cranberry juice while you are taking Coumadin.
Tell your doctor if these products are already part of your diet.
Elevated body temperature may increase the effect of Coumadin.
Be careful to avoid becoming overheated, especially during hot weather.
Coumadin decreases blood clotting.
Use caution while doing activities such as brushing your teeth, flossing, or shaving.
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This may increase your risk of developing a blood clot.
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Discuss any questions or concerns with your doctor.
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These tests may be used to monitor your condition or check for side effects.
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If you may become pregnant, you must use an effective form of birth control while you take Coumadin.
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For best results take with a high fat meal.
Use a specially marked spoon or container to measure your dose.
Household spoons are not accurate.
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Side effects that you should report to your doctor or health care professional as soon as possible:allergic reactions like skin rash or hives, swelling of the face, lips, or tongue breathing problems confusion dark urine fever or infection loss of appetite pain, tingling, numbness in the hands or feet skin rash, redness, blistering, or peeling of skin sores or whites patches in the mouth unusually weak or tired yellowing of the eyes or skin Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):dizziness headache nausea, vomiting stomach pain trouble sleepingThis list may not describe all possible side effects.
Visit your doctor or health care professional for regular check ups.
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Some fungal infections need many weeks or months of treatment to cure.
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Packing: tube 15g 0,1%Advantan is used to treat: Eczema (a skin condition with redness, swelling, oozing of fluid, crusting and later scaling.
Complex therapy of neurotic diseases and arterial hypotension.
Packing: 50gIndications: For relief of muscle aches and stiffness, due to minor injuries, overexertion, falls, and blows.
Reduces pain, swelling and discoloration from bruises.
Packing: 30 gr tube Relieving dry skin, preventing and treating sore nipples during breast-feeding, and promoting healing of burns and poorly-healing wounds.
Packing: 1 tube 15 grGentamicin belongs to a group of antibiotics called aminoglycosides.
Gentamicin possesses a wide spectrum action.
Packing: 1 tube 10 gTopical corticosteroids share anti-inflammatory, anti-pruritic and vasoconstrictive actions.
DAIVONEX is an anti-psoriasis medicine.
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Packing: 1 tube 30 grThis medicine is an antibiotic used to treat acne.
Packing: 1 tube 50 mgDermazin is a sulfa derivative topical antibacterial used primarily on second- and third-degree burns.
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Packing: 1 tubeDermosolon is used to treat infections caused by a fungus.
It used to help relieve redness, swelling, itching, and other discomfort of many skin problems.
Prophylaxis of pyoinflammatory processes while surgical intervention.
Packing: 1 tube 30 gDiprosalic is used to treat the itching, redness, dryness, crusting, scaling, inflammation, and discomfort of various skin conditions.
Ichtiol ointment works as an anti-inflammatory agent, produces a local anesthetic effect, and has antiseptic properties.
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Packing: tuba 0,1% 30grFenistil gel has anti-allergic effects also reduces the urge to scratch the affected area excessively.
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Packing: 1 tube 15 gFlucinar (Fluocinolone) is used to treat the itching, redness, dryness, crusting, scaling, inflammation, and discomfort of various skin conditions.
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This medicine is available as a cream, a nasal inhaler, an oral inhaler, an injection, a lotion, an ointment, and a nasal spray.
What key warnings should I know about before giving this medicine to my child?
Call healthcare provider right away if any of these symptoms occur.
These extra steroids will help the body deal with these extra stresses.
Have your child wear medical alert identification.
Check all medicines with child's healthcare provider.
Is it safe for my child to take this medicine?
Not if your child has an allergy to triamcinolone or any other part of this medicine.
Be sure to let healthcare provider know if your child has any allergies or reactions to medicine, food preservatives, or dyes.
Make sure to tell about the allergy and how it affected your child.
Not if your child has a severe infection.
Not if your child is having a breathing attack.
Why does my child need this medicine?
Your child's healthcare provider will teach you how to use the inhaler.
Have your child rinse out mouth after each use.
Have your child blow nose before use.
Place the nosepiece attached to the medicine bottle as far inside the nostril as possible before giving a spray.
While the tip is inside the nostril, point it toward the inner corner of the eye before giving a spray.
Keep out of your child's mouth, nose, and eyes (may burn).
Do not put coverings (bandages, dressings) over the area unless told to do so by healthcare provider.
Apply a thin layer to the affected area and rub in gently.
How long does this medicine take to work?
Your child may start feeling better several days after starting this medicine.
It may take 1 month to see the full effect from the inhalation and nasal spray.
What do I do if my child misses a dose?
Give a missed dose as soon as possible.
If it is almost time for the next dose, skip the missed dose and return to your child's regular schedule.
Do not give a double dose or extra doses.
Do not change dose or stop your child's medicine.
What safety measures should I take while my child is using this medicine?
Have your child wear a disease medical alert identification.
Check your child's medicines with healthcare provider.
Do not give this medicine to treat an asthma attack.
If your child has been taking this medicine for several weeks, talk with healthcare provider before stopping.
If your child has diabetes, talk with healthcare provider.
If your child has high blood pressure, talk with healthcare provider.
If your child is being treated for any infection, talk with healthcare provider.
If your child has stomach ulcers, talk with healthcare provider.
If your child has tuberculosis, talk with healthcare provider.
If your child has a weakened heart, talk with healthcare provider.
Tell dentists, surgeons, and other healthcare providers that your child is using this medicine.
Small frequent meals and frequent mouth care may help.
Older children may suck hard, sugar-free candy.
For the occurrence of side effects.
Monitor your child's growth carefully.
Dry mouth may cause an increase in cavities.
Take good care of your child's teeth.
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If any of this information causes you to be concerned, any of the common side effects occur, or if your child's symptoms do not improve after taking this medicine.
If your child shows signs of a life-threatening reaction, call healthcare provider or emergency department immediately.
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If your child has a sudden change in vision.
If exposure to chickenpox has occurred and your child has not had chickenpox or been vaccinated against it.
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No improvement in condition or if you believe your child's condition is worse.
The injection will be given to your child in a healthcare setting.
This medicine is available by prescription only.
If there are refills, contact your pharmacy.
If no refills remain, you may need to contact your child's healthcare provider.
This medicine should be thrown out when your child no longer needs it or if the medicine becomes outdated.
Most medicines can be thrown away in household trash after mixing with coffee grounds or kitty litter and sealing in a plastic bag.
Do not share your child's medicine with others and do not give anyone else's medicine to your child.
Many medications interact with other medications.
Keep a list of all your child's medicines (prescription, natural products, supplements, vitamins, over-the-counter) with you.
Give this list to your child's healthcare provider (doctor, nurse, nurse practitioner, pharmacist, physician assistant).
Medicine can be dangerous if used incorrectly.
Follow directions given by healthcare provider.
The Children's Hospital, Denver, CO.
Pediatric Pharmacy Advocacy Group, Inc.
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Unauthorized use or reproduction is prohibited.
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Dosage:A thin film of DIPROSONE Cream or Ointment should be applied to cover completely the affected area once or twice daily, morning and night.
Ointment contains in each gram betamethasone dipropionate, a synthetic corticosteroid, equivalent to 0.
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Package:DIPROSONE Cream: Tubes of 15 and 30 grams.
DIPROSONE Ointment: Tubes of 15 and 30 grams.
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They need to know if you have any of these conditions:liver disease porphyria systemic lupus erythematosus (SLE) an unusual or allergic reaction to griseofulvin, penicillin, other foods, dyes or preservatives pregnant or trying to get pregnant breast-feedingHow should I use this medicine?
While this drug may be prescribed for selected conditions, precautions do apply.
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A healthcare provider may prescribe triamcinolone to treat various conditions, such as asthma attacks, allergies, arthritis, and various skin conditions (like eczema and psoriasis).
The medication comes in several forms, including an inhaler, a nasal spray, an injection, a dental paste, and as a cream, ointment, or spray.
Some possible side effects of triamcinolone can include headaches, a sore throat, and coughing.
Triamcinolone is a prescription medication used to treat various conditions.
Inhaled triamcinolone is used to treat asthma, while triamcinolone nasal spray is used to treat allergic rhinitis (irritated, stuffy, or runny nose due to allergies).
Triamcinolone dental paste or cream is used to treat certain mouth sores.
Triamcinolone is a medication that belongs to a group of drugs called corticosteroids, or steroids for short.
Corticosteroids work by reducing inflammation, helping to relieve the pain or other symptoms of several conditions.
Because corticosteroids can have serious side effects (especially when used over long periods of time), it is beneficial to use triamcinolone products only when needed (such as inhaled into the lungs for asthma or applied to the skin for a rash).
Other medications you may be taking.
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
As with any medicine, there are possible side effects with this drug.
However, not everyone who takes it will experience side effects.
In fact, most people tolerate the medication well.
When side effects do occur, in most cases they are minor and either require no treatment or can easily be treated by you or your healthcare provider.
Serious side effects are less common.
Lightening or darkening of the skin near the injection site.
Triamcinolone can potentially interact with many medications, depending on the particular type of triamcinolone product.
For more information on triamcinolone drug interactions, see each specific product within the eMedTV Web site.
What Should I Tell My Healthcare Provider?
Any allergies, including allergies to food (especially milk), dyes, or preservatives.
Make sure to tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
In studies, high doses of triamcinolone (especially inhaled or topical triamcinolone) did not cause serious problems.
However, if you happen to overdose on triamcinolone, seek medical attention immediately.
Triamcinolone should be stored at room temperature, away from moisture and heat.
Keep triamcinolone and all medications out of the reach of children.
What Should I Do If I Miss a Dose?
If you do not take your triamcinolone as scheduled, take your missed dose as soon as you remember.
If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
For more information about the different triamcinolone products, please see the particular medication within the eMedTV Web site by clicking on any of the links above.
Package insert information for various triamcinolone products is available throughout the eMedTV Web site.
Look up the specific triamcinolone product you are taking for package insert information.
MedTV serves only as an informational resource.
This site does not dispense medical advice or advice of any kind.
Site users seeking medical advice about their specific situation should consult with their own physician.
Terms of Use for more information.
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Congress recently passed a law to enhance the tax benefits of protecting your land by donating a voluntary conservation agreement.
These new incentives make it easier for average Americans, including working family farmers and ranchers, to donate land.
Donors to carry over deductions for their contribution for as many as 15 years.
These changes allow many modest income landowners to deduct much more than they could under the old rules, bringing increased fairness to the tax code.
What do you need to know to enter into a voluntary conservation agreement?
A voluntary conservation agreement, also known as a conservation easement, is a legal agreement between a landowner and a nonprofit land trust or government agency that permanently limits uses of the land in order to protect important conservation values.
It allows you to continue to own and use your land and to sell it or pass it on to heirs.
When you enter into a voluntary conservation agreement with a land trust, you give up some of the rights associated with the land.
For example, you might give up the right to subdivide your land or build additional houses, while retaining the full right to grow crops.
The land trust is responsible for making sure the terms of the agreement are followed.
Voluntary conservation agreements vary widely.
An agreement to protect rare wildlife habitat might prohibit any development there, for example, while one on a farm might allow continued farming and the building of additional agricultural structures.
An agreement may apply to just a portion of the property, and need not require public access.
A conservation donation requires not only a willing donor, but a qualified conservation organization to accept the donation.
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Esclusiva formulazione emolliente particolarmente indicata per pelli con presenza di fenomeni irritativi, allergici o infiammatori associa ai quotidiani gesti di detersione...
Puoi rendere la tua valutazione ancora più utile ad altre persone se aggiungi una Mini Opinione sul prodotto.
Olio da bagno emolliente e protettivo studiato per la detersione quotidiana dì soggetti ...
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Bionike TRIDERM Bagno Oleato 250 ml.
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Ho conosciuto questo prodotto grazie all'amica Diddlina2001 che mi è venuta in soccorso indicandomi una valida alternativa ai detergenti che utilizzavo in un periodo in cui la mia pelle risentiva molto dello stress che avevo accumulato.
Anche io come lei sono allergica al nickel e in quel periodo le pressioni e lo stress hanno fatto precipitare gli eventi peggiorando la mia allergia...
Oltre alle modalità d'uso si specificano poi gli ingredienti, la quantità contenuta, le proprietà la scadenza (36 mesi dall'apertura) e alcune caratteristiche del prodotto.
Leggendo scopro così che il bagno oleato, così come l'olio shampoo è stato testato su soggetti volontari sotto controllo medico, che su ogni lotto viene testata la ricerca di nickel e inoltre su di esso sono eseguiti test microbiologici e in vitro.
Senza conservanti può però presentare tracce di nickel in quantità inferiori allo 0,00001%.
Tutto questo è scritto chiaramente sia in italiano che in inglese.
CHI PUO' USARLOSecondo il produttore, questo prodotto si porrebbe come ideale per tutti coloro che soffrono di problemi di irritazione cutanea, allergie, infiammazioni dell'epidermide ma anche per bambini e anziani poiché si propone come un prodotto non aggressivo che deterge e idrata rispettando il film idrolipidico.
Se devo essere sincera fino in fondo mi sento un po' in imbarazzo a parlare di questi ingredienti, sarebbero da censurare, soprattutto se si parte dal presupposto che il prodotto è destinato a chi ha problemi di pelle e questa robaccia rischia di far venire un'accidente alla povera epidermide!
Mettendoci un po' di sana cattiveria, mi viene da pensare che il produttore non cerchi di curare la pelle ma al contrario faccia in modo che sia continuamente in uno stato di stress che necessiti il perpetuo utilizzo del prodotto.
Potrebbe essere solo una cattiveria...
Il prodotto non produce schiuma nel momento dell'utilizzo e ci mancherebbe!
Contiene un antischiuma, come potrebbe?
Ma il lato estremamente negativo che rilevo, è la presenza di paraffinum liquidum, un petrolato estremamente pericoloso...
Come si può inserire un simile ingrediente in un prodotto destinato anche ai bambini?
Se non sto commettendo un errore di valutazione o memoria direi che è vergognoso, le mie piccine amano stare a mollo, giocano nell'acqua, la vasca è grande e ci stanno insieme con tutti i loro gingilli....
Come dicevo non fa schiuma e nonostante la presenza del profumo in realtà io non ho avvertito nessuna fragranza particolare, l'acqua addizionata con questo prodotto assume un colore vagamente inquietante, diventa leggermente torbida.
Al termine del bagno o della doccia (può essere utilizzato anche in questo modo, direttamente sulla pelle oppure sia su una retina da doccia che su una spugna) la pelle resta idratata (merito della paraffina?
La prossima volta che mi troverò nella stessa situazione utilizzerò solo l'amido e lo stesso farò con le mie piccine che, sfortuna loro sono predisposte ad avere questi problemi, la pediatra mi ha già detto di fare così, nei periodi di crisi dell'epidermide (delle piccine) usare l'amido e lasciar perdere altre cose.
Consiglieresti questo prodotto a un amico?
Mentre gli altri prodotti Bionike si utilizzano per evitare l'insorgere di allergie, arrossamenti, ecc..
Questo prodotto è unico nel suo genere, io lo tengo sempre a casa e se occorre lo uso!
Se volete farvi una doccia versatelo sulla pelle inumidita, massaggiate e vedrete che diviene un po' biancastro.
Se volete farvi un bel bagnetto versatelo dentro la vasca e vedrete una dispersione lattescente non schiumogena!
Ingredienti: paraffininum liquidum, sorbitan oleate laureth-4, phenyl trimethicone, isopropyl myristate, laureth-7, profumo.
Ho avuto occasione di provare bionike triderm bagno oleato grazie ad un campioncino che mi era stato regalato in farmacia ,e soffrendo mia figlia di dermatite atopica l'ho subito utilizzato al bagno (doccia) successivo.
Bionike Triderm Latte Detergente,BioNike Triderm Olio Shampoo,Bionike Acnet Gel Detergente,Bionike Defence Hydra Crema idratante ricca.
Purtroppo non so dirvi il prezzo preciso,avendo io un campioncino..
Bionike e credo se ne possano accorgere tutti guardando il mio elenco di opinioni.
Mi sembra spesso di essere ripetitiva elencando le specificità di tali prodotti, ma credo sia di fondamentale importanza.
Innanzitutto il Bagno Oleato si può trovare nelle farmacie (solo qui sono venduti i prodotti Bionike) in 2 confezioni, quella da 500 ml e quella da 250 ml.
Ho provato questo doccia schiuma grazie a mia sorella, consigliata nell'acquisto dalla sua dermatologa perchè aveva la dermatite atopica ed era quindi allergica all'alcool, sostanza contenuta nella quasi totalità dei prodotti per l'igiene personale.
L'usato per una doccia e me ne sono innamorata.
La consistenza di questo docciaschiuma è oleosa, non fa schiuma, ha un profumo gradevolissimo perchè neutro e ne basta una piccolissima dose per detergere ....
Ho potuto constatare dopo pochissimi lavaggi che la mia pelle è completamente cambiata.
E' più compatta, più morbida e le macchioline rosse che avevo alla fine di ogni doccia sono sparite.
La confezione inoltre è molto bella.
Oggi vi parlerò di questo prodotto che ho iniziato ad usare e devo dire che grazie a mia cognata che ha una farmacia mi ha regalato tanti campioni tra cui una confezione campione di questo bagno oleato Triderm della Bio Nike.
La confezione è come quella normale che si compra ma il prodotto dentro è un quarto...
Sulla scatola esterna in cartoncino si legge il nome del prodotto legato ai caratteristici colori che contraddistinguono questa linea Triderm ....
La confezione originale contiene nel flacone interno inplastica 250 ml di liquido,dalla consistenza oleosa ma non unge e non fa schiuma e lascia la pelle morbidissima.
I suoi principi attivi non schiumogeni rispettano delicatamente il naturale film idrolipidico della pelle.
Ideale anche per bambini e anziani.
Caratteristiche: tutte le caratteristiche e i vantaggi del vero sapone di marsiglia portati in forma liquida....
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Absorbed directly into the bloodstream, it acts faster.
It is used to treat erection problems in men.
The time necessary for the medicine to exercise its action is about half an hour.
The effect is maintained for about four hours.
Generic Propecia is used to treat symptoms of benign prostatic hyperplasia (BPH) in men with an enlarged prostate.
It is also used for treating certain types of male pattern hair loss (androgenic alopecia) in men.
TADALAFIL (Cialis) is the only drug that combines the two most desirable characteristics of an erectile dysfunction tablet: it starts to work faster and the effect lasts longer.
Generic Zithromax is used to treat many different types of infections caused by bacteria, such as respiratory infections, skin infections, ear infections, and sexually transmitted diseases.
In children, it is used to treat middle ear infection, pneumonia, tonsillitis, and strep throat.
Generic Cialis Soft is the medicine that combines two main characteristics important for treating male impotence (Erectile Dysfunction): fast acting and prolonged effect.
You can take the medicine in the morning and be ready for the right moment during that day, evening or even during the next day.
Generic Clomid is used for treating female infertility.
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What is the most important information I should know about triamcinolone topical?
What should I discuss with my healthcare provider before using triamcinolone topical?
How should I use triamcinolone topical?
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Pronunciation: trye am SIN oh lone Brand: Cinolar, Kenalog, Triderm Triamcinolone Acetonide Topical 0.
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SOSA Anesthesiology WorkshopThe anesthesiology workshop is a chance for VCOM students to learn and practice with Carilion Hospital anesthesiologists.
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INDOMETHACIN is a non-steroidal anti-inflammatory drug (NSAID).
It is used to reduce swelling and to treat pain.
