Kenalog Injection

The generic name of the drug is triamcinolone acetonide. Kenalog Injection is a synthetic glucocorticosteroid, which has anti-inflammatory action.

Drug Description

The generic name of the drug is triamcinolone acetonide. Kenalog Injection is a synthetic glucocorticosteroid, which has anti-inflammatory action. A milliliter of the sterile suspension contains 40 mg triamcinolone acetonide, 0.66% sodium chloride, 0.99% benzyl alcohol, 0.63% carboxymethylcellulose sodium, and 0.04% polysorbate 80. Here may be also presented hydrochloric acid or sodium hydroxide to regulate acidity (pH – 5.0 to 7.5). At the period of production, there is nitrogen in the container, instead of air.

Triamcinolone acetonide has a color range from white to ivory. It’s a crystalline powder that has a slight odor and is scarcely insoluble in water and very soluble in alcohol.

Glucocorticosteroids or glucocorticoids (GCs) are part of the feedback action of the immune system that decreases the aspects of immune function, such as lowering of inflammation. So, they are used to treat diseases caused by a highly active immune system (asthma, allergies, autoimmune diseases, and sepsis). GCs are also readily absorbed from the gastrointestinal tract. Triamcinolone is a synthetic analog, which is primarily used for its antiinflammatory effects in diseases of various organ systems. Such medications also interfere with certain abnormal mechanisms in cells of cancer, so they are used in high doses to treat this disorder. Moreover, several studies indicated that this medication as a GS has an extended duration of effects.


The medication is prescribed in different conditions including intestinal disorders, skin diseases, allergic disorders, rheumatic disorders, blood diseases, breathing problems, eye diseases and cancer.

Intestinal disorders: the medication helps to endure a critical period of the ulcerative colitis and regional enteritis.

Skin diseases: including exfoliative erythroderma, bullous dermatitis herpetiformis, mycosis fungoides, severe erythema multiforme and pemphigus.

Allergic disorders: it may provide a control of incapacitating and severe allergic conditions in asthma, contact dermatitis, perennial or seasonal allergic rhinitis, atopic dermatitis, transfusion reactions, drug hypersensitivity reactions and serum sickness.

Rheumatic disorders: it may be used as a therapy during short periods to help a patient to endure exacerbation in acute rheumatic carditis, acute gouty arthritis, ankylosing spondylitis, rheumatoid and psoriatic arthritis.

Blood diseases: including Diamond-Blackfan anemia, acquired hemolytic anemia, pure red cell aplasia and selected cases of secondary thrombocytopenia.

Breathing problems: including symptomatic sarcoidosis, idiopathic eosinophilic pneumonias, berylliosis, fulminating and disseminated pulmonary tuberculosis.

Eye diseases: including temporal arteritis, sympathetic ophthalmia, uveitis and several ocular inflammatory conditions.

Cancer: for instance, cerebral edema connected with primary or metastatic brain tumor; palliative care of leukemias and lymphomas; hypercalcemia associated with cancer.


The initial dose of Kenalog Injection varies from 2.5 mg to 100 mg per day in dependence of the disease being treated. Nevertheless, in certain acute, overwhelming and life-threatening situations excessiveness in dosages may be justified. But, the most important is that dosage requirements must be individualized on the basis of the disease treated and the response of the patient’s organism.

In pediatric patients, the initial dose of medication varies from 0.11 to 1.6 mg/kg/day in divided doses (3–4) depending on the disease entity being treated.

Local administration:

The lower dosages in the initial injections of triamcinolone acetonide produce the desired impact if routed to provide a localized concentration.

The initial dose of the drug for intra-articular route varies from 2.5 mg to 15 mg depending on the size of joints and the disease. Single injections into certain joints may reach up to 20 mg or more. A single injection of medication is often sufficient, but sometimes several injections may be needed.

For intralesional route, the initial dose of the medication per injection varies depending on the specific disease, as well as the lesion being treated. The localization for injection and its size should be carefully considered due to the range of factors. Such injections may be repeated, if there is a necessity, but it should be kept in mind, that the greater the total volume employed the bigger amount of corticosteroid is available for systemic absorption and effects.

Side Effects

There is a range of side effects which may appear during the application of the drug. Among them are:

  • redness or pain at the injection site,
  • bruising or swelling,
  • stomach upset (nausea, bloating, stomach or side pain)
  • headache and dizziness,
  • sleep problems (insomnia),
  • menstrual period changes, 
  • thinning hair,
  • sweating,
  • appetite changes or weight gain.

It should be known that some side effects demand of being immediately consulting with doctor. They are:

  • short of breath;
  • fast, slow, or uneven heart rate;
  • problems with vision;
  • dangerously high blood pressure;
  • swelling, rapid weight gain;
  • changes in mood or behavior;
  • seizure, muscle pain, tenderness, or weakness.

Drug Interactions

A total of 711 drugs are known to interact with Kenalog Injection.

Aminoglutethimide: a loss of corticosteroid-induced adrenal suppression.

Amphotericin B injection and potassium-depleting agents: cardiac enlargement and congestive heart failure.

Antibiotics: a significant decrease in corticosteroid clearance.

Anticholinesterases: severe weakness in patients with myasthenia gravis.

Anticoagulants (warfarin), oral: inhibition of response to warfarin.

Antidiabetics: increase of blood glucose concentrations.

Cholestyramine: increase the clearance of corticosteroids.

Cyclosporine: increased activity of both medications.

Digitalis glycosides: increased risk of arrhythmias due to hypokalemia.

Estrogens, including oral contraceptives: decrease the hepatic metabolism of certain corticosteroids, thereby increasing their effect.

Hepatic enzyme inducers: enhance the metabolism of corticosteroids and require the increase of the corticosteroid dosage.

Ketoconazole: decrease the metabolism of corticosteroid, leading to an increased risk of side effects.

Nonsteroidal anti-inflammatory drugs: increase the risk of gastrointestinal side effects; hypoprothrombinemia.

Vaccines: may exhibit a decreased response to live or inactivated vaccinesand to toxoids.

Warnings & Precautions

Before using this medication, it is necessary to consult with the doctor about patient’s allergies to corticosteroids or any other allergies, as corticosteroid contains inactive ingredients, which can cause some allergic reactions or other problems.

This medication should not be used if patient has untreated fungal infections or certain bleeding disorder (idiopathic thrombocytopenic purpura).

Before using this medication, the medical history should be discussed with the doctor, especially of: high blood pressure, bleeding problems, heart problems, brittle bones, stomach/intestinal problems, kidney disease, severe liver disease, thyroid problems, current infections, certain eye diseases, head injury, diabetes, previously infected joint, seizures, untreated mineral problems, certain mental/mood conditions.

This medication provides dizziness, so it is contraindicated to drive or do any activity that requires alertness.

Drinking alcohol while having the medication treatment may increase the risk of intestinal bleeding.

Corticosteroid medications can make it more difficult to respond to physical stress. Therefore, it is necessary to tell the doctor about using such medication before having emergency treatment or surgery.

Older adults are more sensitive to the side effects, such as poorer blood sugar control or confusion of the drug. In children it may slow down a growth if used for a long time. Injecting this medication is not recommended for children younger than six.

As to the pregnancy this medication should be used only in definite cases. However, there are only rare reports of harm to an unborn baby in case of using corticosteroids during pregnancy. The drug passes into breast milk, but there have been no reports of negative effects to nursing infants.


This medication should be used as scheduled. If overdosed, it is necessary to contact a poison control center or emergency room immediately.

Chronic overdosage requires continuous steroid therapy. Treatment of acute overdosage presupposes supportive or symptomatic therapy.

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