Triamcinolone + Neomycin + Nystatin + Gramicidin
Indications
This medication is a combination antibiotic and steroid used on the skin to treat an infection and relieve associated itching and swelling.
Composition
Each gm cream or ointment contains:
- Triamcinolone 1 mg
- Neomycin 2.5 mg
- Nystatin 10000 unit
- Gramicidin 0.25 mg
Pharmacology
Triamcinolone is a fluorinated corticosteroid with anti-inflammatory, antipruritic and anti-allergic actions.
Nystatin, a polyene antifungal antibiotic, binds to ergosterol and interferes with the permeability of cell membrane of susceptible fungi e.g Candida spp.
Neomycin is an aminoglycoside, often used topically in the infections against susceptible staphylococci and other organisms.
Gramicidin, an antibacterial substance extracted from tyrothricin, is active against many Grampositive bacteria. Used together, this combination provides a wide coverage against gram-positive, gram-negative bacteria and yeast which are responsible for most of the skin infections.
Nystatin, a polyene antifungal antibiotic, binds to ergosterol and interferes with the permeability of cell membrane of susceptible fungi e.g Candida spp.
Neomycin is an aminoglycoside, often used topically in the infections against susceptible staphylococci and other organisms.
Gramicidin, an antibacterial substance extracted from tyrothricin, is active against many Grampositive bacteria. Used together, this combination provides a wide coverage against gram-positive, gram-negative bacteria and yeast which are responsible for most of the skin infections.
Dosage & Administration
This medication is for use on the skin only. Wash your hands before using. Avoid getting this product in your eyes or inside the mouth. If this occurs, wipe off the medication and rinse thoroughly with water. Do not use inside the nose unless directed by your doctor.
Clean and dry the affected area as directed. Apply a small amount of medication in a thin layer on the skin and rub in gently, usually 2 to 3 times daily or as directed by your doctor. Wash your hands after use.
Do not bandage, wrap, or cover the treated area unless you are instructed to do so by your doctor. If this medication is applied to the groin area, do not use tight-fitting plastic pants/diapers/garments for incontinence (loss of control of your bladder or bowels). Doing so may increase the absorption of this product through the skin and increase the risk for side effects.
Do not use large amounts of this medication, apply it more often, or use it for a longer time than directed. Your condition may not improve faster, and the risk for side effects may be increased.
Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day.
Tell your doctor if your condition does not improve or if it worsens after 1 week.
Clean and dry the affected area as directed. Apply a small amount of medication in a thin layer on the skin and rub in gently, usually 2 to 3 times daily or as directed by your doctor. Wash your hands after use.
Do not bandage, wrap, or cover the treated area unless you are instructed to do so by your doctor. If this medication is applied to the groin area, do not use tight-fitting plastic pants/diapers/garments for incontinence (loss of control of your bladder or bowels). Doing so may increase the absorption of this product through the skin and increase the risk for side effects.
Do not use large amounts of this medication, apply it more often, or use it for a longer time than directed. Your condition may not improve faster, and the risk for side effects may be increased.
Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day.
Tell your doctor if your condition does not improve or if it worsens after 1 week.
Interaction
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.
Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of:
Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of:
- other products for the skin (e.g., corticosteroids/antiseptics)
- aminoglycoside antibiotics (e.g., gentamicin, tobramycin)
- corticosteroids taken by mouth (e.g., prednisone)
Contraindications
Tuberculous, viral lesions of the skin (e.g. herpes simplex and varicella); fungal lesions not susceptible to nystatin, facial rosacea, acne vulgaris or perioral dermatitis. Not to be applied to the external auditory canal in patients with perforated tympanic membranes. Do not use on extensive areas to reduce risk of systemic absorption and neomycin-induced ototoxicity. Not recommended for <1 yr.
Side Effects
Prolonged use may cause sensitivity reactions, impaired wound healing, thinning of skin, striae, telangiectasia, hirsutism, hypothalamic-pituitary-adrenal axis suppression, Cushing's syndrome.
Pregnancy & Lactation
Pregnancy Category- Not Classified. FDA has not yet classified the drug into a specified pregnancy category.
Precautions & Warnings
Patients with established hearing loss. Avoid occlusive dressing and prolonged or recurrent use. Avoid contact with eyes or mucous membranes. If there is no clinical improvement after 7 days, discontinue use as the infection may be masked by the steroid. Limit use to 5 days if used on the face or on children <1 yr. Use with caution and sparingly on inflamed or damaged skin (e.g extensive burns, trophic ulceration). Pregnancy.
Therapeutic Class
Triamcinolone & Combined preparations
Storage Conditions
Store at room temperature between 15 and 30 degrees C, away from heat. Check the expiration date on the tube and discard any expired medication.