It may be used for painful joint and muscular problems such as arthritis, tendinitis, bursitis, and gout.
They need to know if you have any of these conditions:asthma, especially aspirin sensitive asthma coronary artery bypass graft (CABG) surgery within the past 2 weeks depression drink more than 3 alcohol containing drinks a day heart disease or circulation problems like heart failure or leg edema (fluid retention) high blood pressure kidney disease liver disease Parkinson's disease seizures stomach bleeding or ulcers an unusual or allergic reaction to indomethacin, aspirin, other NSAIDs, other medicines, foods, dyes, or preservatives pregnant or trying to get pregnant breast-feedingHow should I use this medicine?
Take this medicine by mouth with food and with a full glass of water.
Long-term, continuous use may increase the risk of heart attack or stroke.
A special MedGuide will be given to you by the pharmacist with each prescription and refill.
Be sure to read this information carefully each time.
While this drug may be prescribed for children as young as 15 years for selected conditions, precautions do apply.
Elderly patients over 65 years old may have a stronger reaction and need a smaller dose.
Do not take this medicine with any of the following:cidofovir diflunisal ketorolac methotrexate pemetrexed triamterene This medicine may also interact with the following:alcohol antacids aspirin and aspirin-like medicines cyclosporine digoxin diuretics lithium medicines for diabetes medicines for high blood pressure medicines that affect platelets medicines that treat or prevent blood clots like warfarin NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen probenecid steroid medicines like prednisone or cortisoneThis list may not describe all possible interactions.
Side effects that you should report to your doctor or health care professional as soon as possible:allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue black or bloody stools, blood in the urine or vomit blurred vision chest pain difficulty breathing or wheezing nausea or vomiting slurred speech or weakness on one side of the body unexplained weight gain or swelling unusually weak or tired yellowing of eyes or skin Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):diarrhea dizziness headache heartburnThis list may not describe all possible side effects.
Tell your doctor or health care professional if your pain does not get better.
Talk to your doctor before taking another medicine for pain.
This medicine does not prevent heart attack or stroke.
In fact, this medicine may increase the chance of a heart attack or stroke.
The chance may increase with longer use of this medicine and in people who have heart disease.
If you take aspirin to prevent heart attack or stroke, talk with your doctor or health care professional.
Do not take medicines such as ibuprofen and naproxen with this medicine.
Side effects such as stomach upset, nausea, or ulcers may be more likely to occur.
Many medicines available without a prescription should not be taken with this medicine.
This medicine can cause ulcers and bleeding in the stomach and intestines at any time during treatment.
Do not smoke cigarettes or drink alcohol.
These increase irritation to your stomach and can make it more susceptible to damage from this medicine.
Ulcers and bleeding can happen without warning symptoms and can cause death.
Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you.
Do not stand or sit up quickly, especially if you are an older patient.
This reduces the risk of dizzy or fainting spells.
This medicine can cause you to bleed more easily.
Try to avoid damage to your teeth and gums when you brush or floss your teeth.
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Parents are always concerned about the reaction of neighbours when planning to implement these strategies for helping their children with their sleep problems.
We recommend that parents tell their neighbours of the problem and of the planned intervention.
The first step in learning to control our thinking is to be aware of what is actually taking place.
To do this we can draw from the meditation technique, although with this exercise we will not be meditating.
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A synthetic glucocorticoid, C21H27FO6, used as an anti-inflammatory drug in the treatment of allergic and respiratory disorders.
A synthetic adrenocorticosteroid that has a potent anti-inflammatory effect and is used topically in the treatment of angular cheilosis.
Triamcinolone Acetonide Topical ointmentWhat is this medicine?
It is used on the skin to reduce swelling, redness, itching, and allergic reactions.
This medicine is for external use only.
Wash your hands before and after use.
Apply a thin film of medicine to the affected area.
Do not cover with a bandage or dressing unless your doctor or health care professional tells you to.
Do not use on healthy skin or over large areas of skin.
Do not get this medicine in your eyes.
If you do, rinse out with plenty of cool tap water.
It is important not to use more medicine than prescribed.
Elderly patients are more likely to have damaged skin through aging, and this may increase side effects.
This medicine should only be used for brief periods and infrequently in older patients.
Tell your doctor or health care professional if your symptoms do not start to get better within one week.
Do not use for more than 14 days.
Tell your doctor or health care professional if you are exposed to anyone with measles or chickenpox, or if you develop sores or blisters that do not heal properly.
Do not use an airtight bandage to cover the affected area unless your doctor or health care professional tells you to.
If you are to cover the area, follow the instructions carefully.
Covering the area where the medicine is applied can increase the amount that passes through the skin and increases the risk of side effects.
If treating the diaper area of a child, avoid covering the treated area with tight-fitting diapers or plastic pants.
This may increase the amount of medicine that passes through the skin and increase the risk of serious side effects.
What side effects may I notice from receiving this medicine?
Important Disclaimer: The drug information provided here is for educational purposes only.
It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional.
This drug information does not cover all possible uses, precautions, side effects and interactions.
It should not be construed to indicate that this or any drug is safe for you.
Consult your medical professional for guidance before using any prescription or over the counter drugs.
A prednisolone derivative used as an anti-inflammatory glucocorticoid in the form of the acetonide derivative and the diacetate ester.
Is Triamcinolone a prescription medication?
Triamcinolone cream helps acne?
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They have 7 days to complete this form.
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In such instances usage will be to the credit of the originating organisation.
Nasacort AQ, which is generically prescribed as triamcinolone nasal, and is commonly used to treat the nasal symptoms of allergies.
Nasacort is considered a steroid.
This medication prevents the chemicals in the body that create inflammation from being produced.
Nasacort AQ is not appropriate for everyone.
A thorough medical history should be assessed prior to prescribing this medication.
Patients with a medical history that includes viral infections, fungal infections, or bacterial infections, or a compromised immune system should not take Nasacort AQ.
The American Food and Drug Administration has rated Nasacort AQ as a pregnancy risk category C, which means is has yet to be determined whether or not this medication will cause harm or side effects to an unborn baby.
The prescribing physician should avoid prescribing this medication to a pregnant or nursing woman.
Nasacort AQ has a risk of side effects, some of which are severe.
A patient that is experiencing a serious side effect or an allergic reaction should seek immediate emergency medical care.
An allergic reaction will present with symptoms that include facial swelling, including swelling of the lips, mouth, tongue, or throat, hives, and difficulty breathing.
Other serious side effects which require emergency medical attention include symptoms such as severe nasal burning or a nose bleed that can not be controlled.
Other less serious side effects typically do not require emergency medical attention however they should be reported to the prescribing physician.
Patients should be encouraged to report all side effects.
Less serious side effects include symptoms such as stinging in the nose, burning sensations, sneezing after use, inflammation of the nose, inflammation of the throat, nose bleeds, glaucoma, increased eye pressure, tearing of the eyes, headaches, perforated septum, lightheadedness, nausea, upset stomach, fever, cough, irritation or inflammation of the ears, nasal stuffiness, runny nose, unpleasant taste, or loss of smell.
Less serious side effects can often be reduced to a tolerable level by reducing the dose of the medication.
Nasacort AQ should be taken exactly as prescribed by the physician.
If the patient misses a dose, the dose should be taken as soon as it is remembered.
However, if it is almost time for the next scheduled dose, the missed dose should be skipped to avoid the potential for an overdose.
If an overdose or ingestion is suspected, the patient should seek immediate emergency medical treatment.
Though it is unlikely to overdose on Nasacort AQ, an overdose would present with symptoms such as severe burning in the nostrils, uncontrollable nosebleed, and severe headache.
Ingestion should not occur if this medication is kept out of reach of young children.
Ingestion may result in nausea, vomiting, and diarrhea.
There is a risk of negative drug interactions associated with Nasacort.
Patients should be urged to inquire with the prescribing physician prior to taking any new medications, including over the counter medications and herbal remedies.
Medications that are known to cause negative interactions with Nasacort AQ include inhaled steroids, oral steroids, and additional nasal sprays.
Nasacort AQ comes in a metered dosage container which contains 120 doses.
The patient should be instructed to properly discard the container after 120 doses.
The canister will not deliver the required amount of medication after 120 doses.
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ERYTHROMYCIN is a macrolide antibiotic.
It stops the growth of some bacteria.
It treats many kinds of infection, including pneumonia, skin infections, some sexually transmitted diseases, and Legionnaire's disease.
This medicine also treats severe acne, and prevents heart problems in patients with rheumatic fever.
This medicine will not work for colds, flu, or other viral infections.
They need to know if you have any of these conditions:liver disease myasthenia gravis an unusual or allergic reaction to erythromycin, other medicines, foods, dyes, or preservatives pregnant or trying to get pregnant breast-feedingHow should I use this medicine?
Take this medicine by mouth with glass of water.
Take this medicine on an empty stomach, at least 30 minutes before or 2 hours after food.
If this medicine upsets your stomach, take with food or milk.
Do not take this medicine with any of the following:chloroquine cisapride droperidol eplerenone ergotamine and dihydroergotamine methadone other antibiotics, like grepafloxacin or sparfloxacin sirolimus some medicines for cholesterol like atorvastatin, cerivastatin, lovastatin, and simvastatin some medicines for heart rhythm problems some medicines for psychotic disturbances vinblastine red yeast rice This medicine may also interact with the following:alfentanil bromocriptine carbamazepine cyclosporine digoxin some medicines for anxiety or difficulty sleeping phenytoin terfenadine theophylline valproate warfarinThis list may not describe all possible interactions.
Side effects that you should report to your doctor or health care professional as soon as possible:allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue dark urine difficulty breathing hearing loss irregular heartbeat or chest pain redness, blistering, peeling or loosening of the skin, including inside the mouth severe or watery diarrhea unusually weak or tired yellowing of eyes or skin Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):diarrhea loss of appetite nausea, vomiting stomach painThis list may not describe all possible side effects.
Do not treat diarrhea with over the counter products.
Contact your doctor if you have diarrhea that lasts more than 2 days or if it is severe and watery.
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Roxithromycin is a semi-synthetic macrolide antibiotic.
It is used to treat respiratory tract, urinary and soft tissue infections.
Roxithromycin is derived from erythromycin, containing the same 14-membered lactone ring.
However, an N-oxime side chain is attached to the lactone ring.
It is also currently undergoing clinical trials for the treatment of male-pattern hair loss.
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RecentChangesCachedPlugin 14:48 (wpeurtte) ...
RecentChangesCachedPlugin 14:48 (uttowreo) ...
RecentChangesCachedPlugin 14:48 (wtywtptu) ...
RecentChangesCachedPlugin 14:47 (wiwyrruo) ...
CommentPlugin 14:44 (Levitra) ...
RecentChangesCachedPlugin 13:28 (uwpiitow) ...
RecentChangesCachedPlugin 13:27 (opetuiti) ...
RecentChangesPlugin 22:55 (rywiwpiu) ...
RecentChangesPlugin 22:54 (peuyrppi) ...
RecentChangesPlugin 22:54 (eeitiiut) ...
RecentChangesPlugin 22:54 (ewiyppet) ...
RecentChangesPlugin 22:54 (wupyttuu) ...
CommentPlugin 21:57 (Levitra) ...
RecentChangesPlugin 18:45 (eppiioii) ...
RecentChangesPlugin 18:45 (uuyrrpiu) ...
RecentChangesPlugin 18:45 (pypurioo) ...
RecentChangesPlugin 18:44 (wewetttp) ...
CommentPlugin 17:17 (Levitra) ...
CommentPlugin 17:05 (Levitra) ...
RecentChangesCachedPlugin 17:02 (uruuwyer) ...
RecentChangesCachedPlugin 17:02 (eeiwyyiu) ...
RecentChangesCachedPlugin 17:02 (irpiwutw) ...
RecentChangesCachedPlugin 17:01 (yetrrppt) ...
RecentChangesCachedPlugin 17:01 (tioyiopw) ...
AddingPages 15:52 (pruowwyp) ...
RecentChangesCachedPlugin 12:44 (rwpuoetp) ...
RecentChangesCachedPlugin 12:44 (rypepuro) ...
RecentChangesCachedPlugin 12:44 (pouowrpw) ...
RecentChangesCachedPlugin 12:43 (uweooouo) ...
CommentPlugin 11:56 (Levitra) ...
CommentPlugin 5:43 (Levitra) ...
CommentPlugin 4:36 (Levitra) ...
RecentChangesPlugin 2:04 (woyiriio) ...
RecentChangesPlugin 2:04 (iitpirot) ...
RecentChangesPlugin 2:04 (iyeteyro) ...
RecentChangesPlugin 2:04 (roroepie) ...
RecentChangesPlugin 2:04 (yoiwtyru) ...
RecentChangesCachedPlugin 23:08 (rryyyeoy) ...
RecentChangesCachedPlugin 23:08 (ywpeyoii) ...
RecentChangesCachedPlugin 23:06 (uiwreuit) ...
CommentPlugin 22:48 (Levitra) ...
CommentPlugin 21:58 (Levitra) ...
CommentPlugin 19:43 (Levitra) ...
CommentPlugin 16:16 (Levitra) ...
RecentChangesPlugin 13:49 (uyrepiui) ...
CommentPlugin 12:05 (Levitra) ...
CommentPlugin 9:43 (Levitra) ...
CommentPlugin 5:58 (Levitra) ...
CommentPlugin 5:39 (Levitra) ...
CommentPlugin 4:13 (Levitra) ...
CommentPlugin 3:32 (Levitra) ...
CommentPlugin 0:31 (Levitra) ...
RecentChangesCachedPlugin 0:14 (ruiuuwuo) ...
RecentChangesCachedPlugin 0:14 (epeouryp) ...
RecentChangesCachedPlugin 0:14 (witrootr) ...
RecentChangesCachedPlugin 0:14 (poieyyeo) ...
RecentChangesCachedPlugin 0:14 (ytituyoe) ...
RecentChangesPlugin 23:43 (yupiyueo) ...
RecentChangesPlugin 23:43 (oepoyutr) ...
RecentChangesPlugin 23:43 (uwootyoo) ...
RecentChangesCachedPlugin 18:54 (ioyworpi) ...
RecentChangesCachedPlugin 18:54 (ewruiieu) ...
RecentChangesCachedPlugin 18:54 (tpitepwi) ...
RecentChangesCachedPlugin 18:54 (yuorwrot) ...
RecentChangesCachedPlugin 18:54 (rioypuoe) ...
RecentChangesPlugin 18:16 (ueoeyyoi) ...
RecentChangesPlugin 18:16 (urwwtyte) ...
RecentChangesPlugin 18:16 (oiyeeiet) ...
RecentChangesCachedPlugin 17:39 (poptwerr) ...
RecentChangesCachedPlugin 17:39 (iioruupt) ...
RecentChangesCachedPlugin 17:39 (iirrrwwp) ...
RecentChangesCachedPlugin 17:39 (iwuopire) ...
RecentChangesCachedPlugin 17:39 (epwoptiy) ...
RecentChangesPlugin 17:12 (yieyiipu) ...
RecentChangesPlugin 17:11 (eyrooupr) ...
RecentChangesPlugin 17:11 (teeruyet) ...
RecentChangesPlugin 17:11 (otrtrtre) ...
CommentPlugin 14:34 (Viagra) ...
CommentPlugin 14:04 (Levitra) ...
CommentPlugin 13:07 (Viagra) ...
CommentPlugin 12:56 (Viagra) ...
CommentPlugin 12:21 (Viagra) ...
CommentPlugin 12:11 (Viagra) ...
CommentPlugin 10:24 (Viagra) ...
CommentPlugin 8:35 (Viagra) ...
CommentPlugin 8:14 (Viagra) ...
CommentPlugin 7:21 (Viagra) ...
CommentPlugin 6:34 (Viagra) ...
CommentPlugin 6:15 (Viagra) ...
CommentPlugin 5:56 (Viagra) ...
CommentPlugin 5:31 (Viagra) ...
CommentPlugin 5:03 (Viagra) ...
CommentPlugin 4:42 (Viagra) ...
CommentPlugin 4:36 (Viagra) ...
CommentPlugin 3:52 (Viagra) ...
CommentPlugin 3:51 (Viagra) ...
CommentPlugin 3:46 (Viagra) ...
CommentPlugin 3:40 (Levitra) ...
CommentPlugin 2:59 (Viagra) ...
CommentPlugin 1:44 (Viagra) ...
CommentPlugin 1:34 (Levitra) ...
CommentPlugin 0:36 (Viagra) ...
CommentPlugin 0:12 (Viagra) ...
CommentPlugin 21:37 (Viagra) ...
CommentPlugin 21:21 (Viagra) ...
CommentPlugin 21:04 (Viagra) ...
CommentPlugin 20:43 (Viagra) ...
CommentPlugin 20:27 (Viagra) ...
CommentPlugin 20:27 (Levitra) ...
CommentPlugin 20:23 (Viagra) ...
CommentPlugin 20:20 (Viagra) ...
CommentPlugin 19:39 (Viagra) ...
CommentPlugin 19:36 (Viagra) ...
CommentPlugin 16:40 (Viagra) ...
CommentPlugin 16:09 (Viagra) ...
CommentPlugin 15:55 (Viagra) ...
CommentPlugin 15:50 (Viagra) ...
CommentPlugin 15:31 (Viagra) ...
CommentPlugin 15:17 (Viagra) ...
CommentPlugin 13:42 (Viagra) ...
CommentPlugin 13:39 (Levitra) ...
CommentPlugin 12:51 (Viagra) ...
CommentPlugin 12:42 (Viagra) ...
CommentPlugin 12:41 (Viagra) ...
CommentPlugin 12:30 (Viagra) ...
CommentPlugin 11:38 (Viagra) ...
CommentPlugin 9:10 (Viagra) ...
CommentPlugin 8:24 (Viagra) ...
CommentPlugin 8:13 (Viagra) ...
CommentPlugin 8:02 (Viagra) ...
CommentPlugin 7:52 (Viagra) ...
CommentPlugin 7:46 (Viagra) ...
CommentPlugin 5:22 (Levitra) ...
CommentPlugin 4:48 (Viagra) ...
CommentPlugin 3:27 (Viagra) ...
CommentPlugin 3:13 (Viagra) ...
CommentPlugin 3:08 (Viagra) ...
CommentPlugin 2:43 (Viagra) ...
CommentPlugin 2:34 (Viagra) ...
CommentPlugin 1:45 (Viagra) ...
CommentPlugin 1:41 (Levitra) ...
CommentPlugin 0:03 (Viagra) ...
CommentPlugin 22:57 (Viagra) ...
CommentPlugin 20:47 (Viagra) ...
CommentPlugin 20:42 (Viagra) ...
CommentPlugin 20:01 (Viagra) ...
CommentPlugin 19:53 (Levitra) ...
CommentPlugin 19:15 (Viagra) ...
CommentPlugin 19:13 (Viagra) ...
CommentPlugin 18:31 (Viagra) ...
CommentPlugin 18:30 (Viagra) ...
CommentPlugin 17:57 (Viagra) ...
CommentPlugin 17:40 (Levitra) ...
CommentPlugin 17:14 (Viagra) ...
CommentPlugin 16:52 (Levitra) ...
CommentPlugin 16:39 (Viagra) ...
CommentPlugin 16:32 (Viagra) ...
CommentPlugin 16:21 (Viagra) ...
CommentPlugin 16:11 (Viagra) ...
CommentPlugin 14:44 (Viagra) ...
CommentPlugin 14:43 (Viagra) ...
CommentPlugin 14:04 (Viagra) ...
