From the FDA Drug Label
Intramuscular Where oral therapy is not feasible, injectable corticosteroid therapy, including KENALOG-40 Injection and KENALOG-80 Injection (triamcinolone acetonide injectable suspension, USP) is indicated for intramuscular use as follows: Allergic states: Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, serum sickness, transfusion reactions. Dermatologic diseases: Bullous dermatitis herpetiformis, exfoliative erythroderma, mycosis fungoides, pemphigus, severe erythema multiforme (Stevens-Johnson syndrome)
The proper usage and dosage of Kenalog (Triamcinolone) for treating allergic reactions and skin conditions is for intramuscular use to control severe or incapacitating allergic conditions, such as:
- Asthma
- Atopic dermatitis
- Contact dermatitis
- Drug hypersensitivity reactions
- Perennial or seasonal allergic rhinitis
- Serum sickness
- Transfusion reactions And for dermatologic diseases, such as:
- Bullous dermatitis herpetiformis
- Exfoliative erythroderma
- Mycosis fungoides
- Pemphigus
- Severe erythema multiforme (Stevens-Johnson syndrome) 1
From the Research
Kenalog (triamcinolone acetonide) should be used at the lowest effective dose and for the shortest duration necessary to achieve symptom control, with careful consideration of potential side effects and individual patient factors, as supported by the most recent study on its pharmacokinetic and pharmacodynamic mechanisms 2.
Usage and Dosage
For topical skin applications, Kenalog cream or ointment (0.025% to 0.5% strength) should be applied thinly to affected areas 2-4 times daily.
- For more severe skin conditions, triamcinolone injection may be administered by healthcare providers at doses of 10-40 mg, with effects lasting 1-6 weeks depending on the condition.
- Intralesional injections for specific skin lesions typically use concentrations of 2.5mg/mL, as reported in a survey of dermatology healthcare professionals 3.
- For allergic rhinitis, the nasal spray form is used as 1-2 sprays in each nostril once daily.
Mechanism of Action and Side Effects
Kenalog works by reducing inflammation, suppressing immune responses, and constricting blood vessels.
- Side effects may include skin thinning, discoloration, increased infection risk, and adrenal suppression with prolonged use.
- Patients should avoid applying to large body areas for extended periods, as this increases systemic absorption.
- Treatment duration should be limited to the shortest period needed for symptom control, typically 2-4 weeks for most skin conditions, with gradual tapering for longer treatments to prevent rebound effects.
Important Considerations
- The use of Kenalog can lead to rare but serious side effects, such as anaphylaxis, as reported in a case study on the carboxymethylcellulose component of injectable triamcinolone acetonide suspension 4.
- Postinjection flares can occur, ranging from mild joint effusion to disabling pain, as described in a case report on extreme postinjection flare in response to intra-articular triamcinolone acetonide 5.
- The pharmacokinetic and pharmacodynamic mechanisms of intramuscular triamcinolone acetonide are not fully understood, but its unique properties may contribute to its efficacy in treating dermatologic diseases 2.