Why Was Kenalog Taken Off The Market?

Contents

- 0.0.1 Why was Kenalog banned?

1 Was Kenalog taken off market?
2 Is Kenalog safe to use?
3 Is Kenalog a strong steroid?
4 What is a substitute for Kenalog?
5 How many Kenalog injections are safe?
6 Is Kenalog a potent steroid?

Why was Kenalog banned?

Companies will be prosecuted if they continue to advertise a prescription-only hay-fever drug on social media, the UK government says, Kenalog is a steroid injection that the NHS stopped offering years ago because of the risk of serious side effects.

Some private medical and aesthetic beauty clinics have been told to remove promotional posts for the jab from Facebook and Instagram.
Even including a syringe emoji would be a breach of the law.
Enalog is not licensed for the treatment of hay-fever in the UK, although it is licensed for some other conditions on prescription.

Some beauty and aesthetics clinics, however, are offering it to hay-fever sufferers. Hay fever is a pollen allergy which is most commonly treated with antihistamine drops, tablets and nasal sprays. It causes sneezing, coughing, a blocked nose and additional problems for those with asthma.

For some, these treatments don’t have any effect, which is prompting some people to try Kenalog instead.
It has not been approved for hay-fever treatment by the NHS because its benefits do not outweigh the risks of using it.
Steroids are anti-inflammatory medications used for asthma and arthritis but come with side effects such as weight gain, sleeping difficulties and sometimes anxiety or depression.

The Committees of Advertising Practice (Cap) have worked with the Medicines and Healthcare products Regulatory Agency (MHRA) to issue the enforcement on Kenalog advertising. It must not be advertised anywhere, including on social-media posts or on websites, as a treatment for hay fever in the UK or referred to as a “hay-fever injection” or “hay-fever jab”.

Companies have until the end of August to make these changes before being referred to the MHRA for further enforcement action. Claire Tilstone, from the MHRA, says “the advertising of prescription-only medicines in the UK is banned under UK advertising law” and encourages anyone who sees a clinic advertising Kenalog to report it to the agency or to Cap.

Allergy UK has previously said the steroid injection is not recommended as it is a high-dose steroid given by an intramuscular injection, and once injected, the steroid cannot be removed – and it comes with “a high side-effect profile”.

Was Kenalog taken off market?

SUPPLEMENTARY INFORMATION: – In 1984, Congress enacted the Drug Price Competition and Patent Term Restoration Act of 1984 (Pub.L.98-417) (the 1984 amendments), which authorized the approval of duplicate versions of drug products approved under an ANDA procedure.

ANDA applicants must, with certain exceptions, show that the drug for which they are seeking approval contains the same active ingredient in the same strength and dosage form as the “listed drug,” which is a version of the drug that was previously approved.
ANDA applicants do not have to repeat the extensive clinical testing otherwise necessary to gain approval of a new drug application (NDA).

The 1984 amendments include what is now section 505(j)(7) of the Federal Food, Drug, and Cosmetic Act (), which requires FDA to publish a list of all approved drugs. FDA publishes this list as part of the “Approved Drug Products With Therapeutic Equivalence Evaluations,” which is generally known as the “Orange Book.” Under FDA regulations, a drug is removed from the list if the Agency withdraws or suspends approval of the drug’s NDA or ANDA for reasons of safety or effectiveness, or if FDA determines that the listed drug was withdrawn from sale for reasons of safety or effectiveness ().

Under § 314.161(a) (), the Agency must determine whether a listed drug was withdrawn from sale for reasons of safety or effectiveness: (1) Before an ANDA that refers to that listed drug may be approved, (2) whenever a listed drug is voluntarily withdrawn from sale and ANDAs that refer to the listed drug have been approved, and (3) when a person petitions for such a determination under and,

Section 314.161(d) provides that if FDA determines that a listed drug was withdrawn from sale for safety or effectiveness reasons, the Agency will initiate proceedings that could result in the withdrawal of approval of the ANDAs that refer to the listed drug.


Application No.	Drug Name	Active Ingredient(s)	Strength(s)	Dosage Form/Route	Applicant
NDA 011602	KENALOG	Triamcinolone Acetonide	0.025%; 0.1%	Lotion; Topical	Delcor Asset Corp.
NDA 016059	INDOCIN	Indomethacin	25 milligrams (mg); 50 mg	Capsule; Oral	Iroko Pharmaceuticals, LLC.
NDA 017560	BACTRIM and BACTRIM PEDIATRIC	Sulfamethoxazole; Trimethoprim	200 mg/5 milliliters (mL); 40 mg/5 mL	Suspension; Oral	Mutual Pharmaceutical Company, Inc.
NDA 017598	SEPTRA and SEPTRA GRAPE	Sulfamethoxazole; Trimethoprim	200 mg/5 mL; 40 mg/5 mL	Suspension; Oral	Monarch Pharmaceuticals, Inc.
NDA 018185	INDOCIN SR	Indomethacin	75 mg	Extended-Release Capsule; Oral	Iroko Pharmaceuticals, LLC.
NDA 018450	NITROPRESS	Sodium Nitroprusside	50 mg/vial	Injectable; Injection	AbbVie Inc.
NDA 019834	PLENDIL	Felodipine	2.5 mg; 5 mg; 10 mg	Extended-Release Tablet; Oral	AstraZeneca.
NDA 021475	METHYLIN	Methylphenidate Hydrochloride	2.5 mg; 5 mg; 10 mg	Chewable Tablet; Oral	Mallinckrodt Pharmaceuticals.
NDA 050320	UNIPEN	Nafcillin Sodium	Equal to (EQ) 500 mg base/vial; EQ 1 g (gram) base/vial; EQ 2 g base/vial; EQ 4 g base/vial; EQ 10 g base/vial; EQ 20 g base/vial	Injectable; Injection	Wyeth Ayerst Pharmaceuticals.
NDA 050406	KEFLEX	Cephalexin	EQ 125 mg base/5 mL; EQ 250 mg base/5 mL; EQ 100 mg base/mL	For Suspension; Oral	Shionogi Inc.
ANDA 060576	MYCOLOG-II	Nystatin; Triamcinolone Acetonide	100,000 units/g; 0.1%	Cream; Topical	Delcor Asset Corp.
ANDA 062117	CEPHALEXIN	Cephalexin	EQ 125 mg base/5 mL; EQ 250 mg base/5 mL; EQ 100 mg base/mL	For suspension; Oral	Facta Farmaceutici S.p.A.
ANDA 062606	MYCOLOG-II	Nystatin; Triamcinolone Acetonide	100,000 units/g; 0.1%	Cream; Topical	Delcor Asset Corp.
ANDA 062717	UNIPEN	Nafcillin Sodium	EQ 500 mg base/vial; EQ 1 g base/vial; EQ 2 g base/vial	Injectable; Injection	Wyeth Ayerst Pharmaceuticals.

