For long-term treatment, the drug is also contraindicated in people with peptic ulcers, severe osteoporosis, severe myopathy, certain viral infections, glaucoma, and metastasizing tumours.There are no contraindications for use in emergency medicine. Side effects
Side effects of triamcinolone are similar to other corticoids. In short-term treatment up to ten days, it has very few adverse effects; however, sometimes gastrointestinal bleeding is seen, as well as acute infections (mainly viral) and impaired glucose tolerance.Side effects of triamcinolone long-term treatment may include coughing (up to bronchospasms), sinusitis, metabolic syndrome–like symptoms such as high blood sugar and cholesterol, weight gain due to water retention, and electrolyte imbalance, as well as cataract, thrush, osteoporosis, reduced muscle mass, and psychosis. Triamcinolone injections can cause bruising and joint swelling. Symptoms of an allergic reaction include rash, itch, swelling, severe dizziness, trouble breathing, and anaphylaxis. Overdose
No acute overdosing of triamcinolone has been described. Interactions
Drug interactions are mainly pharmacodynamic, that is, they result from other drugs either adding to triamcinolones corticoid side effects or working against its desired effects. They include:
Atropine and other anticholinergics can substantially increase pressure in the eyes. Antidiabetic drugs can become less effective because triamcinolone causes diabetes-like symptoms. Aspirin and other NSAIDs, as well as anticoagulants such as warfarin, add to the risk of gastrointestinal bleeding. Diuretics that excrete potassium (such as loop diuretics and thiazides) can increase the risk of hypokalemia and thus lead to abnormal heart rhythm. Cardiac glycosides may have more adverse effects due to reduced potassium levels in the blood.
If any of these lab values are markedly elevated, investigation for other, more serious conditions is warranted.Imaging studies cannot diagnose Rotor syndrome but can help rule out other diseases that cause hyperbilirubinemia. For example, ultrasound of the liver and the biliary tree can help investigate the causes of extra-hepatic biliary obstruction. The gallbladder is visualized on oral cholecystography in Rotor syndrome while it is not visualized in Dubin Johnson syndrome. Ultimately, the best method of diagnosing the disease is the analysis of urine coproporphyrin excretion. The total urine coproporphyrin excretion in Rotor syndrome has a 2- to 5-fold elevation, with 65% constituting coproporphyrin I. Treatment
Rotor syndrome is a benign disease requiring no treatment. Jaundice is a lifelong finding, but the disease is not associated with morbidity or mortality, and life expectancy is not affected. Most individuals with Rotor syndrome are born to consanguineous couples and its diagnosis may coincidently identify consanguinity. Distinguishing Rotor syndrome from other more serious disorders is important to avoid unnecessary workup and interventions. It is also critical to reassure and calm patients or family members of patients with Rotors syndrome that the condition is benign. History
Rotor syndrome is named after the Filipino internist Arturo Belleza Rotor (1907–1988). See also
Jaundice
Bilirubin metabolism
Gilberts syndrome
Crigler–Najjar syndrome

References
External links
Hyperbilirubinemia, Conjugated at eMedicine
Rotor syndrome at NIHs Office of Rare Diseases
Mentioned in MedlinePlus Encyclopedia: Jaundice – yellow skin