CommentPlugin 13:17 (Viagra) ...
CommentPlugin 11:16 (Viagra) ...
CommentPlugin 11:09 (Levitra) ...
CommentPlugin 10:17 (Viagra) ...
CommentPlugin 10:12 (Viagra) ...
CommentPlugin 10:09 (Viagra) ...
CommentPlugin 10:01 (Viagra) ...
CommentPlugin 9:00 (Viagra) ...
CommentPlugin 8:47 (Viagra) ...
CommentPlugin 7:42 (Viagra) ...
CommentPlugin 7:16 (Viagra) ...
CommentPlugin 7:08 (Viagra) ...
CommentPlugin 6:51 (Viagra) ...
CommentPlugin 6:36 (Viagra) ...
CommentPlugin 6:21 (Viagra) ...
CommentPlugin 5:25 (Levitra) ...
CommentPlugin 3:02 (Viagra) ...
CommentPlugin 2:23 (Viagra) ...
CommentPlugin 2:09 (Viagra) ...
CommentPlugin 1:21 (Levitra) ...
AddingPages 1:21 (iioetrue) ...
CommentPlugin 23:57 (Viagra) ...
CommentPlugin 21:59 (Viagra) ...
CommentPlugin 21:22 (Viagra) ...
CommentPlugin 20:51 (Viagra) ...
CommentPlugin 19:48 (Viagra) ...
CommentPlugin 19:37 (Levitra) ...
CommentPlugin 17:48 (Viagra) ...
CommentPlugin 17:37 (Viagra) ...
CommentPlugin 16:49 (Viagra) ...
CommentPlugin 16:19 (Viagra) ...
CommentPlugin 14:55 (Viagra) ...
CommentPlugin 14:38 (Viagra) ...
CommentPlugin 13:40 (Viagra) ...
CommentPlugin 13:29 (Viagra) ...
CommentPlugin 12:55 (Viagra) ...
CommentPlugin 11:55 (Viagra) ...
CommentPlugin 11:50 (Viagra) ...
CommentPlugin 11:26 (Viagra) ...
CommentPlugin 11:01 (Levitra) ...
CommentPlugin 10:59 (Viagra) ...
CommentPlugin 10:51 (Levitra) ...
CommentPlugin 9:07 (Viagra) ...
CommentPlugin 9:04 (Viagra) ...
CommentPlugin 8:51 (Levitra) ...
CommentPlugin 8:08 (Viagra) ...
CommentPlugin 7:55 (Viagra) ...
CommentPlugin 6:56 (Levitra) ...
CommentPlugin 6:53 (Viagra) ...
CommentPlugin 5:59 (Viagra) ...
CommentPlugin 5:49 (Viagra) ...
CommentPlugin 4:34 (Viagra) ...
CommentPlugin 3:49 (Viagra) ...
CommentPlugin 3:45 (Viagra) ...
CommentPlugin 2:52 (Viagra) ...
CommentPlugin 1:31 (Viagra) ...
CommentPlugin 0:56 (Viagra) ...
CommentPlugin 0:37 (Viagra) ...
CommentPlugin 22:45 (Viagra) ...
CommentPlugin 22:36 (Viagra) ...
CommentPlugin 22:21 (Viagra) ...
CommentPlugin 22:19 (Levitra) ...
CommentPlugin 21:52 (Viagra) ...
CommentPlugin 21:44 (Viagra) ...
CommentPlugin 21:33 (Viagra) ...
CommentPlugin 20:21 (Viagra) ...
CommentPlugin 20:12 (Viagra) ...
CommentPlugin 19:50 (Viagra) ...
CommentPlugin 18:43 (Viagra) ...
CommentPlugin 17:53 (Viagra) ...
CommentPlugin 17:39 (Levitra) ...
CommentPlugin 15:46 (Viagra) ...
CommentPlugin 15:15 (Viagra) ...
CommentPlugin 13:53 (Viagra) ...
CommentPlugin 13:14 (Viagra) ...
CommentPlugin 13:12 (Viagra) ...
CommentPlugin 12:23 (Viagra) ...
CommentPlugin 11:52 (Viagra) ...
CommentPlugin 11:18 (Viagra) ...
CommentPlugin 9:54 (Viagra) ...
CommentPlugin 9:30 (Viagra) ...
CommentPlugin 8:12 (Viagra) ...
CommentPlugin 7:15 (Viagra) ...
CommentPlugin 6:13 (Viagra) ...
CommentPlugin 3:21 (Viagra) ...
CommentPlugin 2:38 (Viagra) ...
CommentPlugin 2:36 (Viagra) ...
CommentPlugin 2:13 (Viagra) ...
CommentPlugin 1:50 (Viagra) ...
CommentPlugin 1:34 (Viagra) ...
CommentPlugin 1:21 (Viagra) ...
CommentPlugin 23:49 (Viagra) ...
CommentPlugin 23:15 (Viagra) ...
CommentPlugin 23:00 (Viagra) ...
CommentPlugin 22:58 (Viagra) ...
CommentPlugin 22:01 (Viagra) ...
CommentPlugin 19:43 (Viagra) ...
CommentPlugin 19:41 (Viagra) ...
CommentPlugin 19:28 (Viagra) ...
CommentPlugin 18:27 (Viagra) ...
CommentPlugin 17:32 (Levitra) ...
CommentPlugin 17:29 (Viagra) ...
CommentPlugin 16:57 (Viagra) ...
CommentPlugin 15:51 (Viagra) ...
CommentPlugin 15:40 (Viagra) ...
CommentPlugin 14:41 (Viagra) ...
CommentPlugin 14:17 (Viagra) ...
CommentPlugin 12:54 (Levitra) ...
CommentPlugin 10:50 (Viagra) ...
CommentPlugin 8:31 (Viagra) ...
CommentPlugin 8:00 (Viagra) ...
CommentPlugin 6:59 (Viagra) ...
CommentPlugin 6:27 (Viagra) ...
CommentPlugin 6:05 (Levitra) ...
CommentPlugin 5:24 (Viagra) ...
CommentPlugin 5:16 (Viagra) ...
CommentPlugin 3:17 (Viagra) ...
CommentPlugin 2:58 (Viagra) ...
CommentPlugin 2:01 (Levitra) ...
CommentPlugin 1:50 (Levitra) ...
CommentPlugin 0:35 (Viagra) ...
CommentPlugin 22:26 (Viagra) ...
CommentPlugin 22:23 (Viagra) ...
CommentPlugin 21:55 (Viagra) ...
CommentPlugin 20:18 (Viagra) ...
CommentPlugin 19:32 (Viagra) ...
CommentPlugin 18:13 (Viagra) ...
CommentPlugin 18:08 (Levitra) ...
CommentPlugin 17:13 (Viagra) ...
CommentPlugin 16:23 (Viagra) ...
CommentPlugin 16:06 (Viagra) ...
CommentPlugin 15:27 (Viagra) ...
CommentPlugin 15:26 (Viagra) ...
CommentPlugin 12:37 (Viagra) ...
CommentPlugin 12:25 (Viagra) ...
CommentPlugin 11:40 (Viagra) ...
CommentPlugin 10:53 (Viagra) ...
CommentPlugin 10:28 (Viagra) ...
CommentPlugin 10:02 (Viagra) ...
CommentPlugin 9:49 (Viagra) ...
CommentPlugin 8:29 (Levitra) ...
CommentPlugin 8:01 (Viagra) ...
CommentPlugin 6:32 (Viagra) ...
CommentPlugin 6:29 (Viagra) ...
CommentPlugin 6:00 (Viagra) ...
CommentPlugin 5:40 (Levitra) ...
CommentPlugin 5:00 (Viagra) ...
CommentPlugin 4:46 (Viagra) ...
CommentPlugin 4:07 (Viagra) ...
CommentPlugin 3:47 (Viagra) ...
CommentPlugin 2:48 (Viagra) ...
CommentPlugin 0:47 (Viagra) ...
CommentPlugin 22:43 (Viagra) ...
CommentPlugin 21:39 (Viagra) ...
CommentPlugin 21:38 (Viagra) ...
CommentPlugin 20:41 (Viagra) ...
CommentPlugin 19:37 (Viagra) ...
CommentPlugin 19:25 (Viagra) ...
CommentPlugin 18:09 (Viagra) ...
CommentPlugin 16:58 (Viagra) ...
CommentPlugin 16:26 (Viagra) ...
CommentPlugin 16:05 (Levitra) ...
CommentPlugin 15:47 (Viagra) ...
CommentPlugin 15:13 (Viagra) ...
CommentPlugin 15:06 (Viagra) ...
CommentPlugin 15:02 (Viagra) ...
CommentPlugin 14:22 (Levitra) ...
CommentPlugin 12:44 (Viagra) ...
CommentPlugin 12:17 (Viagra) ...
CommentPlugin 11:17 (Levitra) ...
CommentPlugin 10:44 (Viagra) ...
CommentPlugin 9:20 (Levitra) ...
CommentPlugin 7:22 (Viagra) ...
CommentPlugin 7:01 (Viagra) ...
CommentPlugin 5:14 (Viagra) ...
CommentPlugin 5:04 (Viagra) ...
CommentPlugin 4:54 (Viagra) ...
CommentPlugin 3:55 (Levitra) ...
CommentPlugin 3:05 (Viagra) ...
CommentPlugin 2:47 (Viagra) ...
CommentPlugin 2:35 (Viagra) ...
CommentPlugin 2:18 (Levitra) ...
CommentPlugin 1:24 (Viagra) ...
CommentPlugin 1:07 (Viagra) ...
CommentPlugin 1:01 (Viagra) ...
CommentPlugin 0:23 (Viagra) ...
CommentPlugin 23:59 (Viagra) ...
CommentPlugin 22:42 (Viagra) ...
CommentPlugin 22:22 (Viagra) ...
CommentPlugin 21:32 (Viagra) ...
CommentPlugin 20:59 (Viagra) ...
CommentPlugin 20:48 (Viagra) ...
CommentPlugin 18:27 (Levitra) ...
CommentPlugin 17:56 (Viagra) ...
CommentPlugin 17:26 (Levitra) ...
CommentPlugin 15:53 (Viagra) ...
CommentPlugin 15:48 (Viagra) ...
CommentPlugin 15:07 (Viagra) ...
CommentPlugin 14:48 (Levitra) ...
CommentPlugin 14:25 (Viagra) ...
CommentPlugin 14:18 (Viagra) ...
CommentPlugin 13:46 (Viagra) ...
CommentPlugin 12:03 (Viagra) ...
CommentPlugin 11:45 (Viagra) ...
RecentChangesPlugin 11:03 (ttitotup) ...
CommentPlugin 10:55 (Viagra) ...
CommentPlugin 10:54 (Viagra) ...
CommentPlugin 9:58 (Viagra) ...
CommentPlugin 9:46 (Viagra) ...
CommentPlugin 9:42 (Viagra) ...
CommentPlugin 8:58 (Levitra) ...
CommentPlugin 8:45 (Viagra) ...
CommentPlugin 8:03 (Levitra) ...
CommentPlugin 6:24 (Viagra) ...
CommentPlugin 5:13 (Viagra) ...
CommentPlugin 4:52 (Viagra) ...
CommentPlugin 4:50 (Levitra) ...
CommentPlugin 4:33 (Levitra) ...
CommentPlugin 4:27 (Viagra) ...
CommentPlugin 4:11 (Viagra) ...
CommentPlugin 3:48 (Viagra) ...
CommentPlugin 2:31 (Levitra) ...
RecentChangesCachedPlugin 1:04 (upotoiuy) ...
CommentPlugin 23:55 (Viagra) ...
CommentPlugin 23:47 (Viagra) ...
CommentPlugin 23:46 (Viagra) ...
CommentPlugin 22:08 (Viagra) ...
CommentPlugin 22:03 (Viagra) ...
CommentPlugin 21:42 (Viagra) ...
CommentPlugin 21:26 (Viagra) ...
CommentPlugin 20:45 (Viagra) ...
CommentPlugin 20:24 (Viagra) ...
AddingPages 20:23 (pypyorwr) ...
CommentPlugin 20:07 (Viagra) ...
RecentEditsPlugin 20:03 (wrppprew) ...
CommentPlugin 19:51 (Viagra) ...
CommentPlugin 19:04 (Viagra) ...
CommentPlugin 18:40 (Viagra) ...
CommentPlugin 18:37 (Viagra) ...
CommentPlugin 18:06 (Viagra) ...
CommentPlugin 17:22 (ppopouyt) ...
CommentPlugin 17:03 (Levitra) ...
CommentPlugin 16:47 (Levitra) ...
CommentPlugin 16:10 (Levitra) ...
CommentPlugin 15:34 (Viagra) ...
CommentPlugin 15:29 (Viagra) ...
CommentPlugin 15:04 (Viagra) ...
CommentPlugin 14:28 (Viagra) ...
CommentPlugin 13:06 (Viagra) ...
CommentPlugin 12:34 (Viagra) ...
CommentPlugin 12:01 (Viagra) ...
CommentPlugin 10:35 (Viagra) ...
CommentPlugin 9:37 (Viagra) ...
CommentPlugin 8:50 (Viagra) ...
CommentPlugin 8:38 (Viagra) ...
CommentPlugin 6:57 (Viagra) ...
CommentPlugin 6:42 (Viagra) ...
CommentPlugin 6:05 (Viagra) ...
CommentPlugin 5:50 (Viagra) ...
CommentPlugin 5:29 (Viagra) ...
CommentPlugin 5:10 (Viagra) ...
CommentPlugin 4:21 (Viagra) ...
CommentPlugin 4:02 (Viagra) ...
CommentPlugin 3:58 (Viagra) ...
CommentPlugin 3:56 (Viagra) ...
CommentPlugin 3:36 (Viagra) ...
CommentPlugin 3:03 (Viagra) ...
CommentPlugin 2:05 (Viagra) ...
CommentPlugin 0:19 (Viagra) ...
CommentPlugin 22:40 (Viagra) ...
CommentPlugin 22:33 (Levitra) ...
CommentPlugin 22:30 (Viagra) ...
CommentPlugin 22:19 (Viagra) ...
CommentPlugin 21:30 (Levitra) ...
CommentPlugin 21:18 (Viagra) ...
CommentPlugin 20:10 (Viagra) ...
CommentPlugin 19:53 (Viagra) ...
CommentPlugin 19:49 (Viagra) ...
CommentPlugin 18:38 (Viagra) ...
CommentPlugin 16:19 (Levitra) ...
CommentPlugin 16:14 (Viagra) ...
CommentPlugin 15:30 (Viagra) ...
CommentPlugin 14:19 (Viagra) ...
CommentPlugin 13:28 (Viagra) ...
CommentPlugin 13:24 (Levitra) ...
CommentPlugin 13:04 (Viagra) ...
CommentPlugin 12:27 (Viagra) ...
CommentPlugin 11:46 (Viagra) ...
CommentPlugin 11:34 (Levitra) ...
CommentPlugin 10:12 (Levitra) ...
CommentPlugin 9:24 (Viagra) ...
CommentPlugin 8:48 (Viagra) ...
CommentPlugin 6:31 (Viagra) ...
CommentPlugin 5:22 (Viagra) ...
CommentPlugin 5:19 (Viagra) ...
CommentPlugin 3:20 (Viagra) ...
CommentPlugin 2:39 (Viagra) ...
CommentPlugin 2:06 (Viagra) ...
CommentPlugin 1:58 (Viagra) ...
CommentPlugin 1:11 (Levitra) ...
CommentPlugin 1:03 (Viagra) ...
CommentPlugin 0:18 (Viagra) ...
CommentPlugin 0:15 (Viagra) ...
CommentPlugin 23:04 (Viagra) ...
CommentPlugin 22:07 (Viagra) ...
CommentPlugin 21:58 (Viagra) ...
CommentPlugin 20:08 (Viagra) ...
CommentPlugin 19:29 (Viagra) ...
CommentPlugin 18:01 (Viagra) ...
CommentPlugin 17:59 (Viagra) ...
CommentPlugin 17:52 (Viagra) ...
CommentPlugin 17:05 (Viagra) ...
CommentPlugin 15:36 (Viagra) ...
CommentPlugin 14:05 (Viagra) ...
CommentPlugin 14:01 (Levitra) ...
CommentPlugin 12:54 (Viagra) ...
CommentPlugin 11:51 (Viagra) ...
CommentPlugin 11:45 (Levitra) ...
CommentPlugin 11:24 (Viagra) ...
CommentPlugin 8:53 (Levitra) ...
CommentPlugin 8:20 (Viagra) ...
CommentPlugin 8:19 (Viagra) ...
CommentPlugin 7:57 (Viagra) ...
CommentPlugin 7:47 (Levitra) ...
CommentPlugin 6:38 (Viagra) ...
CommentPlugin 4:43 (Viagra) ...
CommentPlugin 4:26 (Viagra) ...
CommentPlugin 4:22 (Viagra) ...
CommentPlugin 3:33 (Viagra) ...
CommentPlugin 3:22 (Viagra) ...
CommentPlugin 3:14 (Viagra) ...
CommentPlugin 1:22 (Viagra) ...
CommentPlugin 1:20 (Viagra) ...
CommentPlugin 20:49 (Levitra) ...
CommentPlugin 19:45 (Levitra) ...
CommentPlugin 19:10 (Viagra) ...
CommentPlugin 18:58 (Viagra) ...
CommentPlugin 17:39 (Viagra) ...
CommentPlugin 14:45 (Levitra) ...
CommentPlugin 14:32 (Viagra) ...
CommentPlugin 14:00 (Viagra) ...
CommentPlugin 13:10 (Viagra) ...
CommentPlugin 12:58 (Viagra) ...
CommentPlugin 12:48 (Levitra) ...
CommentPlugin 12:29 (Viagra) ...
CommentPlugin 12:20 (Viagra) ...
CommentPlugin 11:02 (Viagra) ...
CommentPlugin 10:56 (Viagra) ...
CommentPlugin 9:26 (Viagra) ...
CommentPlugin 8:48 (Levitra) ...
CommentPlugin 8:43 (Viagra) ...
CommentPlugin 7:37 (Viagra) ...
CommentPlugin 7:35 (Viagra) ...
CommentPlugin 6:17 (Viagra) ...
AddingPages 5:43 (Roberto Vaughan) ...
CommentPlugin 2:51 (Viagra) ...
CommentPlugin 2:46 (Viagra) ...
CommentPlugin 2:43 (Levitra) ...
AddingPages 1:57 (Forrest Stephens) ...
CommentPlugin 1:05 (Levitra) ...
CommentPlugin 1:04 (Viagra) ...
CommentPlugin 0:43 (Levitra) ...
CommentPlugin 0:24 (Viagra) ...
CommentPlugin 23:22 (Viagra) ...
CommentPlugin 22:47 (Viagra) ...
CommentPlugin 22:28 (Viagra) ...
AddingPages 22:21 (David Calderon) ...
CommentPlugin 21:51 (Viagra) ...
CommentPlugin 20:14 (Viagra) ...
CommentPlugin 19:54 (Viagra) ...
CommentPlugin 18:03 (Viagra) ...
CommentPlugin 17:54 (Viagra) ...
CommentPlugin 17:36 (Viagra) ...
AddingPages 17:25 (Rena Nicholson) ...
CommentPlugin 17:02 (Levitra) ...
CommentPlugin 16:08 (Levitra) ...
CommentPlugin 16:06 (Levitra) ...
CommentPlugin 16:00 (Viagra) ...
AddingPages 14:59 (Dedra Allison) ...
