Kenalog Cream – Uses, Side effects, Dosage, Precautions

Kenalog Cream contains Triamcinolone Acetonide as an active ingredient. It is a corticosteroid hormone and is chemically 9α-fluoro-11β, 16α, 17α, 21-tetrahydroxypregna-1, 4-diene-3, 20-dione.

What is it used for?

It is used for the treatment, control, prevention of diseases & conditions like

  • Dermatitis
  • Eczema (itchy inflammation of skin)
  • Stomatitis (inflammation of mucous membrane of mouth)
  • Rheumatoid arthritis
  • Osteoarthritis
  • Skin irritation and rashes
  • Inflammation and pruritis
  • Psoriasis (scaly and itchy dry patches on skin)
  • Certain cancers
Therapeutic class Corticosteroid
Method of administration Applied topically to the affected area
Prescription Required
Alternatives Triacet, Triamcort, Trianex, Triderm, Aristocort, Dermasorb etc..

Dosage and Administration

  • For the treatment of psoriasis 0.025% cream is applied to the affected area for two to four times daily where as 0.1% or 0.5% is to be applied for two to three times daily. 
  • Used as a first aid dressing, gently rub a small amount of cream into the lesion until it disappears. Reapplication is recommended at each dressing change. If an infection develops, dressing should be discontinued.
Dosage Form Strength
Cream/ointment 0.025%, 0.05%, 0.1%, 0.5%
Lotion 0.025%, 0.1%
Dental  paste 0.1%
Topical spray 0.0147%
Injection 40mg Intra muscular (IM)
Condition Dosage form Adults and Pediatrics
Dermatitis, Eczema, Psoriasis Cream/ointment Apply for 2-4 times a day as a
thin film to affected area.
Dermatitis, Eczema, Psoriasis Lotion Apply for 3-4 times a day as a
thin film to affected area.
Dermatitis, Eczema, Psoriasis Spray Apply for 3-4 times a day.
Stomatitis Paste Swab a small amount(i.e
¼ inch) of paste on lesion until a thin film develops.

How To Use

  • This medicine is for topical application only.
  • Wash your hands before and after using this medicine.
  • Before applying the cream, clean the affected area and make sure to dry well.
  • Apply a thin layer of medicine on the affected area and rub gently.

Information For The Patient

  • Don’t use on face, groin or axillae, eyes unless directed by a physician.
  • Don’t cover or use bandage on treated area.
  • Patients on long term therapy should not be given any live attenuated vaccines.
  • Not to be used for diaper rash.
  • Don’t apply on cuts, scrapes or damaged skin.
  • Don’t use this medication on skin that is sunburned.
  • Do not use tight-fitting diapers or plastic pants if treated part is in the diaper area. This may cause more drug to get into the body.
  • Avoid applying excessive amounts as it results in pilling.
  • Avoid using soaps that are hard and skin products that cause irritation while using Kenalog.
  • Don’t use this medicine if you have infection or sore present at the area to be treated.

Different Brands of Triamcinolone :

Brand name Manufacturer
Kenalog Bristol Meyers squibb
Kenacort Abbott Health Care Private Ltd
Triacet Perrigo
Triamcort Zentiva
Trianex Upsher smith laboratories
Triderm Merck Sharp Dohme
Aristocort Aspen Pharma Pvt Ltd
Pediaderm TA Arbor Pharmaceuticals
Dermasorb Crown Laboratories
Oace Swiss Pharma Private Ltd
Nasacort Sanofi
Flutex Leeford Healthcare Ltd
Oralone Taro Pharmaceuticals

Missed a dose?

If you miss a dose, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and follow your regular dosing schedule.

Precautions to be taken to apply this cream

  • Check the progress of the patient at regular visits if the patient experiences any adverse effects caused by this medicine.
  • If the symptoms don’t improve within few weeks, check your doctor.
  • Do not use large doses for a longer time as this a synthetic corticosteroid and it supresses the body’s ability to produce natural steroids.
  • The risk of having adrenal gland problems may increase prolonged or too much use of this medicine.
  • You shouldn’t use this medicine if you have any skin rashes, burning sensation and swelling or if you experience any irritation on your skin.
  • Do not use this medication with other corticosteroid containing products without checking with your doctor first.
  • If this ream is used in larger amounts in children it leads to more toxic effects.
  • If you take too often this medicine your skin problem may increase.
  • In some cases this drug may effect growth in children and teens so should need regular growth checks.
  • If you use large doses of cream for a large surface area your affected area you should be closely monitored for symptoms of hypothalamic pituitary adrenal suppression (checking for urine cortisol test)  and symptoms of Cushing’s syndrome (weight gain, fat deposits around face and neck, fat loss from arms and legs). If any of these symptoms occur withdraw the application of drug or reduce the frequency of drug application.

