Kenalog-80 Inj 1ml Vial

Triamcinolone acetonide is a synthetic corticosteroid with potent anti-inflammatory and immunosuppressive properties. It acts by binding to intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus and modulates gene expression. This leads to the synthesis of anti-inflammatory proteins (e.g., lipocortin) and inhibition of pro-inflammatory mediators (e.g., prostaglandins, leukotrienes, cytokines). It also suppresses the migration of polymorphonuclear leukocytes and reverses increased capillary permeability.

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: 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, or swelling of the mouth, face, lips, tongue, or throat. In rare cases, allergic reactions can be fatal.
Signs of infection: fever, chills, severe sore throat, ear or sinus pain, cough, increased or changed sputum production, painful urination, mouth sores, or a wound that won't heal.
Signs of Cushing's syndrome: weight gain in the upper back or abdomen, moon face, severe headache, or slow wound healing.
Signs of adrenal gland weakness: severe nausea or vomiting, severe dizziness or fainting, muscle weakness, fatigue, mood changes, decreased appetite, or weight loss.
Signs of high blood sugar: confusion, drowsiness, increased thirst or hunger, frequent urination, flushing, rapid breathing, or fruity-smelling breath.
Signs of high blood pressure: severe headache or dizziness, fainting, or changes in vision.
Signs of low potassium levels: muscle pain or weakness, muscle cramps, or an irregular heartbeat.
Signs of pancreatitis: severe abdominal pain, severe back pain, or severe nausea and vomiting.
Shortness of breath, significant weight gain, or 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 vomit.
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 periods.
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're concerned about any of the following side effects or if they persist, contact your doctor:

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

This is not an exhaustive list of possible side effects. If you have questions or concerns, 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 about 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 bleeding disorder (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

It is crucial to verify that it is safe to take this medication with all your other medications and health conditions. Do not initiate, stop, or adjust the dose of any medication without consulting your doctor.

Important Information About Your Medication

It is crucial that you inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood tests, as directed by your doctor, are necessary to monitor your health. If you are taking this medication long-term, you may also need to have your eye pressure and bone density checked.

Special Precautions

This medication may 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; consult with your doctor for guidance.
If you have diabetes, it is essential to closely monitor your blood sugar levels.
Before receiving any vaccines, discuss the potential risks and benefits with your doctor, as some vaccines may not be effective or may increase the risk of infection when taken with this medication.

Infection Risks

Steroid medications like this one can increase your risk of infection, which can be severe or even life-threatening. Avoid close contact with individuals who have chickenpox or measles, especially if you have not had these illnesses before. If you have been exposed to chickenpox or measles, notify your doctor immediately.
Wash your hands frequently, and avoid people with infections, colds, or flu. Inform your doctor if you experience any signs of infection.
Certain infections, such as tuberculosis and hepatitis B, may reactivate in patients taking this medication. If you have a history of these infections, notify your doctor.

Additional Warnings

This medication may lower your body's natural steroid production. If you experience a fever, infection, surgery, or injury, consult with your doctor, as you may require additional oral steroid doses. Carry a warning card indicating that you may need extra steroids in certain situations.
The use of this medication in the spine (epidural) has been associated with severe health problems, including paralysis, loss of vision, stroke, and death. This use is not approved, and you should discuss the risks with your doctor.

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, consult with your doctor before stopping, as you may need to gradually taper off the medication.
If you experience fatigue, weakness, shakiness, rapid heartbeat, confusion, sweating, or dizziness after missing a dose or stopping the medication, notify your doctor.

Long-term Use Risks

Prolonged use of this medication may increase your risk of osteoporosis (weak bones); discuss your risk factors with your doctor.
Long-term use may also increase the risk of cataracts or glaucoma; consult with your doctor for more information.
Some products containing this medication may include benzyl alcohol, which can be harmful to newborns and infants; consult with your doctor to determine if this applies to your medication.

Rare but Serious Risks

Long-term use of this medication has been associated with an increased risk of Kaposi's sarcoma, a type of cancer; discuss this risk with your doctor.
This medication may affect growth in children and teenagers; regular growth checks may be necessary.