AddingPages 11:02 (Ramon Gates) ...
CommentPlugin 9:43 (Viagra) ...
CommentPlugin 9:36 (Levitra) ...
CommentPlugin 9:20 (Viagra) ...
CommentPlugin 8:52 (Viagra) ...
CommentPlugin 8:22 (Viagra) ...
CommentPlugin 7:59 (Viagra) ...
AddingPages 7:12 (Forrest Byers) ...
CommentPlugin 6:50 (Viagra) ...
CommentPlugin 6:09 (Viagra) ...
CommentPlugin 5:53 (Viagra) ...
CommentPlugin 5:41 (Levitra) ...
CommentPlugin 4:41 (Viagra) ...
CommentPlugin 4:38 (Viagra) ...
CommentPlugin 3:43 (Levitra) ...
CommentPlugin 3:37 (Viagra) ...
CommentPlugin 3:18 (Viagra) ...
CommentPlugin 3:16 (Viagra) ...
AddingPages 3:11 (Joan Reese) ...
CommentPlugin 3:07 (Levitra) ...
CommentPlugin 2:53 (Viagra) ...
CommentPlugin 2:41 (Viagra) ...
CommentPlugin 2:28 (Viagra) ...
CommentPlugin 0:44 (Viagra) ...
CommentPlugin 0:17 (Viagra) ...
CommentPlugin 0:10 (Viagra) ...
CommentPlugin 23:32 (Viagra) ...
CommentPlugin 23:16 (Viagra) ...
CommentPlugin 23:11 (Levitra) ...
CommentPlugin 22:35 (Viagra) ...
AddingPages 21:55 (Lori Hancock) ...
CommentPlugin 20:53 (Viagra) ...
CommentPlugin 20:34 (Viagra) ...
CommentPlugin 19:44 (Viagra) ...
CommentPlugin 19:40 (Viagra) ...
CommentPlugin 19:17 (Viagra) ...
AddingPages 18:30 (Agnes Santiago) ...
CommentPlugin 18:04 (Viagra) ...
CommentPlugin 16:47 (Viagra) ...
CommentPlugin 16:44 (Viagra) ...
CommentPlugin 16:26 (Levitra) ...
CommentPlugin 16:07 (Levitra) ...
CommentPlugin 14:48 (Viagra) ...
AddingPages 14:11 (Mara James) ...
CommentPlugin 12:59 (Viagra) ...
CommentPlugin 11:39 (Viagra) ...
CommentPlugin 11:01 (Viagra) ...
CommentPlugin 10:40 (Viagra) ...
CommentPlugin 10:23 (Levitra) ...
CommentPlugin 10:21 (Viagra) ...
AddingPages 9:28 (Garret Willis) ...
CommentPlugin 8:55 (Viagra) ...
CommentPlugin 7:42 (Levitra) ...
CommentPlugin 7:34 (Viagra) ...
CommentPlugin 7:29 (Viagra) ...
CommentPlugin 7:17 (Viagra) ...
CommentPlugin 6:54 (Viagra) ...
CommentPlugin 6:48 (Viagra) ...
CommentPlugin 6:08 (Levitra) ...
AddingPages 5:15 (Bradly Franco) ...
CommentPlugin 4:29 (Viagra) ...
CommentPlugin 4:26 (Levitra) ...
CommentPlugin 3:38 (Viagra) ...
CommentPlugin 2:42 (Viagra) ...
CommentPlugin 1:56 (Viagra) ...
AddingPages 1:02 (Dinah Ferrell) ...
CommentPlugin 0:08 (Viagra) ...
CommentPlugin 22:56 (Viagra) ...
CommentPlugin 22:38 (Viagra) ...
CommentPlugin 21:36 (Viagra) ...
CommentPlugin 21:15 (Levitra) ...
AddingPages 20:25 (Kecia Wiggins) ...
CommentPlugin 20:07 (Levitra) ...
CommentPlugin 19:56 (Viagra) ...
CommentPlugin 19:27 (Viagra) ...
CommentPlugin 18:51 (Viagra) ...
CommentPlugin 17:42 (Levitra) ...
CommentPlugin 17:28 (Viagra) ...
CommentPlugin 17:17 (Viagra) ...
AddingPages 16:32 (Trudy Chen) ...
CommentPlugin 16:25 (Viagra) ...
CommentPlugin 16:01 (Levitra) ...
CommentPlugin 15:42 (Levitra) ...
CommentPlugin 14:52 (Viagra) ...
CommentPlugin 14:47 (Viagra) ...
CommentPlugin 13:59 (Viagra) ...
AddingPages 13:23 (tpweeiue) ...
CommentPlugin 12:14 (Viagra) ...
CommentPlugin 11:47 (Viagra) ...
AddingPages 11:31 (Dell Price) ...
CommentPlugin 11:19 (Viagra) ...
CommentPlugin 10:38 (Viagra) ...
CommentPlugin 10:32 (Viagra) ...
CommentPlugin 10:30 (Viagra) ...
CommentPlugin 8:21 (Viagra) ...
CommentPlugin 8:07 (Levitra) ...
CommentPlugin 5:45 (Levitra) ...
CommentPlugin 5:21 (Viagra) ...
CommentPlugin 4:57 (Viagra) ...
CommentPlugin 4:44 (Viagra) ...
CommentPlugin 4:18 (Viagra) ...
CommentPlugin 3:39 (Viagra) ...
CommentPlugin 3:31 (Viagra) ...
CommentPlugin 3:14 (Levitra) ...
CommentPlugin 2:21 (Levitra) ...
CommentPlugin 2:17 (Levitra) ...
CommentPlugin 1:49 (Viagra) ...
CommentPlugin 23:46 (Levitra) ...
CommentPlugin 21:07 (Viagra) ...
CommentPlugin 20:54 (Viagra) ...
CommentPlugin 20:44 (Viagra) ...
CommentPlugin 20:32 (Viagra) ...
CommentPlugin 18:57 (Viagra) ...
RecentChangesPlugin 15:31 (upwrweiy) ...
CommentPlugin 14:21 (Viagra) ...
CommentPlugin 13:58 (Viagra) ...
CommentPlugin 13:56 (Viagra) ...
CommentPlugin 10:34 (Viagra) ...
CommentPlugin 9:51 (Viagra) ...
CommentPlugin 9:28 (Viagra) ...
CommentPlugin 7:44 (Viagra) ...
CommentPlugin 5:54 (Levitra) ...
CommentPlugin 5:43 (Viagra) ...
CommentPlugin 5:12 (Levitra) ...
CommentPlugin 4:32 (Levitra) ...
CommentPlugin 0:57 (Viagra) ...
CommentPlugin 21:30 (Viagra) ...
CommentPlugin 21:26 (Levitra) ...
CommentPlugin 20:46 (Levitra) ...
AddingPages 19:52 (Peter Lynch) ...
CommentPlugin 18:49 (Viagra) ...
CommentPlugin 17:16 (Viagra) ...
CommentPlugin 16:43 (Viagra) ...
AddingPages 16:35 (ytwrutte) ...
CommentPlugin 16:22 (Viagra) ...
AddingPages 14:41 (Aimee Osborn) ...
CommentPlugin 12:13 (Levitra) ...
CommentPlugin 11:34 (Viagra) ...
AddingPages 11:28 (Benny Hayden) ...
CommentPlugin 10:00 (Levitra) ...
CommentPlugin 8:30 (Viagra) ...
CommentPlugin 8:23 (Viagra) ...
CommentPlugin 8:18 (Viagra) ...
CommentPlugin 7:25 (Viagra) ...
AddingPages 7:08 (Ed Weaver) ...
CommentPlugin 6:46 (Viagra) ...
CommentPlugin 5:54 (Viagra) ...
CommentPlugin 5:47 (Levitra) ...
CommentPlugin 5:40 (Viagra) ...
CommentPlugin 5:25 (Viagra) ...
CommentPlugin 5:01 (Viagra) ...
CommentPlugin 4:15 (Levitra) ...
CommentPlugin 4:08 (Viagra) ...
CommentPlugin 4:05 (Viagra) ...
CommentPlugin 4:03 (Levitra) ...
AddingPages 2:34 (Benton Buckley) ...
CommentPlugin 2:23 (Levitra) ...
CommentPlugin 1:29 (Viagra) ...
CommentPlugin 1:00 (Viagra) ...
CommentPlugin 0:52 (Viagra) ...
AddingPages 22:48 (Kendra Ryan) ...
CommentPlugin 22:12 (Viagra) ...
CommentPlugin 21:48 (Viagra) ...
CommentPlugin 20:31 (Viagra) ...
AddingPages 18:46 (Wilford Glass) ...
CommentPlugin 18:41 (Levitra) ...
CommentPlugin 18:26 (Viagra) ...
CommentPlugin 18:18 (Viagra) ...
CommentPlugin 18:00 (Levitra) ...
CommentPlugin 17:58 (Viagra) ...
CommentPlugin 17:02 (Viagra) ...
CommentPlugin 16:51 (Viagra) ...
CommentPlugin 16:38 (Viagra) ...
CommentPlugin 16:34 (Levitra) ...
CommentPlugin 16:07 (Viagra) ...
AddingPages 14:02 (David Huff) ...
CommentPlugin 11:29 (Viagra) ...
CommentPlugin 11:08 (Viagra) ...
CommentPlugin 10:52 (Viagra) ...
AddingPages 10:49 (Rosemary Mcdaniel) ...
CommentPlugin 10:00 (Viagra) ...
CommentPlugin 9:41 (Viagra) ...
CommentPlugin 9:25 (Viagra) ...
CommentPlugin 8:33 (Viagra) ...
CommentPlugin 6:49 (Viagra) ...
CommentPlugin 6:43 (Viagra) ...
AddingPages 5:44 (Michael Morton) ...
CommentPlugin 4:25 (Viagra) ...
CommentPlugin 3:40 (Viagra) ...
CommentPlugin 3:23 (Levitra) ...
CommentPlugin 3:09 (Viagra) ...
AddingPages 2:18 (Darry Monroe) ...
CommentPlugin 1:35 (Viagra) ...
CommentPlugin 1:27 (Viagra) ...
CommentPlugin 1:16 (Levitra) ...
CommentPlugin 1:10 (Viagra) ...
CommentPlugin 0:40 (Viagra) ...
CommentPlugin 23:54 (Levitra) ...
CommentPlugin 23:13 (Levitra) ...
CommentPlugin 22:54 (Viagra) ...
AddingPages 21:14 (Claire Pitts) ...
CommentPlugin 20:36 (Viagra) ...
CommentPlugin 17:20 (Viagra) ...
AddingPages 17:06 (Lydia Cotton) ...
CommentPlugin 13:47 (Viagra) ...
AddingPages 13:30 (Lourdes Wilkinson) ...
CommentPlugin 10:47 (Viagra) ...
CommentPlugin 10:43 (Viagra) ...
CommentPlugin 10:41 (Viagra) ...
CommentPlugin 10:26 (Viagra) ...
CommentPlugin 10:25 (Viagra) ...
CommentPlugin 7:02 (Viagra) ...
CommentPlugin 6:02 (Viagra) ...
CommentPlugin 5:37 (Viagra) ...
CommentPlugin 4:17 (Viagra) ...
CommentPlugin 1:47 (Levitra) ...
CommentPlugin 1:31 (Levitra) ...
CommentPlugin 1:29 (Levitra) ...
CommentPlugin 23:44 (Viagra) ...
CommentPlugin 22:53 (Viagra) ...
CommentPlugin 21:07 (Levitra) ...
CommentPlugin 17:04 (Viagra) ...
CommentPlugin 16:24 (Viagra) ...
CommentPlugin 16:15 (Viagra) ...
CommentPlugin 16:10 (Viagra) ...
CommentPlugin 13:43 (Viagra) ...
CommentPlugin 13:09 (Viagra) ...
CommentPlugin 13:03 (Viagra) ...
CommentPlugin 13:01 (Viagra) ...
CommentPlugin 12:16 (Viagra) ...
CommentPlugin 10:49 (Viagra) ...
CommentPlugin 10:36 (Viagra) ...
CommentPlugin 9:14 (Viagra) ...
CommentPlugin 9:12 (Viagra) ...
CommentPlugin 8:10 (Levitra) ...
CommentPlugin 8:05 (Viagra) ...
CommentPlugin 7:54 (Viagra) ...
CommentPlugin 7:33 (Viagra) ...
CommentPlugin 6:47 (Viagra) ...
CommentPlugin 5:11 (Viagra) ...
CommentPlugin 3:28 (Levitra) ...
CommentPlugin 2:57 (Viagra) ...
CommentPlugin 2:45 (Viagra) ...
CommentPlugin 2:28 (Levitra) ...
CommentPlugin 2:20 (Viagra) ...
CommentPlugin 2:11 (Viagra) ...
CommentPlugin 1:51 (Viagra) ...
CommentPlugin 1:18 (Viagra) ...
CommentPlugin 1:12 (Viagra) ...
CommentPlugin 0:45 (Viagra) ...
CommentPlugin 22:16 (Viagra) ...
CommentPlugin 22:11 (Viagra) ...
CommentPlugin 19:01 (Levitra) ...
CommentPlugin 17:35 (Viagra) ...
CommentPlugin 17:30 (Viagra) ...
CommentPlugin 17:25 (Levitra) ...
CommentPlugin 17:21 (Viagra) ...
CommentPlugin 17:01 (Viagra) ...
CommentPlugin 13:45 (Levitra) ...
CommentPlugin 13:08 (Viagra) ...
CommentPlugin 11:36 (Viagra) ...
CommentPlugin 11:28 (Viagra) ...
CommentPlugin 10:03 (Viagra) ...
CommentPlugin 9:06 (Viagra) ...
CommentPlugin 8:25 (Levitra) ...
CommentPlugin 7:13 (Viagra) ...
CommentPlugin 4:33 (Viagra) ...
CommentPlugin 3:41 (Viagra) ...
CommentPlugin 2:55 (Levitra) ...
CommentPlugin 2:04 (Viagra) ...
CommentPlugin 1:37 (Viagra) ...
CommentPlugin 1:11 (Viagra) ...
CommentPlugin 0:02 (Viagra) ...
CommentPlugin 23:21 (Viagra) ...
CommentPlugin 22:32 (Viagra) ...
CommentPlugin 21:35 (Viagra) ...
CommentPlugin 20:55 (Viagra) ...
CommentPlugin 17:07 (Viagra) ...
CommentPlugin 16:55 (Viagra) ...
CommentPlugin 16:03 (Viagra) ...
AddingPages 15:22 (Donna Townsend) ...
CommentPlugin 15:20 (Viagra) ...
CommentPlugin 14:02 (Levitra) ...
CommentPlugin 12:19 (Viagra) ...
CommentPlugin 12:13 (Viagra) ...
AddingPages 10:50 (Marisol Nielsen) ...
CommentPlugin 8:53 (Viagra) ...
CommentPlugin 7:36 (Viagra) ...
CommentPlugin 7:18 (Viagra) ...
AddingPages 7:17 (Francis Blackwell) ...
CommentPlugin 4:23 (Viagra) ...
CommentPlugin 3:54 (Viagra) ...
AddingPages 3:20 (Fonda Burris) ...
CommentPlugin 2:33 (Levitra) ...
CommentPlugin 2:31 (Viagra) ...
CommentPlugin 1:43 (Viagra) ...
CommentPlugin 0:32 (Viagra) ...
CommentPlugin 0:29 (Levitra) ...
CommentPlugin 23:18 (Levitra) ...
CommentPlugin 23:12 (Viagra) ...
CommentPlugin 23:08 (Viagra) ...
AddingPages 22:48 (Sondra Pennington) ...
CommentPlugin 21:57 (Viagra) ...
CommentPlugin 21:28 (Viagra) ...
CommentPlugin 21:06 (Viagra) ...
CommentPlugin 20:13 (Viagra) ...
CommentPlugin 19:38 (Viagra) ...
CommentPlugin 19:24 (Viagra) ...
CommentPlugin 18:56 (Viagra) ...
CommentPlugin 18:17 (Viagra) ...
CommentPlugin 15:49 (Viagra) ...
CommentPlugin 15:27 (Levitra) ...
CommentPlugin 14:31 (Viagra) ...
CommentPlugin 14:23 (Viagra) ...
CommentPlugin 12:27 (Levitra) ...
CommentPlugin 11:37 (Viagra) ...
CommentPlugin 11:35 (Viagra) ...
CommentPlugin 8:34 (Levitra) ...
CommentPlugin 8:07 (Viagra) ...
CommentPlugin 8:03 (Viagra) ...
CommentPlugin 7:58 (Viagra) ...
CommentPlugin 4:46 (Levitra) ...
CommentPlugin 0:53 (Viagra) ...
CommentPlugin 22:39 (Viagra) ...
CommentPlugin 22:37 (Levitra) ...
CommentPlugin 22:29 (Viagra) ...
CommentPlugin 19:03 (Levitra) ...
CommentPlugin 16:37 (Viagra) ...
CommentPlugin 14:56 (Levitra) ...
CommentPlugin 13:30 (Viagra) ...
CommentPlugin 11:43 (Levitra) ...
CommentPlugin 10:46 (Viagra) ...
CommentPlugin 10:23 (Viagra) ...
CommentPlugin 10:22 (Viagra) ...
AddingPages 8:01 (Brock Dickson) ...
CommentPlugin 7:38 (Levitra) ...
CommentPlugin 7:00 (Viagra) ...
AddingPages 6:47 (tipiiipw) ...
CommentPlugin 5:03 (Cialis) ...
CommentPlugin 4:43 (Levitra) ...
CommentPlugin 4:14 (Viagra) ...
CommentPlugin 4:00 (Viagra) ...
AddingPages 2:44 (Oscar Hanson) ...
CommentPlugin 1:24 (Cialis) ...
CommentPlugin 1:00 (Levitra) ...
CommentPlugin 0:41 (Viagra) ...
CommentPlugin 0:30 (Viagra) ...
CommentPlugin 0:29 (Viagra) ...
CommentPlugin 22:44 (Cialis) ...
CommentPlugin 22:21 (Levitra) ...
CommentPlugin 22:04 (Viagra) ...
CommentPlugin 22:00 (Viagra) ...
AddingPages 20:52 (Florence Beard) ...
CommentPlugin 18:45 (Viagra) ...
CommentPlugin 18:09 (Levitra) ...
CommentPlugin 17:10 (Viagra) ...
CommentPlugin 16:41 (Viagra) ...
CommentPlugin 16:33 (Viagra) ...
CommentPlugin 14:32 (Levitra) ...
AddingPages 14:25 (Tricia Jimenez) ...
CommentPlugin 13:55 (Viagra) ...
CommentPlugin 13:26 (Viagra) ...
CommentPlugin 13:23 (Viagra) ...
CommentPlugin 13:20 (Viagra) ...
CommentPlugin 11:05 (Viagra) ...
CommentPlugin 10:42 (Viagra) ...
CommentPlugin 10:39 (Viagra) ...
AddingPages 9:35 (Shelia Deleon) ...
CommentPlugin 8:32 (Viagra) ...
CommentPlugin 8:20 (Levitra) ...
CommentPlugin 7:43 (Viagra) ...
CommentPlugin 7:41 (Viagra) ...
CommentPlugin 7:40 (Viagra) ...
CommentPlugin 7:39 (Viagra) ...
CommentPlugin 5:36 (Viagra) ...
CommentPlugin 5:33 (Levitra) ...
CommentPlugin 5:15 (Viagra) ...
AddingPages 4:26 (Claude Rojas) ...
