lntraarticular inj Adult Large joints: 10-20 mg. Medium-sized joints: 5-10 mg. Small joints: 2-5 mg. Given as a single inj. If another inj is necessary, do not give for at least another 3-4 wk. Max number of inj per joint: 3-4. Childn Juvenile idiopathic arthritis Large joints: 0.5-1 mg/kg. Smaller joints: Reduce dose accordingly. Sub- & intralesional inj Adult Single inj not exceeding 0.1 mg/cm2 of the skin surface area. Should be generally diluted at a ratio of at least 1:1. Infiltration therapy Adult 2-20 mg.
View Trispan overdosage for action to be taken in the event of an overdose.
Contraindications
Hypersensitivity. Preterm or newborn infants (due to benzyl alcohol content). Intraarticular inj: Infections w/in or in the immediate vicinity of the joint to be treated; bacterial arthritis; instability of the joint to be treated; bleeding diathesis (spontaneous or caused by anticoagulants); periarticular calcification; non-vascularised osteonecrosis; tendon rupture; Charcot's joint. Prolonged therapy: GI ulcers; severe osteoporosis; psychiatric history; acute viral infections (HZV, HSV, varicella); HBsAG-positive chronic active hepatitis; about 8 wk before & up to 2 wk after prophylactic vaccinations; systemic mycoses & parasitoses; poliomyelitis; lymphadenitis after BCG vaccination; narrow & open-angle glaucoma.
Serious neurologic events. Increase in joint infection risk. Post-inj flare. Worsening of degenerative changes w/in the joint. In patients w/ history of TB, use only w/ tuberculostatic protection. Severe course of specific viral diseases (chickenpox, measles). Risk of intestinal perforation. Regular medical check-ups (including ophthalmological at 3-mthly intervals) during long-term therapy. Adequate K intake & Na restriction should be ensured & serum K levels monitored in high-dose therapy. Exacerbation or relapse of underlying disease, acute adrenocortical insufficiency & cortisone w/drawal syndrome as risks in discontinuing long-term therapy. Potentially increased need for insulin or oral antidiabetics in patients w/ diabetes. Monitor BP regularly in patients w/ difficult to control HTN. Carefully monitoring in patients w/ severe heart failure. Rare hereditary problems of fructose intolerance. Skin reactions to allergy tests may be suppressed. Can lead to positive doping test results. Should not be used in the 1st 5 mth of pregnancy. Discontinue breast-feeding if treatment w/ higher doses or long-term treatment is required. Childn & elderly.
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