FDA has reviewed its records and, under § 314.161, has determined that the drug products listed in this document were not withdrawn from sale for reasons of safety or effectiveness. Accordingly, the Agency will continue to list the drug products listed in this document in the “Discontinued Drug Product List” section of the Orange Book.

The “Discontinued Drug Product List” identifies, among other items, drug products that have been discontinued from marketing for reasons other than safety or effectiveness. Approved ANDAs that refer to the NDAs and ANDAs listed in this document are unaffected by the discontinued marketing of the products subject to those NDAs and ANDAs.

Additional ANDAs that refer to these products may also be approved by the Agency if they comply with relevant legal and regulatory requirements. If FDA determines that labeling for these drug products should be revised to meet current standards, the Agency will advise ANDA applicants to submit such labeling.

Dated: March 9, 2016.Leslie Kux,Associate Commissioner for Policy.

End Signature End Supplemental Information BILLING CODE 4164-01-P : Determination That KENALOG (Triamcinolone Acetonide) Lotion and Other Drug Products Were Not Withdrawn From Sale for Reasons of Safety or Effectiveness

Why did the NHS stop Kenalog injection?

The pros and cons of the hay fever injection For one in four people, the arrival of warmer weather marks the beginning of an annual struggle against hay fever. The Kenalog hay fever injection has previously offered relief to many in the UK, but the potential risks of this jab has caused the NHS to stop prescriptions.

Concerns over side effects have even spurred the UK government to ban social media adverts – although some companies continue to breach this law.
We explore the safety concerns of getting the hay fever jab elsewhere.
Is caused by an allergic reaction to pollen.
When it comes into contact with the mouth, eyes, nose or throat, the body reacts by making specific antibodies.

Hay fever affects people at different times depending on which pollen they are allergic to. The majority of people are allergic to grass pollen, so will experience their worst symptoms between May and June; tree pollen affects people in late spring between March and May; while others are affected by weed and mould pollens in the autumn.

The condition is characterised by sneezing and, a runny or blocked nose, red watery eyes, itchy throat, mouth, nose, eyes or ears, headaches and sometimes a feeling of fatigue or tiredness. Sufferers may also experience a wheeze and tightness in the chest. Many people by taking simple steps to stop the pollen reaching them – wraparound sunglasses to protect the eyes, or Vaseline around the nostrils – or by taking over-the-counter antihistamine drops or, and using a,

For around one in ten people with hay fever, home and over-the-counter medications aren’t enough to relieve their symptoms. In the past, some have turned to the hay fever jab, a steroid injection marketed as Kenalog which works by suppressing the body’s immune response to histamines which in turn relieves symptoms.

Dr Farah Gilani, a GP, says “This is an injection of a steroid called triamcinolone into a large muscle in the body.
Once the steroid is injected, it slowly leaks from the muscle for three to eight weeks and travels throughout the body, theoretically offering relief from hay fever symptoms.” There are many anecdotal accounts by individuals who report significant improvements in their symptoms with this injection.

For many, the hay fever jab offers relief when over-the-counter and prescribed medicines aren’t enough. However, in the UK the NHS stopped offering Kenalog, due to concerns over possible side effects. As some people turn to private clinics, beauticians, and aestheticians for their yearly injection, it’s important to be aware of the potential long-term damage this drug may cause.

Raised blood pressureHeadache.Dizziness.Water retention.Skin rashes.Muscle weakness.Swelling.Breathing difficulties.Abdominal pain.Insomnia.Taste disturbance.Mental health problems – such as depression and mood swings.

Kenalog can also increase your susceptibility to infections, such as flu, shingles, and chickenpox. “Once the steroid has been injected, nothing can be done to prevent it from spreading through the body over the following weeks, even if side effects are experienced,” states Gilani.

“In addition, it is contra-indicated in some patients, such as those who have stomach ulcers, diabetes or an active infection.” Repeated use of steroid medications like the hay fever jab can also lead to, Just how high the risk is with one yearly hay fever injection is not yet fully understood. For these reasons, Kenalog is not licensed for treating hay fever in the UK.

Charity does not endorse the injection: “The steroid injection is not recommended as it is a high-dose steroid given by an intramuscular injection and once injected, the amount of steroid cannot be removed and it comes with a high side-effect profile.

Chief pharmacist Stuart Gale at adds: “Kenalog is only safe and recommended for use in a small group of people, as intramuscular steroids can exacerbate existing medical conditions.
The mainstay of is oral antihistamines, nasal sprays and eye drops.” The UK government is also clamping down on advertisements for the hay fever injection.

In 2022, private clinics offering Kenalog were warned that promotional social media posts would be in breach of the law. For those who find these treatments ineffective, immunotherapy – which involves injecting a small amount of pollen under the skin to help build up immunity – is recommended.

