Pharmacological properties of the drug Kenalog
Triamcinolone is a synthetic corticosteroid with pronounced anti-inflammatory, antiallergic, antipruritic and immunosuppressive effects. It does not cause sodium and water retention in the body, its diabetogenic effect is 2–3 times less pronounced than that of dexamethasone. The inhibitory effect of triamcinolone on pituitary function is somewhat less than with the use of other corticosteroids. When taken orally, it is quickly absorbed from the digestive tract. The maximum concentration of triamcinolone in blood plasma is determined 8–12 hours after administration. The half-life is about 3.3 hours. Metabolized mainly in the liver, less in the kidneys, about 15% of the drug is excreted unchanged in the urine.
Description and composition
The main active ingredient is triamcinolone. It belongs to the group of glucocorticosteroid hormones and exhibits a wide range of effects that are characteristic of them:
- Anti-inflammatory.
- Antipruritic.
- Antiallergic.
- Immunosuppressive.
- Decongestant.
Thanks to this, Kenalog is able to influence the mechanism of development of many diseases, stopping pathogenetic processes and eliminating symptoms in the patient. The mechanism of action of Kenalog is to block the release of inflammatory mediators, as well as stabilize lysosomal membranes. It also neutralizes the negative effect of histamine, which is to increase the permeability of cell membranes. In addition, steroidal anti-inflammatory drugs suppress the production of antibodies and reduce the number of circulating lymphocytes.
Triamcinolone is one of the most powerful corticosteroid hormones. In the form of acetonide, it is 8 times more effective than prednisolone.
Triamcinolone exhibits negligible mineralocorticoid activity. At the same time, it affects the metabolism of fats, proteins and carbohydrates.
During treatment, there is an increase in the number of red blood cells and neutrophils, as well as a decrease in eosinophils and basophils.
Corticosteroid hormones are highly effective and quick to achieve effect. In addition, their advantage is the ability to influence all stages of the inflammatory process. Triamcinolone prevents or inhibits the first signs of inflammation (pain, redness, increased local temperature, swelling), and also prevents the pathology from progressing and entering later stages (fibroblast proliferation, collagen formation).
When administered intramuscularly, the maximum concentration can be achieved only after 8 hours. However, the drug is also eliminated slowly - its level decreases after 72 hours, which provides a long-term therapeutic effect. According to research, with any method of administration, the drug is completely absorbed, the difference is only in the speed of absorption and the area of effect.
Use of the drug Kenalog
The dose and duration of treatment are determined individually. The drug is prescribed once a day (preferably in the morning) or in several doses, especially if the total dose exceeds 16 mg. The usual daily dose for adults is 4–32 mg. If side effects develop, the dose is gradually reduced (by 4 mg every 2–3 days) until an adequate dose is reached (usually 4 mg/day). Children whose body weight exceeds 25 kg are prescribed at the dose recommended for adults. Children weighing up to 25 kg are prescribed an initial dose of 12 mg/day, then the dose is selected taking into account the nature of the disease and tolerability of the drug.
Price for Kenalog, where to buy
You can buy Kenalog in 4 mg tablets for 300-350 rubles per pack of 50 pieces.
The price of Kenalog 40 is 520-700 rubles for 5 ampoules.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Kenalog Susp.
for injection 40 mg/ml 1 ml 5 pcs. JSC KRKA, d.d., Novo mesto 538 rub. order
Pharmacy Dialogue
- Kenalog ampoules 40 mg/ml 1 ml No. 5KPKA
RUR 615 order
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Pharmacy24
- Kenalog 40 mg/ml No. 5 suspension KPKA, d.d., Novo Mesto, Slovenia
572 UAH.order - Kenalog 4 mg N50 tablets KRKA, Slovenia
280 UAH order
PaniPharmacy
- Kenalog tablets Kenalog tablets. 4mg No. 50 Slovenia, KRKA dd Novo Mesto
310 UAH. order
- Kenalog ampoule Kenalog suspension for injection 40 mg/ml ampoules 1 ml No. 5 Slovenia, KRKA dd Novo Mesto
606 UAH. order
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Contraindications to the use of the drug Kenalog
Hypersensitivity to triamcinolone or to other components of the drug, peptic ulcer of the stomach, duodenum or anastomosis, diverticulitis, glaucoma, diabetes mellitus, osteoporosis, psychosis, lymphadenitis after BCG vaccination, a period of 2 months after vaccination with live viral vaccines, myasthenia gravis, tuberculosis, viral infections , systemic mycosis, bacterial infections (without adequate antibiotic therapy), amebiasis, Cushing's syndrome, severe injuries and surgical interventions, vascular thrombosis and thromboembolism.
