Kenalog Spray 100gm
It is used to treat skin rashes and other skin irritation.
Drug Class
Anti-inflammatory agent, Corticosteroid
Pharmacologic Class
Glucocorticoid, Topical
Pregnancy Category
Category C
FDA Approved
Jun 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Kenalog Spray contains a medicine called triamcinolone, which is a type of steroid. It works by reducing swelling, itching, and redness caused by various skin conditions like eczema or dermatitis. It's sprayed directly onto the affected skin.
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. Use this medication only as directed, and continue to use it even if your symptoms improve.
Application Instructions
Apply this medication only to your skin, avoiding the mouth, nose, and eyes, as it may cause burning.
Wash your hands before and after applying the medication, unless your hand is the treated area.
Clean and dry the affected area before applying a thin layer of the medication, gently rubbing it in.
Avoid applying the medication to the face, underarms, or groin area unless your doctor instructs you to do so.
Do not use bandages, dressings, or tight-fitting diapers or plastic pants on the treated area, as this may increase the amount of medication absorbed into the body.
Do not use this medication to treat diaper rash or apply it to cuts, scrapes, or damaged skin.
Shake the medication well before use.
Storage and Disposal
Store the medication at room temperature, away from heat and open flames.
Do not freeze the medication or puncture or burn the container, even if it appears empty.
Keep all medications in a safe place, out of the reach of children and pets.
Missed Dose
If you miss a dose, apply it as soon as you remember.
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 use extra doses.
To use this medication correctly, follow your doctor's instructions and read all the information provided. Use this medication only as directed, and continue to use it even if your symptoms improve.
Application Instructions
Apply this medication only to your skin, avoiding the mouth, nose, and eyes, as it may cause burning.
Wash your hands before and after applying the medication, unless your hand is the treated area.
Clean and dry the affected area before applying a thin layer of the medication, gently rubbing it in.
Avoid applying the medication to the face, underarms, or groin area unless your doctor instructs you to do so.
Do not use bandages, dressings, or tight-fitting diapers or plastic pants on the treated area, as this may increase the amount of medication absorbed into the body.
Do not use this medication to treat diaper rash or apply it to cuts, scrapes, or damaged skin.
Shake the medication well before use.
Storage and Disposal
Store the medication at room temperature, away from heat and open flames.
Do not freeze the medication or puncture or burn the container, even if it appears empty.
Keep all medications in a safe place, out of the reach of children and pets.
Missed Dose
If you miss a dose, apply it as soon as you remember.
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 use extra doses.
Lifestyle & Tips
- Shake the can well before each use.
- Hold the can upright about 3 to 6 inches away from the skin and spray for 3 to 5 seconds.
- Do not spray near your eyes, nose, or mouth. If it gets in your eyes, rinse thoroughly with water.
- Do not inhale the spray.
- Do not use on broken skin, open wounds, or infected areas unless directed by your doctor.
- Do not cover the treated area with bandages or dressings unless specifically instructed by your doctor, as this can increase absorption and side effects.
- Wash your hands before and after applying the spray.
- Use only as directed by your doctor and for the prescribed duration. Do not use more often or for longer than recommended.
- Keep out of reach of children.
Available Forms & Alternatives
Available Strengths:
Generic Alternatives:
Dosing & Administration
Adult Dosing
Standard Dose:
Apply to affected area 3 to 4 times daily.
Dose Range:
3 - 4 mg
Condition-Specific Dosing:
generalApplication:
Hold container upright about 3 to 6 inches from the affected area and spray for 3 to 5 seconds. Do not spray near eyes or mouth. Avoid inhalation of spray.
Pediatric Dosing
Neonatal:
Not established
Infant:
Use with caution; increased risk of systemic absorption due to higher surface area to body weight ratio and immature skin barrier. Limit duration and amount.
Child:
Apply to affected area 3 to 4 times daily. Use with caution; increased risk of systemic absorption. Limit duration and amount. Avoid use on large surface areas or under occlusive dressings.