Side effects

After application of Kenalog cream to the skin, patients may notice some of the following reactions

Common side effects

  • Burning
  • Itching
  • Irritation
  • Dryness
  • Acne
  • Thinning of skin
  • Blistering skin
  • Stretch marks
  • Scaling around mouth
  • Folliculitis (inflammation of hair follicles)
  • Hypertrichosis (excessive hair growth)
  • Hypopigmentation
  • Skin atrophy (decrease in dermal and epidermal thickness)

Serious side effects

  • Cushing’s syndrome (pituitary gland tumour which occurs due to high levels of cortisol)
  • Severe skin rash
  • Irregular heartbeat
  • Blurred vision
  • Difficulty in breathing or swallowing
  • Wheezing
  • Mood changes
  • Sleep disturbances
  • Weight gain
  • Puffiness in face
  • Fatigue
  • Insomnia (lack of sleep)
  • Hyperglycaemia (increased blood sugar levels)

Contraindications

Should not be used if you have following conditions

  • Allergic reactions
  • Hypersensitivity
  • Lactation
  • Pregnancy

How it acts?

  • It works by reducing the inflammation of the body. It inhibits arachidonic acid a protein responsible for pain and controls the synthesis of prostaglandins and leukotrienes (pain mediators).
  • It supresses overactive immune system by decreasing the function of lymphatic system and interfere with antigen and antibody binding.
  • It also has antipruritic activities preventing the release of destructive acid hydrolases from leukocytes, reducing edema formation, inhibits histamine activity and subsequent scar tissue formation.

How to store it?

  • Store in a closed container at room temperature and avoid freezing.
  • Protect from light, moisture and heat.
  • Discard unused portion and don’t store for later use.

Pharmacokinetics

Absorption: It depends on strength of preparation, quantity applied, condition of skin at application site. About 1% of the applied cream is absorbed in areas with a thick skin such as the palms, soles, elbows, and knees and 36% of the applied cream is absorbed in areas of the thin skin.

Distribution: After application of the cream it is distributed throughout the local skin layer.

Metabolism: After showing its local effect it is metabolized primarily in the skin. Most of the drug is metabolised by skin and if a small amount that reaches blood circulation is metabolised by liver enzymes to inactive compounds.

Drug interactions

Tell your doctor about all prescription, non-prescription, herbal or nutritional drugs you take before taking kenalog cream especially

  • Chemotherapy drugs
  • Other topical medications
  • Vitamins
  • Diabetes
  • Diaper rash
  • Hyperadrenocortism
  • Infections
  • Ocular toxicities
  • It interacts with other corticosteroids taken orally like prednisone and other drugs which supress immune system like cyclosporine.
  • It also interacts with other medicines like aspirin, acetazolamide, antacids, carbamazepine and carbenoxolone.

FAQ’s

Is this medicine or product addictive or habit forming?

Please see the product package insert to ensure that the medicine does not belong to such special (narcotics and opioids) categories of medicines. Do not self-medicate and increase your body’s dependence to medicines without the advice of a doctor.

Is it safe to drive or operate heavy machinery when consuming?

It may not be safe to drive a vehicle or operate heavy machinery if you experience drowsiness, dizziness. Always consult with your doctor if you experience such situations.

Can it be stopped immediately?

Consult with your doctor if you want to stop this medicine immediately as some medicines cannot be stopped immediately because of rebound effects. 

Is Kenalog Cream safe to consume or apply when pregnant?

Generally corticosteroids are teratogenic (causes harm to foetus) in animal studies but however there are no studies conducted on pregnant women so it should be used during pregnancy if the benefits overweigh the risks.

Is Kenalog Cream safe while breastfeeding?

No

How long does it take to Kenalog to work?

It is generally applied for seven days as a course to the affected area. If the symptoms have not improved consult your doctor.

Is Kenalog cream used for acne?

It is used in the treatment of eczema and even for mild to moderate acne. It depends on the type of acne and its severity.

References

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