Side effects of the drug Kenalog
Side effects of triamcinolone are similar to those of other corticosteroids. Skin: stretch marks, acne, petechiae, ecchymoses, telangiectasia, pigmentation, delayed wound healing. Musculoskeletal system: muscle weakness and atrophy, osteoporosis with an increased risk of fractures, aseptic bone necrosis, growth inhibition in children and adolescents. Organ of vision: glaucoma, cataract. Digestive tract and liver: dyspeptic symptoms, nausea, anorexia, steroid gastric ulcer, pancreatitis. Endocrine system: suppression of the adrenal cortex, Cushing's syndrome, steroid diabetes, impaired secretion of sex hormones (dysmenorrhea, impotence, hirsutism), weight gain. Immune system: immunosuppression with an increased risk of developing infections, masking the symptoms of a developed infection, rarely allergic reactions. Blood system: increased tendency to thrombosis. Cardiovascular system: hypertension (arterial hypertension) . CNS: dizziness, headache, increased intracranial pressure, psychosis, depression.
Special instructions for the use of Kenalog
Long-term use of triamcinolone inhibits the secretion of endogenous hormones of the adrenal cortex, so treatment should be stopped gradually. Suppression of adrenal function may last for several months after cessation of treatment. Patients with a history of tuberculosis should be under close medical supervision, as there is a risk of reactivation of the process during GCS therapy; this also applies to patients with peptic ulcers. For severe infections, triamcinolone can only be used in combination with antimicrobial therapy. There is also an increased risk of developing a viral infection when exposed to someone who is sick (such as chickenpox or herpes). The drug should be prescribed with caution to patients with severe muscle diseases. Triamcinolone is used in children only when absolutely necessary because it can inhibit growth and development. GCS should be prescribed with caution to patients with hypertension (arterial hypertension), severe chronic heart failure, epilepsy and severe liver dysfunction. GCS can affect the results of allergy tests and also increase the risk of hypokalemia. The safety of the use of GCS during pregnancy has not been established; their use is indicated only in extreme cases, when the possible benefit to the expectant mother outweighs the potential risk to the fetus. During treatment you should stop breastfeeding. Newborns whose mothers received GCS during pregnancy should be under medical supervision to identify possible adrenal insufficiency.
Analogs
Other glucocorticosteroid hormones that are used systemically include:
- Betamethasone. The active substance is betamethasone, which also belongs to the group of corticosteroid hormones. Available in the form of an injection solution with a concentration of 4 mg/ml. The therapeutic effect is the same as that of Kenalog.
- Betaspan. Ukrainian analogue, which is produced on the basis of betamethasone. It often becomes the drug of choice among patients due to its affordable price.
- Diprospan. Hormonal drug produced in Switzerland. Available in the form of a suspension, which is administered intramuscularly. The active ingredient is betamethasone. The spectrum of action is the same as that of Kenalog.
- Loracort. Manufacturer: Iran. As an auxiliary component it contains sodium bisulfite, which can cause additional allergic reactions.
- Betaspan Depot. Contains a highly soluble form of betamethasone, which is quickly absorbed from the injection site. This leads to a faster onset of therapeutic action. In addition, it contains a second component - a slightly soluble form, due to which the absorption of the hormone occurs slowly and provides a long-lasting therapeutic effect. Not suitable for mixing with local anesthetics.
- Hydrocortisone acetate. The main active ingredient is hydrocortisone, which is why this drug is weaker than Kenalog. It is produced by different pharmaceutical companies, so it may differ in price, which allows patients to choose the most affordable product. It is not recommended to prescribe hydrocortisone to children, however, if necessary, the drug can be used from 3 years of age. Hungarian-made hydrocortisone contains lidocaine as an additional component. It exhibits not only an analgesic effect, but also acts as a membrane stabilizer. The Hungarian medicine can be administered to children from 3 months of age using the periarticular route.
- Dexon. A German drug in injectable form based on another corticosteroid hormone - dexamethasone. It has a very wide range of applications and can be prescribed in almost any branch of medicine. It can be used in children from the neonatal period under careful monitoring of the dynamics of growth and development. Dexamethasone-based drugs are produced by many pharmaceutical companies.
- Medrol. Medicine based on methylprednisolone. Available in the form of tablets of various dosages (4, 16, 32 mg), as well as in injection form under the name Depo-Medrol. Depo-Medrol is a suspension that has a wide range of applications. It can be used in children, but it should be remembered that methylprednisolone can cause irreversible growth retardation in a child of any age. Manufacturer – Belgium.
Interactions of the drug Kenalog
Weakens the effect of anticoagulants, reduces the concentration of salicylates and increases the level of glucose in the blood plasma (dosage adjustment of insulin or oral hypoglycemic drugs is necessary). Concomitant use of triamcinolone and diuretics may increase potassium excretion (in patients with hypokalemia, sensitivity to cardiac glycosides increases). Co-administration of beta-adrenergic blockers increases the risk of hypokalemia. Estrogens can reduce the metabolism of GCS. Concomitant administration of barbiturates, phenytoin or rifampicin reduces the effectiveness of triamcinolone. Triamcinolone used concomitantly with NSAIDs increases the risk of gastrointestinal bleeding. GCS reduce the effectiveness of antihypertensive drugs.