Product Name:	Triamcinolone
Synonyms:	9α-Fluoro-16α-hydroxyprednisolone;9α-fluoro-11β,16α,17,21-tetrahydroxy-1,4-pregnadiene-3,20-dione;TRIAMCINOLONE,USP;11b,16a,17a,21-Tetrahydroxy-9a-fluoro-1,4-pregnadiene-3,20-dione;11b,16a,17a,21-Tetrahydroxy-9a-fluoro-D1,4-pregnadiene-3,20-dione;31: PN: US20030109453 SEQID: 30 claimed sequence;9a-Fluoro-11b,16a,17,21-tetrahydroxypregna-1,4-diene-3,20-dione;9a-Fluoro-11b,16a,17a,21-tetrahydroxypregna-1,4-diene-3,20-dione
CAS:	124-94-7
MF:	C21H27FO6
MW:	394.43
EINECS:	204-718-7
Product Categories:	Biochemistry;Hydroxyketosteroids;Intermediates & Fine Chemicals;Pharmaceuticals;Steroid and Hormone;ARISTOCORT;Steroids;API
Mol File:	124-94-7.mol
Triamcinolone Structure
Triamcinolone Chemical Properties
Melting point 	262-263 °C(lit.)
alpha 	69 º (c=2, DMF)
Boiling point 	587.5±50.0 °C(Predicted)
density 	1.1703 (estimate)
storage temp. 	2-8°C
solubility 	DMF: soluble20 mg/mL
pka	11.57±0.70(Predicted)
form 	neat
color 	Crystals
optical activity	[α]25/D +69°, c = 2 in DMF
Water Solubility 	79.99mg/L(25 ºC)
Merck 	9595
InChIKey	GFNANZIMVAIWHM-OBYCQNJPSA-N
CAS DataBase Reference	124-94-7(CAS DataBase Reference)
NIST Chemistry Reference	Triamcinolone(124-94-7)
EPA Substance Registry System	Triamcinolone (124-94-7)
Safety Information
Hazard Codes 	Xn
Risk Statements 	40
Safety Statements 	22-36
WGK Germany 	3
RTECS 	TU3850000
HS Code 	2937220000
Hazardous Substances Data	124-94-7(Hazardous Substances Data)
Toxicity	LD50 subcutaneous in mouse: > 4gm/kg
MSDS Information
Provider	Language
SigmaAldrich	English
Triamcinolone Usage And Synthesis
Description	A natural extension of corticoid research involved examination of compounds containing both a 9α-fluoro group and a double bond between positions 1 and 2. Triamcinolone (9-fluoro-11β, 16α, 17, 21-tetrahydroxypregna- 1,4-diene-3,20-dione), introduced in 1958, combines the structural features of a ?1 -corticoid and a 9α-fluoro corticoid. As mentioned previously, the 9α-fluoro group increases the anti-inflammatory potency, but it also markedly increases the mineralocorticoid potency. This is undesirable if the drug is to be used internally for the treatment of rheumatoid arthritis. By inserting a 16α-hydroxy group into the molecule, one can decrease the mineralocorticoid activity.
Chemical Properties	White, crystalline powder. Insoluble in water; slightly soluble in usual organic solvents; soluble in dimethylformamide.
Originator	Kenacort,Squibb,US,1958
Uses	A glucocorticoid, antiasthmatic (inhalant); antiallergic (nasal).
Uses	Triamcinolone is a glucocorticoid. Triamcinolone is used as an antiasthmatic (inhalant); antiallergic (nasal).
Definition	ChEBI: A C21-steroid hormone that is 1,4-pregnadiene-3,20-dione carrying four hydroxy substituents at positions 11beta, 16alpha, 17alpha and 21 as well as a fluoro substituent at position 9. sed in the form of its 16,17-acetonide to treat various skin infections.
Indications	Intralesional bleomycin, a cytotoxic drug that inhibits DNA synthesis, is effective for all varieties of recalcitrant warts. Various concentrations of the drug have been used, although the total dose must be carefully tracked over time to avoid potential systemic toxicity.