This usually begins in the winter, around three months before the hay fever season starts.
Its aim is to desensitise the body to the allergen so it doesn’t react so severely.
Although it won’t cure hay fever, it’s effective at making symptoms much milder – and is much safer for your overall health and wellbeing.

: The pros and cons of the hay fever injection

Is Kenalog still used?

Kenalog is still officially licensed for the treatment of severe hay fever in the UK and continues to be routinely administered to patients in most other countries around the world. A Kenalog injection does not cure hay fever.

Is Kenalog injection illegal?

Kenalog is a prescription-only medicine (POM) which must not be directly or indirectly advertised to the public.

Is Kenalog injection bad?

Redness or pain at the injection site, stomach upset, headache, dizziness, trouble sleeping, or weight gain may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects.

Many people using this medication do not have serious side effects. This medication may raise your blood pressure, Check your blood pressure regularly and tell your doctor if the results are high. This medication may make your blood sugar rise, which can cause or worsen diabetes, Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination.

If you already have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet. This medication may lower your ability to fight infections.

This may make you more likely to get a serious (rarely fatal) infection or make any infection you have worse.
Tell your doctor right away if you have any signs of infection (such as sore throat that doesn’t go away, fever, chills, cough ).
Tell your doctor right away if you have any serious side effects, including: weakness, puffy face, unusual weight gain, thinning skin, bone pain, menstrual period changes, mental/mood changes (such as depression, mood swings, agitation), easy bruising/bleeding, vision problems, swelling ankles /feet/hands, fast/slow/irregular heartbeat.

If you have received injection of this medication into the joint, temporary discomfort of the joint may occur. Tell your doctor right away if you have fever, increased/severe pain with swelling of the joint, weakness in the joint, or decreased range of motion in the joint.

Get medical help right away if you have any very serious side effects, including: symptoms of stomach /intestinal bleeding (such as stomach/ abdominal pain, black/tarry stools, vomit that looks like coffee grounds). A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching /swelling (especially of the face/ tongue /throat), severe dizziness, trouble breathing,

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

Is Kenalog safe to use?

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.

How safe is Kenalog?

Side Effects – Kenalog-40’s side effects can include skin thinning and hair loss. It can also cause a decrease in bone density. More severe side effects include skin ulceration, redness, swelling of the face, lips, or tongue, changes in blood cells, and liver damage. However, if you experience any of these immediate effects, seek medical attention immediately:

shortness of breath seizure blurred vision fever, pain, or swelling severe headaches ringing in the ears nausea

This list is incomplete, so if you have any effects causing immediate pain or discomfort, let your doctor know as soon as you can.

Who Cannot have Kenalog injections?

My Account Area – The Patient Information Leaflet (PIL) is the leaflet included in the pack with a medicine. Last updated on emc: 29 Apr 2022 KENALOG™ INTRA-ARTICULAR / INTRAMUSCULAR INJECTION 40 mg/ml Triamcinolone Acetonide

Keep this leaflet. You may need to read it again.If you have any further questions, ask your doctor or pharmacist.If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

Kenalog IA/IM Injection is a steroid medicine, prescribed for many different conditions, including serious illnesses. You need to take it regularly to get the maximum benefit. Don’t stop taking this medicine without talking to your doctor – you may need to reduce the dose gradually. Kenalog IA/IM Injection can cause side effects in some people (read section 4 below). Some problems such as mood changes (feeling depressed or ‘high’), or stomach problems can happen straight away. If you feel unwell in any way, keep taking your tablets, but see your doctor straight away, Some side effects only happen after weeks or months. These include weakness of arms and legs, or developing a rounder face (read section 4 for more information). If you take it for more than 3 weeks, you will get a blue ‘Steroid Treatment Card’; if your doctor administers Kenalog IA/IM Injection for a longer period, and you have to return for a new dose a number of times, you should also carry a ‘Steroid Emergency Card’: always keep these cards with you and show them to any doctor or nurse treating you. Keep away from people who have chicken pox or shingles, if you have never had them. They could affect you severely. If you do come into contact with chicken pox or shingles, see your doctor straight away.

1. What Kenalog IA/IM Injection is and what it is used for 2. What you need to know before you are given Kenalog IA/IM Injection 3. Receiving Kenalog IA/IM Injection 4. Possible side effects 5. How to store Kenalog IA/IM Injection 6. Content of the pack and other information The name of this medicine is Kenalog IA/IM Injection.

Each injection contains triamcinolone acetonide 40 mg/ml as the active ingredient. Triamcinolone acetonide belongs to a group of medicine called corticosteroids (steroids). Kenalog IA/IM Injection is for the treatment of joint pain, swelling and stiffness in inflammatory disorders such as rheumatoid arthritis.

It is also for the treatment of various allergic disorders including asthma, blood disorders, hormone problems, rheumatic fever, and problems associated with digestive system, kidneys, lungs or skin.

You have had an allergic reaction to a similar medicine or any of the ingredients in this medicine. See section 6 for full list of ingredientsYou are suffering from an infection unless your doctor has also prescribed a treatment for the infection.

Kenalog IA/IM Injection is not recommended for children under 6 years.

You have had any recent infection You have had recent bowel surgeryYou have, or have had a bowel disorder or stomach ulcerYou have an infection or inflammation of the veins in your legsYou have had any mental health disorders or epilepsyYou have had any kidney, liver or thyroid (gland in the neck) problems as the dose of Kenalog may need to be adjustedYou have recently suffered from any form of cancerYou have thin or brittle bones (osteoporosis)You have myasthenia gravis (a disease which causes weak muscles)You have high blood pressure or heart failureYou or someone in your family has glaucoma (increased pressure in your eyes)you have visual disturbances, loss of vision, eye inflammation (red, bloodshot aching eye) and viral retinitis (inflammation of retina caused mainly by cytomegalovirus). Inflammation of the retina can affect your vision if not treated. Symptoms of inflammation includes experiencing loss of vision, general blurriness of vision, blind spots, seeing flashes of light or floaters (dark spots and squiggles in vision).You are diabetic as your insulin dose may need to be changed

Contact your doctor if you experience blurred vision or other visual disturbances.

