Kenalog 50mg

FDA pregnancy category C. It is not known whether Kenalog will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether triamcinolone passes into breast milk or if it could harm a nursing baby. Do not use Kenalog without telling your doctor if you are breast-feeding a baby. Do not use this medication on a child without a doctor's advice. Pregnancy and breastfeeding warnings in more detail How should I use Kenalog?

Use Kenalog exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Follow the directions on your prescription label. Pharmacists on duty are available Monday-Friday, 9: The dose is a single injection of 0. Remission of symptoms, if not permanent, usually lasts 7 to 15 days. After this time, if symptoms recur, the dose may be repeated or oral corticosteroid therapy may be instituted. The dose is 0. The usual intralesional dosage is 1. Injections should be circumscribed around the lesion in various sites to insure adequate distribution of the dose.

Kaposi's sarcoma has been reported to occur in patients receiving corticosteroid therapy, most often for chronic conditions. Discontinuation of corticosteroids may result in clinical improvement. Cardio-Renal As sodium retention with resultant edema and potassium loss may occur in patients receiving corticosteroids, these agents should be used with caution in patients with congestive heart failure , hypertension , or renal insufficiency.

Endocrine Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted.

Gastrointestinal Steroids should be used with caution in active or latent peptic ulcers, diverticulitis , fresh intestinal anastomoses, and nonspecific ulcerative colitis , since they may increase the risk of a perforation. Signs of peritoneal irritation following gastrointestinal perforation in patients receiving corticosteroids may be minimal or absent. There is an enhanced effect of corticosteroids in patients with cirrhosis.

Intra-Articular and Soft Tissue Administration Intra-articularly injected corticosteroids may be systemically absorbed. Appropriate examination of any joint fluid present is necessary to exclude a septic process. A marked increase in pain accompanied by local swelling, further restriction of joint motion, fever , and malaise are suggestive of septic arthritis.

If this complication occurs and the diagnosis of sepsis is confirmed, appropriate antimicrobial therapy should be instituted. Injection of a steroid into an infected site is to be avoided. Local injection of a steroid into a previously infected joint is not usually recommended. Corticosteroid injection into unstable joints is generally not recommended. Musculoskeletal Corticosteroids decrease bone formation and increase bone resorption both through their effect on calcium regulation ie, decreasing absorption and increasing excretion and inhibition of osteoblast function.

This, together with a decrease in the protein matrix of the bone secondary to an increase in protein catabolism , and reduced sex hormone production, may lead to inhibition of bone growth in pediatric patients and the development of osteoporosis at any age.

Special consideration should be given to patients at increased risk of osteoporosis ie, postmenopausal women before initiating corticosteroid therapy. Neuro-Psychiatric Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis , they do not show that they affect the ultimate outcome or natural history of the disease.

The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect. An acute myopathy has been observed with the use of high doses of corticosteroids, most often occurring in patients with disorders of neuromuscular transmission eg, myasthenia gravis , or in patients receiving concomitant therapy with neuromuscular blocking drugs eg, pancuronium.

This acute myopathy is generalized, may involve ocular and respiratory muscles, and may result in quadriparesis.

Elevation of creatinine kinase may occur. Clinical improvement or recovery after stopping corticosteroids may require weeks to years.

Psychiatric derangements may appear when corticosteroids are used, ranging from euphoria , insomnia , mood swings, personality changes, and severe depression to frank psychotic manifestations.

Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids. Ophthalmic Intraocular pressure may become elevated in some individuals. If steroid therapy is continued for more than 6 weeks, intraocular pressure should be monitored. Carcinogenesis, Mutagenesis, Impairment of Fertility No adequate studies have been conducted in animals to determine whether corticosteroids have a potential for carcinogenesis or mutagenesis.

Steroids may increase or decrease motility and number of spermatozoa in some patients. Pregnancy Teratogenic Effects - Pregnancy Category C Corticosteroids have been shown to be teratogenic in many species when given in doses equivalent to the human dose.

Serum concentrations of isoniazid may be decreased. 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. Patients on digitalis glycosides may be at increased risk of arrhythmias due to hypokalemia. Estrogens, including oral contraceptives: Estrogens may decrease the hepatic metabolism of certain corticosteroids, thereby increasing their effect. Hepatic enzyme inducers eg, barbiturates, phenytoin, carbamazepine, rifampin: Drugs which induce hepatic microsomal drug metabolizing enzyme activity may enhance the metabolism of corticosteroids and require that the dosage of the corticosteroid be increased.

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. The clearance of salicylates may be increased with concurrent use of corticosteroids. Corticosteroids may suppress reactions to skin tests. Patients on prolonged corticosteroid therapy may exhibit a diminished response to toxoids and live or inactivated vaccines due to inhibition of antibody response.

