Kenalog 40 for allergies

Kenalog Shots for Allergies?

Q1. My doctor gave me a Kenalog shot for allergies. Is this a common remedy? Is there something better?

Kenalog, an injectable corticosteroid, is a medication that reduces inflammation in the body, including inflammation related to allergies. Whenever possible, it is better to use corticosteroid medications that only go where they are needed. Specifically, corticosteroids can be sprayed into the nose for nasal symptoms, or inhaled into the lungs for allergy-related asthma, rather than injected or taken in pill form. This is preferable, because much of your body is not affected by allergies, and there is usually no reason to give a whole-body medicine. In addition, the doses involved with injected or oral corticosteroids are much higher than the doses in sprays, and therefore the side effects are greater. See my earlier answer about the side effects of corticosteroid medications for more information on this subject.

Doctors will give someone a corticosteroid shot or pills to take by mouth for allergies when that person comes in with disabling symptoms (interfering with sleep or work performance) that have been going on for weeks. In this setting, injections or pills are sometimes the only treatment strong enough to work.

It is important to start medications for allergies as soon as symptoms appear, and if you know what time of year your symptoms are typically the worst, then medication can be started a week or two before. If you don’t know exactly when to expect your symptoms, it is best to have prescriptions on hand so that you can start the medicines quickly, when you need them. This approach works far better than waiting until the symptoms become severe and require a much stronger treatment.

Q2. I am taking allergy shots every week, one for cats and dogs and one for mold and weeds. I have gained 26 pounds since I started the shots six months ago. Could the shots cause me to gain weight?

— Carol, Ohio

No, allergy shots are not known to be associated with weight gain. On the other hand, some allergy medications are. If you are taking antihistamines on a regular basis, they may be contributing to your weight gain, as some of them are known to increase appetite. Perhaps you could talk to your doctor about using fewer antihistamines, and/or using steroid-containing nasal sprays instead. These don’t cause weight gain and are generally more effective, when used daily, for nasal allergy symptoms.

Another medication that definitely contributes to weight gain is oral steroids, which cause both water retention and actual weight gain. The doses used in pills are much higher than those in steroid inhalers and nasal sprays, which is why the pills have so many side effects while the inhalers and nasal sprays don’t. You didn’t mention steroids in your question, but check with your doctor to make sure they aren’t a factor for you.

Occasionally, I have a patient who feels very tired after his or her shots, which leads to a reduction in activity levels for a couple of days each week. This could also contribute to weight gain. I would suggest having a focused visit with the allergist who is treating you to think about what might be causing your weight gain. It is a significant amount, and I’m sure you are very frustrated. However, I wouldn’t advise just stopping the shots, because there is probably another reason. You would need to factor in any changes that occurred around the same time. For example, are you eating out more, exercising less, or did you change your job activities? Did you start any new prescription or over-the-counter medications?

Also, if you are just six months into the allergy shot process, you are not yet seeing all the improvement that the shots should provide. That’s why it’s worthwhile trying to sort out the cause of your weight gain and persist with the shots for at least two years so you can see their full effects.

Q3. While pregnant, I developed asthma, as well as polyps in my sinuses. I had sinus surgery to remove the polyps, but my problems persist with swollen nasal passageways and a chronic runny/stuffy nose. My ENT said my IgE level is over 400. He suggested allergy shots, but since I want to get pregnant again, he said I shouldn’t start the shots now. Why is that? Do you also suggest that women who are trying to get pregnant avoid allergy shots?

— Patty, Maryland

Allergy shots (or allergen immunotherapy) can be safely continued during pregnancy if a woman has not had any serious reactions to the shots previously, but it is not advised that women begin shots or increase the dose of their shots while pregnant. This is because allergic reactions to the shots, which are uncommon but can be dangerous, occur more often during the initial, buildup stage, when the dose is being increased. A severe allergic reaction could cause low blood pressure in the mother, and the baby might not get enough oxygen for a few minutes. In addition, the treatment for a severe allergic reaction — which is epinephrine — could temporarily reduce the blood supply to the baby. So rather than taking these risks, allergists avoid beginning or increasing allergy shots during pregnancy, an approach accepted by professional allergy and obstetrical societies. There is some preliminary evidence that mothers who get allergy shots while they are pregnant may lower their baby’s risk of being allergic, but more study is needed before this can be considered fact.

