Instruction for use
Synthetic drug the group of glucocorticosteroids for systemic use. The active ingredient of the drug – triamcinolone – has a pronounced anti-inflammatory, antiallergic and immunosuppressive effect. In comparison with other systemic corticosteroids triamcinolone to a much lesser extent inhibits the production of corticotropin in the pituitary gland. In addition, when you use triamcinolone practically does not change the water-salt balance, there is no delay sodium and fluid in the body. Diabetogenic effect of the drug is negligible.
Anti-inflammatory effect the drug has by reducing the number of proteolytic enzymes at the site of inflammation, inhibition of release of cyclooxygenase, reducing prostaglandin. Triamcinolone reduces the number of T - and b-lymphocytes, other immune agents, suppresses the formation of antibodies. Reduces secretion and the release of mediators of Allergy.
The drug is available in several dosage forms, which allows you to pick the perfect form of treatment for each patient.
After intramuscular triamcinolone at a dose of 80-100mg inhibition of adrenal function is observed within 24-48 hours, complete recovery of adrenal function after a single injection observed after 20-40 days.
After intra-articular injection into the systemic circulation over 3 days is released, about 60% of the drug.
After oral administration the drug is rapidly absorbed into the systemic circulation. Maximum drug concentration achieved in 8-12 hours.
The metabolism of the drug occurs mainly in the liver and to some extent in the kidneys. Excreted in the urine, both in unchanged form and as metabolites.
Indications for use
The drug is prescribed for conditions that require therapy with corticosteroids. Form of the drug for systemic use (tablets, suspension for intramuscular injection) is prescribed to patients who suffer from such diseases:
- Hay fever.
- Chronic diseases of the respiratory tract, accompanied by obstruction, in cases when topical therapy is ineffective. Including obstruguy chronic bronchitis, bronchial asthma.
- Allergic diseases and diseases of the skin, including allergic dermatitis, allergic rhinitis, conjunctivitis and urticaria, atopic dermatitis, psoriasis, atopic dermatitis and eczematoid.
- Insufficiency of adrenal function.
- Cancer of the blood and the prostate gland.
The drug in form of suspension for injection is also used for intra-articular introduction of such diseases of the joints:
- Arthrosis, arthritis, including exudative arthritis.
- Dropsy of the joints, the blockade of the joints due to disorders of the joint capsule.
Method of application
The dose and course of treatment determined by the attending physician.
The drug is taken orally, preferably in the morning. If the daily dose exceeds 16 mg, it is recommended to take 1 times a day, however, if the dose exceeds 16my, it must be divided into several stages.
Adults are usually appointed at the beginning of drug therapy Kenalog at 4-32 mg depending on the severity and nature of the disease. In patients suffering from chronic leukemia, the dose may be increased to 75 mg per day. In the case of side effects and/or achieve the desired therapeutic effect gradually reduce the dose every 3 days, reducing to 1-2 mg to achieve the desired maintenance dose. If necessary, discontinuation of the drug reduce the dose gradually, it is not recommended abrupt withdrawal of the drug.
Children over the age of 6 years the drug is administered given the body weight at the rate of 0.1-0.5 mg/kg of body weight per day. The calculated dose of the drug is taken in one or more steps. The maximum daily dose for children, 14 mg.
Suspension for injection:
The drug is not used for intravenous injection. Intramuscular you must make sure that the needle does not hit the vessel, and then inject the drug.
The drug is injected slowly, deep into the buttock, it is not recommended to exceed the dose of 40mg (1ml), however, in severe cases, you can assign 80 mg (2 ml) of the drug. The drug in the treatment of children under 12 years is dosed body weight, respectively. Usually appoint 0.03-0.2 mg/kg of body weight.
For the treatment of seasonal allergic diseases for adults and children over 12 years is usually prescribed 40mg (1ml) once a year. The injection is usually done before the onset of the pollen season.
If necessary, repeated use of the drug should observe the interval between injections 2-4 weeks.
Usual dose is 10-40mg 1 introduction when using the drug for injections in different joints total dose should not exceed 80 mg. Repeated injections are usually carried out not earlier than in 3-4 weeks.