CommentPlugin 2:19 (Viagra) ...
CommentPlugin 2:08 (Viagra) ...
CommentPlugin 2:07 (Viagra) ...
CommentPlugin 23:57 (Levitra) ...
CommentPlugin 23:52 (Viagra) ...
CommentPlugin 23:43 (Viagra) ...
CommentPlugin 23:39 (Viagra) ...
CommentPlugin 23:38 (Viagra) ...
CommentPlugin 23:37 (Viagra) ...
CommentPlugin 23:36 (Viagra) ...
AddingPages 22:52 (Valarie Cain) ...
CommentPlugin 14:37 (Levitra) ...
CommentPlugin 14:14 (Viagra) ...
CommentPlugin 13:51 (Viagra) ...
CommentPlugin 8:31 (Levitra) ...
CommentPlugin 8:16 (Viagra) ...
CommentPlugin 7:56 (Viagra) ...
CommentPlugin 3:00 (Levitra) ...
CommentPlugin 2:56 (Viagra) ...
CommentPlugin 2:49 (Viagra) ...
CommentPlugin 2:44 (Viagra) ...
CommentPlugin 22:41 (Levitra) ...
CommentPlugin 20:52 (Viagra) ...
CommentPlugin 20:35 (Viagra) ...
CommentPlugin 20:33 (Viagra) ...
CommentPlugin 17:06 (Levitra) ...
CommentPlugin 16:56 (Viagra) ...
CommentPlugin 15:59 (Viagra) ...
CommentPlugin 15:45 (Viagra) ...
CommentPlugin 15:44 (Viagra) ...
CommentPlugin 11:32 (Viagra) ...
CommentPlugin 11:31 (Levitra) ...
CommentPlugin 8:19 (Levitra) ...
CommentPlugin 6:26 (Viagra) ...
CommentPlugin 6:26 (Levitra) ...
CommentPlugin 6:11 (Viagra) ...
CommentPlugin 6:10 (Viagra) ...
CommentPlugin 6:07 (Viagra) ...
CommentPlugin 3:04 (Levitra) ...
CommentPlugin 1:47 (Viagra) ...
CommentPlugin 1:45 (Levitra) ...
CommentPlugin 1:41 (Viagra) ...
CommentPlugin 1:40 (Viagra) ...
CommentPlugin 1:38 (Viagra) ...
CommentPlugin 1:36 (Viagra) ...
CommentPlugin 23:42 (Viagra) ...
CommentPlugin 21:55 (Levitra) ...
CommentPlugin 20:27 (Cialis) ...
CommentPlugin 20:15 (Viagra) ...
CommentPlugin 19:22 (Viagra) ...
CommentPlugin 19:12 (Viagra) ...
CommentPlugin 19:11 (Viagra) ...
CommentPlugin 19:06 (Viagra) ...
CommentPlugin 16:35 (Levitra) ...
CommentPlugin 15:32 (Cialis) ...
CommentPlugin 15:16 (Viagra) ...
CommentPlugin 14:33 (Viagra) ...
CommentPlugin 14:29 (Viagra) ...
CommentPlugin 14:26 (Viagra) ...
CommentPlugin 10:50 (Levitra) ...
CommentPlugin 10:20 (Cialis) ...
CommentPlugin 10:06 (Viagra) ...
CommentPlugin 9:47 (Viagra) ...
CommentPlugin 9:45 (Viagra) ...
CommentPlugin 5:29 (Levitra) ...
CommentPlugin 5:21 (Cialis) ...
CommentPlugin 5:09 (Viagra) ...
CommentPlugin 5:08 (Viagra) ...
CommentPlugin 5:07 (Viagra) ...
CommentPlugin 5:05 (Viagra) ...
AddingPages 1:35 (reeupore) ...
AddingPages 23:21 (iyioiyor) ...
CommentPlugin 4:06 (Viagra) ...
CommentPlugin 3:23 (Viagra) ...
CommentPlugin 3:12 (Viagra) ...
CommentPlugin 3:07 (Viagra) ...
AddingPages 1:19 (ywrtutyy) ...
CommentPlugin 16:14 (Levitra) ...
CommentPlugin 14:06 (Cialis) ...
CommentPlugin 13:59 (Levitra) ...
CommentPlugin 13:38 (Viagra) ...
CommentPlugin 13:05 (Viagra) ...
CommentPlugin 12:10 (Cialis) ...
CommentPlugin 11:21 (Viagra) ...
CommentPlugin 11:17 (Viagra) ...
CommentPlugin 21:53 (Cialis) ...
CommentPlugin 21:50 (Viagra) ...
CommentPlugin 21:46 (Viagra) ...
CommentPlugin 21:40 (Viagra) ...
AddingPages 19:34 (Blanca King) ...
CommentPlugin 10:31 (Cialis) ...
CommentPlugin 9:50 (Levitra) ...
CommentPlugin 9:13 (Viagra) ...
CommentPlugin 8:54 (Viagra) ...
CommentPlugin 8:45 (Cialis) ...
CommentPlugin 7:30 (Viagra) ...
CommentPlugin 7:14 (Viagra) ...
CommentPlugin 7:12 (Viagra) ...
CommentPlugin 17:47 (Levitra) ...
CommentPlugin 17:45 (Cialis) ...
CommentPlugin 17:40 (Viagra) ...
CommentPlugin 17:34 (Viagra) ...
CommentPlugin 17:33 (Viagra) ...
CommentPlugin 10:42 (Levitra) ...
CommentPlugin 9:00 (Cialis) ...
CommentPlugin 8:57 (Viagra) ...
CommentPlugin 8:42 (Viagra) ...
CommentPlugin 6:17 (Levitra) ...
CommentPlugin 5:02 (Viagra) ...
CommentPlugin 4:59 (Cialis) ...
CommentPlugin 4:50 (Viagra) ...
CommentPlugin 4:49 (Viagra) ...
CommentPlugin 4:40 (Viagra) ...
CommentPlugin 4:35 (Viagra) ...
CommentPlugin 9:30 (Levitra) ...
AddingPages 8:50 (ywooioiw) ...
CommentPlugin 8:22 (Cialis) ...
CommentPlugin 5:20 (Levitra) ...
CommentPlugin 4:24 (Cialis) ...
CommentPlugin 3:55 (Viagra) ...
AddingPages 18:47 (uttyyyiw) ...
CommentPlugin 17:51 (Cialis) ...
CommentPlugin 17:00 (Viagra) ...
CommentPlugin 16:48 (Viagra) ...
CommentPlugin 15:56 (Viagra) ...
CommentPlugin 4:35 (Levitra) ...
CommentPlugin 3:55 (Cialis) ...
CommentPlugin 2:50 (Viagra) ...
CommentPlugin 0:24 (Levitra) ...
CommentPlugin 23:44 (Cialis) ...
CommentPlugin 23:27 (Viagra) ...
CommentPlugin 22:24 (Viagra) ...
CommentPlugin 22:16 (Cialis) ...
CommentPlugin 22:15 (Cialis) ...
CommentPlugin 22:14 (Viagra) ...
CommentPlugin 22:10 (Viagra) ...
CommentPlugin 22:08 (Cialis) ...
CommentPlugin 18:15 (Viagra) ...
CommentPlugin 18:03 (Cialis) ...
CommentPlugin 18:02 (Viagra) ...
CommentPlugin 17:56 (Cialis) ...
CommentPlugin 6:06 (Cialis) ...
CommentPlugin 6:03 (Viagra) ...
CommentPlugin 6:01 (Cialis) ...
CommentPlugin 6:01 (Viagra) ...
CommentPlugin 5:20 (Viagra) ...
CommentPlugin 5:10 (Cialis) ...
CommentPlugin 2:09 (Levitra) ...
CommentPlugin 2:03 (Cialis) ...
CommentPlugin 2:02 (Cialis) ...
CommentPlugin 2:00 (Cialis) ...
CommentPlugin 2:00 (Viagra) ...
CommentPlugin 1:59 (Viagra) ...
CommentPlugin 1:58 (Cialis) ...
CommentPlugin 1:32 (Viagra) ...
CommentPlugin 1:17 (Cialis) ...
CommentPlugin 7:18 (Cialis) ...
CommentPlugin 6:52 (Cialis) ...
CommentPlugin 6:47 (Cialis) ...
CommentPlugin 6:35 (Cialis) ...
CommentPlugin 5:58 (Viagra) ...
CommentPlugin 3:10 (Cialis) ...
CommentPlugin 2:54 (Levitra) ...
CommentPlugin 2:46 (Cialis) ...
CommentPlugin 2:45 (Cialis) ...
CommentPlugin 2:36 (Cialis) ...
CommentPlugin 2:14 (Viagra) ...
CommentPlugin 2:10 (Viagra) ...
CommentPlugin 2:10 (Cialis) ...
RecentChangesCachedPlugin 17:50 (ueyiiirr) ...
RecentChangesCachedPlugin 17:50 (iwpypwut) ...
RecentChangesCachedPlugin 17:50 (otwroyew) ...
RecentChangesCachedPlugin 17:50 (irooporw) ...
RecentChangesCachedPlugin 17:50 (wtipproe) ...
CommentPlugin 7:14 (Levitra) ...
CommentPlugin 7:14 (Cialis) ...
CommentPlugin 7:09 (Viagra) ...
CommentPlugin 7:05 (Cialis) ...
CommentPlugin 6:50 (Cialis) ...
CommentPlugin 6:08 (Cialis) ...
CommentPlugin 6:08 (Viagra) ...
CommentPlugin 6:04 (Viagra) ...
CommentPlugin 3:06 (Cialis) ...
CommentPlugin 2:43 (Cialis) ...
CommentPlugin 2:12 (Cialis) ...
CommentPlugin 2:12 (Viagra) ...
CommentPlugin 21:14 (Sharla Larsen) ...
CommentPlugin 8:51 (Viagra) ...
CommentPlugin 8:42 (Cialis) ...
CommentPlugin 8:39 (Cialis) ...
CommentPlugin 8:11 (Viagra) ...
CommentPlugin 8:00 (Cialis) ...
CommentPlugin 7:53 (Viagra) ...
CommentPlugin 4:31 (Cialis) ...
CommentPlugin 4:22 (Cialis) ...
CommentPlugin 3:59 (Viagra) ...
CommentPlugin 3:56 (Cialis) ...
CommentPlugin 17:50 (Levitra) ...
CommentPlugin 17:23 (Cialis) ...
CommentPlugin 17:15 (Viagra) ...
CommentPlugin 17:11 (Cialis) ...
CommentPlugin 17:05 (Cialis) ...
CommentPlugin 17:01 (Cialis) ...
CommentPlugin 16:20 (Viagra) ...
CommentPlugin 15:42 (Cialis) ...
CommentPlugin 5:57 (Cialis) ...
CommentPlugin 5:52 (Cialis) ...
CommentPlugin 5:50 (Cialis) ...
CommentPlugin 5:02 (Cialis) ...
AddingPages 4:27 (weroiyuo) ...
RecentChangesCachedPlugin 4:11 (urtetiop) ...
AddingPages 2:12 (ewwwriur) ...
CommentPlugin 1:52 (Viagra) ...
CommentPlugin 1:50 (Cialis) ...
CommentPlugin 1:45 (Cialis) ...
CommentPlugin 1:44 (Cialis) ...
CommentPlugin 1:07 (Cialis) ...
RecentEditsPlugin 23:09 (ortiirut) ...
RecentEditsPlugin 23:06 (iytuwwwi) ...
CommentPlugin 20:17 (ypwwrpyp) ...
CommentPlugin 16:23 (Levitra) ...
CommentPlugin 16:11 (Cialis) ...
CommentPlugin 16:06 (Cialis) ...
CommentPlugin 15:41 (Viagra) ...
CommentPlugin 15:17 (Cialis) ...
CommentPlugin 15:08 (Cialis) ...
CommentPlugin 15:08 (Viagra) ...
CommentPlugin 14:54 (Viagra) ...
CommentPlugin 5:27 (Cialis) ...
CommentPlugin 5:17 (Viagra) ...
CommentPlugin 5:16 (Cialis) ...
CommentPlugin 5:07 (Cialis) ...
CommentPlugin 5:06 (Cialis) ...
CommentPlugin 4:25 (Cialis) ...
CommentPlugin 4:21 (Cialis) ...
CommentPlugin 1:16 (Cialis) ...
CommentPlugin 1:07 (Levitra) ...
CommentPlugin 1:06 (Viagra) ...
CommentPlugin 1:01 (Cialis) ...
CommentPlugin 1:00 (Cialis) ...
CommentPlugin 0:59 (Cialis) ...
CommentPlugin 0:58 (Viagra) ...
CommentPlugin 0:46 (Cialis) ...
CommentPlugin 0:26 (Cialis) ...
CommentPlugin 0:25 (Viagra) ...
CommentPlugin 0:24 (Cialis) ...
CommentPlugin 15:54 (Cialis) ...
CommentPlugin 15:43 (Viagra) ...
CommentPlugin 14:49 (Viagra) ...
CommentPlugin 14:46 (Viagra) ...
CommentPlugin 14:19 (Cialis) ...
CommentPlugin 4:51 (Cialis) ...
CommentPlugin 4:47 (Cialis) ...
CommentPlugin 4:41 (Cialis) ...
CommentPlugin 4:40 (Cialis) ...
CommentPlugin 4:40 (Levitra) ...
CommentPlugin 4:34 (Cialis) ...
CommentPlugin 4:20 (Viagra) ...
CommentPlugin 4:15 (Viagra) ...
CommentPlugin 4:13 (Cialis) ...
CommentPlugin 3:57 (Cialis) ...
CommentPlugin 0:40 (Cialis) ...
CommentPlugin 0:34 (Cialis) ...
CommentPlugin 0:34 (Viagra) ...
CommentPlugin 0:28 (Cialis) ...
CommentPlugin 0:27 (Cialis) ...
CommentPlugin 0:19 (Cialis) ...
CommentPlugin 0:09 (Cialis) ...
CommentPlugin 14:55 (Levitra) ...
CommentPlugin 14:48 (Cialis) ...
CommentPlugin 14:18 (Cialis) ...
CommentPlugin 13:58 (Cialis) ...
CommentPlugin 13:48 (Viagra) ...
CommentPlugin 13:22 (Viagra) ...
CommentPlugin 13:19 (Viagra) ...
CommentPlugin 13:17 (Cialis) ...
CommentPlugin 11:04 (Cialis) ...
Metoprolol-Hydrochlorothiazide) ...
CommentPlugin 4:19 (Viagra) ...
CommentPlugin 4:13 (Viagra) ...
CommentPlugin 4:12 (Cialis) ...
CommentPlugin 4:10 (Levitra) ...
CommentPlugin 4:00 (Cialis) ...
CommentPlugin 3:42 (Cialis) ...
CommentPlugin 3:35 (Cialis) ...
CommentPlugin 3:34 (Viagra) ...
CommentPlugin 3:30 (Cialis) ...
Acetaminophen-Caff-Pyrilamine) ...
CommentPlugin 0:14 (Viagra) ...
CommentPlugin 0:00 (Cialis) ...
CommentPlugin 23:58 (Viagra) ...
CommentPlugin 23:52 (Levitra) ...
CommentPlugin 23:45 (Cialis) ...
CommentPlugin 23:31 (Viagra) ...
CommentPlugin 23:30 (Cialis) ...
CommentPlugin 23:29 (Cialis) ...
CommentPlugin 23:28 (Viagra) ...
CommentPlugin 23:26 (Cialis) ...
CommentPlugin 12:12 (Cialis) ...
CommentPlugin 12:03 (Levitra) ...
CommentPlugin 11:59 (Viagra) ...
CommentPlugin 11:53 (Cialis) ...
CommentPlugin 11:51 (Cialis) ...
CommentPlugin 11:47 (Cialis) ...
CommentPlugin 11:31 (Viagra) ...
CommentPlugin 10:59 (Cialis) ...
CommentPlugin 10:54 (Cialis) ...
CommentPlugin 2:06 (Cialis) ...
CommentPlugin 2:02 (Levitra) ...
CommentPlugin 1:54 (Cialis) ...
CommentPlugin 1:53 (Viagra) ...
CommentPlugin 1:46 (Viagra) ...
CommentPlugin 1:39 (Cialis) ...
CommentPlugin 1:35 (Cialis) ...
CommentPlugin 1:26 (Cialis) ...
CommentPlugin 1:25 (Viagra) ...
CommentPlugin 21:52 (Levitra) ...
CommentPlugin 21:50 (Cialis) ...
CommentPlugin 21:39 (Cialis) ...
CommentPlugin 21:37 (Cialis) ...
CommentPlugin 21:32 (Cialis) ...
CommentPlugin 21:30 (Cialis) ...
CommentPlugin 21:15 (Cialis) ...
CommentPlugin 5:13 (Levitra) ...
CommentPlugin 4:38 (Cialis) ...
CommentPlugin 4:10 (Cialis) ...
AddingPages 3:00 (oyupwrty) ...
CommentPlugin 23:28 (Cialis) ...
CommentPlugin 23:24 (Cialis) ...
CommentPlugin 23:20 (Viagra) ...
CommentPlugin 23:13 (Cialis) ...
CommentPlugin 23:11 (Viagra) ...
CommentPlugin 23:03 (Cialis) ...
CommentPlugin 23:02 (Viagra) ...
CommentPlugin 9:22 (Cialis) ...
CommentPlugin 9:19 (Cialis) ...
CommentPlugin 9:09 (Cialis) ...
CommentPlugin 8:46 (Viagra) ...
CommentPlugin 8:34 (Viagra) ...
CommentPlugin 5:34 (Viagra) ...
CommentPlugin 5:17 (Cialis) ...
CommentPlugin 5:09 (Levitra) ...
CommentPlugin 4:58 (Cialis) ...
CommentPlugin 4:55 (Cialis) ...
CommentPlugin 4:39 (Viagra) ...
CommentPlugin 20:18 (Levitra) ...
CommentPlugin 20:09 (Cialis) ...
CommentPlugin 20:01 (Cialis) ...
CommentPlugin 19:47 (Cialis) ...
CommentPlugin 19:36 (Cialis) ...
CommentPlugin 19:32 (Cialis) ...
CommentPlugin 18:34 (Cialis) ...
CommentPlugin 18:24 (Viagra) ...
CommentPlugin 15:40 (Cialis) ...
CommentPlugin 15:39 (Levitra) ...
CommentPlugin 15:22 (Cialis) ...
CommentPlugin 15:11 (Cialis) ...
CommentPlugin 15:07 (Cialis) ...
CommentPlugin 14:57 (Cialis) ...
CommentPlugin 14:03 (Viagra) ...
CommentPlugin 14:03 (Cialis) ...
CommentPlugin 5:51 (Levitra) ...
CommentPlugin 5:47 (Cialis) ...
CommentPlugin 5:40 (Cialis) ...
CommentPlugin 5:35 (Cialis) ...
CommentPlugin 5:28 (Cialis) ...
CommentPlugin 5:23 (Cialis) ...
CommentPlugin 4:48 (Cialis) ...
CommentPlugin 1:30 (Cialis) ...
CommentPlugin 1:19 (Levitra) ...
CommentPlugin 1:18 (Cialis) ...
CommentPlugin 1:06 (Cialis) ...
CommentPlugin 1:05 (Cialis) ...
CommentPlugin 0:55 (Cialis) ...
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OSELTAMIVIR is an antiviral medication that blocks the actions of influenza virus types A and B in your body.
It is used to prevent and to treat some kinds of influenza or the flu.