You mentioned that the allergy shots were suggested because you had developed nasal polyps. Nasal polyps are a difficult condition to treat, and most people end up having surgery to remove them at some point. After surgery, many patients’ polyps grow back within three years, unless something dramatic is done to prevent this. The approach at my center after surgery is to begin treatment with a combination of medications, including nasal steroid sprays (used at maximal dose absolutely every day), montelukast (Singulair), and sinus saline rinses once or twice a day. All these therapies have been taken safely by pregnant women, although you should always ask your doctor about the best treatment in your particular circumstances.

Q4. I am considering allergy shots for my daughter. If they work, will she be able to cut down on her allergy medications? Also, are the shots safe?

Also called immunotherapy, allergy shots are an extremely effective and safe way of manipulating the immune system so that a person becomes less allergic, sneezes less, has decreased itching of the nose and eyes and, in the best case scenario, is able to reduce or even prevent wheezing. With this approach, small doses of allergens are given to the patient by injection and gradually increased as the person’s immune system learns to tolerate them. Immunotherapy is especially effective for allergies to pollen, dust mites, animal dander and insect stings. It’s not recommend as a treatment for food allergies.

Allergy shots are effective in 85 percent of people who receive this method of treatment. However, they don’t cure allergies, so your daughter may still need some medication, depending on how effective the shots are for her.

Q5. Can you explain how allergy shots work? I have horrible hay fever and would like to be able to stop taking antihistamines, which make me groggy. How early would I have to start for them to be effective? Thanks.

— Diana, New Jersey

Allergy shots, or allergen immunotherapy, is a form of vaccination much like vaccines against tetanus or measles. However, this form of vaccination injects a solution containing the item that the person is allergic to, unlike vaccines against infections (which contain small, harmless pieces of a bacteria or virus, or viruses that have been altered so that they cannot cause infection). For example, if a person undergoes allergen immunotherapy for ragweed pollen, they are actually getting injected with ragweed pollen. This does not result in a dangerous allergic reaction because allergy vaccines are given in a gradual manner, over a long period of time. In the case of an allergy to ragweed pollen, the process would start with weekly injections of very tiny amounts of ragweed. Each week, the person would return for a bit more, and over time, they would be able to tolerate more and more. The process can be accomplished using several different schedules, although the end result is the same. After a period of time, usually a few months, the person can tolerate large doses of ragweed pollen. This ongoing exposure produces multiple changes in the immune system of the patient; their bodies no longer see ragweed pollen as a dangerous thing that needs to be attacked, but rather something that can safely be ignored.

Once the person can tolerate a strong dose of ragweed pollen, the shots can be reduced in number (but not strength) to once a month. Monthly shots should be continued for 3 to 5 years to reach the maximum benefit, but most people notice that their symptoms begin to improve within 6 to 9 months. By the second year, people usually notice a dramatic improvement.

The drawbacks to allergen immunotherapy are the following:

  • There is a risk of an allergic reaction to the shots, which can be severe
  • It can be inconvenient to make frequent visits to the allergist’s office
  • It can be expensive, although most insurance companies will cover the process, since it is cost-effective for members to be using less allergy medication

Most allergists will recommend allergen immunotherapy to patients who are not getting enough relief with combination medications (a nasal corticosteroid spray, an antihistamine, and antihistamine eyedrops if eye symptoms are prominent), or to patients who do not want to use medication.

Learn more in the Everyday Health Allergy Center.

Kenalog-40

SIDE EFFECTS

(listed alphabetically under each subsection)

The following adverse reactions may be associated with corticosteroid therapy:

Allergic reactions

Anaphylaxis including death, angioedema.

Cardiovascular

Bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, fat embolism, hypertension, hypertrophic cardiomyopathy in premature infants, myocardial rupture following recent myocardial infarction (see WARNINGS), pulmonary edema, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis.

Dermatologic

Acne, allergic dermatitis, cutaneous and subcutaneous atrophy, dry scaly skin, ecchymoses and petechiae, edema, erythema, hyperpigmentation, hypopigmentation, impaired wound healing, increased sweating, lupus erythematosus-like lesions, purpura, rash, sterile abscess, striae, suppressed reactions to skin tests, thin fragile skin, thinning scalp hair, urticaria.