Manufacturing Process	Preparation of δ1,4-Pregnandiene-9α-fluoro-11β,16α,17α,21-Tetrol-16,21- Diacetate: An agar slant of Corynebacterium simplex was washed with 5 ml of sterile saline and the spore suspension added to 100 ml of Trypticase soy broth in a 500 ml Erlenmeyer. The mixture was incubated at 32°C for 8 hr and 1 ml was used to inoculate 10 flasks, each containing 100 ml of Trypticase soy broth. The flasks were incubated with shaking at 32°C for 16 hr. 20 mg δ4- pregnene-9α-fluoro-11β,16α,17α,21-tetrol-3,20-dione16,21-diacetate dissolved in 2 ml ethanol was added and the flasks pooled. This solution was extracted several times with methylene chloride, washed with saturated saline and evaporated under reduced pressure. The residue was dissolved in methanol, treated with activated charcoal, filtered through diatomaceous earth and reevaporated to afford 277 mg of oil and acetylated overnight.
Paper strip chromatography showed approximately equal amounts of substrate and a more polar product (δ1,4-pregnadiene-9α-fluoro-11β,16α,17α,21-tetrol- 3,20-dione 16,21-diacetate) together with very small amounts of two less polar products. Partition chromatography of 0.25 gram of the residue (diatomaceous earth column; system: 2 parts ethyl acetate, 3 parts petroleum ether (90° to 100°C), 3 parts methanol and 2 parts water) separated the less polar products and the substrate. The desired most polar product remained on the column and was eluted with 500 ml of methanol. The residue (90 mg) from the evaporated methanol was repartitioned on diatomaceous earth [system: 3 parts ethyl acetate, 2 parts petroleum ether (90° to 100°C), 3 parts methanol, and 2 parts water] and the cut containing the desired product (determined by ultraviolet absorption spectrum) was evaporated under reduced pressure to afford 18 mg of solid.
Crystallization from acetone-petroleum ether gave 13 mg of colorless needles of δ1,4-pregnadiene-9α-fluoro-11β,16α,17α,21-tetrol-3,20-dione16,21- diacetate; melting point (Kofler block) about 150° to 240°C with apparent loss of solvent at 150°C. Recrystallization from acetone-petroleum ether did not alter the melting point.
Preparation of δ1,4-Pregnadiene-9α-Fluoro-11β,16α,17α,21-Tetrol-3,20-Dione: A solution of 100 mg of δ1,4-pregnadiene-9α-fluoro-11β,16α,17α,21-tetrol- 3,20-dione16,21-diacetate was dissolved in 10 ml of methanol and cooled to 0°C. After flushing with nitrogen, a solution of 35 mg of potassium hydroxide in 2 ml of methanol was added to the steroid solution. After standing at room temperature for 1 hour, the solution was neutralized with glacial acetic acid and evaporated under a nitrogen atmosphere to a white solid. Water was added, and after cooling, the product was filtered and washed with water to afford 52 mg of δ1,4-pregnadiene-9α-fluoro-11β,16α,17α,21-tetrol-3,20-dione, melting point 246° to 249°C. Three crystallizations from acetone-petroleum ether gave 29 mg of the tetrol, melting point 260° to 262.5°C according to US Patent 2,789,118.
Therapeutic Function	Glucocorticoid
Biochem/physiol Actions	Triamcinolone is a synthetic glucocorticoid agonist; induces gene expression and apoptosis; inhibits prostaglandin synthesis; impairs tumor necrosis factor (TNF)-α-induced degradation of κB-α; potentiates the differentiation-inducing effects of bone morphogenetic proteins (BMP-2, -4, -6).
