Kenalog 40 is a hormone product with a basic substance called triamcinolone. The drug is directly related to the type of glucocorticosteroids, the mechanism of which suppresses the function of white blood cells in places of inflammation. The release structure is an aqueous suspension used for anti-shock, anti-inflammatory, antipruritic, immunosuppressive and anti-allergic effects.
Drug action
The anti-shock component is necessary for use in critical situations. Medicines with a similar effect, along with Kenalog 40, produced in Slovenia, are included in anti-shock kits and are used in the work of ambulance teams, resuscitation groups and in burn centers. The anti-inflammatory effect is aimed at relieving inflammation, the drug inhibits the production of antibodies and anesthetizes. The antipruritic effect is achieved by overlapping histamine receptors to relieve unpleasant sensations of the skin. An immunosuppressive effect is used to artificially suppress immunity, for example, due to transplantation of human organs . The antiallergic component of Kenalog 40 weakens reactions to an allergen.
The active substance triamcinolone affects the metabolism of fats, proteins and carbohydrates. It activates gluconeogenesis - the formation of glucose in the body and maintaining its level in the blood, helps the liver to capture the necessary amino acids. Additionally affects catabolism, that is, oxidation or decomposition into simpler substances in adipose, connective, bone tissue, muscles and skin.
Triamcinolone was developed by Astellas. The drug has been tested and approved for sale from the 60s of the last century by the US Food and Drug Administration. In Russia, it is also approved for use.
Indications for use
There are four treatments for triamcinolone: parenterally (as an injection), inhalation, oral and topical. A wide range of the main substance of triamcinolone has the drug "Kenalog 40". Instructions for use recommend the use of the drug with the following symptoms:
- Parenteral: lupus, emphysema, lymphogranulomatosis, rheumatoid arthritis, dermatosis, connective tissue disorders, pulmonary fibrosis.
- Inhalation: exacerbation of asthma, allergic rhinitis.
- Oral: lupus erythematosus, acute allergy attacks, including skin type, rheumatoid arthritis; hemorrhagic diathesis, anemia, leukemia, lymphoma, rheumatism, bronchial asthma.
- Locally: psoriasis, eczema, dermatitis, non-microbial inflammation of the skin.
Release Forms
Medicines with triamcinolone are available in tablet form, in tubes with ointments and in ampoules. This allows you to choose a competent treatment system. The trade name of the Kenalog product is used in the sale of drugs in the following forms:
- Injection suspension. Packing is carried out in boxes in a contour cell of 5 ampoules with 1 ml of substance.
- Tablets, packaged in dark glass bottles of 50 pieces.
According to the instructions, Kenalog 40 is only available as a suspension for injection. The suspension contains 40 milligrams of triamcinolone acetonide and 9.9 milligrams of benzyl alcohol dissolved in sodium chloride.
Ways to use
The use of "Kenalog 40" parenterally is carried out intramuscularly and intraarticularly. Intravenous injections are contraindicated. Before the injection, the ampoule is shaken. Intramuscular injection is carried out by slow injection into the buttock, making sure that the needle does not penetrate into the vessels.
Children should not be prescribed the drug. From 12 years, appointment with caution is possible. In this case, the recommended dose of the drug administered by intramuscular injection is 0.03-0.2 mg / kg of body weight with an interval of one to seven days. For adults, intramuscular injections begin with a dose of 40 mg, after which they are increased to 80 mg with a frequency of two weeks. It is permissible to increase the amount of the administered substance to 120 mg per administration.
The dose of Kenalog 40 for intra-articular administration ranges from 10 to 40 mg and is determined by its size. In small joints (fingers and toes), 10 mg of the drug is administered, in the middle joints (shoulders, elbows), the amount of drug administered is 20 mg, and in large joints (knee and hip) the volume of the drug reaches 40 mg. With a one-day administration in two or more joints, the recommended dosage is not more than 80 mg. The next injection is usually done after 3 weeks. If it is necessary to use small doses, doctors recommend using the Kenalog 10 tool.