Endocrine

Decreased carbohydrate and glucose tolerance, development of cushingoid state, glycosuria, hirsutism, hypertrichosis, increased requirements for insulin or oral hypoglycemic agents in diabetes, manifestations of latent diabetes mellitus, menstrual irregularities, secondary adrenocortical and pituitary unresponsiveness (particularly in times of stress, as in trauma, surgery, or illness), suppression of growth in pediatric patients.

Fluid and electrolyte disturbances

Congestive heart failure in susceptible patients, fluid retention, hypokalemic alkalosis, potassium loss, sodium retention.

Gastrointestinal

Abdominal distention, bowel/bladder dysfunction (after intrathecal administration ), elevation in serum liver enzyme levels (usually reversible upon discontinuation), hepatomegaly, increased appetite, nausea, pancreatitis, peptic ulcer with possible perforation and hemorrhage, perforation of the small and large intestine (particularly in patients with inflammatory bowel disease), ulcerative esophagitis.

Metabolic

Negative nitrogen balance due to protein catabolism.

Musculoskeletal

Aseptic necrosis of femoral and humeral heads, calcinosis (following intra-articular or intralesional use), Charcot-like arthropathy, loss of muscle mass, muscle weakness, osteoporosis, pathologic fracture of long bones, post injection flare (following intra-articular use), steroid myopathy, tendon rupture, vertebral compression fractures.

Neurologic/Psychiatric

Convulsions, depression, emotional instability, euphoria, headache, increased intracranial pressure with papilledema (pseudotumor cerebri) usually following discontinuation of treatment, insomnia, mood swings, neuritis, neuropathy, paresthesia, personality changes, psychiatric disorders, vertigo. Arachnoiditis, meningitis, paraparesis/paraplegia, and sensory disturbances have occurred after intrathecal administration. Spinal cord infarction, paraplegia, quadriplegia, cortical blindness, and stroke (including brainstem) have been reported after epidural administration of corticosteroids (see WARNINGS: Serious Neurologic Adverse Reactions with Epidural Administration and WARNINGS: Neurologic).

Ophthalmic

Exophthalmos, glaucoma, increased intraocular pressure, posterior subcapsular cataracts, rare instances of blindness associated with periocular injections. Other: Abnormal fat deposits, decreased resistance to infection, hiccups, increased or decreased motility and number of spermatozoa, malaise, moon face, weight gain.

Read the entire FDA prescribing information for Kenalog-40 (Triamcinolone Acetonide Injectable Suspension)

Manage Your Allergy Symptoms with a KenalogⓇ Steroid Injection

If you’re one of the millions of people in the United States who greets spring with mixed feelings, thanks to hay fever, there’s good news. We offer a steroid injection called KenalogⓇ that takes the teeth out of spring allergies, allowing you to get out and enjoy this season of renewal.

At Express Lane Urgent Care, we see our fair share of patients from the Turlock, California, area who come to us each spring (and fall) with symptoms that range from sneezing and watery eyes to body aches and sinus problems. To help keep these symptoms at bay, we offer a steroid injection — Kenalog — that can provide months of relief.

Here’s a look at how we can manage your seasonal allergy symptoms with Kenalog.

Seasonal allergies 101

In order to better understand how we can manage your allergies with a simple injection, let’s take a look at what happens to your body when seasonal allergies strike. The main driver behind seasonal allergies is a reaction to the pollen flying around in the air, which is most prevalent in the springtime (though fall allergies are also common).

Your body, for reasons unknown, regards pollen as a dangerous invader, which is what kicks your immune system into action. The first step in this response is the release of histamines, which are what make you cough, sneeze, and tear up as you body attempts to expel the foreign substance.

These histamines also create inflammation in order to signal your immune system to step up its involvement, and this reaction is what can cause more serious responses, like difficulty breathing and those flu-like symptoms.

Kenalog fights inflammation

While spot medications can offset some of your symptoms, the fact is that your allergic response has already begun, which makes it harder to reverse. To stop your symptoms from developing in the first place we offer Kenalog, which contains triamcinolone acetonide, a corticosteroid hormone that prevents inflammation.

Kenalog is a long-acting steroid injection that slowly releases the steroid into your system over the course of three months, preventing your body from responding to allergens with inflammation.

The Kenalog injection works systemically, which means your entire body is primed against inflammation. This is important because allergies affect people in different ways. So with this blanket approach, we can help the person who suffers from congestion as much as the person who experiences rashes or hives.