Adolescent:
Apply to affected area 3 to 4 times daily. Similar to adult dosing, but monitor for systemic effects.
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; systemic absorption is minimal.
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 exerts its anti-inflammatory, antipruritic, and vasoconstrictive actions by inducing phospholipase A2 inhibitory proteins, lipocortins. These proteins 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 integrity of epidermal barrier, vehicle, and use of occlusive dressings. Increased absorption with inflamed or damaged skin.
Tmax:
Not precisely defined for topical application due to variable absorption.
FoodEffect:
Not applicable for topical administration.
Distribution:
Vd:
Not precisely defined for topical application; systemically absorbed corticosteroids are bound to plasma proteins, primarily corticosteroid-binding globulin and albumin.
ProteinBinding:
Approximately 60-70% (for systemically absorbed portion)
CnssPenetration:
Limited (for systemically absorbed portion)
Elimination:
HalfLife:
Approximately 2-5 hours (for systemically absorbed portion); biological half-life is longer.
Clearance:
Not precisely defined for topical application.
ExcretionRoute:
Primarily renal (metabolites), some biliary.
Unchanged:
Minimal
Pharmacodynamics
OnsetOfAction:
Hours to days for noticeable clinical effect.
PeakEffect:
Days to weeks of consistent application.
DurationOfAction:
Varies with application frequency and individual response; effects persist as long as applied.
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 immediate medical attention:
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 unusual symptoms, contact your doctor or seek medical help:
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 immediate medical attention:
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 unusual symptoms, contact your doctor or seek medical help:
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 irritation, burning, itching, or redness at the application site.
- Development of new skin problems like acne, thinning skin, stretch marks, or changes in skin color.
- Signs of infection (e.g., pus, worsening pain, fever).
- Unusual weight gain, swelling in the face, or increased hair growth (rare, but can indicate too much medicine absorbed into the body).
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 to this medication, its components, or other substances, including foods and drugs. Be sure to describe the allergic reaction you experienced, including the 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 and health issues to your doctor and pharmacist.
Any health problems you have, as they may interact with this medication. Your doctor and pharmacist need to be aware of your complete medical profile to ensure safe treatment.
Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor. It is vital to verify the safety of taking this medication with all your other drugs and health conditions to avoid potential interactions.
It is essential to inform your doctor about the following:
Any allergies you have to this medication, its components, or other substances, including foods and drugs. Be sure to describe the allergic reaction you experienced, including the 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 and health issues to your doctor and pharmacist.
Any health problems you have, as they may interact with this medication. Your doctor and pharmacist need to be aware of your complete medical profile to ensure safe treatment.
Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor. It is vital to verify the safety of taking this medication with all your other drugs and health conditions to avoid potential interactions.
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 use, as directed by your doctor, and avoid using it for an extended period.
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. Be aware that this medication is flammable, so avoid using it near open flames or while smoking. Additionally, avoid inhaling the vapors.
When using this medication in children, exercise caution, as the risk of certain side effects may be higher in this population. In some cases, this medication may affect growth in children and teenagers, so regular growth checks may be necessary. Consult with your doctor to discuss this further.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor, as they will need to weigh the benefits and risks of using this medication for both you and your baby.
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. Be aware that this medication is flammable, so avoid using it near open flames or while smoking. Additionally, avoid inhaling the vapors.
When using this medication in children, exercise caution, as the risk of certain side effects may be higher in this population. In some cases, this medication may affect growth in children and teenagers, so regular growth checks may be necessary. Consult with your doctor to discuss this further.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor, as they will need to weigh the benefits and risks of using this medication for both you and your baby.
Overdose Information
Overdose Symptoms:
- Prolonged or excessive use, especially on large areas of skin or under occlusive dressings, can lead to systemic absorption and symptoms of hypercorticism (Cushing's syndrome), including:
- Moon face
- Central obesity
- Thinning skin, easy bruising
- Muscle weakness
- High blood pressure
- High blood sugar
- Adrenal suppression (fatigue, weakness, nausea, vomiting)
What to Do:
Discontinue use gradually under medical supervision. Symptomatic and supportive treatment. Call 1-800-222-1222 (Poison Control Center) for advice.
