This medication is used to treat skin rashes that have become infected by certain bacteria or fungi. It contains 4 ingredients: triamcinolone, neomycin, gramicidin, and nystatin.

Triamcinolone belongs to the class of medications called corticosteroids and works by decreasing inflammation. Neomycin and gramicidin belong to the class of medications called antibiotics and work by killing certain bacteria. Nystatin belongs to the class of medications called anti-fungals and works by killing certain fungi.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

Cream: Rub a small amount of cream into the affected areas 2 to 3 times daily.

Ointment: Apply a thin film to the affected areas 2 to 3 times daily.

If your condition has not improved after using this medication for 7 days, contact your doctor. Avoid applying this medication near your eyes. If it does get into the eyes, flush with plenty of clear water and consult your doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones given here, do not change the way that you are taking the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, use it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not use a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light, and keep it out of the reach of children.

Each g of cream contains 1 mg of triamcinolone, USP 100,000 units of nystatin, USP 2.5 mg of neomycin base (in sulfate), and USP 0.25 mg of gramicidin in a vanishing cream base. Nonmedicinal ingredients: aluminum hydroxide, ceteareth-20, cetearyl alcohol, glyceryl monostearate, glyceryl stearate, methylparaben, petrolatum, polysorbate 60, propylene glycol, propylene glycol monostearate, propylparaben, purified water, sorbitol, and titanium dioxide.

Do not use this medication if you:

• are allergic to triamcinolone, neomycin, nystatin, gramicidin, or any ingredients of the medication
• have a skin infection caused by bacteria or by viruses, including herpes simplex, vaccinia, and varicella (chickenpox)
• have tuberculosis of the skin
• are treating an allergic reaction and are covering the affected skin with a dressing that does not breathe

Do not use this medication in the eyes. People with perforated eardrums or otitis media should not apply it to the external ear canal.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• burning, dryness, irritation, itching, or redness of skin (usually mild and temporary)
• increased redness or scaling of skin sores (usually mild and temporary)
• skin rash (usually mild and temporary)

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• blood-containing blisters on skin
• burning and itching of skin
• lack of healing of skin condition
• numbness in fingers
• painful, red or itchy, pus-containing blisters in hair follicles
• raised, dark-red, wart-like spots on skin, especially when used on the face
• skin infection
• thinning of skin with easy bruising

Additional side effects may occur if this medication is used improperly or for long periods of time. Check with your doctor as soon as possible if any of the following side effects occur:

• acne or oily skin
• backache
• blurring or loss of vision (occurs gradually if used near the eye)
• burning and itching of skin with pinhead-sized red blisters
• depression
• eye pain (if used near the eye)
• filling or rounding of the face
• increased blood pressure
• irregular heartbeat
• irregular menstrual periods
• irritability
• irritation of skin around mouth
• loss of appetite
• muscle cramps, pain, or weakness
• nausea
• rapid weight gain or loss
• reddish-purple lines on arms, face, legs, trunk, or groin
• skin colour changes
• softening of the skin
• stomach bloating, burning, cramping, or pain
• swelling of feet or lower legs
• tearing of the skin
• unusual bruising
• unusual decrease in sexual desire or ability (in men)
• unusual increase in hair growth, especially on the face
• unusual loss of hair, especially on the scalp
• unusual tiredness or weakness
• vomiting
• weakness of the arms, legs, or trunk (severe)
• worsening of infections

Stop taking the medication and seek immediate medical attention if any of the following occur:

• symptoms of a serious allergic reaction (such as hives, swelling of the face or throat, or difficulty breathing)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Amount to be applied: Because of the potential risk of kidney and ear problems, avoid prolonged use or the use of large amounts in the treatment of skin infections following burns, ulceration, and other conditions where the absorption of neomycin into the bloodstream is possible.

Medical treatment: Inform all health care professionals involved in your care that you have been using skin-applied corticosteroids.

Occlusive dressings: The use of occlusive dressings (those that don't breathe) is not recommended for this medication. This can increase the amount of medication that is taken in by the body and may cause side effects.

Overgrowth of organisms: Prolonged use of this medication may result in the overgrowth of organisms not killed by the medication, including fungi other than candida. If your condition does not improve or gets worse, call your doctor.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.

Breast-feeding: It is not known if this medication passes into breast milk. If you are breast-feeding and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

There may be an interaction between triamcinolone - neomycin - nystatin - gramicidin and any of the following:

• aldesleukin
• other topical (skin-applied) corticosteroids
• preparations that irritate the skin

If you are using any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop using one of the medications,
• change one of the medications to another,
• change how you are using one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.