Version May 2024
Dermatoses (corticosteroid-responsive): Topical (cream, ointment): Apply a small quantity 2 or 3 times/day.
Pruritus (anal, vulvar): Topical (cream): Apply a small quantity 2 or 3 times/day.
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer’s labeling.
There are no dosage adjustments provided in the manufacturer’s labeling.
Refer to adult dosing.
See individual agents.
Hypersensitivity to triamcinolone, neomycin, gramicidin, nystatin, or any component of the formulation; tuberculosis and most viral skin lesions (including herpes simplex, vaccinia, varicella), fungal skin lesions (excluding candidiasis); primary skin infections; ophthalmic use; application to the external auditory canal of patients with perforated tympanic membrane or patients with otitis media; as occlusive therapy in patients with atopic dermatitis
Concerns related to adverse effects:
• Adrenal suppression: Corticosteroids may cause hypercortisolism or suppression of hypothalamic-pituitary-adrenal (HPA) axis, particularly in patients receiving high doses for prolonged periods. HPA axis suppression may lead to adrenal crisis. Steroid withdrawal may occur with discontinuation following prolonged therapy.
• Immunosuppression: Prolonged use may result in fungal or bacterial superinfection; discontinue if dermatological infection persists despite appropriate antimicrobial therapy.
• Local effects: Topical use of triamcinolone or gramicidin has been associated with local sensitivity reactions; skin atrophy, striae, burning, itching, erythema, dryness, hypertrichosis, hypopigmentation folliculitis, acneiform eruptions have been reported with use of topical corticosteroids. Discontinue use if local irritation or sensitization occur.
• Systemic effects: May be absorbed percutaneously; absorption is increased by the use of occlusive dressings, application to denuded skin or to large surface areas. Absorption of topical corticosteroids may cause manifestations of Cushing's syndrome, hyperglycemia, or glycosuria. Rarely, ototoxicity (eg, tinnitus and deafness) has been reported with topical corticosteroids or topical neomycin. Avoid prolonged use (may increase risk of systemic effects).
Disease-related concerns:
• Cardiovascular disease: Use topical corticosteroids with caution in patients with skin disease associated with impaired circulation (eg, stasis dermatitis); reassess patient if symptomatic response is not observed within 1 week.
Other warnings/precautions:
• Appropriate use: For external use only; avoid contact with eyes. Treated area(s) should not be covered with occlusive dressings.
Not available in the US
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Cream, External:
Viaderm K.C. Cream: Triamcinolone 1 mg (as acetonide), nystatin 100,000 units, neomycin 2.5 mg (as sulfate), gramicidin 0.25 mg per g [contains methylparaben, propylene glycol, propylparaben]
Ointment, External:
Viaderm K.C. Ointment: Triamcinolone 1 mg (as acetonide), nystatin 100,000 units, neomycin 2.5 mg (as sulfate), gramicidin 0.25 mg per g
Topical: For topical use only. Do not apply to open wounds or burns. Do not cover treated area(s) with occlusive dressing. Avoid contact with the eyes.
Note: Not approved in the US.
Dermatoses (corticosteroid-responsive): Relief of corticosteroid-responsive inflammatory or pruritic dermatoses associated with bacterial and/or candida infection.
Pruritus (anal, vulvar): Treatment of pruritus ani and pruritus vulvae.
KIDs List: Medium, high, and very high potency topical corticosteroids, when used in neonates and infants <1 year of age for diaper dermatitis, are identified on the Key Potentially Inappropriate Drugs in Pediatrics (KIDs) list; use should be avoided due to risk of adrenal suppression; systemic absorption is higher in pediatric patients than adults (strong recommendation; low quality of evidence) (PPA [Meyers 2020]).
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
CYP3A4 Inhibitors (Strong): May increase the serum concentration of Triamcinolone (Topical). Risk C: Monitor therapy
Nirmatrelvir and Ritonavir: May increase the serum concentration of Corticosteroids (Topical). Risk C: Monitor therapy
Progesterone: Antifungal Agents (Vaginal) may diminish the therapeutic effect of Progesterone. Risk X: Avoid combination
Animal reproduction studies have not been conducted with this combination. See individual monographs for triamcinolone, neomycin, and nystatin.
See individual monographs for triamcinolone, neomycin, and nystatin.
Corticosteroid, antibacterial, and antifungal combination topical product with anti-inflammatory, antipruritic, and vasoconstrictive effects (triamcinolone); broad spectrum anti-bacterial activity (neomycin, gramicidin); anticandidal activity (nystatin). Also see individual agents.
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