Most people tolerate the treatment very well, though you may experience some temporary soreness at the site of the injection. If you have a pre-existing medical condition, such as diabetes or high blood pressure, we may try a different approach to your seasonal allergies, depending upon your medical history.

There are also some side effects that come with steroid use, such as increased appetite and sleep issues, and we’ll review them with you when you come in.

If you’d like to take back control of your life in every season, give us a call or just walk-in to find out about our Kenalog injections for seasonal allergies.

triamcinolone acetonide injectable suspension (Rx)

Contraindications

Systemic fungal infection, except as intra-articular injection for localized joint conditions

Documented hypersensitivity to corticosteroids or any components of the product

IM corticosteroids contraindicated for idiopathic thrombocytopenic purpura (ITP)

Triamcinolone diacetate injectable suspension contraindicated for intrathecal administration

Cerebral malaria

Benzyl alcohol-containing formulations associated with potentially fatal “gasping syndrome” in premature newborns

Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids

Cautions

Triamcinolone acetonide injectable suspension is for intra-articular or intralesional use only, not for IV, SC, intraocular, epidural, or IT use

Triamcinolone acetonide suspensions contain benzyl alcohol; exposure to excessive amounts of benzyl alcohol has been associated with toxicity (hypotension, metabolic acidosis), particularly in neonates, and an increased incidence of kernicterus, particularly in small preterm infants

Rare instances of anaphylaxis have been reported in individuals receiving triamcinolone acetonide injection, regardless of the route of administration (see Contraindications)

Corticosteroids can produce reversible hypothalamic-pituitary-adrenal axis suppression, potential for adrenal sufficiency after withdrawal of treatment, which may persist for months; institute corticosteroid replacement therapy in situations of stress (eg, stress) during that period

Corticosteroids may increase blood pressure, salt and water retention, and potassium excretion; monitor for signs or symptoms (eg, edema, weight gain, and imbalance in serum electrolytes) in congestive heart failure or hypertensive patients

Corticosteroid may be associated with development or exacerbation of increased intraocular pressure; monitor patients with elevated intraocular pressure for potential treatment adjustment

Corticosteroids decrease bone formation and increase bone resorption through their effect on calcium regulation and inhibition of osteoblast function

Risk of behavioral and mood disturbances may be associated with corticosteroid use; advise patients and/or caregivers to immediately report any new or worsening behavior or mood disturbances

Atrophy at injection site reported; avoid IM deltoid injection; subcutaneous atrophy may occur

Prolonged use of corticosteroids may increase incidence of secondary infection, cause activation of latent infections, mask acute infection, prolong or exacerbate viral infections, or limit response to killed or inactivated vaccines; avoid exposure to chickenpox or measles; should not be used to treat ocular herpes simplex, cerebral malaria, fungal infections, or viral hepatitis; closely monitor patients with latent tuberculosis (TB) and/or reactivity; not for use in active TB; prior to initiating corticosteroid therapy, amebiasis should be rulsed out in any patient with recent travel to tropic climates or unexplained diarrhea; use caution in patients with Strongylides infections

Prolonged treatment with corticosteroids associated with development of Kaposi sarcoma; consider discontinuing therapy

Acute myopathy reported with high-dose corticosteroids when given concomitantly with neuromuscular blocking agents or patients with neuromuscular transmission disorders; may involve ocular and/or respiratory muscles; monitor creatinine kinase

Psychiatric disturbances associated with corticosteroid use, including insomnia, mood swings, euphoria, and personality changes; preexisting psychiatric conditions may be exacerbated by corticosteroid use

Septic arthritis may occur as a complication to intra-articular or soft tissues manifestation; institute appropriate antibacterial therapy as necessary

Use with caution in patients with gastrointestinal diseases due to perforation risk

Not for management of head injury; increased mortality reported in patients receiving high-dose IV-methylprednisolone to manage head injuries

Use caution in patients with myasthenia gravis; exacerbation of symptoms may occur

Changes in thyroid status may necessitate dosage adjustments; metabolic clearance of corticosteroids increases in hyperthyroid patients and decreases in hypothyroid ones

Use caution in patients with history of seizure disorder; seizures reported with adrenal crisis

Use cautioni in patients with renal impairment; fluid retention may occur

Use with caution in patients with osteoporosis; increased bone loss and osteoporotic fractures reported with high doses and/or long-term use of corticosteroids