According to the instructions, the drug can be administered once and relieve most of the symptoms for a long time. For example, in case of an allergic reaction to flowering plants according to the instructions, Kenalog 40 injections are enough to apply once per season. Deep intramuscular injection involves applying a sterile tissue for an extended period after injection to avoid possible atrophy. It is necessary to monitor the injection site if an unintentional intravascular injection has occurred. To speed up the relief of the condition, Kenalog 40 is used together with anesthetic drugs. A prerequisite is the use of an anesthetic, which does not contain any vasoconstrictor agents. The drug is diluted with sodium chloride solution for injection of the affected joint. The input system in this case is a fan type. For injection of subcutaneous lesions, the substance is mixed in a syringe with an anesthetic. With keloids, the drug must be injected directly into the scar. In accordance with the instructions for use "Kenalog 40" injections injected directly into the space of cysts using a cannula.
In the time interval from 24 to 48 hours after intramuscular injection, inhibition of adrenal function is observed, the restoration of which after a single injection occurs in a month. After intra-articular injection, about 60% of the drug enters the blood within 70 hours. Metabolism occurs mainly in the liver and a little in the kidneys. The drug is excreted in the urine.
The course of treatment with triamcinolone varies from one dose to several times or course injections. With periodic administration, it is necessary to observe the time intervals recommended in the instructions. The absence of signs of improvement after three injections is the basis for drug withdrawal and the search for other forms of getting rid of the disease.
Application features
The drug is used with caution for the treatment of patients with complex diseases of muscle tissue. In childhood, it can cause inhibition of development. The use of the drug for a long time weakens the function of the adrenal cortex for a period of up to two months. With tuberculosis, there is the possibility of reactivation of the disease, possibly the transient development of viral infections.
In case of severe infections, antimicrobial therapy is necessary in addition to the drug. Patient reviews indicate that there is no need for operable treatment after using Kenalog 40 injections. The instructions for the use of injections by doctors during pregnancy are ambiguous, since safety for mothers and children by scientific methods has not been confirmed. Appointments are performed solely for health reasons, since fetal malformations are possible. If it is necessary to use the drug during lactation, breast-feeding is stopped. Caution is required when using the drug in patients with epilepsy, arterial hypertension, a chronic form of heart failure.
Side effect
Given the belonging of the drug to a group of hormonal drugs, it is prescribed extremely rarely. When using Kenalog 40, positive reviews often tend to decrease quantitatively after such negative consequences as:
- discoloration of the skin and draining of the texture, the appearance of spider veins, pronounced bruising;
- problems with the mucous membrane;
- difficulty falling asleep, including a complete lack of quality sleep;
- prolonged use can lead to stomach ulcers, up to the opening of bleeding;
- the appearance of body hair, increased sweat glands, a feeling of weakness and depression;
- anorexia
- pancreatitis
- prolonged healing of wounds and abrasions;
- detection of diabetes;
- the development of ophthalmic diseases;
- change in blood pressure upwards;
- increased risk of fractures;
- risk of blood clots;
- growth retardation in childhood.
Patient Reviews
Since this is a serious hormonal drug, doctors are in no hurry to prescribe it and use the drug only in cases when the patient suffers from a whole complex of painful conditions. General statistics on reviews of injections "Kenalog 40" shows that most patients speak out about the drug in a positive way. The drug helps pretty quickly, but many note side effects that simply do not go away by themselves. There is a need for therapeutic treatment after administration of the drug.
Patients leave positive reviews when using the drug from bursitis - inflammation of the fluid cavity, which occurs when there is friction between the bones and soft tissues. When the medicines used up to this point bring only temporary relief, and the pain is permanent, the living conditions are complicated. Patients take risks by agreeing to take a hormonal drug. Often, the risk lives up to expectations, despite the pain of administration. People get rid of pain forever.