If you are taking triamcinolone acetonide and medicines to control HIV (anti-retrovirals) or fungal infections (anti-fungals) because you could experience more adverse effects and your doctor may wish to monitor you carefully. Refer to list of medicines mentioned in “Taking other medicines with Adcortyl IA/ID Injection.” If you have ever had severe depression or manic-depression (bipolar disorder). This includes having had depression before while taking steroid medicines like Kenalog IA/IM Injection.If any of your close family has had these illnesses.

If any of these applies to you, talk to a doctor before taking Kenalog IA/IM Injection, Steroid medicines suppress your body’s natural immune response. Therefore, if you come into contact with anyone who has an infectious disease such as chickenpox, shingles or measles, consult your doctor as soon as possible.

While you are being treated with this medicine (or if you have recently stopped a course of treatment) do not have any vaccination without consulting your doctor. You must take care not to over-use a joint which feels better after you receive Kenalog IA/IM injection. The joint will still need to recover from the inflammation which caused your symptoms.

Please tell your doctor if you are taking, or have recently taken any other medicines, including medicines obtained without a prescription. Some medicines may increase the effects of Adcortyl and your doctor may wish to monitor you carefully if you are taking these medicines (including some medicines for HIV: ritonavir, cobicistat).

Aspirin, ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs) as corticosteroids can increase the chance of bleeding from the gut.Anti-retroviral inhibitors and anti-fungals: ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, ketoconazole, and telithromycin because increased adverse effects may occur, resulting in systemic corticosteroid effects including Cushing’s syndrome and adrenal suppressionWarfarin or other medicines to thin the bloodOral contraceptive pill or hormone replacement therapy (HRT)Human growth hormoneA medicine called ciclosporinA medicine called rifampicin

or medicines to treat;

High blood pressure or irregular heart beat (e.g. digoxin)Myasthenia gravis (a disease which causes weak muscles)Epilepsy or other sorts of fits (e.g. phenytoin)Tuberculosis (TB)DiabetesThyroid problems

If you are taking any of these medicines, or are not sure, please consult your doctor. Before surgery and anaesthesia (even at the dentist) you should tell the doctor or dentist that you are being treated with Kenalog IA/IM injection. If you are pregnant, planning to become pregnant, or if you are breast-feeding you should make sure you discuss this with your doctor as soon as possible before receiving Kenalog IA/IM injection.

This medicine does not usually affect your ability to drive or operate machinery but it can affect your eyesight. Tell your doctor immediately if you have any pain in the eyes, problems with your vision. Your doctor or pharmacist will have given you a ‘Steroid Treatment Card’ and, if required also a ‘Steroid Emergency Card’ with your prescription or medicine.

YOU SHOULD ALWAYS CARRY THESE CARDS WITH YOU as they must be shown to any of the following persons: Doctor or Nurse – before having any surgery or emergency treatment or if any new treatment is prescribed. Dentist – before having any dental surgery Pharmacist – before buying any medicine Optician – it is advisable to have regular eye tests Kenalog IA/IM Injection contains 15 mg/ml benzyl alcohol which may cause harmful or allergic reactions in infants and children.

Kenalog IA/IM injection must not be given to premature or newly born babies The effect of the injection will vary from patient to patient and further injections may be given to you when symptoms return and not at regular intervals. The usual doses are; Use in inflammatory joint disorders: The dose of injection into a joint or tendon sheath depends upon the size of the joint to be treated and the severity of the condition which is being treated.

Doses of 5-10 mg (0.125-0.25 ml) for smaller joints and up to 40 mg (1.0 ml) for larger joints usually give relief of symptoms. This medicine should not be used for injection into the Achilles tendon. Use in allergic disorders: The usual starting dose is 40 mg (1.0 ml) injected deeply into the upper outer area of the buttock.

If you require a further injection, this should be made into the same area on the other buttock. Some patients with pollen asthma find that one injection of 40-100 mg improves asthmatic symptoms. Your doctor will advise you whether it is wise for you to have further injections. Deep intramuscular injection must be given into the large muscles of the buttock and not into the upper arm or the thigh.

This medicine should not be given into a vein. If you are receiving long-term intramuscular treatment with Kenalog IA/IM injection your doctor may advise you to eat more protein. This should help to reduce the gradual loss of weight that can sometimes occur with long-term treatment.

Treatment with steroids is usually kept as short as possible and must not be stopped abruptly.
Joints may become permanently damaged by repeated injections over a long period of time.
When the treatment is stopped you may notice flu-like symptoms, runny nose or itchy eyes or skin.
During times of illness or stress, patients on long-term treatment may require the addition of oral steroid tablets, or, if they have recently finished a course of Kenalog IA/IM injections, may need to start taking oral steroid tablets for a while.

Mental health problems while taking Kenalog IA/IM injection Mental health problems can happen while taking steroids like Kenalog IA/IM Injection (see also section 4 Possible Side Effects).

These illnesses can be serious.Usually they start within a few days or weeks of starting the medicine.They are more likely to happen at high doses.Most of these problems go away if the dose is lowered or the medicine is stopped. However, if problems do happen they might need treatment.

Talk to a doctor if you (or someone taking this medicine), shows any signs of mental health problems. This is particularly important if you are depressed, or might be thinking about suicide. In a few cases, mental health problems have happened when doses are being lowered or stopped.