Clinical Use	Triamcinolone to be used topically is generally dispensed as its more potent and lipophilic acetonide, a 16α,17α-methylenedioxy cyclic ketal or isopropylidene derivative. It is effective in the treatment of psoriasis and other corticoid-sensitive dermatologic conditions. Topically, triamcinolone acetonide is a more potent derivative of triamcinolone and is approximately eight times more active than prednisolone.
Side effects	Even though triamcinolone has an apparently decreased tendency to cause salt and water retention and edema and may induce sodium and water diuresis, it causes other unwanted side effects, including anorexia, weight loss, muscle weakness, leg cramps, nausea, dizziness, and a general toxic feeling.
Safety Profile	Poison by subcutaneous route.An experimental teratogen. Other experimentalreproductive effects. Human mutation data reported.When heated to decomposition it emits toxic fumes of F??.An anti-inflammatory and antiallergic agent.
Chemical Synthesis	Triamcinolone, 9a-fluoro-11b,16a,17,21-tetrahydroxypregna-1, 4-dien-3,20-dione (27.1.61), differs from dexamethsone in terms of chemical structure in that the a methyl group at C16 is replaced with a hydroxyl group. It is synthesized from the 21-O-acetate of hydrocortisone 27.1.17. In the first stage, both carbonyl groups of this compound undergo ketalization by ethylene glycol. Next, the hydroxyl group in the resulting diketal 27.1.53 is replaced with chlorine using thionyl chloride, and the product undergoes dehydrochlorination using an alkaline, during which the 21-O-acetyl group also is hydrolyzed. Acetylating the hydroxyl group once again with acetic anhydride gives a triene 27.1.54. Reacting this with osmium tetroxide gives the vicinal diol 27.1.55. The secondary hydroxyl group at C16 of this product undergoes acetylation by acetic anhydride in pyridine, which forms the diacetate 27.1.56. Treating the product with N-bromoacetamide in chloric acid gives a bromohydrin (27.1.57), which upon reaction with potassium acetate is transformed to an epoxide (27.1.58). Opening of the epoxide ring, using hydrofluoric acid, gives the corresponding 9-fluoro-11-hydroxy derivative 27.1.59. Upon microbiological dehydrogenation, the C1–C2 bond is oxidized to a double bond, forming triamcinolone acetate (27.1.60), the acetyl group of which is hydrolyzed, forming the desired triamcinolone (27.1.61).

Drug interactions	Potentially hazardous interactions with other drugs
Aldesleukin: avoid concomitant use.
Antibacterials: metabolism accelerated by rifamycins; metabolism possibly inhibited by erythromycin; concentration of isoniazid possibly reduced.
Anticoagulants: efficacy of coumarins and phenindione may be altered.
Antiepileptics: metabolism accelerated by carbamazepine, fosphenytoin, phenobarbital, phenytoin and primidone.
Antifungals: increased risk of hypokalaemia with amphotericin - avoid; metabolism possibly inhibited by itraconazole and ketoconazole.
Antivirals: concentration possibly increased by ritonavir.
Ciclosporin: rare reports of convulsions in patients on ciclosporin and high-dose corticosteroids.
Cobicistat: concentration of triamcinolone possibly increased.
Diuretics: enhanced hypokalaemic effects of acetazolamide, loop diuretics and thiazide diuretics.
Vaccines: high dose corticosteroids can impair immune response to vaccines; avoid with live vaccines.
Metabolism	Triamcinolone is metabolised largely hepatically but also by the kidney and is excreted in urine. The main metabolic route is 6-beta-hydroxylation; no significant hydrolytic cleavage of the acetonide occurs.
Triamcinolone Preparation Products And Raw materials
Raw materials	Triamcinolone diacetate-->soy broth-->Potassium hydroxide-->Pancuronium bromide-->Pregna-1,4-diene-3,20-dione, 11β,16α,17,21-tetrahydroxy-, 16,21-diacetate-->9-Fluoro-11,16,17,21-tetrahydroxypregna-1,4-diene-3,20-dione 21-acetate-->Budesonide Impurity 18
Preparation Products	Triamcinolone acetonide 21-acetate