Kenalog 0.1% Cream 80gm
It is used to treat skin rashes and other skin irritation.
Drug Class
Topical Corticosteroid
Pharmacologic Class
Glucocorticoid
Pregnancy Category
Category C
FDA Approved
May 1958
DEA Schedule
Not Controlled
Overview
What is this medicine?
Triamcinolone is a type of medicine called a corticosteroid. It works by reducing swelling, redness, and itching caused by various skin conditions like eczema or psoriasis. It helps calm down your skin's overactive immune response.
How to Use This Medicine
Proper Use of This Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. This medication is for topical use only, meaning it should be applied directly to the affected area of your skin. Avoid getting it in your mouth, nose, or eyes, as it may cause burning.
Application Instructions
1. Wash your hands before and after applying the medication, unless your hand is the area being treated.
2. Clean the affected area before applying the medication and dry it thoroughly.
3. Apply a thin layer of the medication to the affected skin and gently rub it in.
4. Do not apply the medication to your face, underarms, or groin area unless your doctor instructs you to do so.
5. Unless directed by your doctor, do not cover the treated area with bandages, dressings, or tight-fitting diapers or plastic pants, as this may increase the amount of medication absorbed into your body.
Important Warnings
Do not use this medication to treat diaper rash.
Avoid applying the medication to cuts, scrapes, or damaged skin.
* Continue using the medication as directed, even if your symptoms improve.
Storage and Disposal
Store this medication at room temperature, away from freezing temperatures. Keep all medications in a safe place, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist. Check with your pharmacist for guidance on the best way to dispose of medications, and consider participating in local drug take-back programs.
Missed Dose
If you miss a dose, apply it as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and resume your regular schedule. Do not apply two doses at the same time or extra doses to make up for a missed dose.
To use this medication correctly, follow your doctor's instructions and read all the information provided. This medication is for topical use only, meaning it should be applied directly to the affected area of your skin. Avoid getting it in your mouth, nose, or eyes, as it may cause burning.
Application Instructions
1. Wash your hands before and after applying the medication, unless your hand is the area being treated.
2. Clean the affected area before applying the medication and dry it thoroughly.
3. Apply a thin layer of the medication to the affected skin and gently rub it in.
4. Do not apply the medication to your face, underarms, or groin area unless your doctor instructs you to do so.
5. Unless directed by your doctor, do not cover the treated area with bandages, dressings, or tight-fitting diapers or plastic pants, as this may increase the amount of medication absorbed into your body.
Important Warnings
Do not use this medication to treat diaper rash.
Avoid applying the medication to cuts, scrapes, or damaged skin.
* Continue using the medication as directed, even if your symptoms improve.
Storage and Disposal
Store this medication at room temperature, away from freezing temperatures. Keep all medications in a safe place, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist. Check with your pharmacist for guidance on the best way to dispose of medications, and consider participating in local drug take-back programs.
Missed Dose
If you miss a dose, apply it as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and resume your regular schedule. Do not apply two doses at the same time or extra doses to make up for a missed dose.
Lifestyle & Tips
- Wash your hands before and after applying the cream/ointment.
- Apply a thin layer to the affected skin area and rub it in gently until it disappears. Do not use more than directed.
- Do not cover the treated area with bandages or other dressings unless specifically instructed by your doctor, as this can increase absorption and side effects.
- Avoid applying the cream/ointment to your eyes, mouth, or inside your nose.
- Do not use on broken skin or open wounds unless directed by your doctor.
- If you are treating a child, be extra careful not to use too much or cover the treated area, as children are more susceptible to side effects.
- Do not use for longer than prescribed by your doctor.
Available Forms & Alternatives
Available Strengths:
Generic Alternatives:
Dosing & Administration
Adult Dosing
Standard Dose:
Apply a thin film to the affected area two to four times daily, depending on severity and formulation.
Condition-Specific Dosing:
psoriasis:
Apply 2-4 times daily.
eczema:
Apply 2-4 times daily.
Pediatric Dosing
Neonatal:
Not established
Infant:
Apply a thin film to the affected area two to four times daily. Use with caution; increased risk of systemic absorption due to higher surface area to body weight ratio and immature skin barrier. Avoid occlusive dressings.
Child:
Apply a thin film to the affected area two to four times daily. Use with caution; increased risk of systemic absorption due to higher surface area to body weight ratio. Avoid occlusive dressings.
Adolescent:
Apply a thin film to the affected area two to four times daily.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed for topical use.
Moderate:
No adjustment needed for topical use.
Severe:
No adjustment needed for topical use.
Dialysis:
No specific considerations for topical use.
Hepatic Impairment:
Mild:
No adjustment needed for topical use.
Moderate:
No adjustment needed for topical use.
Severe:
No adjustment needed for topical use.
