Note: This document contains side effect information about triamcinolone. Some dosage forms listed on this page may not apply to the brand name Kenalog-40.

Applies to triamcinolone: injection powder for suspension extended release, injection suspension.

Serious side effects of Kenalog-40

Along with its needed effects, triamcinolone (the active ingredient contained in Kenalog-40) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking triamcinolone:

More common

• Aggression
• agitation
• anxiety
• blurred vision
• decrease in the amount of urine
• dizziness
• fast, slow, pounding, or irregular heartbeat or pulse
• headache
• irritability
• mental depression
• mood changes
• nervousness
• noisy, rattling breathing
• numbness or tingling in the arms or legs
• pounding in the ears
• shortness of breath
• swelling of the fingers, hands, feet, or lower legs
• trouble thinking, speaking, or walking
• troubled breathing at rest
• weight gain

Incidence not known

• Abdominal cramping and/or burning (severe)
• abdominal pain
• backache
• bloody, black, or tarry stools
• cough or hoarseness
• darkening of skin
• decreased vision
• diarrhea
• dry mouth
• eye pain
• eye tearing
• facial hair growth in females
• fainting
• fatigue
• fever or chills
• flushed, dry skin
• fractures
• fruit-like breath odor
• full or round face, neck, or trunk
• heartburn and/or indigestion (severe and continuous)
• increased hunger
• increased thirst
• increased urination
• loss of appetite
• loss of sexual desire or ability
• lower back or side pain
• menstrual irregularities
• muscle pain or tenderness
• muscle wasting or weakness
• nausea
• pain in back, ribs, arms, or legs
• painful or difficult urination
• skin rash
• sleeplessness
• sweating
• trouble healing
• trouble sleeping
• unexplained weight loss
• unusual tiredness or weakness
• vision changes
• vomiting
• vomiting of material that looks like coffee grounds

Other side effects of Kenalog-40

Some side effects of triamcinolone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

• Blemishes on the skin
• bruising
• dry, scaly skin
• feeling of constant movement of self or surroundings
• full or bloated feeling
• increased appetite
• increased hair growth on the face, forehead, back, arms, and legs
• large, flat, blue, or purplish patches in the skin
• pimples
• pitting or depression of the skin at the injection site
• reddish purple lines on the arms, face, legs, trunk, or groin
• redness of the skin
• redness, swelling, tenderness, or pain at the injection site
• sensation of spinning
• small, red, or purple spots on the skin
• thin, fragile, or shiny skin
• thinning of the scalp hair

For Healthcare Professionals

Applies to triamcinolone: compounding powder, inhalation aerosol, inhalation aerosol with adapter, injectable kit, injectable suspension, intra-articular powder for injection extended release, intra-articular suspension, oral tablet.

General

The most commonly occurring adverse effects following local administration have included injection site reaction, headache, and arthralgia. Since systemic absorption may occasionally occur with intra-articular or other local administration, patients may experience adverse effects associated with corticosteroid therapy.^[Ref]

Local

Common (1% to 10%): Injection site reaction

Uncommon (0.1% to 1%): Injection site abscess (sterile), injection site irritation, injection site discomfort

Corticosteroids:

Frequency not reported: Post injection flare, brief increased in joint discomfort, excess dosage or too-frequent administration into same site resulting in local subcutaneous atrophy (may return to normal after several months)

Hypersensitivity

Uncommon (0.1% to 1%): Anaphylactoid reaction, anaphylactic reaction, anaphylactoid shock

Dermatologic

Common (1% to 10%): Contusions

Uncommon (0.1% to 1%): Urticaria, rash, skin hyperpigmentation, skin hypopigmentation, skin atrophy, skin fragility, petechiae, ecchymosis, erythema, hyperhidrosis, purpura, skin striae, hirsutism, dermatitis acneiform, cutaneous lupus erythematosus, angioedema, pruritus

Corticosteroids:

Frequency not reported: Acne, allergic dermatitis, cutaneous and subcutaneous atrophy, dry scaly skin, ecchymoses and petechiae, edema, erythema, hyperpigmentation, 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^[Ref]

Musculoskeletal

Common (1% to 10%): Arthralgia, joint swelling

Uncommon (0.1% to 1%): Osteoporosis, osteonecrosis, pathological fracture, fracture delayed union, musculoskeletal discomfort, muscular weakness, myopathy, muscle atrophy, growth retardation, neuropathic arthropathy, myalgia, synovitis

Frequency not reported: Loss of muscle mass, aseptic necrosis of the heads of the humerous and femur, spontaneous fractures, Charcot-like arthropathy^[Ref]

Nervous system

Common (1% to 10%): Headache

Uncommon (0.1% to 1%): Convulsion, epilepsy, syncope, benign intracranial hypertension, neuritis, paresthesia, intracranial pressure increased, dizziness

Corticosteroids:

Frequency not reported: Serious neurologic events (with epidural administration)^[Ref]

Psychiatric

Uncommon (0.1% to 1%): Psychiatric symptom, depression, euphoric mood, mood swings, psychotic disorder, personality change, insomnia, drug dependence, mental disorder, irritability, suicidal ideation, anxiety, cognitive disorder

Gastrointestinal

Uncommon (0.1% to 1%): Peptic ulcer, peptic ulcer perforation, peptic ulcer hemorrhage, pancreatitis, abdominal distension, esophagitis ulcerative, dyspepsia

Corticosteroids:

Frequency not reported: Abdominal distention, nausea^[Ref]

Endocrine

Uncommon (0.1% to 1%): Cushingoid, adrenal suppression, secondary adrenocortical insufficiency, hypopituitarism

Frequency not reported: Hirsutism

Corticosteroids:

Frequency not reported: HPA suppression, hypertrichosis^[Ref]

Ocular

Uncommon (0.1% to 1%): Viral eye infection, fungal eye infection, conjunctivitis, blindness, cataract, glaucoma, exophthalmos, corneal perforation, papilledema

Corticosteroids;

Rare (less than 0.1%): Blindness associated with intralesional therapy around the face and head^[Ref]

Metabolic

Uncommon (0.1% to 1%): Sodium retention, fluid retention, alkalosis hypokalemic, hyperglycemia, out of range diabetes mellitus control, calcium deficiency, increased appetite

Frequency not reported: Decreased carbohydrate tolerance, manifestation of diabetes mellitus

Corticosteroids:

Frequency not reported: Weight gain^[Ref]

Other

Uncommon (0.1% to 1%): Vertigo, fatigue, hyperthermia

Corticosteroids:

Frequency not reported: Malaise

Immunologic

Common (1% to 10%): Infection

Uncommon (0.1% to 1%): Tuberculosis, Candida infection, impaired healing

Frequency not reported: Infection (masked)

Cardiovascular

Uncommon (0.1% to 1%): Cardiac failure (congestive), arrhythmia, hypertension, embolism, thrombophlebitis, vasculitis necrotizing, hypotension, flushing

Corticosteroids:

Frequency not reported: Bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, hypertension, fat embolism, hypertrophic cardiomyopathy in premature infants, myocardial rupture following recent myocardial infarction, pulmonary edema, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis, necrotising angiitis, ECG changes due to potassium deficiency^[Ref]

Genitourinary

Uncommon (0.1% to 1%): Glycosuria, menstrual irregularities, amenorrhea and postmenopausal vaginal bleeding

Corticosteroids:

Frequency not reported: Increased or decreased motility and number of spermatozoa

Oncologic

Corticosteroids:

Frequency not reported: Kaposi's sarcoma

Respiratory

Common (1% to 10%): Sinusitis, cough

Uncommon (0.1% to 1%): Rhinitis

Corticosteroids:

Frequency not reported: Hiccups