With existing hernias in various parts of the spine, doctors sometimes carry out several blockages so that the pain recedes. In the spring, during the flowering period of plants, various allergic reactions become more frequent. The use of the drug eliminates tearing within 20-30 minutes after administration, and a satisfied patient no longer feels discomfort. After insect bites, accompanied by itching and swelling, Kenalog 40 is also recommended.
If the applied ointments with the active substance diclofenac do not help with lower back pain, the doctor decides to use this drug. By palpation, the most inflamed place for administration is determined. Despite the pain of the procedure, relief comes after the first injection. For pain of this kind, a course medication is usually required. Reviews of patients who completed the prescribed course are extremely positive.
Negative patient comments about the drug are mainly associated with side effects.
During medical practice, each doctor decides on the prescription of the drug, taking into account his experience and the patient’s condition and weighing all the risks. For example, a dermatologist with fifteen years of experience prescribes a medicine according to the instructions for the treatment of allergies during the flowering period of plants. "Kenalog 40" reviews of doctors dissatisfied with the drug contrasts the improvement already within the next hour: tearing and itching go away.
When prescribing this drug, doctors recommend a diet rich in proteins, additional intake of vitamins. It is incompatible to drink alcohol after injecting. Usually the most active phase of the effect of the drug on the body occurs on the first day. Therefore, it is not recommended to perform actions that require physical effort or concentration on the first day after use.
Analogs
There are about twenty drugs - analogues. The most famous and often appointed:
- Diprospan. It is made in Switzerland, the active substance is betamethasone dipropionate. It belongs to the same category of drugs as triamcinolone. It has a wider spectrum of action and a number of contraindications: tuberculosis, sexually transmitted infections, glaucoma, polio in childhood, dermatitis.
- "Polcortolon". Produced in Poland, the active substance is the same as the previous product. The main difference is the impossibility of injection by injection, as it is available in the form of ointments and tablets.
- "Tricortal". It is made in Iran, the active substance is the same. Most often used as an immunosuppressant.
- "Fluorocort". The manufacturer is Hungary, the consistency is ointment, contraindications are not used in patients with cancer.
Contraindications
When choosing a drug treatment, you should consult your doctor, as well as study the reviews of Kenalog 40. The instructions for the use of injections list the following contraindications:
- skin lesions, including bacterial and fungal;
- smallpox
- bone atrophy;
- Mental illness
- inflammatory manifestations of the skin of the face;
- tuberculosis;
- syphilis;
- stomach ulcer and duodenal ulcer.
Use with other drugs
- It weakens the hypoglycemic effect of diabetic drugs.
- Together with steroids - acne and swelling can form.
- Together with saluretics - increases the elimination of potassium from the body.
- With rifampicin - weakens its corticoid effect.
- The effect of the drug is weakened when used with histamine receptor blockers.
- Together with cardiac glycosides, heart rhythm disturbances are possible.
- With paracetamol, the rate of calcium excretion increases.
- With anti-rheumatic drugs - may cause stomach bleeding.
- With simultaneous use with thyroid hormones, a change in its functioning is observed.
- With tricyclic antidepressants - mental disorders can develop.
- When used with atropine, an increase in intraocular pressure is expected.
Overdose
An excess of the drug in the body, manifested in an increase in the amount of the drug administered, leads to insomnia, excessive agitation, nausea, vomiting, muscle weakness, osteoporosis, fluid retention in the body and Cushing's syndrome.
Cushing's syndrome is accompanied by hirsutism, skin changes, weight gain, mental disorders, thirst, symptoms of hypertension and urolithiasis. Treatment is based on the observed symptoms.
Use in veterinary medicine
The drug was widely used in the treatment of animals. Used for administration to dogs, cats, horses. Here the dosage is calculated per kilogram of weight. The main reason for using this hormonal drug is a violation of the motor function associated with the problems of movement of the animal.
Cost, conditions of sale and storage
The price of the drug varies from 350 to 900 rubles. The suspension is dispensed by prescription and must be stored in a dark place at a temperature of 8 to 25 ° C.