Mood changes, mental health disorders, feeling dependent on the medicine, trouble sleeping, fits or epilepsy, fainting and dizzinessFeeling depressed, including thinking about suicide.Feeling high (euphoria and mania) or moods that go up and down.Feeling anxious/irritable, having problems sleeping, difficulty in thinking or being confused and losing your memory.Feeling, seeing or hearing things which do not exist. Having strange and frightening thoughts, changing how you act or having feelings of being alone.

If you notice any of the following side effects talk to a doctor straight away. Serious cases of anaphylactic reactions (i.e. a serious allergic reaction) and anaphylactic shock including death have been reported. If you notice any of the following, contact your doctor immediately:

Swelling of the face, lips or throatBreathing difficultiesSkin itching, redness or a rash

As these may be signs of an allergic reaction Common: may affect up to 1 in 10 people

Increased risk of infectionInjection site reactionsHeadacheJoint pain

Uncommon: may affect up to 1 in 100 people

Changes in blood chemicals, which can cause fluid retentionHeart failure or irregular heart beatWeak or fragile bones or muscles, poor healing of broken bones or destruction of the ends of bones, decrease in muscle mass, muscle or bone pain, muscular weakness/discomfort, bone fractureLoss of bone tissue (osteoporosis)Thin/fragile skin, rashes, stretch marks, bruising, sweating, flushing and increased hair growth, itchy bumps, loss/darkening of skin colourIndigestion, stomach pain, stomach ulcers and perforation, bloating, increased appetite and weight loss, inflammation of the pancreas/oesophagus, stomach bleedingEye problems including inflammation, glaucoma and cataracts, blindness, bulging of the eye, damage to the cornea or white of eyeInfection of the noseIrregular periods/ postmenopausal women may also experience vaginal bleedingFungal or Viral eye infectionsYeast infections e.g. thrushTiredness and tingling, Increased pressure in the brainIncreased appetiteWeight lossLess tolerance to carbohydratesMild form of diabetes with no obvious symptomsInadequately controlled diabetes mellitus, high blood sugarPain, swelling and worsening of the pain in the injected jointImpaired healingHigh body temperatureTreatment with steroids can stop the body from producing some hormones and may slow or stop children’s growth.Hormone production by certain glands may be increased or decreased.VertigoHigh/low blood pressureAbnormal blood clotsLongstanding chronic infections such as tuberculosis could be made worse

Not known: frequency cannot be estimated from available data Blurred vision If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.

By reporting side effects you can help provide more information on the safety of this medicine.
Eep this medicine out of the sight and reach of children.
Enalog IA/IM injection will be kept in the pharmacy until it is given to you by your doctor or nurse.
It should not be used after the expiry date shown on the outer packaging.

It should not be stored above 25°C nor should it be allowed to freeze. The container should be kept in the outer carton. The active substance is triamcinolone acetonide 40 mg/ml. The other ingredients are; benzyl alcohol, polysorbate 80, carmellose sodium, sodium chloride and water.

Enalog IA/IM Injection belongs to a group of medicines called steroids.
Their full name is corticosteroids.
These corticosteroids occur naturally in the body, and help to maintain health and well-being.
Boosting your body with extra corticosteroid (such as Kenalog IA/IM Injection) is an effective way to treat various illnesses involving inflammation in the body.

Kenalog IA/IM Injection reduces this inflammation, which could otherwise go on making your condition worse. You must take this medicine regularly to get maximum benefit from it. Kenalog IA/IM injection is a sterile aqueous suspension for injection and is supplied in 1.0 ml glass vials.

Are Kenalog injections worth it?

Kenalog-40 has an average rating of 5.9 out of 10 from a total of 97 reviews on Drugs.com.51% of reviewers reported a positive experience, while 39% reported a negative experience.

Is Kenalog stronger than cortisone?

In Part A ‘Relative Potencies’ should be read in the following manner: Celestone Soluspan is 25 times more potent then Hydrocortisone, and Kenalog is 5 times more potent than Hydrocortisone, and etc.

Is Kenalog addictive?

Kenalog in Orabase is not addictive or habit forming. It may be prescribed by your doctor or bought at a pharmacy when recommended by your dentist, pharmacist or other healthcare professional.

Is Kenalog a strong steroid?

Triamcinolone is a potent steroid that helps reduce inflammation in the body.

What is a substitute for Kenalog?

Kenalog-40 Alternatives Compared

Kenalog-40 (triamcinolone)	Simponi (golimumab)	Methotrexate
More about Kenalog-40 (triamcinolone)	More about Simponi (golimumab)	More about Methotrexate
Generic Status
Lower-cost generic is available	No lower-cost generic available	Lower-cost generic is available
Ratings & Reviews

What is another name for Kenalog?

Triamcinolone (Kenalog) is a first-choice injectable medication used to treat gout attacks. It’s also used to treat many other conditions, including allergies, skin conditions, multiple sclerosis, and arthritis.

Is Kenalog permanent?

Glucocorticoids cause profound and varied metabolic effects. In addition, they modify the body’s immune responses to diverse stimuli. KENALOG-40 has an extended duration of effect which may be permanent, or sustained over a period of several weeks.

Is Kenalog the same as cortisone?

Injection Series #3 – Are All Injections Created Equal? Michael Huang, MD When it comes to musculoskeletal injections, there are more choices than ever before. Cortisone (corticosteroid) injections are probably the most commonly performed and, most likely, what comes to mind when someone mentions an injection.

But even within this category of “cortisone” there are multiple types.
Then there are the viscosupplement (aka rooster comb) injections.
And beyond those, there are biologic injections that can be administered.
So, let’s dig in and see what these injections are all about.
Let us begin with cortisone or corticosteroid injections.

These are all steroid injections. As we have discussed in prior blog posts, there are a lot of myths and facts. But basically, if you have a really inflamed joint, there probably isn’t a better choice than an injection of cortisone. If the knee is swollen, hot, and painful, an injection of cortisone can help in a matter of a day.

