Kenalog Information
Kenalog (Triamcinolone) Description
The topical corticosteroids constitute a class of primarily synthetic steroids used as anti-inflammatory and antipruric 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. Graphic formula:
Each mL of 0.025% and 0.1% Kenalog (Triamcinolone) Lotion (Triamcinolone Acetonide Lotion) provides 0.25 mg and 1 mg triamcinolone acetonide, respectively, in a lotion base containing propylene glycol, cetyl alcohol, stearyl alcohol, sorbitan monopalmitate, polysorbate 20, simethicone, and purified water.
Kenalog (Triamcinolone) Clinical Pharmacology
Topical corticosteroids share anti-inflammatory, antipruritic and vasoconstrictive actions.
The mechanism of anti-inflammatory activity of the topical corticosteroids is unclear.
Various laboratory methods, including vasoconstrictor assays are used to compare and predict potencies and/or clinical efficacies of the topical corticosteroids. There is some evidence to suggest that a recognizable correlation exists between vasoconstrictor potency and therapeutic efficacy in man.
Kenalog (Triamcinolone) Indications And Usage
Kenalog (Triamcinolone) Lotion (Triamcinolone Acetonide Lotion) 0.025% and 0.1% are indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses.
Kenalog (Triamcinolone) Contraindications
Topical corticosteroids are contraindicated in those patients with a history of hypersensitivity to any of the components of the preparations.
Kenalog (Triamcinolone) Precautions
Systemic absorption of topical corticosteroids has produced reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, manifestations of Cushing’s syndrome, hyperglycemia, and glucosuria in some patients.
Conditions which augment systemic absorption include the application of the more potent steroids, use over large surface areas, prolonged use, and the addition of occlusive dressings.
Therefore, patients receiving a large dose of any potent topical steroid applied to a large surface area or under an occlusive dressing should be evaluated periodically for evidence of HPA axis suppression by using the urinary free cortisol and ACTH stimulation tests, and for impairment of thermal homeostasis. If HPA axis suppression of elevation of the body temperature occurs, an attempt should be made to withdraw the drug, to reduce the frequency of application, substitute a less potent steroid, or use a sequential approach when utilizing the occlusive technique.
Recovery of HPA axis function and thermal homeostasis are generally prompt and complete upon discontinuation of the drug. Infrequently, signs and symptoms of steroid withdrawal may occur, requiring supplemental systemic corticosteroids. Occasionally, a patient may develop a sensitivity reaction to a particular occlusive dressing material or adhesive and a substitute material may be necessary.
Children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity (see ).
If irritation develops, topical corticosteroids should be discontinued and appropriate therapy instituted.
In the presence of dermatological infections, the use of an appropriate antifungal or antibacterial agent should be instituted. If a favorable response does not occur promptly, the corticosteroid should be discontinued until the infection has been adequately controlled.
These preparations are not for ophthalmic use.
Long-term animal studies have not been performed to evaluate the carcinogenic potential or the effect on fertility of topical corticosteroids.
Studies to determine mutagenicity with prednisolone and hydrocortisone showed negative results.
Pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced HPA axis suppression and Cushing’s syndrome than mature patients because of a larger skin surface area to body weight ratio.
HPA axis suppression, Cushing’s syndrome, and intracranial hypertension have been reported in children receiving topical corticosteroids. Manifestations of adrenal suppression in children include linear growth retardation, delayed weight gain, low plasma cortisol levels, and absence of response to ACTH stimulation. Manifestations of intracranial hypertension include bulging fontanelles, headaches, and bilateral papilledema.
Administration of topical corticosteroids to children should be limited to the least amount compatible with an effective therapeutic regimen. Chronic corticosteroid therapy may interfere with the growth and development of children.
Kenalog (Triamcinolone) Adverse Reactions
The following local adverse reactions are reported infrequently with topical corticosteroids, but may occur more frequently with the use of occlusive dressings (reactions are listed in an approximate decreasing order of occurrence): burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, secondary infection, skin atrophy, striae, and miliaria.
Kenalog (Triamcinolone) Overdosage
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects (see ).
Kenalog (Triamcinolone) Dosage And Administration
Apply the 0.025% Kenalog (Triamcinolone) Lotion (Triamcinolone Acetonide Lotion) to the affected area two to four times daily. Rub in gently.
Apply the 0.1% Kenalog (Triamcinolone) Lotion (Triamcinolone Acetonide Lotion) to the affected area two to three times daily. Rub in gently.
Kenalog (Triamcinolone) How Supplied
Kenalog (Triamcinolone) Lotion (Triamcinolone Acetonide Lotion USP)
0.025%; plastic squeeze bottle containing 60 mL (NDC 0003-0173-60) of lotion. 0.1%; plastic squeeze bottles containing 15 mL (NDC 0003-0502-20) and 60 mL (NDC 0003-0502-70) of lotion.
Kenalog (Triamcinolone)