Epidural injection

  • Serious neurologic events, some resulting in death, have been reported with epidural injection
  • Specific events reported include, but are not limited to, spinal cord infarction, paraplegia, quadriplegia, cortical blindness, and stroke
  • These serious neurologic events have been reported with and without use of fluoroscopy
  • Safety and effectiveness of epidural administration of corticosteroids have not been established, and corticosteroids are not approved for this use

Drug interactions overview

  • Aminoglutethimide may lead to a loss of corticosteroid-induced adrenal suppression
  • Concomitant with potassium-depleting agents (ie, amphotericin B, diuretics), observe for development of hypokalemia
  • Cases reported in which concomitant use of amphotericin B and hydrocortisone was followed by cardiac enlargement and congestive heart failure
  • Macrolide antibiotics have been reported to cause a significant decrease in corticosteroid clearance
  • Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis; if possible, withdraw anticholinesterase agents at least 24 hours before initiating corticosteroid therapy
  • Coadministration of corticosteroids and warfarin usually results in inhibition of response to warfarin; monitor INR
  • Corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required
  • Cholestyramine may increase the clearance of corticosteroids
  • Increased activity of both cyclosporine and corticosteroids may occur when the two are used concurrently; convulsions have been reported with this concurrent use
  • Estrogens may decrease the hepatic metabolism of certain corticosteroids, thereby increasing their effect
  • Patients on digitalis glycosides may be at increased risk of arrhythmias due to hypokalemia
  • Corticosteroids may suppress reactions to allergy related skin tests
  • Aspirin
    • Concomitant use of aspirin (or other nonsteroidal anti-inflammatory drugs) and corticosteroids increases the risk of gastrointestinal side effects
    • Aspirin should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia
    • Clearance of salicylates may be increased with concurrent use of corticosteroids
  • CYP3A4 inducers/inhibitors
    • Concomitant use with CYP3A4 inducers may enhance the metabolism of corticosteroids and may require an increase in the corticosteroid dose
    • Ketoconazole, a strong CYP3A4 inhibitor, has been reported to decrease the metabolism of certain corticosteroids by up to 60% leading to an increased risk of corticosteroid side effects
  • Vaccines
    • Prolonged corticosteroid therapy may cause a diminished response to toxoids, live, or inactivated vaccines due to inhibition of antibody response; possibly potentiate the replication of some organisms contained in live attenuated vaccines
    • If possible, defer routine administration of vaccines or toxoids until corticosteroid therapy is discontinued

Triamcinolone Nasal Spray

Triamcinolone comes as a liquid (prescription and nonprescription) to spray in the nose. It is usually sprayed in each nostril once daily. If you are an adult, you will begin your treatment with a higher dose of triamcinolone nasal spray and then decrease your dose when your symptoms improve. If you are giving triamcinolone nasal spray to a child, treatment will begin with a lower dose of the medication and then the dose may increase if the child’s symptoms do not improve. You will decrease the dose when the child’s symptoms improve. Follow the directions on the package or product label carefully and ask your doctor or pharmacist if you have any questions. Use triamcinolone spray exactly as directed. Do not use more or less of it or use it more often than directed on the package label or prescribed by your doctor.

An adult should help children under 12 years old to use triamcinolone nasal spray. Children younger than 2 years of age should not use this medication.

Triamcinolone nasal spray is only for use in the nose. Do not swallow the nasal spray and be careful not to spray it in your eyes. If you accidentally get triamcinolone nasal spray in your eyes, rinse your eyes well with water.

Each bottle of triamcinolone nasal spray should only be used by one person. Do not share triamcinolone nasal spray because this may spread germs.

Triamcinolone nasal spray controls the symptoms of hay fever and allergies but does not cure these conditions. Your symptoms may improve on the day that you begin using triamcinolone nasal spray, but it may take up to 1 week of daily use before you feel the full benefit of this medication. If you use the prescription triamcinolone nasal spray daily and your symptoms do not improve after 3 weeks, call your doctor. If you use the nonprescription triamcinolone nasal spray daily and your symptoms do not improve after 1 week, call your doctor.

Triamcinolone nasal spray is designed to provide a certain number of sprays. After the marked number of sprays have been used, the remaining sprays in the bottle might not contain the correct amount of medication. You should keep track of the number of sprays you have used and dispose of the bottle after you have used the marked number of sprays even if it still contains some liquid.

