From the Guidelines
It is not recommended to receive a Kenalog (triamcinolone) shot while taking Enbrel (etanercept) due to the increased risk of infection and other adverse effects associated with combined immunosuppressive therapy, as highlighted in the American College of Chest Physicians evidence-based clinical practice guidelines 1. When considering the use of Kenalog in patients already on Enbrel, it's crucial to weigh the potential benefits against the risks, particularly the risk of infection, which is a well-documented concern with TNF inhibitors like etanercept 1. Some key points to consider include:
- The risk of reactivation of latent infections such as tuberculosis (TB) and hepatitis B virus (HBV) is increased with TNF inhibitors, although the specific risk with etanercept may be lower compared to other TNF antagonists 1.
- The combination of immunosuppressive agents can lead to an increased risk of opportunistic infections, which has been observed in postmarketing reports for etanercept 1.
- While there is controversy regarding the use of TNF antagonists in patients with cardiomyopathy, etanercept has not been convincingly linked to an increased risk of cardiac failure, but caution is still advised 1. Given these considerations, any decision to administer a Kenalog shot to a patient on Enbrel should be made with caution and under close medical supervision, taking into account the patient's overall health status, the reason for the Kenalog injection, and the potential risks and benefits of combined therapy.
From the Research
Receiving a Single Kenalog Shot While Taking Enbrel
- There is limited direct evidence regarding the safety and efficacy of receiving a single Kenalog (triamcinolone) shot while taking Enbrel (etanercept) 2, 3, 4, 5, 6.
- However, studies have shown that triamcinolone and etanercept can be used separately to treat various conditions, such as psoriasis, keloids, and osteoarthritis 2, 3, 5, 6.
- One study compared the efficacy of etanercept and triamcinolone acetonide for the intralesional treatment of keloids, and found that both treatments were safe and well tolerated 3.
- Another study assessed the safety and efficacy of repeat administration of triamcinolone acetonide extended-release in patients with symptomatic knee osteoarthritis, and found that the treatment was well tolerated with no unexpected adverse events or significant radiographic changes 5.
- While there is no direct evidence on the use of Kenalog shots with Enbrel, the available studies suggest that both medications can be used safely in various conditions, but it is essential to consult a healthcare professional for specific guidance on using these medications together.
Potential Interactions and Considerations
- The use of corticosteroids like triamcinolone with biologics like etanercept may increase the risk of infections and other adverse events 4.
- Healthcare professionals should carefully evaluate the potential benefits and risks of using Kenalog shots with Enbrel and monitor patients closely for any adverse reactions.
- Patients should inform their healthcare provider about all medications they are taking, including Enbrel, before receiving a Kenalog shot.