Kenalog-40 Vial 10ml

Triamcinolone is a synthetic glucocorticoid that binds to specific intracellular glucocorticoid receptors in target tissues. This binding leads to the formation of a steroid-receptor complex that translocates to the nucleus, where it modulates gene expression. This results in potent anti-inflammatory and immunosuppressive effects by inhibiting the synthesis of inflammatory mediators (e.g., prostaglandins, leukotrienes), suppressing the migration and activity of immune cells (e.g., lymphocytes, macrophages), and stabilizing lysosomal membranes.

Serious 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
Note: In rare cases, allergic reactions can be fatal.
Signs of infection, including:
+ Fever
+ Chills
+ Severe sore throat
+ Ear or sinus pain
+ Cough
+ Increased or changed sputum production
+ Painful urination
+ Mouth sores
+ Wounds that won't heal
Signs of Cushing's syndrome, such as:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Signs of a weak adrenal gland, including:
+ Severe stomach upset or vomiting
+ Severe dizziness or fainting
+ Muscle weakness
+ Fatigue
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of high blood sugar, such as:
+ Confusion
+ Drowsiness
+ Increased thirst or hunger
+ Frequent urination
+ Flushing
+ Rapid breathing
+ Fruity-smelling breath
Signs of high blood pressure, including:
+ Severe headache or dizziness
+ Fainting
+ Changes in vision
Signs of low potassium levels, such as:
+ Muscle pain or weakness
+ Muscle cramps
+ Abnormal heartbeat
Signs of pancreatitis, including:
+ Severe stomach pain
+ Severe back pain
+ Severe stomach upset or vomiting
Shortness of breath
Sudden weight gain
Swelling in the arms or legs
Abnormal heartbeat (fast, slow, or irregular)
Chest pain
Stomach pain
Black, tarry, or bloody stools
Vomiting blood or coffee ground-like material
Unexplained bruising or bleeding
Bone pain
Joint pain or swelling
Muscle pain or weakness
Fatigue or weakness
Redness or white patches in the mouth or throat
Changes in vision
New or worsening mental, mood, or behavioral changes
Changes in menstrual period
Seizures
Skin changes (acne, stretch marks, slow healing, hair growth)
Purple, red, blue, brown, or black bumps or patches on the skin or in the mouth
Burning, numbness, or tingling sensations
Redness or swelling at the injection site

Other Possible Side Effects

Like all medications, this drug can cause side effects. Many people experience no side effects or only mild ones. If you notice any of the following side effects or any other symptoms that bother you or don't go away, contact your doctor:

Trouble sleeping
Upset stomach or vomiting
Weight gain
Restlessness
Excessive sweating
Hair thinning

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.

Before Taking This Medication: Important Information to Share with Your Doctor

To ensure safe treatment, inform your doctor of the following:

Any allergies you have to this medication, its components, or other substances, including foods and drugs. Describe the allergic reaction you experienced, such as symptoms and signs.
Stomach or bowel problems, including diverticulitis, diverticulosis, ulcerative colitis, or ulcers.
Any current infections, such as bacterial, viral, or fungal infections, including:
+ Amoeba infections (e.g., traveler's diarrhea)
+ Herpes infection of the eye
+ Malaria infection in the brain
+ Threadworm infestation
+ Other infections
If you have an infection at the site where the injection will be administered (for intramuscular injections).
If you have idiopathic thrombocytopenic purpura (ITP), a condition affecting platelet count (for intramuscular injections).

Additionally, provide your doctor and pharmacist with a comprehensive list of:

All prescription and over-the-counter (OTC) medications you are taking
Natural products and vitamins you are using
Any health problems you have

This information is crucial to determine the safety of taking this medication with your other drugs and health conditions. Never start, stop, or change the dose of any medication without consulting your doctor first.

Important Information About Your Medication

It is crucial that you inform all of your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

Your doctor will need to monitor your blood work regularly. If you are taking this medication long-term, you may also require regular checks on your eye pressure and bone density.

This medication can interfere with allergy skin tests, so be sure to notify your doctor and laboratory personnel that you are taking it.

You may need to reduce your salt intake and increase your potassium consumption. Discuss this with your doctor to determine the best approach for your situation.

If you have diabetes, it is essential to closely monitor your blood sugar levels while taking this medication.

Before receiving any vaccines, consult with your doctor. Certain vaccines may not be effective or may increase the risk of infection when taken with this medication.

Warning: Risk of Infection

Steroid medications like this one can increase your risk of developing infections, which can be severe or even life-threatening. Chickenpox and measles can be particularly dangerous for people taking steroids. If you have not had these illnesses before, avoid close contact with anyone who has them. If you have been exposed to chickenpox or measles, notify your doctor immediately.

To minimize the risk of infection, practice good hygiene by washing your hands frequently, and avoid close contact with people who have infections, colds, or flu. If you experience any signs of infection, such as fever, chills, or sore throat, inform your doctor promptly.