Pharmacology
Mechanism of Action
Triamcinolone acetonide is a synthetic corticosteroid that possesses anti-inflammatory, antipruritic, and vasoconstrictive properties. It acts by inducing phospholipase A2 inhibitory proteins, lipocortins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption; varies with skin integrity, vehicle, site of application, and use of occlusive dressings. Absorption can be up to 1-5% in healthy skin, significantly higher in damaged skin.
Tmax:
Not well-defined for topical application due to minimal systemic absorption.
FoodEffect:
Not applicable for topical formulation.
Distribution:
Vd:
Not well-defined for topical application.
ProteinBinding:
Approximately 60-80% (if systemically absorbed).
CnssPenetration:
Limited (if systemically absorbed).
Elimination:
HalfLife:
Approximately 2-5 hours (if systemically absorbed).
Clearance:
Not well-defined for topical application.
ExcretionRoute:
Renal (primarily) and biliary (if systemically absorbed).
Unchanged:
Minimal unchanged drug excreted.
Pharmacodynamics
OnsetOfAction:
Within hours to days for symptomatic relief.
PeakEffect:
Days to weeks for maximal therapeutic effect.
DurationOfAction:
Varies with frequency of application and severity of condition.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood sugar, including:
+ Confusion
+ Feeling sleepy
+ Unusual thirst or hunger
+ Passing urine more often
+ Flushing
+ Fast breathing
+ Breath that smells like fruit
Signs of a weak adrenal gland, such as:
+ Severe upset stomach or vomiting
+ Severe dizziness or passing out
+ Muscle weakness
+ Feeling very tired
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, including:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Irritation at the site where the medication was applied
Skin changes, such as:
+ Pimples
+ Stretch marks
+ Slow healing
+ Hair growth
Change in skin color
Thinning of the skin
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Burning
Itching
* Dry skin
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood sugar, including:
+ Confusion
+ Feeling sleepy
+ Unusual thirst or hunger
+ Passing urine more often
+ Flushing
+ Fast breathing
+ Breath that smells like fruit
Signs of a weak adrenal gland, such as:
+ Severe upset stomach or vomiting
+ Severe dizziness or passing out
+ Muscle weakness
+ Feeling very tired
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, including:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Irritation at the site where the medication was applied
Skin changes, such as:
+ Pimples
+ Stretch marks
+ Slow healing
+ Hair growth
Change in skin color
Thinning of the skin
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Burning
Itching
* Dry skin
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Increased redness, swelling, or irritation of the skin where the medicine is applied.
- Signs of skin infection (e.g., pus, fever, spreading redness).
- Thinning of the skin, easy bruising, or stretch marks in the treated area.
- Acne-like breakouts or increased hair growth in the treated area.
- Changes in skin color (lightening or darkening).
- If used extensively or for prolonged periods, watch for signs of systemic absorption such as unusual weight gain, swelling in the face (moon face), fatigue, or muscle weakness.
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, any of its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is not an exhaustive list, and it is crucial to disclose all your medications to avoid potential interactions.
* Any health problems you have, as they may affect the safety of taking this medication.
To ensure your safety, do not start, stop, or change the dose of any medication without first consulting your doctor. It is your responsibility to verify that it is safe to take this medication with all your other medications and health conditions. Your doctor and pharmacist will work together to help you make informed decisions about your treatment.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, any of its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is not an exhaustive list, and it is crucial to disclose all your medications to avoid potential interactions.
* Any health problems you have, as they may affect the safety of taking this medication.
To ensure your safety, do not start, stop, or change the dose of any medication without first consulting your doctor. It is your responsibility to verify that it is safe to take this medication with all your other medications and health conditions. Your doctor and pharmacist will work together to help you make informed decisions about your treatment.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Adhere to the prescribed duration of treatment and do not use this drug for longer than recommended by your doctor.
Before using any other medications or products on your skin, including soaps, consult with your doctor to ensure safe use. Exercise caution when applying this medication to a large area of skin and discuss this with your doctor if necessary.
Using this medication too frequently can exacerbate your skin condition. If the patient is a child, use this medication with caution, as the risk of certain side effects may be higher in children. In some cases, this drug may affect growth in children and teenagers, and regular growth checks may be necessary. Consult with your doctor regarding this potential risk.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor. It is crucial to discuss the benefits and risks of this medication to both you and your baby to make an informed decision.
Before using any other medications or products on your skin, including soaps, consult with your doctor to ensure safe use. Exercise caution when applying this medication to a large area of skin and discuss this with your doctor if necessary.
Using this medication too frequently can exacerbate your skin condition. If the patient is a child, use this medication with caution, as the risk of certain side effects may be higher in children. In some cases, this drug may affect growth in children and teenagers, and regular growth checks may be necessary. Consult with your doctor regarding this potential risk.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor. It is crucial to discuss the benefits and risks of this medication to both you and your baby to make an informed decision.