Corticosteroids may also potentiate the replication of some organisms contained in live attenuated vaccines. 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. The safety and effectiveness of epidural administration of corticosteroids have not been established, and corticosteroids are not approved for this use. 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.

There have been rare reports of deaths, primarily in preterm infants, associated with exposure to excessive amounts of benzyl alcohol. The amount of benzyl alcohol from medications is usually considered negligible compared to that received in flush solutions containing benzyl alcohol. Administration of high dosages of medications containing this preservative must take into account the total amount of benzyl alcohol administered.

The amount of benzyl alcohol at which toxicity may occur is not known. Cases of serious anaphylaxis, including death, have been reported in individuals receiving triamcinolone acetonide injection, regardless of the route of administration. Because Kenalog Injection triamcinolone acetonide injectable suspension, USP is a suspension, it should not be administered intravenously. Unless a deep intramuscular injection is given, local atrophy is likely to occur.

Due to the significantly higher incidence of local atrophy when the material is injected into the deltoid area, this injection site should be avoided in favor of the gluteal area. Increased dosage of rapidly acting corticosteroids is indicated in patients on corticosteroid therapy subjected to any unusual stress before, during, and after the stressful situation.

Kenalog Injection is a long-acting preparation, and is not suitable for use in acute stress situations. To avoid drug-induced adrenal insufficiency, supportive dosage may be required in times of stress such as trauma , surgery, or severe illness both during treatment with Kenalog Injection and for a year afterwards. Results from one multicenter, randomized, placebo-controlled study with methylprednisolone hemisuccinate, an intravenous corticosteroid, showed an increase in early at 2 weeks and late at 6 months mortality in patients with cranial trauma who were determined not to have other clear indications for corticosteroid treatment.

High doses of systemic corticosteroids, including Kenalog Injection, should not be used for the treatment of traumatic brain injury. Cardio-Renal Average and large doses of corticosteroids can cause elevation of blood pressure, salt and water retention , and increased excretion of potassium. These effects are less likely to occur with the synthetic derivatives except when they are used in large doses.

Viral Infections Chicken pox and measles can have a more serious or even fatal course in pediatric and adult patients on corticosteroids. In pediatric and adult patients who have not had these diseases, particular care should be taken to avoid exposure. If exposed to chicken pox, prophylaxis with varicella zoster immune globulin VZIG may be indicated. If exposed to measles, prophylaxis with immunoglobulin IG may be indicated.

If chicken pox develops, treatment with antiviral agents should be considered. Neurologic Epidural and intrathecal administration of this product is not recommended. Ophthalmic Use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to bacteria, fungi, or viruses.

The use of oral corticosteroids is not recommended in the treatment of optic neuritis and may lead to an increase in the risk of new episodes. Corticosteroids should not be used in active ocular herpes simplex. Adequate studies to demonstrate the safety of Kenalog Injection use by intraturbinal, subconjunctival, sub-Tenons, retrobulbar, and intraocular intravitreal injections have not been performed.

Endophthalmitis, eye inflammation, increased intraocular pressure, and visual disturbances including vision loss have been reported with intravitreal administration. Administration of Kenalog Injection intraocularly or into the nasal turbinates is not recommended. Intraocular injection of corticosteroid formulations containing benzyl alcohol, such as Kenalog Injection, is not recommended because of potential toxicity from the benzyl alcohol.

Therefore, it should not be autoclaved when it is desirable to sterilize the exterior of the vial. The lowest possible dose of corticosteroid should be used to control the condition under treatment. When reduction in dosage is possible, the reduction should be gradual. Discontinuation of corticosteroids may result in clinical improvement. Cardio-Renal As sodium retention with resultant edema and potassium loss may occur in patients receiving corticosteroids, these agents should be used with caution in patients with congestive heart failure, hypertension, or renal insufficiency.

Gastrointestinal Steroids should be used with caution in active or latent peptic ulcers, diverticulitis, fresh intestinal anastomoses, and nonspecific ulcerative colitis, since they may increase the risk of a perforation. Signs of peritoneal irritation following gastrointestinal perforation in patients receiving corticosteroids may be minimal or absent. There is an enhanced effect of corticosteroids in patients with cirrhosis.

This, together with a decrease in the protein matrix of the bone secondary to an increase in protein catabolism, and reduced sex hormone production, may lead to inhibition of bone growth in pediatric patients and the development of osteoporosis at any age.

Special consideration should be given to patients at increased risk of osteoporosis ie, postmenopausal women before initiating corticosteroid therapy. Neuro-Psychiatric Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that they affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect.

An acute myopathy has been observed with the use of high doses of corticosteroids, most often occurring in patients with disorders of neuromuscular transmission eg, myasthenia gravis , or in patients receiving concomitant therapy with neuromuscular blocking drugs eg, pancuronium.

This acute myopathy is generalized, may involve ocular and respiratory muscles, and may result in quadriparesis.

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