Reactivation of Infections

In some cases, this medication can cause the reactivation of certain infections, including tuberculosis and hepatitis B. If you have a history of these infections, inform your doctor.

Adrenal Insufficiency

This medication can decrease the production of natural steroids in your body. If you experience stress due to fever, infection, surgery, or injury, your doctor may prescribe additional oral steroids to help your body cope. Carry a warning card with you to alert medical personnel that you may require extra steroids in emergency situations.

Epidural Administration

Using this medication via epidural injection is not approved and can cause severe health problems, including paralysis, loss of vision, stroke, and death.

Special Considerations

If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects.

If you have been taking this medication for an extended period, do not stop abruptly. Gradually tapering off the medication under your doctor's guidance can help minimize potential side effects.

If you miss a dose or recently stopped taking this medication and experience symptoms such as fatigue, weakness, shakiness, rapid heartbeat, confusion, sweating, or dizziness, notify your doctor immediately.

Long-term Use

Prolonged use of this medication can increase the risk of osteoporosis (weak bones) and eye problems, such as cataracts or glaucoma. Discuss your individual risk factors with your doctor.

Some formulations of this medication contain benzyl alcohol, which can be hazardous to newborns and infants. If possible, avoid products containing benzyl alcohol in these age groups.

Long-term use of this medication has been associated with an increased risk of Kaposi's sarcoma, a type of cancer.

Pediatric Considerations

This medication can affect growth in children and adolescents. Regular growth checks may be necessary to monitor potential effects.

Pregnancy and Breastfeeding

If you are pregnant, plan to become pregnant, or are breastfeeding, discuss the potential benefits and risks of this medication with your doctor.

• Live or live attenuated vaccines (during immunosuppressive doses of corticosteroids)

• Barbiturates (e.g., phenobarbital)
• Phenytoin
• Rifampin
• Carbamazepine
• Ketoconazole
• Itraconazole
• Macrolide antibiotics (e.g., erythromycin, clarithromycin)
• Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
• Warfarin and other anticoagulants
• Antidiabetic agents (insulin, oral hypoglycemics)

• Thiazide and loop diuretics
• Digoxin
• Neuromuscular blocking agents
• Cholestyramine
• Oral contraceptives

• Not specifically categorized as minor for systemic triamcinolone, but general caution with any drug interaction.

• Signs of infection (fever, chills, sore throat, unusual fatigue)
• Symptoms of adrenal insufficiency (severe fatigue, weakness, nausea, vomiting, dizziness, low blood pressure) upon withdrawal
• Hyperglycemia (increased thirst, increased urination, blurred vision)
• Fluid retention (swelling in ankles/feet, rapid weight gain, shortness of breath)
• Mood changes (irritability, anxiety, depression, euphoria, insomnia)
• Gastrointestinal upset (stomach pain, heartburn, black/tarry stools)
• Muscle weakness or pain
• Vision changes (blurred vision, eye pain)
• Skin changes (thinning, bruising, acne)
• Bone pain or fractures

Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Corticosteroids can cross the placenta. Infants born to mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism.

Triamcinolone is excreted into breast milk. While the amount is generally small, potential for adverse effects in the infant (e.g., growth suppression, interference with endogenous corticosteroid production) exists. Use with caution; consider lowest effective dose and monitor infant.

Corticosteroids can cause growth retardation and adrenal suppression in children. Use the lowest effective dose for the shortest possible duration. Monitor growth and development carefully. Increased susceptibility to infections.

Elderly patients may be at increased risk for common corticosteroid adverse effects, including osteoporosis, diabetes, hypertension, cataracts, and glaucoma. Use the lowest effective dose and monitor closely for adverse reactions.

• Kenalog-40 is a depot formulation, meaning it provides a prolonged effect but also prolonged potential for side effects. Patients should be aware of this extended duration.
• Adrenal suppression is a significant risk with prolonged systemic corticosteroid use. Abrupt discontinuation can lead to life-threatening adrenal crisis. Always taper the dose gradually under medical supervision.
• Corticosteroids can mask signs and symptoms of infection, making diagnosis difficult. Patients should be advised to report any signs of infection promptly.
• Monitor blood glucose closely, especially in diabetic patients, as corticosteroids can cause hyperglycemia.
• Intra-articular injections should be limited to avoid joint damage. Repeated injections into the same joint are generally discouraged.
• Patients should carry a steroid card or wear medical identification if on long-term systemic therapy, indicating their need for corticosteroids in an emergency.

• Nonsteroidal Anti-inflammatory Drugs (NSAIDs) for inflammatory conditions
• Disease-Modifying Antirheumatic Drugs (DMARDs) for autoimmune conditions
• Antihistamines for allergic reactions
• Topical corticosteroids for localized skin conditions
• Immunosuppressants (non-corticosteroid) for severe autoimmune diseases

If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed otherwise, do not flush medications down the toilet or pour them down the drain. If you are unsure about the correct disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the amount, and the time it happened, as this will aid in receiving appropriate treatment.