To use the nasal spray, follow these steps:

  1. Remove the cap from the bottle and shake the bottle gently.
  2. If you are using the pump for the first time you must prime the pump. Press and release the nozzle to release 5 sprays into the air away from the face. If you have not used it for 2 weeks or longer, press and release 1 spray into the air away from the face.
  3. Gently blow your nose until your nostrils are clear. A small child may need help to gently blow his or her nose.
  4. Remove the bottle cap and gently shake the bottle.
  5. Hold the pump with the applicator between your forefinger and middle finger and the bottom resting on your thumb.
  6. Press one finger on the other hand against the side of one of your nostrils to hold it closed.
  7. Put the spray tip into your other nostril. Aim the tip toward the back of your nose, but do not push the tip deep into your nose. Do not point the tip toward your nasal septum (divider between your nostrils).
  8. Sniff gently. While you are sniffing, use your forefinger and middle finger to press firmly down on the applicator and release a spray.
  9. If you are using 2 sprays, repeat steps 6 to 8.
  10. Repeat steps 6 to 8 in the other nostril.
  11. Do not blow your nose for 15 minutes after using the spray.
  12. Wipe the applicator with a clean tissue and cover it with the cap.

Kenalog-40 (injection)

Generic Name: triamcinolone (injection) (TRYE am SIN oh lone)
Brand Name: Kenalog-40, Zilretta

Medically reviewed by Drugs.com on Aug 21, 2019 – Written by Cerner Multum

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Interactions
  • More

What is Kenalog-40?

Kenalog-40 is a steroid that prevents the release of substances in the body that cause inflammation.

Kenalog-40 is used to treat many different types of inflammatory conditions, including severe allergic reactions, skin disorders, severe colitis, inflammation of the joints or tendons, blood cell disorders, inflammatory eye disorders, lung disorders, and problems caused by low adrenal gland hormones.

Kenalog-40 is also used to treat certain skin disorders caused by autoimmune conditions such as lupus, psoriasis, lichen planus, and others.

Different brands of triamcinolone injection have different uses.

Kenalog-40 may also be used for purposes not listed in this medication guide.

Important Information

You may not be able to receive Kenalog-40 if you have a fungal infection, or a condition called idiopathic thrombocytopenic purpura (ITP).

Before taking this medicine

You should not be treated with Kenalog-40 if you are allergic to it.

You may not be able to receive Kenalog-40 if you have a fungal infection, or a condition called idiopathic thrombocytopenic purpura (ITP).

Tell your doctor if you have ever had:

  • an active or chronic infection, including tuberculosis;

  • idiopathic thrombocytopenic purpura (ITP);

  • high blood pressure, heart problems;

  • cataracts, glaucoma, or herpes infection of the eyes;

  • a parasite infection that causes diarrhea (such as threadworms);

  • a nerve-muscle disorder, such as myasthenia gravis;

  • a stomach ulcer, diverticulitis, ulcerative colitis;

  • a colostomy or ileostomy, or stomach surgery;

  • low bone mineral density; or

  • a problem with your thyroid or adrenal gland.

Tell your doctor if you are pregnant or breastfeeding.

How is Kenalog-40 given?

Kenalog-40 is given through a needle and can be injected into different areas of the body: into a muscle, into the space around a joint or tendon, or into a lesion on the skin. A healthcare provider will give you this injection.

Not every brand of Kenalog-40 is used for the same conditions or injected into the same body areas. Some brands are given only one time as needed. Others may be given at regular intervals. Carefully follow your doctor’s dosing instructions.

Kenalog-40 can weaken (suppress) your immune system, and you may get an infection more easily. Call your doctor if you have unusual bruising or bleeding, or signs of infection (fever, weakness, cold or flu symptoms, skin sores, diarrhea, frequent or recurring illness).

Long-term use of steroids can cause harmful effects on the eyes. If you receive Kenalog-40 for longer than 6 weeks, your doctor may want you to have regular eye exams.

Your doctor may instruct you to limit your salt intake while you are receiving Kenalog-40. You may also need to take potassium supplements. Follow all instructions.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using Kenalog-40.

You should not stop using Kenalog-40 suddenly after long-term repeated use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for a scheduled Kenalog-40.

When Kenalog-40 is used as a single dose, you will not be on a regular dosing schedule.

What happens if I overdose?

