What is Kenalog (Triamcinolone)?

From the Guidelines

Kenalog, also known as triamcinolone acetonide, is a synthetic corticosteroid medication used to treat various inflammatory and allergic conditions, with its most recent and highest quality use supported by the 2022 American College of Rheumatology guideline for the treatment of juvenile idiopathic arthritis 1.

Key Characteristics of Kenalog

• It comes in several forms, including injections, topical creams, ointments, and aerosol sprays.
• Kenalog injections are commonly used for conditions like allergic rhinitis, asthma, arthritis, skin disorders, and autoimmune diseases.
• The typical dosage varies based on the condition being treated, but injections generally range from 10 to 80 mg, with effects lasting approximately 2-6 weeks.
• For topical applications, it's usually applied 2-4 times daily to affected areas.

Side Effects and Precautions

• Side effects may include skin thinning, increased blood sugar, mood changes, and suppressed immune function.
• Long-term use can lead to adrenal suppression, so it should be used at the lowest effective dose for the shortest duration possible.
• Kenalog works by reducing inflammation through suppressing the immune response and inhibiting inflammatory mediators.
• It should not be used in patients with systemic fungal infections, and caution is needed in those with diabetes, osteoporosis, or hypertension.

Recent Guidelines and Recommendations

• The 2022 American College of Rheumatology guideline recommends the use of triamcinolone hexacetonide for oligoarthritis, and notes that it has been shown to be superior to alternative injectable glucocorticoids in achieving and maintaining remission in children with JIA 1.
• The guideline also emphasizes the importance of individualizing treatments, shared decision-making, and considering patients' and caregivers' values, goals, and preferences.
• The use of Kenalog should be based on the most recent and highest quality evidence, and should be guided by clinical judgment and shared decision-making in everyday care of individuals with inflammatory and allergic conditions.

From the FDA Drug Label

The topical corticosteroids constitute a class of primarily synthetic steroids used as anti-inflammatory and antipruritic agents. The steroids in this class include triamcinolone acetonide. Triamcinolone acetonide is designated chemically as 9-Fluoro-11β, 16α, 17,21- tetrahydroxypregna-1,4-diene-3,20-dione cyclic 16,17-acetal with acetone. Each gram of Triamcinolone Acetonide Ointment USP, 0.1% contains 1mg triamcinolone acetonide in an ointment base of light mineral oil and white petrolatum.

Kenalog (Triamcinolone) is a topical corticosteroid used as an anti-inflammatory and antipruritic agent 2.

• It is used for the relief of inflammatory and pruritic manifestations of corticosteroid responsive dermatoses 2.
• The active ingredient is triamcinolone acetonide.

From the Research

Definition and Uses of Kenalog (Triamcinolone)

• Kenalog, also known as Triamcinolone, is a synthetic corticosteroid used to treat various inflammatory conditions 3.
• It is used in the treatment of respiratory inflammation, rheumatoid arthritis, and a variety of other inflammatory conditions 3.
• Kenalog can be administered through different routes, including intramuscular, intra-articular, and intralesional injections 4, 5, 6.

Administration and Dosage

• The dosage of Kenalog varies depending on the condition being treated and the route of administration 4, 5, 6.
• For example, a study on older adults with severe, chronic asthma used a high-dose intramuscular injection of 360 mg of triamcinolone (Kenalog) 4.
• Intralesional injections of Kenalog for acne treatment typically use a concentration of 2.5mg/mL and a volume of 0.05mL 5.
• Intra-articular injections for shoulder stiffness have used doses of 20 mg and 40 mg of triamcinolone acetonide 6.

Mechanism of Action and Efficacy

• The exact mechanism of action of Kenalog is not fully understood, but it is thought to have a unique nature of having a long-term effect on dermatologic disease using a seemingly low dose compared with other routes of administration and other corticosteroids 7.
• Possible reasons for its efficacy may be binding differences at the intramuscular site, low solubility due to acetonide esters, a slow rate of absorption from the injected site, and a low renal clearance rate 7.
• Studies have shown that Kenalog can be effective in improving symptoms and functional outcomes in patients with various conditions, including asthma 4, acne 5, and shoulder stiffness 6.