There are many versions of cortisone: Depo-Medrol (Methylprednisolone), Kenalog (triamcinolone acetonide), Celestone (Betamethasone) to name a few. Any and all of these can be effective. I have some patients that respond better to one than another, so if you do not have the response you want, next time try another.

More information can be found in our prior blog, Viscosupplementation describes a group of injections that are designed to lubricate the joint. If you look at all of brands available, they all contain hyaluronic acid (HA). The difference between brands is the way they package these HA molecule and the number of times it is delivered to the joint.

Some brand names include: Synvisc, Hyalgan, GelOne, Euflexxa, Monovisc, Orthovisc.
Different brands are made by different companies and some carry multiple lines.
For instance, Synvisc is a series of three injections placed one week apart in the same joint.
Synvisc One is a single injection.
These injections can be helpful to the knee and some patients respond wonderfully to them, but they will still only be temporarily effective as the HA does breakdown over time.

Most insurance companies will approve these once every 6 months. It is interesting to note that these injections are only approved for usage in the knee joint in the USA while in other countries, they can be injected into almost any joint. Another important thing to note is that some insurance companies have stopped authorizing these injections altogether.

At the time of this blog, Blue Cross and Kaiser, have stopped paying for these injections for their patient members.
I have many patients ask or undergo Prolotherapy, so let’s discuss that next.
I do not perform this type of injection and did not encounter this for many years.
The definition of prolotherapy is “any substance that promotes growth of normal cells, tissues, or organs”.

After searching and searching, I am still not certain exactly what is injected. Some of these injections are dextrose (sugar) which is supposed to cause growth factor production. I cannot find any good scientific articles that suggest this happens in a joint.

Sometimes, prolotherapy injections include dextrose in combination with phenol.
Recall from your chemistry class that phenol is a compound that is acidic and often included in household cleaners.
At any rate, I also cannot find any convincing data that suggests that phenol related joint injections are helpful.

These injections are also being performed for soft tissue disease (tendon and ligament damage). Mayo clinic has withheld judgement of these injections as they have not had any rigorous placebo controlled studies. If you are considering these type of injections, please find out exactly what is being injected and why.

Biologic injections are a category that include cellular or growth factor injections.
This category is very broad and deserves its own blog.
But briefly, a patient could have an injection of platelet rich plasma (a concentrated injection of their own platelets) in an area of damage.
Some patients are getting injections of amniotic fluid which is supposedly chock-full of growth factors.

Other patients are getting “stem cells” which may come from their bodies or could be obtained from another source (typically umbilical cord). At any rate, we have put some information out there on these injections and you can find that, These category of injections are all investigational and very difficult to discuss scientifically because there are so many types of injections and hard core data is lacking thus far.

What steroids are similar to Kenalog?

Corticosteroids are medications that are commonly injected and many people refer to these injections as “cortisone” injections. The first corticosteroid injection was performed in 1953 and the first clinical trial was performed in 1958 1,8. The medications are synthetically formulated to mimic the steroid hormone cortisone, which is produced by the adrenal gland and released in response to stress.

Intra-articular corticosteroids reduce synovial blood flow and alter local collagen synthesis 2. They have also been shown to decrease the local inflammatory modulator response by mechanisms such as interfering with inflammatory cell adhesion, interrupting cytokines like IL-1, and impairing leukotriene and prostaglandin synthesis 3.

There are a few characteristics that are examined when looking at depot corticosteroids. Solubility seems to be mentioned across the orthopedic specialty often and compounds with lower solubility are thought to remain at the injected site for longer periods of time and, in theory, have less systemic effect. Image 1, Comparison of corticosteroids (adopted from 4, 5, 6) The most commonly used corticosteroids include triamcinolone acetonide (Kenalog), betamethasone (Celestone) and methylprednisolone (Depo-medrol). The doses for triamcinolone and methylprednisolone are typically 20 mg,40 mg and 80 mg per mL.

The dosage for betamethasone is usually 6 mg/mL. Triamcinolone and methylprednisolone are branched esters and generally the preferred agents for joints. In a 1994 survey for college of rheumatology members, 35 % preferred methylprednisolone, 31 % preferred triamcinolone hexacetonide and 21 % preferred triamcinolone acetonide for knee osteoarthritis injections,

There were also regional differences with triamcinolone being more used in the West and methylprednisolone being preferred in the East 7, Image 2, Examples of various corticosteroids that are sometimes used in joint injections (adopted from henryschein.com) There are few direct trials comparing efficacy of the most common corticosteroids used. One study from 1981 compared triamcinolone 20 mg with 6 mg of betamethasone in forty two patients that underwent a knee injection for osteoarthritis and triamcinolone was found to have decreased pain and tenderness as well an increased range of motion after one week and two weeks 9,

Another study in 2004 compared 40 mg of methylprednisolone acetate to 20 mg of triamcinolone hexacetonide in 57 patients with knee OA. This study showed triamcinolone hexacetonide with less pain and less disability at week 3, but methylprednisolone to be more effective at week 8 10, Two other studies were performed that showed no difference between methylprednisolone and triamcinolone 11, 12,

Two studies have shown that triamcinolone hexacetonide offered longer lasting pain relief for patients with rheumatoid arthritis of the knee 13, 14, One systematic review in 2009 showed a trend that pain control was better with triamcinolone 15, No difference was found in local site injection when comparing triamcinolone to betamethasone in one trial and hydrocortisone in another 9, 16,

Overall, there is limited randomized control trials comparing the efficacy of depot corticosteroids for joint injections 1,
The choice of corticosteroids is typically based on training tradition and clinical experience but other factors are involved such as cost and availability.
Cost and insurance reimbursement can vary by region.