Drug Interactions
Monitoring
Baseline Monitoring
Skin condition assessment
Rationale: To establish baseline severity of dermatosis and identify areas of broken or infected skin.
Timing: Prior to initiation of therapy.
Routine Monitoring
Local skin reactions (e.g., atrophy, striae, telangiectasias, burning, itching, irritation)
Frequency: At each follow-up visit, or if patient reports symptoms.
Target: Absence of new or worsening reactions.
Action Threshold: If severe or persistent, consider reducing frequency, changing to a lower potency steroid, or discontinuing.
Signs of systemic absorption (e.g., Cushing's syndrome, hyperglycemia, adrenal suppression)
Frequency: Periodically, especially with prolonged use, large surface areas, occlusive dressings, or in pediatric patients.
Target: Absence of clinical signs; normal cortisol levels if tested.
Action Threshold: If suspected, discontinue gradually and consult endocrinology.
Signs of infection (e.g., worsening redness, pus, fever)
Frequency: At each follow-up visit, or if patient reports symptoms.
Target: Absence of infection.
Action Threshold: If infection develops, discontinue triamcinolone and initiate appropriate antimicrobial therapy.
Symptom Monitoring
- Worsening of skin condition
- Increased redness, swelling, or pain at application site
- Development of pus or signs of infection
- Excessive hair growth (hirsutism)
- Skin thinning, easy bruising, or stretch marks
- Weight gain, moon face, or other signs of Cushing's syndrome (rare with topical)
- Blurred vision or eye pain (if applied near eyes)
Special Patient Groups
Pregnancy
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies have shown teratogenic effects with corticosteroids.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenic effects, though systemic absorption from topical use is minimal.
Second Trimester:
Generally considered safer than first trimester, but still use with caution.
Third Trimester:
No specific risks identified beyond general corticosteroid effects; monitor for signs of systemic absorption.
Lactation
Use with caution. It is not known whether topical triamcinolone is excreted in human milk. Systemic corticosteroids are excreted into breast milk. Minimize infant exposure by avoiding application to the breast area.
Infant Risk:
Low risk with minimal systemic absorption, but theoretical risk of growth suppression or other adverse effects if significant amounts are absorbed by the infant.
Pediatric Use
Pediatric patients may be more susceptible to systemic toxicity from topical corticosteroids due to their larger skin surface area to body weight ratio. Adrenal suppression, Cushing's syndrome, and intracranial hypertension have been reported. Avoid prolonged use, large surface areas, and occlusive dressings. Monitor growth and development.
Geriatric Use
No specific dosage adjustments are typically required. However, geriatric patients may have thinner skin, which could increase the risk of local side effects like skin atrophy or purpura. Use with caution and monitor skin integrity.
Clinical Information
Clinical Pearls
- Kenalog Spray is a high-potency topical corticosteroid. Use it sparingly and for the shortest duration necessary to achieve control of symptoms.
- Avoid spraying directly onto the face, groin, or axillae unless specifically directed by a physician, due to increased risk of skin atrophy and other side effects in these sensitive areas.
- Patients should be advised that the aerosol is flammable and should not be used near an open flame or while smoking.
- If no improvement is seen after 2 weeks of treatment, re-evaluate the diagnosis and treatment plan.
- Educate patients on proper application technique to minimize systemic absorption and local side effects.
Alternative Therapies
- Other topical corticosteroids of varying potencies (e.g., clobetasol, betamethasone, fluocinonide, hydrocortisone)
- Topical calcineurin inhibitors (e.g., tacrolimus, pimecrolimus) for certain inflammatory skin conditions
- Emollients and moisturizers for dry skin conditions
Cost & Coverage
Average Cost:
$50 - $150 per 100gm can
Generic Available:
Yes
Insurance Coverage:
Tier 1 or 2 (preferred generic or non-preferred brand)
General Drug Facts
If your symptoms or health issues persist or worsen, it's 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 be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to ensure you receive the best possible care.