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)

• CYP3A4 inducers (e.g., rifampin, phenytoin, barbiturates, carbamazepine): May decrease corticosteroid levels and efficacy.
• CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, clarithromycin, ritonavir): May increase corticosteroid levels and risk of adverse effects.
• NSAIDs (e.g., ibuprofen, naproxen): Increased risk of gastrointestinal ulceration and bleeding.
• Anticoagulants (e.g., warfarin): Effects can be variable (increased or decreased anticoagulant effect); monitor INR.
• Diuretics (thiazide, loop): Increased risk of hypokalemia.
• Antidiabetic agents (e.g., insulin, oral hypoglycemics): Corticosteroids can increase blood glucose, requiring dose adjustment of antidiabetics.

• Cardiac glycosides (e.g., digoxin): Increased risk of digitalis toxicity if hypokalemia occurs.
• Neuromuscular blocking agents: May prolong or antagonize neuromuscular blockade.
• Cholestyramine, colestipol: May decrease absorption of oral corticosteroids (not as relevant for injection, but general interaction).
• Oral contraceptives/estrogens: May increase corticosteroid levels.

• Not readily available for minor interactions specific to triamcinolone injection.

• Signs of infection (fever, malaise, localized pain/redness)
• Symptoms of adrenal insufficiency (fatigue, weakness, nausea, vomiting, hypotension) upon withdrawal
• Mood changes, insomnia, psychiatric disturbances
• Muscle weakness, pain (steroid myopathy)
• Gastrointestinal upset, abdominal pain (ulceration)
• Fluid retention (edema, weight gain)
• Visual disturbances (cataracts, glaucoma)
• Skin thinning, easy bruising

Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies have shown teratogenic effects (e.g., cleft palate). Infants born to mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism.

Triamcinolone is excreted in 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. Monitor breastfed infants for signs of adrenal suppression or other adverse effects. Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for triamcinolone and any potential adverse effects on the breastfed infant from triamcinolone or from the underlying maternal condition.

Corticosteroids can cause growth retardation in children. The lowest effective dose should be used for the shortest possible duration. Monitor growth and development carefully. Systemic IM use is generally not recommended for children under 6 years. Intra-articular use in JIA is common but off-label.

Elderly patients may be more susceptible to the adverse effects of corticosteroids, including osteoporosis, hypertension, diabetes, and fluid retention. Use the lowest effective dose and monitor closely for adverse effects.

• Kenalog-80 is a suspension and should not be administered intravenously (IV). It is for intramuscular, intra-articular, intrabursal, or intralesional use only.
• Shake the vial well before drawing up the dose to ensure uniform suspension.
• When injecting intra-articularly, ensure proper needle placement to avoid injecting into surrounding tissues or blood vessels.
• Patients should be advised not to over-use joints where intra-articular injections have been given, even if pain relief is significant, as this can lead to further joint damage.
• Long-term use of systemic corticosteroids requires careful tapering to avoid adrenal insufficiency.
• Educate patients on signs of infection, as corticosteroids can mask symptoms.
• Consider bone protection (calcium, vitamin D, bisphosphonates) for patients on long-term systemic corticosteroid therapy.

• Other injectable corticosteroids (e.g., methylprednisolone acetate, betamethasone acetate/phosphate)
• Oral corticosteroids (e.g., prednisone, methylprednisolone)
• NSAIDs (for inflammatory conditions)
• Disease-modifying antirheumatic drugs (DMARDs) or biologics (for chronic inflammatory conditions like rheumatoid arthritis)
• Local anesthetics (for pain management, often co-administered with corticosteroids for joint injections)
• Physical therapy, occupational therapy

If your symptoms or health problems persist or worsen, it is essential to contact your doctor for further guidance. 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 to do so by a healthcare professional, 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 for advice. Many communities have drug take-back programs, which your pharmacist can help you locate. Some medications may come with an additional patient information leaflet; check with your pharmacist to see if this applies to your prescription. 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 call 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 was taken to ensure prompt and effective treatment.