The paucity of evidence is the main reason there is so much variability in which agents are used for joint injections.1. Douglas, R. (2012). Corticosteroid injection into the osteoarthritic knee: Drug selection, dose, and injection frequency. International Journal of Clinical Practice,66(7), 699-704.2.

Caldwell JR. Intra-articular corticosteroids. Guide to selection and indications for use. Drugs.1996;52(4):507–514 3. Lavelle W, Lavelle ED, Lavelle L. Intra-articular injection. Med Clin North Am.2007;91(2):241–250.4. Cole, Brian and Harold R. Schumacher. “Injectable corticosteroids in modern practice.” The Journal of the American Academy of Orthopaedic Surgeons 13 1 (2005): 37-46.5.

Derby R, Lee SH, Date ES, Lee JH, Lee CH. Size and aggregation of corticosteroids used for epidural injections. Pain Med.2008; 9:227-34.6. Lento P, Ihm J, Kennedy D, Visco C. Peripheral Joint and Soft Tissue Injection Techniques. In Chan L, et al, eds. Braddom’s Physical Medicine & Rehabilitation.4th Philadelphia, PA: Saunders; 2011:517-540.7.

Centeno LM, Moore ME (1994) Preferred intraarticular corticosteroids and associated practice: a survey of members of the American College of Rheumatology.
Arthritis Care Res 7:151–155.8.
Miller JH, White J, Norton TH: The value of intra-articular injections in osteoarthritis of the knee.
J Bone Joint Surg Br 1958;40:636-643.9.

Valtonen EJ. Clinical comparison of triamcinolone hexacetonide and betamethasone in the treatment of osteoarthrosis of the knee joint. Scan J Rheumatol Suppl 1981; 41: 1–7.10. Pyne, D., Ioannou, Y., Mootoo, R., & Bhanji, A. (2004). Intra-articular steroids in knee osteoarthritis: A comparative study of triamcinolone hexacetonide and methylprednisolone acetate.

Clinical Rheumatology, 23(2), 116-120.11.
Thorpe P: Intra-articular triamcinolone acetonide and methyprednisolone acetate in arthritis.
Curr Ther Res 1985;38:513-518.12.
Bain LS, Balch HW, Wetherly JM, Yeadon A: Intraarticular triamcinolone hexacetonide: Double-blind comparison with methylprednisolone.

Br J Clin Pract 1972;26:559-561.13. Sambrook P, Champion G, Browne C et al. (1989) Corticosteroid injection for osteoarthritis of the knee:peripatellar compared to intra-articular route. Clin Rheumatol 7:609–613.14. Bird HA, Ring EFJ, Bacon PA (1979) A thermographic and clinical comparison of three intra-articular steroid preparations in rheumatoid arthritis.

Ann Rheum Dis 38:36–39.15. Hepper CT, Halvorson JJ, Duncan STet al. The efficacy and duration of intra‐articular corticosteroid injection for knee osteoarthritis: a systematic review of level 1 studies. J Am Acad Orthop Surg 2009; 17: 638–46.16. Wright V, Chandler GN, Morison RAH, Hartfall SJ. Intra‐articular therapy in osteo‐arthritis.

Comparison of hydrocortisone acetate and hydrocortisone tertiary‐butylacetate. Annals of the Rheumatic Diseases 1960;19:257‐61.

How many Kenalog injections are safe?

How Many Is Kenalog Injections Safe? – Kenalog may sometimes need to be taken twice. The doctor will talk to you about this. No one should get more than 80mg (2 injections) per season unless there are exceptional circumstances.

Does Kenalog make your hair fall out?

What causes hair loss? – The medical term for hair loss is alopecia, and it can be caused by a number of factors, including vitamin deficiencies, chemotherapy, stress, anemia, genetic susceptibility, and hormonal changes. Regarding hormonal changes, major life events such as puberty, pregnancy, and menopause can all affect hair growth in some way.

Most common among the general population, hereditary male- and female-pattern baldness affects 50 million men and 30 million women in the United States. This condition is called “androgenetic or androgenic alopecia” and is often attributed to genetic predisposition and family history, according to, Hereditary male- and female-pattern baldness causes certain predisposed hair follicles to shrink, which shortens the typical hair growth cycle.

Hairs will progressively grow in thinner and finer, until the hairs stop growing altogether. By age 50, approximately 50% of men and 25% of women will experience some degree of hereditary hair loss. Male-pattern baldness is most evident on the temples and the crown of the head; female-pattern baldness tends to be less obvious.

Some women simply notice a general thinning, or they might feel like their ponytail isn’t as thick as it used to be. According to, more women have underlying causes of hair loss than men, such as thyroid disorders and polycystic ovary syndrome. It’s best to visit a doctor to eliminate any medical factors before beginning a treatment regime.

Minoxidil – or, as it’s commonly known – is an FDA-approved over-the-counter topical medication for the treatment of hereditary hair loss in men and women. With daily use, Rogaine works to revive hair follicles, increase their size, and extend the length of the Anagen growth phase.

Rogaine is available in a 2%, 4%, and extra-strength 5% solution, and it needs to be applied every day for optimal results. Additionally, it works best on the crown of the head vs. the temple, and it can cause accidental hair growth in unwanted places, such as the forehead. It’s important to note that topical medications such as Rogaine are not a “cure” for hair loss, and they must be used regularly to maintain their results.

In addition to Rogaine, there are a number of shampoos that claim to stimulate hair growth and increase scalp circulation. One such solution is the, which includes growth-stimulating shampoo and conditioner, in addition to a hair growth lotion and nutritional food supplements.

The Ducray solution can be used by both men and women alike to achieve results. For men who would rather take a pill than apply topical medication, 1 mg finasteride (or Propecia) tablets can be prescribed for the treatment of male-pattern hair loss, but not female-pattern hair loss. According to, Propecia works by preventing the conversion of testosterone to dihydrotestosterone (DHT), which can shrink hair follicles and lead to baldness.

