Medical Editor: John P. Cunha, DO, FACOEP
Kenalog-40 (triamcinolone acetonide) is a corticosteroid indicated for intramuscular or intraarticular use only in allergic states, dermatologic diseases, endocrine disorders, gastrointestinal diseases, hematologic disorders, renal diseases, respiratory diseases, rheumatic disorders, and nervous system disorders where oral therapy is not feasible. Kenalog-40 is available as a generic drug. Side effects of Kenalog-40 include:
- allergic reactions,
- sleep problems (insomnia),
- mood swings,
- spinning sensation (vertigo),
- appetite changes,
- stomach or side pain,
- stomach upset,
- scaling or other skin changes,
- a wound that is slow to heal,
- thinning hair,
- bruising or swelling,
- sweating more than usual,
- irregular menstrual periods,
- redness or pain at the injection site, or
- weight gain.
The usual suggested initial dose of Kenalog-40 is 60 mg, injected deeply into the gluteal muscle. Dosage is usually adjusted within the range of 40 mg to 80 mg, depending upon patient response and duration of relief. However, some patients may be well controlled on doses as low as 20 mg or less. Many doses are based on the patient's response to the medication and can be quite variable. Kenalog-40 may interact with birth control pills or hormone replacement therapy, blood thinners, cyclosporine, digoxin, insulin or oral diabetes medications, isoniazid, rifampin, seizure medications, antibiotics, aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs), or "live" vaccines. Tell your doctor all medications and supplements you use and all vaccines you recently received. Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. Caution should be exercised when corticosteroids are administered to a nursing woman. There are no adequate and well-controlled studies in pregnant women. Corticosteroids like Kenalog-40 should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Infants born to mothers who have received corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism. Because of potential toxicity, Kenalog-40 use in pediatrics is cautioned.
Our Kenalog-40 (triamcinolone acetonide) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have a serious side effect such as:
- fast, slow, or uneven heart rate;
- feeling short of breath, even with mild exertion;
- swelling, rapid weight gain;
- dangerously high blood pressure (severe headache, buzzing in your ears, anxiety, confusion, chest pain);
- problems with your vision;
- eye swelling, redness, discomfort, or drainage (may be signs of infection);
- severe depression, changes in mood or behavior;
- seizure (convulsions); or
- muscle pain, tenderness, or weakness.
Less serious side effects may include:
- nausea, bloating, appetite changes;
- stomach or side pain;
- headache, sleep problems (insomnia);
- acne, scaling, or other skin changes;
- a wound that is slow to heal;
- thinning hair;
- bruising or swelling;
- sweating more than usual; or
- irregular menstrual periods.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Read the entire detailed patient monograph for Kenalog-40 (Triamcinolone Acetonide Injectable Suspension)
(listed alphabetically under each subsection)
The following adverse reactions may be associated with corticosteroid therapy:
Bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, fat embolism, hypertension, hypertrophic cardiomyopathy in premature infants, myocardial rupture following recent myocardial infarction (see WARNINGS), pulmonary edema, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis.
Acne, allergic dermatitis, cutaneous and subcutaneous atrophy, dry scaly skin, ecchymoses and petechiae, edema, erythema, hyperpigmentation, hypopigmentation, impaired wound healing, increased sweating, lupus erythematosus-like lesions, purpura, rash, sterile abscess, striae, suppressed reactions to skin tests, thin fragile skin, thinning scalp hair, urticaria.
Decreased carbohydrate and glucose tolerance, development of cushingoid state, glycosuria, hirsutism, hypertrichosis, increased requirements for insulin or oral hypoglycemic agents in diabetes, manifestations of latent diabetes mellitus, menstrual irregularities, secondary adrenocortical and pituitary unresponsiveness (particularly in times of stress, as in trauma, surgery, or illness), suppression of growth in pediatric patients.
Fluid and electrolyte disturbances
Congestive heart failure in susceptible patients, fluid retention, hypokalemic alkalosis, potassium loss, sodium retention.
Abdominal distention, bowel/bladder dysfunction (after intrathecal administration [see WARNINGS: Neurologic]), elevation in serum liver enzyme levels (usually reversible upon discontinuation), hepatomegaly, increased appetite, nausea, pancreatitis, peptic ulcer with possible perforation and hemorrhage, perforation of the small and large intestine (particularly in patients with inflammatory bowel disease), ulcerative esophagitis.
Aseptic necrosis of femoral and humeral heads, calcinosis (following intra-articular or intralesional use), Charcot-like arthropathy, loss of muscle mass, muscle weakness, osteoporosis, pathologic fracture of long bones, post injection flare (following intra-articular use), steroid myopathy, tendon rupture, vertebral compression fractures.
Convulsions, depression, emotional instability, euphoria, headache, increased intracranial pressure with papilledema (pseudotumor cerebri) usually following discontinuation of treatment, insomnia, mood swings, neuritis, neuropathy, paresthesia, personality changes, psychiatric disorders, vertigo. Arachnoiditis, meningitis, paraparesis/paraplegia, and sensory disturbances have occurred after intrathecal administration. Spinal cord infarction, paraplegia, quadriplegia, cortical blindness, and stroke (including brainstem) have been reported after epidural administration of corticosteroids (see WARNINGS: Serious Neurologic Adverse Reactions with Epidural Administration and WARNINGS: Neurologic).
Exophthalmos, glaucoma, increased intraocular pressure, posterior subcapsular cataracts, rare instances of blindness associated with periocular injections. Other: Abnormal fat deposits, decreased resistance to infection, hiccups, increased or decreased motility and number of spermatozoa, malaise, moon face, weight gain.
Read the entire FDA prescribing information for Kenalog-40 (Triamcinolone Acetonide Injectable Suspension)
© Kenalog-40 Patient Information is supplied by Cerner Multum, Inc. and Kenalog-40 Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.