It will not treat the common cold.
Start taking it at the first sign of flu symptoms.
If it upsets your stomach, take it with food.
To clear up your infection completely, take the medicine for the full course of treatment.
Keep taking it even if you feel better in a few days.
To treat flu symptoms: take oseltamivir every 12 hours for 5 days.
To prevent flu symptoms: take oseltamivir every 24 hours for 10 days or as prescribed.
While this drug may be prescribed for children as young as 1 year old for selected conditions, precautions do apply.
Do not use a nasal flu vaccine (FluMist) within 48 hours after taking oseltamivir.
What should I watch for while taking this medicine?
Tell your doctor if your symptoms do not start to get better or if they get worse.
If you have the flu, you may be at an increased risk of developing seizures, confusion, or abnormal behavior.
This occurs early in the illness, and more frequently in children and teens.
These events are not common, but may result in accidental injury to the patient.
Families and caregivers of patients should watch for signs of unusual behavior and contact a doctor or health care professional right away if the patient shows signs of unusual behavior.
This medicine is not a substitute for the flu shot.
Talk to your doctor each year about an annual flu shot.
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CYCLOSPORINE is used to decrease the immune system's response to a transplanted organ.
The medicine (Neoral only) is also used for rheumatoid arthritis and psoriasis.
They need to know if you have any of these conditions:cancer high blood pressure immune system problems infection kidney disease liver disease previous coal tar, PUVA, ultraviolet, or radiation therapy an unusual or allergic reaction to cyclosporine, alcohol, corn oil (Neoral only), castor oil (Neoral only), other medicines, foods, dyes, or preservatives pregnant or trying to get pregnant breast feedingHow should I use this medicine?
Use the dosing syringe provided to measure your dose.
For the Sandimmune brand, mix your dose in milk, chocolate milk, or orange juice (at room temperature).
If you are taking any other brand of cyclosporine, mix the measured dose in a glass of orange or apple juice that is at room temperature.
Do not use grapefruit juice or milk.
Mix in a glass container (not plastic) and stir well just before taking.
Rinse the glass with more liquid and swallow to make sure you get all the dose.
Try to mix with the same diluent for each dose.
This will help you keep a constant amount of cyclosporine in your body.
After use, dry the outside of the dosing syringe with a clean towel.
Do not rinse with water or any other cleaning agent.
The dosing syringe must be dry before use.
Take it at the same time each day and at the same time in relation to meals.
While this drug may be prescribed for children as young as 1 year for selected conditions (Neoral) and for children as young as 6 months for selected conditions (Sandimmune), precautions do apply.
Patients over 65 years old may have a stronger reaction and need a smaller dose.
Call your doctor or health care professional if you miss more than one dose or if you miss doses on a regular basis.
Do not take this medicine with any of the following:bosentan cidofovir cisapride mibefradil ranolazine red yeast rice, monascus purpureus St.
B, fluconazole, itraconazole, terbinafine, and ketoconazole medicines for blood pressure like diltiazem, nicardipine, verapamil, enalapril, ramipril, and losartan medicines for cholesterol like lovastatin, simvastatin, atorvastatin, and fenofibrate medicines for HIV infection like indinavir, nelfinavir, ritonavir, and saquinavir medicines that suppress the immune system melphalan methotrexate metoclopramide NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen octreotide orlistat oxcarbazepine phenobarbital phenytoin ranitidine sirolimus spironolactone steroid medicines like prednisone or cortisone sulfinpyrazone ticlopidine triamterene vaccines voriconazoleThis list may not describe all possible interactions.
Side effects that you should report to your doctor or health care professional as soon as possible:allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue changes in vision high blood pressure increased urge to urinate or frequent urination numbness or tingling in the hands and feet seizures severe stomach pain vomiting yellowing of the eyes or skin Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):bleeding or tender gums, overgrowth of gum tissue diarrhea excessive hair growth on the face or body nausea tremorsThis list may not describe all possible side effects.
Alcohol may interfere with the effect of this medicine.
You will have regular blood checks.
Do not change the brand of medicine unless directed by your doctor or health care professional.
If you get a cold or other infection while taking this medicine, call your doctor or health care professional.
The medicine may decrease your body's ability to fight infections.
The medicine can cause unusual growth of gum tissue and can make your gums bleed.
Practice good oral hygiene, and be careful when brushing and flossing your teeth.
Store Neoral at room temperature between 20 and 25 degrees C (68 and 77 degrees F).
Store Sandimmune below 30 degrees C (86 degrees F).
Do not keep in the refrigerator.
Keep the medicine in the original packaging.
Throw away any unused medicine after two months of opening the bottle or after the expiration date.
At a temperature below 20 degrees C (68 degrees F) some brands of cyclosporine oral solution (e.
Neoral and its generic forms) may form a gel or sediment.
If this happens, let the medicine warm to room temperature (about 77 degrees F) before use.
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Conservative means to maintain the ability to walk are often the first line of defense against Ledderhose.
Soft inlays of shoes have proved to reduce pain, sometimes also holes are cut into the inlays or inner soles to reduce pressure on the nodules.
Which type of shoes is best suited depends probably on the specific match of foot and shoe.
Further information on convenient shoes can e.
Besides that, below therapies might help.
Can stop the disease progression in the initial stage and can dissolve nodules, if they are still in the initial stage and tiny.
Radiation therapy is also applied if surgery cannot be repeated anymore due to excessive scar tissue.
Can be useful if the toes are contracted.
As this is often not the case and the problems arise rather due to the size of the nodule and its inflammation, NA is less frequently applied for Morbus Ledderhose than for Morbus Dupuytren.
We have heard of cases where shock waves were able to soften Ledderhose nodules and reduce pain.
But other patients experienced this therapy as painful and without effect.
We have heard of a few cases where cryotherapy has successfully been used to treat Ledderhose disease (see for example cryo_surgery_david).
We view cryotherapy as a potentially promising therapy for Ledderhose but due to the few documented cases consider it still experimental.
To our knowledge surgery is the only therapy that can actually remove big Ledderhose nodules.
Additionally to the side effects that can appear when operating a hand (Morbus Dupuytren), the foot has to bear heavy weight and gravity pulls blood into it much more than into the hand.
Unfortunately you have to expect to use crutches after surgery for quite a while and possibly not being able to drive.
While some patients report that after surgery new nodules grew faster and more frequently, others report satisfying results.
Some doctors advocate the total removal of the foot's fascies to avoid recurrence (in the same place) and extension (to other areas).
We believe that surgery for Ledderhose is overall more critical than for Dupuytren and should be considered as last resort, though still a valuable resort.
ACC) for Dupuytren's disease also showed good results for Ledderhose.
Still experimental, not an established therapy.
Several patients reported that taking glucosamine forstered growth of Ledderhose nodules and cords.
This is just anecdotal but patients taking glucosamine, chondroitin or similar medication, might watch whether those affect their Ledderhose disease.
Our case series uniquely demonstrates that continuous phenobarbital treatment leads to recurrent plantar fibromatosis and may result in long-term disability and numerous unnecessary operations.
See also effect_on Dupuytren's.
Contraction is typically less of an issue for Ledderhose's disease than for Dupuytren's contracture.
Therefore the extension deficit is not a good measure to classify Ledderhose disease, rather visible characteristics of the tumor are used to describe the grade of Ledderhose.
These grades not necessarily resemble development stages of Morbus Ledderhose (as the Tubiana stages of Morbus Dupuytren do).
It is not directly related to the above mentioned therapies.
NO adherence to the skin, NO deep extension to the flexor sheath.
Grade 2: MULTIFOCAL disease, with or without proximal or distal extension, NO adherence to the skin, NO deep extension to the flexor sheath.
Grade 3: MULTIFOCAL disease, with or without proximal or distal extension, EITHER adherence to the skin OR deep extension to the flexor sheath.
Grade 4: MULTIFOCAL disease, with or without proximal or distal extension, Adherence to the skin AND deep extension to the flexor sheath.
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International brand names outside U.
Indicates foreign drugs without region specification at time of publication.
Nasal and Oral Inhalers and AQ Nasal Spray : Triamcinolone acetonide, nasal inhaler, is a glucocorticosteroid with a molecular weight of 434.
Fluoro-11beta, 16alpha, 17,21-tetrahydroxypregna-1, 4-diene-3,20-dione cyclic 16,17-acetal with acetone.
Each canister contains 60 mg Triamcinolone acetonide.
Each actuation releases approximately 200 mcg Triamcinolone acetonide, of which approximately 100 mcg are delivered from the unit (in vitro testing).
There are at least 240 actuations in one Triamcinolone acetonide aerosol canister.
After 240 actuations, the amount delivered per actuation may not be consistent and the unit should be discarded.
AQ Nasal Spray : Triamcinolone acetonide AQ nasal spray is an unscented, thixotropic, water-based metered-dose pump spray formulation unit containing a microcrystalline suspension of triamconolone acetonide in an aqueous medium.
Each actuation delivers 55 mcg Triamcinolone acetonide from the nasal actuator to the patient (estimated from in vitro testing) after an initial priming of 5 sprays.
It will remain adequately primed for 2 weeks.
If the product is not used for more than 2 weeks, then it can be adequately reprimed with one spray.
There are at least 120 actuations in one Triamcinolone acetonide AQ nasal spray bottle.
After 120 actuations, the amount of Triamcinolone acetonide delivered per actuation may not be consistent and the unit should be discarded.
In the manufacturer's original package insert, patients are provided with a check-off form to track usage in the Information for Patients tear-off sheet.
Nasal Inhaler : Triamcinolone acetonide Nasal Inhaler is a metered-dose aerosol unit containing a microcrystalline suspension of Triamcinolone acetonide in dichlorodifluoromethane and dehydrated alcohol 0.
Each canister contains 15 mg Triamcinolone acetonide.
Each actuation releases approximately 55 mcg Triamcinolone acetonide from the nasal actuator to the patient (estimated from in vitro testing).
There are at least 100 actuations in one Triamcinolone acetonide Nasal Inhaler canister.
After 100 actuations, the amount delivered per actuation may not be consistent and the unit should be discarded.
Patients are provided with a check-off card to track usage as part of the Information for Patients tear-off sheet.
Dental Paste : Each gram of Triamcinolone acetonide in Orabase provides 1 mg (0.
Triamcinolone acetonide in emollient dental paste containing gelatin, pectin, and carboxymethylcellulose sodium is a plastibase (plasticized Hydrocarbon Gel), a polyethylene and mineral oil gel base.
Triamcinolone acetonide (sterile Triamcinolone acetonide suspension) provides Triamcinolone acetonide, a synthetic corticosteroid with marked anti-inflammatory action, in a sterile aqueous suspension suitable for intradermal, intra-articular, and intrabursal injection into tendon sheaths.
The preparation is NOT suitable for IV or IM use.
Each ml of the sterile aqueous suspension provides 10 mg Triamcinolone acetonide, with sodium chloride for isotonicity, 0.
At the time of manufacture, the air in the container is replaced by nitrogen.
The chemical name is 9-fluoro- 11beta,16alpha,17,21-tetrahyroxypregna-1,4-diene -3,20- dione cyclic 16,17- acetal with- acetone.
Injection-40 : Not for IV or intradermal use.
Triamcinolone acetonide (sterile Triamcinolone acetonide suspension) provides Triamcinolone acetonide, a synthetic corticosteroid with marked anti-inflammatory action.
Each ml of the sterile aqueous suspension provides 40 mg Triamcinolone acetonide, with sodium chloride for isotonicity, 0.
Sodium hydroxide or hydrochloric may have been added to adjust pH between 5.
Aerosol Spray, Cream, and Ointment : For dermatologic use only.
The topical corticosteroids constitute a class of primarily synthetic steroids used as anti-inflammatory and antipruritic agents.
The steroids in the class include Triamcinolone acetonide.
The chemical name is 9- Fluoro-11beta,16beta,17, 21- tetrahyroxypregna-1,4-diene-3,20-dione cyclic 16,17-acetal with acetone.
Aerosol Spray: A two-second application which covers an area approximately the size of the hand, delivers an amount of Triamcinolone acetonide not exceeding 0.
After spraying, the nonvolatile vehicle remaining on the skin contains approximately 0.
Triamcinolone acetonide in a vehicle of isopropyl palmitate, dehydrated alcohol (10.
Triamcinolone acetonide cream provides 0.
Triamcinolone acetonide, respectively, in a vanishing cream base containing propylene glycol, cetearyl alcohol (and) ceteareth-20 white petrolatum, sorbitol solution, glyceryl monostearate, polyethylene glycol monostearate, simethicone, sorbic acid, and purified water.
Triamcinolone acetonide ointment provides 0.
Triamcinolone acetonide, respectively in Plastibase (plasticized hydrocarbon gel), a polyethylene and mineral oil gel base.
Oral Inhaler: The precise mechanism of the action of the inhaled drug is unknown.
However, use of the inhaler makes it possible to provide effective local steroid activity with minimal systemic effect.
Triamcinolone acetonide is a more potent derivative of triamcinolone.
Although triamcinolone itself is approximately one to two times as potent as prednisone in animal models of inflammation, Triamcinolone acetonide is approximately 8 times more potent than prednisone.
Pharmacokinetic studies with radiolabeled Triamcinolone acetonide have been carried out by the oral route and intravenous route in several species.
The pharmacokinetic behavior of the Triamcinolone acetonide was similar in all species within each route of administration.
The major portion of the dose was eliminated in the feces irrespective of route of administration with only one species (rabbit) showing significant urinary excretion of radioactivity.
The results of studies in which Triamcinolone acetonide was administered as an aerosol showed rapid disappearance of radioactivity from the lungs comparable to that observed following oral administration with peak blood levels occurring in one to two hours.
Virtually no radioactivity was present in the lung and trachea 24 hours after dosing.
Based upon intravenous dosing of Triamcinolone acetonide phosphate ester, the half-life of Triamcinolone acetonide was reported to be 88 minutes.
The volume of distribution (Vd) reported was 99.
The plasma half-life of corticoids does not correlate well with the biologic half-life.
Three metabolites of Triamcinolone acetonide have been identified.
They are 6beta-hydroxyTriamcinolone acetonide, 21-carboxyTriamcinolone acetonide and 21-carboxy-6beta-hydroxyTriamcinolone acetonide.
All three metabolites are expected to be substantially less active than the parent compound due to (a) the dependence of anti-inflammatory activity on the presence of anti-inflammatory activity on the presence of a 21-hydroxyl group, (b) the decreased activity observed upon 6-hydroxylation, and (c) the markedly increased water solubility favoring rapid elimination.
There appeared to be some quantitative differences in the metabolites among species.
No differences were detected in metabolic pattern as a function of route of administration.
Nasal Inhaler and AQ Nasal Spray: Triamcinolone acetonide is a more potent derivative of triamcinolone.
Although the precise mechanism of corticosteroid antiallergic action is unknown, corticosteroids are very effective.
However, they do not have an immediate effect on allergic signs and symptoms.
When allergic symptoms are very severe, local treatment with recommended doses (microgram) of any available topical corticosteroids are not as effective as treatment with larger doses (milligram) of oral or parenteral formulations.
When corticosteroids are prematurely discontinued symptoms may not recur for several days.
The plasma half-life of corticosteroids does not correlate well with the biologic half-life.
Pharmacokinetic characterization of the Triamcinolone acetonide AQ nasal spray formulation was determined in both normal subjects and in patients with allergic rhinitis.
Single dose intranasal administration of 220 mcg of the AQ nasal spray in normal subjects and patients demonstrated minimal absorption of Triamcinolone acetonide.
The mean peak plasma concentration was approximately 0.
THe mean plasma drug concentration was less than 0.
L at 12 hours, and below the assay detection limit at 24 hours.
The average terminal half-life was 3.
The range of mean AUC 0 - values was 1.
L between doses of 110 mcg to 440 mcg in both patients and healthy volunteers.
Dose proportionality was demonstrated in both normal subjects and in allergic rhinitis patients following single intranasal doses of 110 mcg or 220 mcg Triamcinolone acetonide AQ nasal spray.
The Cmax and AUC of the 440 mcg dose increased less than proportionally when compared to 110 and 220 mcg doses.
In animal studies using rats and dogs, three metabolites of Triamcinolone acetonide have been identified.
They are 6beta-hydroxyTriamcinolone acetonide, 21-carboxyTriamcinolone acetonide and 21-carboxy-6beta-Triamcinolone acetonide.
All three metabolites are expected to be substantially less active than the parent compound due to (a) the dependence of anti-inflammatory activity on the presence of 21-hydroxyl group, (b) the decreased activity observed upon --hydroxylation, and (c) the markedly increased water solublity favoring rapid elimination.
No differences were detected in metabolic pattern as a function of route of adminstration.
Nasal Inhaler: Individual patients will experience a variable time to onset and degree of symptom relief when using Triamcinolone acetonide.
It is recommended that dosing be started at 220 mcg once a day and the effect be assessed in four to seven days.
Adults and Children 12 Years of Age and Older: Some relief can be expected in approximately two-thirds of patients within four to seven days.
If greater effect is desired an increase of dose to 440 mcg once a day can be tried.
If adequate relief has not been obtained by the third week of Triamcinolone acetonide treatment, consideration to alternate forms of treatment should be considered.
In general, in the clinical trials the highest dose tended to provide relief sooner.
This suggests an alternative approach to starting therapy with Triamcinolone acetonide (e.
As with other nasal corticosteroids, the vehicle used to deliver the corticosteroid may cause symptoms that are difficult to distinguish from the patient's rhinitis symptoms.
Thus, depending upon the balance between these vehicle side effects and the benefits of treatment, in determining the optimal dose for the relief of symptoms, individual patients may need to have a trial of high and low doses.
In clinical trials, significant relief of rhinitis symptoms in children was observed as early as the fourth day of treatment and generally, it took one to two weeks to achieve maximum benefit.
If adequate relief has not been obtained by the third week of treatment, alternate forms of treatment should be considered.
In general, it is always desirable to titrate an individual patient to the minimum effective dose to reduce the possibility of side effects.
In clinical trials, after symptoms have been brought under control at the recommended starting doses, reducing the daily dose to 110 mcg (one spray in each nostril oncer per day) has been shown to be effective in controlling symptoms in approximatley one-half of adult patients being treated long-term for allergic rhinitis.
See PRECAUTIONS, WARNINGS, Information for the Patient, and ADVERSE REACTIONS).
AQ Nasal Spray: It is recommended that dosing be started at 220 mcg as 2 sprays in each nostril once daily for adults and children 12 years and older.
An improvement in some patient symptoms may be seen within the first day of treatment, and generally, it takes one week of treatment to reach maximum benefit.
Initial assessment for response should be made during this time frame and periodically until the patient's symptoms are stabilized.
If adequate relief of symptoms has not been obtained after 3 weeks of treatment, Triamcinolone acetonide AQ nasal spary should be discontinued.
It is always desirable to titrate an individual patient to the minimum effective dose to reduce the possibility of side effects.
See PRECAUTIONS, WARNINGS, Information for the Patient, and ADVERSE REACTIONS.
Aerosol Spray, Cream, and Ointment: Topical corticosteroids share anti-inflammatory, antipruritic and vasoconstrictive actions.
The mechanism of anti-inflammatory activity of the topical corticosteroids is unclear.
There is some evidence to suggest that a recognizable correlation exists between vasoconstrictor potency and therapeutic efficacy in man.
The extent of percutaneous absorption of topical corticosteroids is determined by many factors including the vehicle, the integrity of the epidermal barrier, and the use of occlusive dressings.