Since Kenalog-40 is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

Using too much Kenalog-40 is not likely to cause serious problems. However, long term use of high doses can lead to thinning skin, easy bruising, changes in body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.

What should I avoid while receiving Kenalog-40?

After injection of triamcinolone into a joint, avoid overusing that joint through strenuous activity or high-impact sports. You could cause damage to the joint.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chickenpox or measles. These conditions can be serious or even fatal in people who are using Kenalog-40.

Do not receive a “live” vaccine or a toxoid vaccine while using Kenalog-40, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine. Toxoid vaccines include diphtheria-tetanus toxoid (DT or Td).

Kenalog-40 side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • (after injection into a joint space) increased pain or swelling, joint stiffness, fever, and general ill feeling;

  • blurred vision, tunnel vision, eye pain, or seeing halos around lights;

  • unusual changes in mood or behavior;

  • swelling, rapid weight gain, feeling short of breath;

  • stomach cramps, vomiting, diarrhea, bloody or tarry stools, rectal irritation;

  • sudden numbness or weakness (especially on one side of the body);

  • a seizure (convulsions);

  • severe headache, blurred vision, pounding in your neck or ears;

  • increased pressure inside the skull–severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes; or

  • signs of low adrenal gland hormones–flu-like symptoms, headache, depression, weakness, tiredness, diarrhea, vomiting, stomach pain, craving salty foods, and feeling light-headed.

Certain side effects may be more likely with long-term use or repeated doses of triamcinolone injection.

Steroids can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using Kenalog-40.

Common side effects may include:

  • skin changes (acne, dryness, redness, bruising, discoloration);

  • increased hair growth, or thinning hair;

  • nausea, bloating, appetite changes;

  • stomach or side pain;

  • cough, runny or stuffy nose;

  • headache, sleep problems (insomnia);

  • a wound that is slow to heal;

  • sweating more than usual; or

  • changes in your menstrual periods.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Kenalog-40?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your current medicines. Many drugs can affect Kenalog-40, especially:

  • an antibiotic or antifungal medication;

  • birth control pills or hormone replacement therapy;

  • a blood thinner (warfarin, Coumadin, and others);

  • a diuretic or “water pill”;

  • insulin or oral diabetes medicine;

  • medicine to treat tuberculosis;

  • a nonsteroidal anti-inflammatory drug or NSAID (aspirin, ibuprofen, naproxen, diclofenac, indomethacin, Advil, Aleve, Celebrex, and many others); or

  • seizure medication.

This list is not complete and many other drugs may affect Kenalog-40. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 4.05.

Related questions

  • Can triamcinolone acetonide B be used to treat severe diaper rash on a little girl?

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  • Kenalog
  • Kenalog-10

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  • Adrenocortical Insufficiency
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  • Alopecia
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Dear Dr. Roach: I have severe allergies to pollen every spring. I have been tested many times and get allergy injections once a week. These seem to help, but what relieves all of my symptoms for the season is an 80-mg Kenalog injection once a year at the beginning of March. I question whether I can stop the allergy shots altogether and just get the Kenalog injection. I’ve asked my allergy doctor about this, and he indicates that I should stay on the regular allergy shots. Besides the complete allergy relief I get from the steroid shot, I get good side effects — increased energy, and it seems to relieve 75 per cent of my lower-back pain, at least for a couple of months. My second question is, how often can a person take this steroid injection without harm? I’m 63 and am in great shape.

L.F.

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I don’t recommend steroid injections such as triamcinolone (Kenalog) at all for seasonal allergies. They certainly are effective, but the absorption is unpredictable.

The potential side effects are serious, and there is no way to get rid of the injected steroid if side effects occur. Serious side effects include elevations in blood pressure and blood sugar (occasionally converting borderline high blood sugars to overt diabetes), loss of bone strength and mental status changes, including acute psychosis.

You report good side effects, but you might be having significant side effects without knowing it.

A good response to systemic steroids, whether by injection or by oral steroids such as prednisone, predicts a good response to topical nasal steroids, which have far fewer side effects.

Dear Dr. Roach: I have taken a thyroid supplement since it was first prescribed for me, nearly 30 years ago. The dose has changed from time to time as the lab work would indicate. My dosage has been 75 micrograms for the past several years.

