Its use must be accompanied by appropriate, specific antituberculous therapy. Triamcinolone should not be used to alleviate joint pain arising from infectious states such as gonococcal or tuberculous arthritis. Systemic steroid administration for prolonged periods may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerve or may enhance the establishment of secondary ocular infection due to fungi and viruses. Average and large doses of hydrocortisone or cortisone can cause elevation of blood pressure, salt and water retention, and increased potassium excretion. Edema may occur in the presence of renal disease with a fixed or decreased glomerular filtration rate.
All corticosteroids increase calcium excretion.
Triamcinolone should be administered only with full knowledge of characteristic activity of, and varied responses to, adrenocortical hormones. Use corticosteroids under close clinical supervision. Unlike other corticosteroids, triamcinolone and its derivatives do not stimulate the appetite. During prolonged therapy, a liberal protein intake is essential, and administration of anabolic steroids may be useful for counteracting the tendency to gradual weight loss, sometimes associated with negative nitrogen balance and wasting or weakness of skeletal muscles. There is an enhanced corticosteroid effect in patients with hyperthyroidism and in those with cirrhosis of the liver.