Topical corticosteroids can be absorbed from normal intact skin.
Occlusive dressings substantially increase the percutaneous absorption of topical corticosteroids.
Thus, occlusive dressings may be a valuable therapeutic adjunct for treatment of resistant dermatoses (see DOSAGE AND ADMINISTRATION).
Once absorbed through the skin, topical corticosteroids are handled through pharmacokinetic pathways similar to systematically administered corticosteroids.
Corticosteroids are bound to plasma proteins in varying degrees.
Corticosteroids are metabolized primarily in the liver and are then excreted by the kidneys.
Some of the topical corticosteroids and their metabolites are also excreted into the bile.
Nasal Inhaler In double-blind, parallel, placebo-controlled clinical trials of seasonal and perennial allergic rhinitis, in adults and adolescentes in fixed total daily doses of 110, 220 and 440 mcg per day, the responses to aerosolized Triamcinolone acetonide demonstrated a statistically significant improvement over placebo.
In open label trials where the doses were sometimes adjusted according to patients' signs and symptoms, the daily doses and regimens varied.
The most commonly used dose was 110 mcg per day.
The Nasal Inhaler, at a dose of 220 mcg once daily, has also been studied in two double blind placebo controlled trials of two and four weeks duration in children ages 6 through 11 years with seasonal and perennial allergic rhinitis.
These trials included 162 males and 91 females.
The nasal inhaler, administered at a fixed dose of 220 mcg once daily resulted in consistent and statistically significant reductions of allergic rhinitis symptoms over vehicle placebo.
In attempting to determine if systemic absorption played a role in the response to Triamcinolone acetonide, a clinical study comparing intranasal and depot intramuscular Triamcinolone acetonide was conducted.
The doses used were based on bioavailability studies of each formulation.
The final doses of Triamcinolone acetonide 440 mcg once a day and Kenalog-40, 4 mg intramuscularly once a week, were chosen to deliver comparable total amounts of weekly Triamcinolone acetonide.
However, the weekly injection yielded sustained plasma levels throughout the dosing interval while the daily Triamcinolone acetonide application resulted in daily peak and trough concentrations, the mean of which was 3.
Both topical Triamcinolone acetonide and intramuscular Kenalog-40 were clinically effective.
In addition, in some studies there was evidence of improvement of eye symptoms.
This suggests that Triamcinolone acetonide, at least to some degree is acting by a systemic mechanism.
In order to evaluate the effects of systemic absorption on the Hypothalamic-Pituitary-Adrenal (HPA) axis, Triamcinolone acetonide to adults in doses of 440 mcg once a day was compared to placebo and 42 days of a single morning dose of prednisone 10 mg.
No evidence of adrenal axis suppression was observed in 26 pediatric patients exposed for 6 weeks to systemic levels of Triamcinolone acetonide higher than the systemic levels observed following administration of the maximum recommended dose of Triamcinolone acetonide nasal inhaler.
AQ Nasal Spray: The safety and efficacy of Triamcinolone acetonide AQ nasal spray has been evaluated in 10 double-blind, placebo-controlled clinical trials of two to four weeks in duration in adults and children 12 years and older with seasonal or perennial allergic rhinitis.
Overall, the results of these clinical trials showed that Triamcinolone acetonide AQ nasal spray 220 mcg once daily (2 sprays in each nostril) when compared to placebo provides statistically significant relief of nasal symptoms including sneezing, stuffiness, discharge, and itching.
Oral Inhaler: Triamcinolone acetonide Oral Inhaler is indicated only for patients who require chronic treatment with corticosteroids for the control of the symptoms of bronchial asthma.
Such patients would include those already receiving systemic corticosteroids and selected patients who are inadequately controlled on a non-steroid regimen and in whom steroid therapy has been withheld because of concern over potential adverse effects.
For relief of asthma which can be controlled by bronchodilators and other non-steroid medications.
In patients who require systemic corticosteroid treatment infrequently.
In the treatment of non-asthmatic bronchitis.
AQ Nasal Spray: Triamcinolone acetonide AQ nasal spray is indicated for the treatment of seasonal and perennial allergic rhinitis symptoms.
Nasal Inhaler: Triamcinolone acetonide Nasal Inhaler is indicated for the nasal treatment of seasonal and perennial allergic rhinitis symptoms in adults and children 6 years of age and older.
Dental Paste: Triamcinolone acetonide dental paste is indicated for adjunctive treatment and for the temporary relief of symptoms associated with oral inflammatory lesions and ulcerative resulting from trauma.
Injection-10: Intra-Articular: Triamcinolone acetonide Injection-10 is indicated for intra-articular or intrabursal administration, and for injection into tendon sheaths, as adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in: synovitis of osteoarthritis, rheumatoid arthritis, acute and subacute bursitis, acute gouty arthritis, epicondylitis, acute nonspecific, tenospecific, and posttraumatic osteoarthritis.
Intradermal: Intralesional administration is indicated for the treatment of keloids, discoid lupus erythematosus, necrobiosis, lipoidica, diabeticorum, alopecia areata, and localized hypertrophic, infiltrated, inflammatory lesions of: licheplanus, psoriatic plaques, granuloma annulare, and lichen simplex chronicus (neurodermatitis).
This drug may be useful in cystic tumors of an aponeurosis or tendon (ganglia).
Hematologic Disorders: Acquired (autoimmune) hemolytic anemia.
Edematous State: To induce diuresis or remission of proteinuria in the nephrotic syndrome without uremia, of the idiopathic type or that due to lupus erythematosus.
Aerosol Spray: Triamcinolone acetonide aerosol spray is indicated for relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses.
Indicated for relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses.
Oral Inhaler: Triamcinolone acetonide Oral Inhaler is contraindicated in the primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required.
Oral and Nasal Inhalers and AQ Nasal Spray: Hypersensitivity to any of the ingredients of this preparation contraindicates its use.
Aerosol Spray, Cream and Ointment: Topical corticosteroids are contraindicated in those patients with a history of hypersensitivity to any of the components of the preparations.
Oral Inhaler : Particular care is needed in patients who are transferred from systemically active corticosteroids to Triamcinolone acetonide Oral Inhaler because deaths due to adrenal insufficiency have occurred in asthmatic patients during and after transfer from systemic corticosteroids to aerosolized steroids in recommended doses.
After withdrawal from systemic corticosteroids, a number of months is usually required for recovery of hypothalamic-pituitary- adrenal (HPA) function.
For some patients who have received large doses of oral steroids for long periods of time before therapy with Triamcinolone acetonide Oral Inhaler is initiated, recovery may be delayed for one year or longer.
During this period of HPA suppression, patients may exhibit signs and symptoms of adrenal insufficiency when exposed to trauma, surgery or infections, particularly gastroenteritis or other conditions with acute electrolyte loss.
Although Triamcinolone acetonide Oral Inhaler may provide control of asthmatic symptoms during these episodes, in recommended doses it supplies only normal physiological amounts of corticosteroid systemically and does NOT provide the increased systemic steroid which is necessary for coping with these emergencies.
During periods of stress or a severe asthmatic attack, patients who have been recently withdrawn from systemic corticosteroids should be instructed to resume systemic steroids (in large doses) immediately and to contact their physician for further instruction.
These patients should also be instructed to carry a warning card indicating that they may need supplementary systemic steroids during periods of stress or a severe asthma attack.
Localized infections with Candida albicans have occurred infrequently in the mouth and pharynx.
These areas should be examined by the treating physician at each patient visit.
The percentage of positive mouth and throat cultures Candida albicans did not change during a year of continuous therapy.
The incidence of clinically apparent infection is low (2.
These infections may disappear spontaneously or may require treatment with appropriate antifungal therapy or discontinuance of treatment with Triamcinolone acetonide Oral Inhaler.
Triamcinolone acetonide Oral Inhaler is not to be regarded as a bronchodilator and is not indicated for rapid relief of bronchospasm.
Patients should be instructed to contact their physician immediately when episodes of asthma which are not responsive to bronchodilators occur during the course of treatment with Triamcinolone acetonide Oral Inhaler.
During such episodes, patients may require therapy with systemic corticosteroids.
Transfer of patients from systemic steroid therapy to Triamcinolone acetonide Oral Inhaler may unmask allergic conditions previously suppressed by the systemic steroid therapy, e.
Nasal Inhaler : The replacement of a systemic corticosteroid with a topical corticoid can be accompanied by signs of adrenal insufficiency and, in addition, some patients may experience symptoms of withdrawal, e.
Patients previously treated for prolonged periods with systemic corticosteroids and transferred to topical corticoids should be carefully monitored for acute adrenal insufficiency in response to stress.
In those patients who have asthma or other clinical conditions requiring long-term systemic corticosteroid treatment, too rapid a decrease in systemic corticosteroids may cause a severe exacerbation of their symptoms.
Children who are on immunosuppressant drugs are more susceptible to infections than healthy children.
Chickenpox and measles, for example, can have a more serious or even fatal course in children on immunosuppressant doses of corticosteroids.
In such chcildren, or in adults who have not had these diseases, particular care should be taken to avoid exposure.
If exposed, therapy with varicella zoster immune globulin (VZIG) or pooled intravenous immunoglobulin (IVIG), as appropriate, may be indicated.
If chickenpox develops, treatment with antiviral agents may be considered.
The use of Triamcinolone acetonide nasal inhaler with alternate-day systemic prednisone could increase the likelihood of hypothalamic-pituitary-adrenal (HPA) suppression compared to a therapeutic dose of either one alone.
Therefore, Triamcinolone acetonide nasal inhaler should be used with caution in patients already receiving alternate-day prednisone treatment for any disease.
Patients previously treated for prolonged periods with systemic corticosteroids and transferred to topical corticosteroids should be carefully monitored for acute adrenal insufficiency in response to stress.
In such children, or in adults who have not had these diseases, particular care should be taken to avoid exposure.
If exposed, therapy with varicella-zoster immune globulin (VZIG) or pooled intravenous immunoglobulin (IVIG), as appropriate may be indicated.
The use of Triamcinolone acetonide AQ nasal spray with alternate day systemic prednisone could increase the likelihood of hypothalamic-pituitary-adrenal (HPA) suppression compared to a therapeutic dose of either one alone.
Therefore, Triamcinolone acetonide nasal spray should be used with caution in patients already receiving alternate day prednisone treatment for any disease.
In clinical studies with Triamcinolone acetonide administered intranasally, the development of localized infections of the nose and pharynx with Candida albicans has rarely occurred.
When such an infection develops it may require treatment with appropriate local therapy and discontinuance of treatment with Triamcinolone acetonide nasal inhaler or AQ nasal spray.
Triamcinolone acetonide administered intranasally has been shown to be minimally absorbed into the systemic circulation in humans.
Patients with active rhinitis showed absorption similar to that found in normal volunteers.
ACTH over the same period (see CLINICAL STUDIES).
AQ Nasal Spray : Daily doses of 220 mcg or 440 mcg Triamcinolone acetonide AQ nasal spray, 10 mg prednisone each was compared to placebo.
Either Triamcinolone acetonide Nasal Inhaler or AQ Nasal Spray should be used with caution, if at all, in patients with active or quiescent tuberculous infections of the respiratory tract or in patients with untreated fungal, bacterial, or systemic viral infections or ocular herpes simplex.
Because of the inhibitory effect of corticosteroids on wound healing in patients who have experienced recent nasal septal ulcers, nasal surgery or trauma, a corticosteroid should be used with caution until healing has occurred.
As with other nasally inhaled corticosteroids, nasal septal perforations have been reported in rare instances.
When used inexcessive doses, systemic corticosteroid effects such as hypercorticism and adrenal suppression may appear.
If such changes occur, Triamcinolone acetonide nasal inhaler should be discontinued slowly, consistent with accepted procedures for discontinuing oral steroid therapy.
Oral and Nasal Inhalers and AQ Nasal Spray : When used at excessive doses, systemic corticosteroid effects such as hypercorticism and adrenal suppression may appear.
AQ nasal spray should be discontinued slowly, consistent with accepted procedures for discontinuing oral steroid therapy.
Aerosol Spray, Cream and Ointment : Systemic absorption of topical corticosteroids has produced reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, manifestations of Cushing's syndrome, hyperglycemia, and glucosuria in some patients.
Conditions which augment systemic absorption include the application of the more potent steroids, use over large surface areas, prolonged use, and the addition of occlusive dressings.
Therefore, patients receiving a large dose of any potent topical steroid applied to a large surface area or under an occlusive dressing should be evaluated periodically for evidence of HPA axis suppression by using the urinary free cortisol and ACTH stimulation tests, and for the impairment of thermal homeostasis.
If HPA axis suppression or elevation of the body temperature occurs, an attempt should be made to withdraw the drug, to reduce the frequency of application, substitute a less potent steroid, or use a sequential approach when utilizing the occlusive technique.
Recovery of HPA axis function and thermal homostasis are generally prompt and complete upon discontinuation of the drug.
Infrequently, signs and symptoms of steroid withdrawal may occur, requiring supplemental systemic corticosteroids.
Occasionally, a patient may develop a sensitivity reaction to a particular occlusive dressing material or adhesive and a substitute material may be necessary.
Children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity (see Pediatric Use).
If irritation develops, topical corticosteroids should be discontinued and appropriate therapy instituted.
In the presence of dermatological infections, the use of an appropriate antifungal or antibacterial agent should be instituted.
If a favorable response does not occur promptly, the corticosteroid should be discontinued until the infection has been adequately controlled.
Oral Inhaler: During withdrawal from oral steroids, some patients may experience symptoms of systemically active steroid withdrawal, e.
DOSAGE AND ADMINISTRATION for details).
In responsive patients, inhaled corticosteroids will often permit control of asthmatic symptoms with less suppression of HPA function than therapeutically equivalent oral doses of prednisone.
Since Triamcinolone acetonide is absorbed into the circulation and can be systemically active, the beneficial effects of Triamcinolone acetonide Oral Inhaler in minimizing or preventing HPA dysfunction may be expected only when recommended dosages are not exceeded.
Suppression of HPA function has been reported in volunteers who received 400 mcg daily of Triamcinolone acetonide.
In addition, suppression of HPA function has been reported in some patients who have received recommended doses for as little as 6 to 12 weeks.
Since the response of HPA function to inhaled corticosteroids is highly individualized, the physician should consider this information when treating patients.
Because of the possibility of systemic absorption of inhaled corticosteroids, patients treated with these drugs should be observed carefully for any evidence of systemic corticosteroid effects including suppression of growth in children.
Particular care should be taken in observing patients postoperatively or during periods of stress for evidence of a decrease in adrenal function.
The long-term effects of Triamcinolone acetonide inhaler in human subjects are not completely known, although patients have received Triamcinolone acetonide Oral Inhaler on a continuous basis for periods of two years or longer.
While there has been no clinical evidence of adverse experiences, the local effects of the agent on developmental or immunologic processes in the mouth, pharynx, trachea and lung are also unknown.
Triamcinolone acetonide Oral Inhaler should be used with caution, if at all, in patients with active or quiescent tuberculous infections of the respiratory tract or in patients with untreated fungal, bacterial, or systemic viral infections or ocular herpes simplex.
The potential effects of long-term administration of Triamcinolone acetonide Oral Inhaler on lung or other tissues are unknown.
However, pulmonary infiltrates with eosinophilia have occurred in patients receiving other inhaled corticosteroids.
Patients being treated with Triamcinolone acetonide nasal inhaler or AQ nasal spray should receive the following information and instructions.
Patients who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chickenpox or measles and, if exposed, to obtain medical advice.
AQ nasal spray at regular intervals since its effectiveness depends on its regular use.
A decrease in symptoms may occur as soon as 12 hours after starting steroid therapy and generally can be expected to occur within a few days of initiating therapy in allergic rhinitis.
The patient should take the medication as directed and should not exceed the prescribed dosage.
The patient should contact the physician if symptoms do not improve after three weeks, or if the condition worsens.
The patient should contact the physician if they occur.
Nasal Inhaler : For the proper use of this unit and to attain maximum improvement, the patient should read and follow the accompanying patient instructions carefully.
Spraying Triamcinolone acetonide directly onto the nasal septum should be avoided.
Because the amount dispensed per puff may not be consistent, it is important to shake the canister well.
Also, the canister should be discarded after 100 actuations.
AQ Nasal Spray : For the proper use of this unit and to attain maximum improvement, the patient should read and follow the accompanying patient instructions carefully.
It is important to shake the bottle well before each use.
Also, the bottle should be discarded after 120 actuations since the amount of Triamcinolone acetonide delivered thereafter per actuation may be substantially less than 55 mcg of drug.
Do not transfer any remaining suspension to another bottle.
Oral and Nasal Inhalers and AQ Nasal Spray : Patients who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chickenpox or measles and, if exposed, to obtain medical advice.
This medication is to be used as directed by the physician.
Patients should be advised not to use this medication for any disorder other than for which it was prescribed.
The treated skin area should not be bandaged or otherwise covered or wrapped as to be occlusive unless directed by the physician.
Patients should report any signs of local adverse reactions especially under occlusive dressing.
Parents of pediatric patients should be advised not to use tight- fitting diapers or plastic pants on a child being treated in the diaper area, as these garments may constitute occlusive dressings.
Aerosol Spray, Cream and Ointment : A urinary free cortisol test and ACTH stimulation test may be helpful in evaluating HPA axis suppression.
Oral and Nasal Inhalers: No evidence of treatment-related carcinogenicity was demonstrated after two years of once daily oral administration of Triamcinolone acetonide at a maximum daily dose of 1.
The maximum human dose, for comparison, is 6.
Developmental toxicity, which included increases in fetal resorptions and stillbirths and decreases in pup body weight and survival, also occurred at the maternally toxic doses (2.
Reproductive performance of female rats and effects on fetuses and offspring were comparable between groups that received placebo and non-toxic or marginally toxic doses (0.
AQ Nasal Spray : No evidence of treatment-related carcinogenicity was demonstrated after two years of once daily gavage of Triamcinolone acetonide at doses of 0.
Mutagenesis studies with Triamcinolone acetonide have not been carried out.
No evidence of impaired fertility was manifested when oral doses of up to 15.
However, triamconolone acetonide at oral doses of 8.
Aerosol Spray, Cream and Ointment: Long-term animal studies have not been performed to evaluate the carcinogenic potential or the effect on fertility of topical corticosteroids.
Studies to determine mutagenicity with prednisolone and hydrocortisone showed negative results.
Oral and Nasal Inhalers: Like other corticoids, Triamcinolone acetonide has been shown to be teratogenic in rats and rabbits.
Teratogenic effects, which occurred in both species at 0.
Teratogenic effects, including CNS and cranial malformations, have also been observed in non-human primates at 0.
Triamcinolone acetonide per day and 3.
Triamcinolone acetonide per day based on a patient body weight of 70 kg.
Administration of aerosol by inhalation to pregnant rats and rabbits produced embryotoxic and fetotoxic effects which were comparable to those produced by administration by other routes.
There are no adequate and well-controlled studies in pregnant women.
Triamcinolone acetonide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Experience with oral corticoids since their introduction in pharmacologic as opposed to physiologic doses suggests that rodents are more prone to teratogenic effects from corticoids than humans.
In addition, because there is a natural increase in glucocorticoid production during pregnancy, most women will require a lower exogenous steroid dose and many will not need corticoid treatment during pregnancy.
There are no adequate and well-contolled studies in pregnant women.
Triamcinolone acetonide should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus.