Overdose Information
Overdose Symptoms:
- Acute overdose with topical application is unlikely due to minimal systemic absorption.
- Chronic overuse or application to large surface areas, especially under occlusion, can lead to systemic effects of corticosteroids, including Cushing's syndrome, hyperglycemia, and HPA axis suppression (adrenal insufficiency).
What to Do:
Discontinue the medication gradually under medical supervision. Symptomatic and supportive treatment for systemic effects. Call 1-800-222-1222 (Poison Control Center) for advice if significant systemic symptoms are suspected.
Drug Interactions
Monitoring
Baseline Monitoring
Skin condition assessment
Rationale: To establish baseline severity of dermatosis and identify any pre-existing skin atrophy or infection.
Timing: Prior to initiation of therapy.
Routine Monitoring
Efficacy of treatment (reduction in inflammation, pruritus)
Frequency: Regularly, at follow-up visits (e.g., weekly to monthly depending on condition).
Target: Significant improvement in symptoms and appearance of affected skin.
Action Threshold: Lack of improvement or worsening of symptoms may indicate need for re-evaluation or alternative therapy.
Local adverse effects (e.g., skin atrophy, striae, telangiectasias, folliculitis, perioral dermatitis)
Frequency: Regularly, at follow-up visits.
Target: Absence of or minimal adverse effects.
Action Threshold: Presence of significant local adverse effects may require reduction in frequency, potency, or discontinuation of therapy.
Signs of systemic absorption (e.g., Cushing's syndrome, hyperglycemia, HPA axis suppression)
Frequency: Periodically, especially with prolonged use, large surface area application, or occlusive dressings, particularly in children.
Target: Normal adrenal function and glucose levels.
Action Threshold: Symptoms or laboratory findings suggestive of systemic absorption (e.g., low morning cortisol, elevated glucose) require immediate re-evaluation and potential discontinuation.
Symptom Monitoring
- Burning
- Itching
- Irritation
- Dryness
- Folliculitis
- Hypertrichosis
- Acneiform eruptions
- Hypopigmentation
- Perioral dermatitis
- Allergic contact dermatitis
- Maceration of the skin
- Secondary infection
- Skin atrophy
- Striae
- Miliaria
- Weight gain
- Moon face
- Fatigue (signs of HPA axis suppression)
Special Patient Groups
Pregnancy
Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Avoid large areas, prolonged use, or occlusive dressings.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenicity, though data for topical corticosteroids are limited and generally low risk.
Second Trimester:
Risk of systemic absorption and potential fetal effects (e.g., growth restriction) with high doses or prolonged use.
Third Trimester:
Risk of systemic absorption and potential fetal effects (e.g., growth restriction) with high doses or prolonged use. Neonatal adrenal suppression is a theoretical risk with extensive maternal use.
Lactation
Use with caution. It is not known whether topical corticosteroids are excreted in human milk. Systemic corticosteroids are excreted in breast milk. Minimize infant exposure by avoiding application to the breast area and ensuring minimal systemic absorption in the mother.
Infant Risk:
Low risk with appropriate use, but monitor for potential adverse effects if significant maternal absorption occurs.
Pediatric Use
Children are more susceptible to systemic adverse effects (e.g., HPA axis suppression, Cushing's syndrome, growth retardation) due to a larger skin surface area to body weight ratio and immature skin barrier. Use the least potent effective dose for the shortest duration possible. Avoid occlusive dressings. Monitor for signs of systemic absorption.
Geriatric Use
No specific dosage adjustments are generally required. However, elderly patients may have thinner skin, which could increase the risk of local adverse effects like skin atrophy and purpura. Use with caution and monitor skin integrity.
Clinical Information
Clinical Pearls
- Triamcinolone acetonide is a medium-potency topical corticosteroid, suitable for a wide range of inflammatory dermatoses.
- The 0.1% cream is generally preferred for moist, weeping lesions, while the ointment is better for dry, scaly lesions.
- Advise patients to apply a very thin layer; 'less is more' with topical steroids to minimize side effects.
- Educate patients on the signs of skin atrophy (thinning, shininess, visible blood vessels) and to report them.
- Avoid prolonged use on the face, groin, or axillae due to increased risk of skin atrophy, striae, and perioral dermatitis.
- If no improvement is seen after 2-4 weeks, re-evaluate the diagnosis or consider alternative treatments.
Alternative Therapies
- Other topical corticosteroids (e.g., hydrocortisone, fluocinonide, clobetasol)
- Topical calcineurin inhibitors (e.g., tacrolimus, pimecrolimus) for eczema
- Topical vitamin D analogs (e.g., calcipotriene) for psoriasis
- Emollients and moisturizers for dry skin conditions
- Systemic therapies for severe or widespread dermatoses
Cost & Coverage
Average Cost:
$15 - $50 per 80gm tube of 0.1% cream/ointment
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 2 (Generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.