Kenalog-40®

GoodRx

Triamcinolone Acetonide 40 mg/mL · injectable suspension

Steroid, Injections & Implants

OFF-LABELNot in the FDA label for this product

Diabetic macular edema, by intravitreal injection

1 mg or 4 mg intravitreally, repeated at 4-month intervals for persistent edema in the trial

RCT · 840 eyes · laser better

The DRCR Network randomised 840 eyes of 693 patients to focal/grid photocoagulation or to 1 mg or 4 mg preservative-free intravitreal triamcinolone. Acuity was better on 4 mg at 4 months, but by 2 years laser was better than both doses. Intraocular pressure rose by 10 mmHg or more in 4%, 16% and 33% of eyes across the three groups, and cataract surgery was performed in 13%, 23% and 51%. Note the trial used the preservative-free product; Kenalog-40 contains benzyl alcohol and is not formulated for intraocular use.

Diabetic Retinopathy Clinical Research Network. A randomized trial comparing intravitreal triamcinolone acetonide and focal/grid photocoagulation for diabetic macular edema. Ophthalmology. 2008;115(9):1447-9, 1449.e1-10

Contraindications

KENALOG-40 Injection and KENALOG-80 Injection are contraindicated in patients who are hypersensitive to any components of this product . Intramuscular corticosteroid preparations are contraindicated for idiopathic thrombocytopenic purpura.

Available Forms

40 mg/mL single-dose vial, 1 mL single-dose vial, 40 mg/mL multiple-dose vial, 5 mL multiple-dose vial, 10 mL multiple-dose vial

Mechanism of Action

Glucocorticoids, naturally occurring and synthetic, are adrenocortical steroids that are readily absorbed from the gastrointestinal tract. Naturally occurring glucocorticoids (hydrocortisone and cortisone), which also have salt-retaining properties, are used as replacement therapy in adrenocortical deficiency states.

Warnings & Precautions

Serious Neurologic Adverse Reactions with Epidural Administration: Serious neurologic events, some resulting in death, have been reported with epidural injection of corticosteroids . Specific events reported include, but are not limited to, spinal cord infarction, paraplegia, quadriplegia, cortical blindness, and stroke.
General: 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.

Common Side Effects

The following adverse reactions may be associated with corticosteroid therapy: Allergic reactions: Anaphylaxis including death, and angioedema.

Pregnancy & Lactation

Lactation: Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. Caution should be exercised when corticosteroids are administered to a nursing woman.

Pediatric Use

This product contains benzyl alcohol as a preservative. Benzyl alcohol, a component of this product, has been associated with serious adverse events and death, particularly in pediatric patients.