A year ago, my thyroid stimulating-hormone reading was 5.21 and my T4 free was 1.37. My physician at that time requested a second blood test before ordering a change in dosage. I had not taken my levothyroxine the morning of the first test, but did take it prior to the second test, which had results in the normal range. That physician has since left, and my new doctor recently ordered lab work. Prior to going for the blood draw, I did take levothyroxine. The readings were TSH 5.60 and 1.69 T4 free, both higher than the normal range. When I asked about them, the assistant said they were not high enough for the doctor to be concerned.

Would these latest readings cause you to order a retest or a change in medication? Those two items appeared alone on the last page of the report, and I am suspicious that the doctor may have missed looking at that page.

C.V.

TSH is a hormone produced by the pituitary gland that regulates the amount of thyroid hormone released. When the gland makes too much (as in Graves’ disease), TSH levels are low. If the gland can’t make enough (as in Hashimoto’s hypothyroidism), TSH is high. If TSH and thyroxine (T4) are high, it could be that the pituitary is making too much (usually from a tumour). However, your levels are very close to the normal range. I would recommend a recheck at your next visit. There are other causes, such as a recent change in thyroxine dose, but normal variation in hormone levels and in the lab is most likely.

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Is There a Single Shot That Can Cure Seasonal Allergies?

Topics > Healthy Outlook > Is There a Single Shot That Can Cure Seasonal Allergies?
Published by Contra Costa Times
Posted on Tue., June 10, 2008
By Stephen J. Daniels, MD

Hey, doc, I need an allergy shot. My brother-in-law’s doctor gave him one, and he’s completely cured. Can I get one?”

I could see that Max (not his real name) was suffering: his eyes were watery, red and swollen, he kept clearing his throat, and his nose was red from so much wiping.

May and June are allergy season in Contra Costa County, especially in Central and East county.

Max’s desire to get a shot and have his symptoms be gone for the rest of the allergy season was certainly understandable.

There are so many treatments for seasonal allergies, from over-the-counter medicines and sprays, to pills, syrups, sprays and shots that need a doctor’s prescription. What treatment is best?

In my experience, the treatments that work best for most people with the fewest serious side effects are prescription steroid sprays for the nose, such as Nasarel, Nasonex and Vancenase AQ, and a variety of prescription eye drops, including Cromolyn and Patanol, for allergic eye symptoms.

These put the medicine directly on the problem, and the side effects are minimal, even if used continuously for months or years on end. But these are often expensive, and require daily or more frequent use.

So, what about “the shot” that Max wanted? This refers to a long-acting glucocorticoid (“steroid”) shot such as Depomedrol. It’s cheap, convenient, and I’ve never seen it fail to alleviate, or at least improve, allergy symptoms.

Note that these steroids are related to, but different from, the anabolic steroids used by athletes to build their muscles.

But physicians disagree about the advisability of giving steroid shots for allergies. Some give it to their allergic patients as an initial therapy. Some refuse to give steroid injections for seasonal allergies altogether. Most physicians, however, reserve it for cases of severe allergies that are unresponsive to pills or sprays.

Doctors frequently use steroid shots for severe asthma, so why not for severe seasonal allergies? Perhaps it is because asthma can be life-threatening, whereas seasonal allergies “only” make one miserable.

Some doctors think that the shot is too potentially dangerous for an illness that is “only” unpleasant.

In almost 30 years of medical practice, though, I have seen very few bad reactions or serious side effects that were definitively caused by a single (even annual) long-acting steroid injection for allergies or asthma.

Cases of severe hip joint degeneration, possibly from a steroid shot, had other possible causes, such as alcoholism or prolonged (six months or more) continuous steroid use.

Steroid shots can cause high blood sugar levels in diabetic patients, but these can usually be addressed by more frequent blood sugar testing and medication dose adjustments.

Other side effects include swelling, anxiety, insomnia, mania and depression, which, in rare instances, can be dangerous.

One strategy might be to use a short-acting steroid to assess the potential side effects. If well-tolerated, a longer-acting steroid shot might be indicated.

Steroid injections for seasonal allergies are controversial and should be discussed with your doctor. Ideally, you know and agree with your doctor’s philosophy of medical practice, and your doctor knows you, your medical history, and how to balance the benefits and risks of a steroid injection for you.

Daniels practices family medicine at the Concord and Pittsburg Health Centers of Contra Costa Health Services, the county health department. Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at [email protected] For more health information, go to www.cchealth.org.

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