Oral and Nasal Inhalers and AQ Nasal Spray : Nonteratogenic Effects: Hypoadrenalism may occur in infants born of mothers receiving corticosteroids during pregnancy.
Such infants should be carefully observed.
Aerosol Spray, Cream and Ointment : Category C.
Teratogenic Effects: Corticosteroids are generally teratogenic in laboratory animals when administered systemically at relatively low dosage levels.
The more potent corticosteroids have been shown to be teratogenic after dermal application in laboratory animals.
There are no adequate and well- controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids.
Therefore, topical corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Drugs of this class should not be used extensively on pregnant patients, in large amounts, or for long periods of time.
AQ Nasal Spray : It is not known whether Triamcinolone acetonide is excreted in human milk.
AQ nasal spray is administered to nursing women.
Aerosol Spray, Cream and Ointment: It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk.
Systemically administered corticosteroids are secreted into breast milk in quantities not likely to have a deleterious effect on the infant.
Nevertheless, caution should be exercised when topical corticosteroids are administered to a nursing woman.
Safety and effectiveness have not been established in children below the age of 6.
Oral corticosteroids have been shown to cause growth suppression in children and teenagers, particularly with higher doses over extended periods.
If a child or teenager on any corticosteroid appears to have growth suppression, the possibility that they are particularly sensitive to this effect of steroids should be considered.
Aerosol Spray, Cream and Ointment: Pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced HPA axis suppression and Cushing's syndrome than mature patients because of a larger skin surface area to body weight ratio.
HPA axis suppression, Cushing's syndrome, and intracranial hypertension have been reported in children receiving topical corticosteroids.
Manifestation of adrenal suppression in children include linear growth retardation, delayed weight gain, low plasma cortisol levels, and absence of response to ACTH stimulation.
Manifestations of intracranial hypertension include bulging fontanelles, headaches, and bilateral papilledema.
Administration of topical corticosteroids to children should be limited to the least amount compatible with an effective therapeutic regimen.
Chronic corticosteroid therapy may interfere with the growth and development of children.
Oral Inhaler : Safety and effectiveness have not been established in children below the age of 6.
Oral corticoids have been shown to cause growth suppression in children and teenagers, particularly with higher doses over extended periods.
If a child or teenager on any corticoid appears to have growth suppression, the possibility that they are particularly sensitive to this effect of steroids should be considered.
WARNING : This product contains CFC-12, a substance which harms public health and environment by destroying ozone in the upper atmosphere.
Oral Inhaler : A few cases of oral candidiasis have been reported (see WARNINGS).
In addition, some patients receiving Triamcinolone acetonide Oral Inhaler have experienced hoarseness, dry throat, irritated throat and dry mouth.
Increased wheezing and cough have been reported infrequently as has facial edema.
These adverse effects have generally been mild and transient.
Nasal Inhaler : Adults and Children 12 Years of Age and Older: In controlled and uncontrolled studies, 1257 patients received treatment with intranasal Triamcinolone acetonide.
Adverse reactions are based on the 567 patients who received a product similar to the marketed Triamcinolone acetonide canister.
These patients were treated for an average of 48 days (range 1 to 117 days).
The 145 patients enrolled in uncontrolled studies received treatment from 1 to 820 days (average 332 days).
The most prevalent adverse experience was headache, being reported by approximately 18% of the patients who received Triamcinolone acetonide nasal inhaler irritation was reported by 2.
Other nasopharyngeal side effects were reported by fewer than 5% of the patients who received Triamcinolone acetonide and included: dry mucous membranes, naso-sinus congestion, throat discomfort, sneezing, and epistaxis.
The complaints do not usually interfere with treatment and in the controlled and uncontrolled studies approximately 1% of patients have discontinued because of these nasal adverse effects.
In the event of accidental overdose, an increased potential for these adverse experiences may be expected, but systemic adverse experiences are unlikely (see OVERDOSAGE).
Children Ages 6 Through 11 Years of Age : Adverse event data in children 6 through 11 years of age are derived from two controlled clinical trials of two and four weeks duration.
Adverse events occurring at a rate of 3% or greater that were more common in the placebo group were: upper respiratory tract infection, headache, and concurrent infection.
No patient discontinued due to a serious adverse event related to Triamcinolone acetonide nasal inhaler therapy.
Though not observed in controlled clinical trials of Triamcinolone acetonide nasal inhaler in children, cases of nasal septum perforation among pediatric users have been reported in post marketing surveillance of this product.
AQ Nasal Spray: In placebo-controlled, double-blind and open-label clinical studies, 1483 patients received treatment with Triamcinolone acetonide aqeous nasal spray.
These patients were treated for an average duration of 50.
In the controlled trials (2-5 weeks duration) from which the following adverse reaction data is derived, 1394 patients were treated with the Triamcinolone acetonide AQ nasal spray for an average of 18.
In the long-term, open-label study, the 172 patients received treatment for an average duration of 286 days.
Also, these adverse events occurring at an incidence of 2% or greater and more common among patients treated with placebo than 220 mcg Triamcinolone acetonide daily were: Headache and Rhinitis.
Nasal septum perforation was reported in one patient although relationship to Triamcinolone acetonide AQ nasal spray has not been established.
In the event of accidental overdosage, an increased potential for these adverse experiences may be expected, but systemic adverse experiences are unlikely.
Aerosol Spray, Cream and Ointment: The following local adverse reactions are reported infrequently with topical corticosteroids, but may occur more frequently with the use of occlusive dressing (reactions are listed in an approximate decreasing order of occurrence): burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, secondary infection, skin atrophy, striae, and miliaria.
Nasal Inhaler: Acute overdosage with this dosage form is unlikely.
The acute topical application of the entire 15 mg of the canister would most likely cause nasal irritation and headache.
It would be unlikely to see acute systemic adverse effects if the nasal application of the 15 mg of Triamcinolone acetonide was administered all at once.
AQ Nasal Spray: Like any other nasally administered corticosteroid acute overdosing is unlikely in view of the total amount of active ingredient present.
In the event that the entire contents of the bottle were administered all at once, via either oral or nasal application, clinically significant systemic adverse events would most likely not result.
The patient may experience some gastrointestinal upset.
Aerosol Spray, Cream and Ointment: Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects (see General).
Oral Inhaler : All patients should be instructed that the Triamcinolone acetonide oral inhaler must be used on a regular daily basis rather than prn .
Reliable dosage delivery cannot be assured after 240 actuations and patients should be cautioned against longer use of individual canisters.
Good oral hygiene including rinsing of the mouth after inhalation is recommended.
Adults : The usual dosage is two inhalations (approximately 200 mcg) given three to four times a day.
The maximum daily intake should not exceed 16 inhalations (1600 mcg) in adults.
Higher initial doses (12 to 16 inhalations per day) may be advisable in patients with more severe asthma, the dosage then being adjusted downward according to the response of the patient.
In some patients maintenance can be accomplished when the total daily dose is given on a twice a day schedule.
Children 6 to 12 Years of Age : The usual dosage is two inhalations (100 to 200 mcg) given three or four times a day according to the response of the patient.
The maximal daily intake should not exceed 12 inhalations (1200 mcg) in children 6 to 12 years of age.
Insufficient clinical data exist with respect to the administration of Triamcinolone acetonide oral inhaler in children below the age of 6.
The long-term effects of inhaled steroids on growth are still under evaluation.
Patients receiving bronchodilators by inhalation should be advised to use the bronchodilator before Triamcinolone acetonide Oral Inhaler in order to enhance penetration of Triamcinolone acetonide into the bronchial tree.
After use of an aerosol bronchodilator, several minutes should elapse before use of the Triamcinolone acetonide Oral Inhaler to reduce the potential toxicity from the inhaled fluorocarbon propellants in the two aerosols.
Patients not Receiving Systemic Steroids : The use of Triamcinolone acetonide Oral Inhaler is straightforward in patients who are inadequately controlled with non-steroid medications but in whom systemic steroid therapy has been withheld because of concern over potential adverse reactions.
In patients who respond to Triamcinolone acetonide, an improvement in pulmonary function is usually apparent within one to two weeks after the start of Triamcinolone acetonide Oral Inhaler.
Patients Receiving Systemic Steroids : In those patients dependent on systemic steroids, transfer to Triamcinolone acetonide Oral Inhaler and subsequent management may be more difficult because recovery from impaired adrenal function is usually slow.
Such suppression has been known to last up to 12 months or longer.
Clinical studies, however, have demonstrated that Triamcinolone acetonide Oral Inhaler may be effective in the management of these asthmatic patients and may permit replacement or significant reduction in the dosage of systemic corticosteroids.
The patient's asthma should be reasonably stable before treatment with Triamcinolone acetonide Oral Inhaler is started.
Initially, the inhaler should be used concurrently with the patient's usual maintenance dose of systemic steroid.
After approximately one week, gradual withdrawal of the systemic steroid is started by reducing the dose.
The next reduction is made after an interval of one or two weeks, depending on the response of the patient.
Generally, these decrements should not exceed 2.
A slow rate of withdrawal cannot be overemphasized.
During withdrawal, some patients may experience symptoms of systemically active steroid withdrawal, e.
Such patients should be encouraged to continue with the inhaler but should be watched carefully for objective signs of adrenal insufficiency, such as hypotension and weight loss.
If evidence of adrenal insufficiency occurs, the systemic steroid dose should be boosted temporarily and thereafter further withdrawal should continue more slowly.
No clinical studies have been conducted evaluating Triamcinolone acetonide with alternate day prednisone regimens.
However, based on the results of such a study with another inhaled corticosteroid, inhaled corticosteroids generally are not recommended for chronic use with alternate day prednisone regimens (see WARNINGS).
During periods of stress or a severe asthma attack, transfer patients will require supplementary treatment with systemic steroids.
Exacerbations of asthma which occur during the course of treatment with Triamcinolone acetonide Oral Inhaler should be treated with a short course of systemic steroid which is gradually tapered as these symptoms subside.
There is no evidence that control of asthma can be achieved by administration of Triamcinolone acetonide Oral Inhaler in amounts greater than the recommended doses.
Do not use or store near heat or an open flame.
Never throw container into fire or incinerator.
Nasal Inhaler and AQ Nasal Spray : A decrease in symptoms may occur as soon as 12 hours after starting steroid therapy and generally can be expected to occur within a few days of initiating therapy in allergic rhinitis.
If improvement is not evident after 2-3 weeks, the patient should be re-evaluated or discontinue treatment.
See CLINICAL PHARMACOLOGY, Individualization Of Dosage).
After the desired effect is obtained, some patients may be maintained on a dose of as little as one spray (approximately 55 mcg) in each nostril once a day (total daily dose 110 mcg per day).
Once the maximal effect has been achieved, it always desirable to titrate the patient to the minimum effective dose.
Triamcinolone acetonide Nasal Inhaler is not recommended for children below 6 years of age since adequate numbers of patients have not been studied in this age group.
Directions for Use : Illustrated Patient's Instructions for use accompany each package of Triamcinolone acetonide Nasal Inhaler.
Do not use or store near heat or open flame.
WARNING : Contains CFC-12, a substance which harms public health and enviroment by destroying ozone in the upper atmosphere.
A notice similar to the above WARNING has been placed in the Information for the Patient portion of this monograph pursuant to EPA regulations.
For optimal results use only enough to coat the lesion with a thin film.
Attempting to spread this preparation may result in a granular, gritty sensation, however, a smooth slippery film develops.
The preparation should be applied at bedtime to permit steroid contact with the lesion throughout the night.
Depending on the severity of symptoms, it may be necessary to apply the preparation two or three times a day, preferably after meals.
If significant repair or regeneration has not occurred in seven days, further investigation is advisable.
Dosage: The initial dose for intra-articular or intrabursal administration and for injection into tendon sheaths may vary from 2.
Single injections into several joints for multiple locus involvement, up to 20 mg or more, have been given without incident.
For intradermal administration, the initial dose of Triamcinolone acetonide will vary depending upon the specific disease entity being treated but should be limited to 1.
Multiple sites (separated by one centimeter or more) may be injected, keeping in mind that the greater the total volume employed the more corticosteroids become available for possible systemic absorption and subsequent corticosteroid effects.
Such injections may be repeated, if necessary, at weekly or less frequent intervals.
The lower dosages in the initial dosage range of Triamcinolone acetonide may produce the desired effect when the corticosteroid is administered to provide a localized concentration.
The site of the injection and the volume of the injection should be carefully considered when Triamcinolone acetonide is administered for this purpose.
The initial dosage should be maintained for this purpose.
The initial dosage should be maintained or adjusted until a satisfactory response is noted.
If after a reasonable period of time there is a lack of satisfactory clinical response, this drug should be discontinued and the patient transferred to other appropriate therapy.
IT SHOULD BE EMPHASIZED THAT DOSAGE REQUIREMENTS ARE VARIABLE AND MUST BE INDIVIDUALIZED ON THE BASIS OF THE DISEASE UNDER TREATMENT AND THE RESPONSE OF THE PATIENT.
After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small increments at appropriate time intervals until the lowest dosage which will maintain an adequate clinical response is reached.
It should be kept in mind that constant monitoring is needed in regard to drug dosage.
If the drug is to be stopped after long-term therapy, it is recommended that it be withdrawn gradually rather than abruptly.
Shake the vial before use to insure a uniform suspension.
Prior to withdraw, inspect suspension for clumping or granular appearance (agglomeration).
An agglomerated product results from exposure to freezing temperatures and should not be used.
After withdraw, inject without delay to prevent settling in the syringe.
Careful technique should be employed to avoid the possibility of entering a blood vessel or introducing infection.
Routine laboratory studies, such as urinalysis, two-hour postprandial blood sugar, determination of blood pressure and body weight, and a chest x-ray should be made at regular intervals during prolonged therapy.
Upper GI x-rays are desirable with an ulcer history or significant dyspepsia.
For treatment of joints, the usual intra-articular Injection technique as described in standard textbooks, should be followed.
If excessive amount of synovial fluid is present in the joint, some but not all, should be aspirated to aid in the relief of pain and to prevent undue dilation of the steroid.
With intra-articular or intrabursal administration, and with injection of this drug into tendon sheaths, the use of a local anesthetic is used, its package insert should be read with care and all the precautions connected with its use should be observed.
It should be injected into the surrounding soft tissues prior to the injection of the injection of the corticosteroid.
A small amount of the anesthetic solution may be instilled into the joint.
In treating acute nonspecific tenosynovitis, care should be taken to insure that the injection of this drug is made into the tendon sheath rather than the tendon substance.
Epicondylitis (tennis elbow) may be treated by infiltrating the preparation into the area of greatest tenderness.
For treatment of dermal lesions, inject this drug directly into the lesion, i.
For accuracy of dosage measurement and ease of administration, it is preferable to employ a tuberculin syringe and a small-bore needle (23 to 25 gauge).
Ethyl chloride spray may be used to alleviate the discomfort of the injection.
Injection-40 : The initial dose may vary from 2.
Depending on the specific disease entity being treated.
In situations of less severity, lower doses will generally suffice while in selected patients higher initial doses may be required.
However in certain overwhelming, acute, life-threatening situations, administrations of dosages exceeding the usual dosages may be justified and may be in multiples of the usual dosages.
Systemic: Although this drug may be administered for most initial therapy, most physicians's prefer to adjust the dose orally until adequate control is attained.
IM administration provides a sustained or depot action which can be used to supplement or reduce initial oral therapy.
With IM therapy, greater supervision of the amount of steroid used is made possible in the patient who is inconsistent in following an oral dosage schedule.
In maintenance therapy, the patient-to-patient response is not uniform and, therefore, the dose must be individualized for optimal control.
For Adults and Children Over 12 Years of Age: The suggested initial dose is 60 mg, injected deeply into the gluteal muscle.
Subcutaneous fat atrophy may occur if care is not taken to inject the preparation intramuscularly.
Dosage is usually adjusted within the range of 40 to 80 mg depending upon the patient response and duration of relief.
However, some patients may be well controlled on dosages as low as 20 mg or less patients with hay fever or pollen asthma who are not responding to pollen administration and other conventional therapy may obtain a remission of symptoms lasting throughout the pollen season after one injection of 40 to 100 mg.
For Children from 6 to 12 Years of Age: The suggested initial dose is 40 mg, although dosage depends more upon the severity of symptoms than on age or weight.
There is insufficient clinical experience with this drug to recommend its use in children under six years of age.
For intra-articular or intra-bursal administration and for injection into tendon sheaths, the initial dose of this drug may vary from 2.
A more dilute form of sterile Triamcinolone acetonide suspension is available).
For adults, doses of up to 10 mg for smaller areas and up to 40 mg for larger areas have usually been sufficient to alleviate symptoms.
Single injections into several joints for multiple locus involvement, up to a total of 80 mg, have been given without undue reactions.
A single local infection of Triamcinolone acetonide is frequently sufficient, but several injections may be needed for adequate relief of symptoms.
The site of injection and the volume of the injection should be carefully considered when Triamcinolone acetonide is administered for this purpose.
General : Shake the vial before use to insure a uniform suspension.
Systemic : For systemic therapy, injection should be made deeply into the gluteal muscles to insure IM delivery.
In obese patients, a longer needle may be required.
Use alternate sites for subsequent injections.
Local : For treatment of joints, the usual intra-articular Injection technique as described in standard textbooks, should be followed.
If excessive amount of synovial fluid is present in the joint, some but not all, should be aspirated to aid in the relief of pain and to prevent undue dilation of the corticosteroid.
Directions for use of the spray can are provided on the label.
What is/are Triamcinolone Tablets?
TRIAMCINOLONE is a corticosteroid. It helps to reduce swelling, redness, itching, and allergic reactions. This medicine is used to treat allergies, arthritis, asthma, skin problems, and many other conditions. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.
What should I tell my health care providers before I take this medicine?
They need to know if you have any of these conditions:
depression, anxiety, or psychotic disturbances diabetes infection, like tuberculosis, herpes, or fungal infection liver disease osteoporosis previous heart attack seizures stomach or intestine disease thyroid disease an unusual or allergic reaction to triamcinolone, corticosteroids, other medicines, foods, dyes, or preservatives pregnant or trying to get pregnant breast-feeding
How should I use this medicine?
Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take with milk or food to avoid stomach upset. For best results, take this medicine at or about 8:00 in the morning. Take your medicine at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on your doctor's advice. You may need to gradually reduce the dose.
Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
Note: This medicine is only for you. Do not share this medicine with others.
What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.
What may interact with this medicine?
Do not take this medicine with any of the following:
mifepristone
This medicine may also interact with the following:
aspirin other steroid medicines vaccines and other immunization products
This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
What side effects may I notice from this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:
allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue black, tarry stools breathing difficulty change in vision confusion, depression, excitement, mood swings dizziness fever, infection, sores that do not heal frequent passing of urine increased thirst high blood pressure menstrual problems pain in back, hips, shoulders, ribs rounding of face seizures stomach pain swelling of feet, hands unusual bruising or red pinpoint spots on the skin unusually weak or tired
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
headache increased sweating trouble sleeping unusual increased growth of hair on the face or body upset stomach, nausea
This list may not describe all possible side effects.
What should I watch for while using this medicine?
Visit your doctor or health care professional for regular checks on your progress. If you are diabetic, check your blood sugar as directed. If you are taking this medicine for a long time, carry an identification card with your name, the type and dose of medicine, and your doctor's name and address.
You may need to be on a special diet while taking this medicine. Talk to your doctor.
Do not come in contact with people who have chickenpox or the measles while you are taking this medicine. If you do, call your doctor right away.
Where should I keep this medicine?
Keep out of the reach of children.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.