Interestingly, notes that Propecia is a lower-dose version of a commercially available drug called Proscar that helps shrink enlarged prostates in middle-aged and older men. Although Propecia can grow and thicken hair, it does a better job at preserving the hair men already have rather than stimulating new growth.

According to, The American Hair Loss Association recommends Propecia as the first line of attack for all men interested in treating male-pattern baldness.
However, the drug is not without its downfalls.
The common side effects of Propecia include impotence or a decreased sex drive, and the pills cost about $70-$100 for a one-month supply.

Kenalog Steroids are used to treat Alopecia Areata (AA), which is the most common autoimmune disease in the United States. AA causes the body’s immune system to attack its own hair follicles, which eventually leads to thinning and baldness. This thinning and baldness can range from person to person – some experience small, coin-sized patches that can be easily covered, while others lose all the hair on their head, including eyebrows and eyelashes.

According to, Kenalog steroids are “administered via injection into the scalp and appear to have some efficacy for patients with mild to moderate alopecia areata.” When Kenalog steroids are injected directly into a bald patch, they work by calming the body’s immune response, thus eliminating the attack on hair follicles.

Kenalog steroids usually need to be injected every 30 days, or as prescribed by a doctor. Additionally, Kenalog steroids are only affective for people who suffer from Alopecia Areata, not male- or female-pattern baldness. PRP – or “” – is a concentration of platelet-rich plasma protein, and it’s produced by drawing a person’s blood and separating the red and white blood cells from the platelets and plasma.

This leaves a plasma rich in platelets that can be used for therapeutic purposes. PRP is said to help heal tissues and generate new cells, and injecting PRP into the skin can naturally boost collagen growth to smooth fine lines and wrinkles. Recently, PRP has also been used as an innovative therapy for hair loss in men and women.

According to, PRP for hair loss is “a three-step medical treatment in which a person’s blood is drawn, processed, and then injected into the scalp.” It’s thought that PRP triggers hair growth by increasing blood supply to the hair follicles. Although there have been promising results from PRP, it’s not FDA-cleared for the treatment of hair loss.

Additionally, it requires treatments every 3-6 months to maintain results.
Doctors have been performing hair transplants since the 1950s, but methods and techniques have come a long way in the ~70 years since.
If a patient opts for a hair transplant, they can choose from one of two methods: follicular unit strip surgery (FUSS) or follicular unit extraction (FUE).

The FUSS method involves cutting a 6- to 10-inch strip of skin from the back of a patient’s head, and then dividing the strip of scalp into 500-2,000 tiny grafts of healthy hair follicles. Then, a doctor individually implants each graft into the area of balding scalp.

Patients are left with a horizontal scar that typically runs from ear to ear.
The FUE method is less invasive, but it requires a patient to shave his or her head prior to treatment.
Then, a doctor will remove healthy hair follicles one by one.
Just like with the FUE method, the doctor individually implants each hair follicle into the area of balding scalp.

Both the FUSS and FUE methods take about 4-8 hours, depending on the number of grafts and hair follicles that are transplanted. Patients will experience some pain over the next week or so, and they’re usually prescribed antibiotics to prevent infection.

According to, most people see about 60% of new hair growth after 6-9 months.
Currently, is the most advanced, FDA-cleared medical treatment for the reversal of hair loss in men and women.
NeoGraft is a cutting-edge procedure that piggybacks off the FUE hair transplant method.
However, NeoGraft has a higher success rate than both FUSS and FUE, with about 90% of a patient’s transplanted hair surviving post procedure.

The NeoGraft procedure uses a handheld automated device to detect and locate healthy, hormone-resistant hair follicles that are the same length and diameter of the transplant site follicles, which allows the “take rate” to be dramatically increased. The device then individually extracts and transplants those healthy hair follicles into the areas where a patient is experiencing thinning and baldness. NeoGraft is the most advanced surgery for hair loss, and patients can expect to return to their normal lives and routines within a week after the procedure. Millions of men and women experience hair thinning and hair loss each year, and hereditary male- and female- pattern baldness is most often the cause.

Although hereditary hair loss is a natural, normal part of life, it can severely impact self-confidence in both men and women.
Thankfully, modern advances in medication and treatment technology have provided viable solutions to combat hair loss and even reverse the condition.
If you’re looking to improve the way you look and feel with treatment for hair loss, Jiva Med Spa can help.

We specialize in NeoGraft hair restoration surgery, and we also offer PRP treatments and professional-grade hair loss shampoos including Ducray. With our free consultation services and financing options, you can find the right hair loss solution to fit your needs and budget.

Is Kenalog bad for liver?

References –

“Product Information. Hydeltrasol (prednisolone).” Merck & Co., Inc (2001):
“Product Information. Deltasone (prednisone).” Pharmacia and Upjohn (2001):
“Product Information. Decadron (dexamethasone).” Merck & Co., Inc (2001):
“Product Information. Hydrocortone (hydrocortisone).” Merck & Co., Inc (2001):
“Product Information. Medrol (methylprednisolone).” Pharmacia and Upjohn (2001):
“Product Information. Florinef Acetate (fludrocortisone).” Bristol-Myers Squibb (2001):
“Product Information. Cortone Acetate (cortisone).” Merck & Co., Inc (2001):
“Product Information. Kenalog (triamcinolone).” Bristol-Myers Squibb (2001):
“Product Information. Celestone (betamethasone).” Schering Corporation (2001):
“Product Information. Emflaza (deflazacort).” PTC Therapeutics, Inc. (2021):

View all 10 references Corticosteroids are primarily metabolized by the liver and may have enhanced effects in patients with liver disease. Dosage adjustments may be necessary in these patients.