In applying the drug you must follow the conditions of asepsis. The injection site is treated the same way as before the surgery.
After the introduction should be within a few minutes to close the injection site with a sterile cloth.
In applying the drug in patients may experience the following side effects:
The gastro-intestinal tract: nausea, vomiting, indigestion, flatulence, ulceration of the stomach and duodenum, disorders of appetite, disorders of the pancreas.
From the side of cardiovascular system: arterial hypertension, cardiac arrhythmias, increased blood clotting, increased blood clots.
In the Central and peripheral nervous system: depression, disturbance of sleep and wakefulness, headache, dizziness. Nervous disorders, including manic-depressive psychosis, paranoia, anxiety, irritability. Convulsions, tremor of limbs, increased intracranial pressure, impaired orientation in space.
With the skin: stretch marks, acne, dark spots, impaired wound healing, petechiae.
From the endocrine system: reduced tolerance to glucose, increased body mass, delayed sexual development in children, inhibition of secretion of endogenous hormones by the adrenal glands, syndrome Itsenko-Kushinga.
From the sensory organs: changes of cornea, cataract, increased intraocular pressure.
From the metabolic processes: the increase in sodium and decrease in the levels of calcium and potassium in the blood.
From the musculoskeletal: muscle atrophy, impaired growth in children, osteoporosis, necrosis of bone tissue.
Other: may develop local allergic reactions and urticaria, pruritus. In addition, possible changes in laboratory parameters.
For a drug characterized by the development of the syndrome.
In applying the drug in the form of solution for injection possible side effects such as pain, burning, numbness, scarring at the injection site.
Increased individual sensitivity to product components;
children up to age 6 years;
pregnancy and lactation;
ulcerative lesions of the stomach and duodenum;
diseases of the bones;
period after severe injuries, surgeries;
an increased tendency to thrombosis and bleeding, including as a result of taking anticoagulants;
the syndrome Itsenko-Kushinga;
the drug is prescribed with caution in elderly patients and/or suffering from impaired liver function, Hypo - or hyperthyroidism, and with immunodeficiency, hyperlipidemia, cardiac dysfunction, obesity, epilepsy.
The drug is contraindicated in pregnancy because it can cause malformations in the fetus. Kenalog in pregnancy appointed only for health reasons. Newborns whose mothers during pregnancy took corticosteroids should be under close medical supervision, as they have increased risk of adrenal insufficiency.
The drug enters breast milk and is not recommended for use during lactation.
The drug in case of simultaneous use of anticoagulants weakens their action.
Kenalog increases the excretion of potassium diuretics. Increases sensitivity to cardiac glycosides.
Coadministration of the drug with high doses of beta-blockers increases the risk of gipokaliemii.
Barbiturates, phenytoin, rifampicin reduces the efficacy of the drug Kenalog.
Estrogens alter the rate of metabolism of triamcinolone.
Preparations of non-steroidal anti-inflammatory drugs when administered simultaneously with the drug Kenalog increase the risk of side effects from the gastrointestinal tract.
If overdose patients observed symptoms such as nausea, vomiting, a feeling of euphoria and excitation, sleep disorders.
In chronic overdose resulting from the ingestion of excessive doses of the drug for several weeks or more, patients experience fluid retention in the body, muscle weakness, hypertension, syndrome Itsenko-Kushinga, inhibition of hormone secretion by the adrenal cortex.
Hemodialysis is ineffective.
Shows a gradual reduction in the dose of the drug until its complete abolition.
Treatment of overdose is symptomatic, no specific antidote.
After the overdose of the drug characteristic state can be observed for several weeks after the last high dose.
Kenalog tablets at 4mg of active ingredient, 50 tablets in a pack.
Kenalog 40 suspension for injection 1 ml in ampoules, 5 ampoules in a cardboard box.
The drug should be stored in dry protected from sunlight place at a temperature not exceeding 25 degrees Celsius.
Shelf life pill – 5 years.
Shelf life suspension for injection – 3 years.
1 ml suspension for injection contains:
triamcinolone acetate 40mg;
1 tablet contains:
triamcinolone – 4mg;
excipients, including lactose.