Kenalog-40 Side Effects

Steroids can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using Kenalog-40.

Kenalog-40 (injection)

Medically reviewed by Drugs.com on Jan 31, 2022. Written by Cerner Multum.

What is Kenalog-40?

Kenalog-40 is a steroid medicine that is used to treat many different types of inflammatory conditions, including severe allergic reactions, skin disorders, severe colitis, inflammation of the joints or tendons, blood cell disorders, inflammatory eye disorders, lung disorders, and problems caused by low adrenal gland hormones.

Kenalog-40 is also used to treat certain skin disorders caused by autoimmune conditions such as lupus, psoriasis, lichen planus, and others.

Different brands of triamcinolone injection have different uses.

Kenalog-40 may also be used for purposes not listed in this medication guide.

Part of the reason for these long wait times and short appointments is due to a nationwide shortage of physicians that is only getting worse. A report by the Association of American Medical Colleges predicts that, due to population growth and specifically growth of the elderly population, the physician shortfall in the U.S. could reach 121,300 by the year 2030.

Warnings

You may not be able to receive Kenalog-40 if you have a fungal infection, or a condition called idiopathic thrombocytopenic purpura (ITP).

Before taking this medicine

You should not be treated with Kenalog-40 if you are allergic to it.

You may not be able to receive Kenalog-40 if you have a fungal infection, or a condition called idiopathic thrombocytopenic purpura (ITP).

Tell your doctor if you have ever had:

• an active or chronic infection, including tuberculosis;
• idiopathic thrombocytopenic purpura (ITP);
• high blood pressure, heart problems;
• cataracts, glaucoma, or herpes infection of the eyes;
• a parasite infection that causes diarrhea (such as threadworms);
• a nerve-muscle disorder, such as myasthenia gravis;
• a stomach ulcer, diverticulitis, ulcerative colitis;
• a colostomy or ileostomy, or stomach surgery;
• low bone mineral density; or
• a problem with your thyroid or adrenal gland.

Tell your doctor if you are pregnant or breastfeeding.

How is Kenalog-40 given?

Kenalog-40 is given through a needle and can be injected into different areas of the body: into a muscle, into the space around a joint or tendon, or into a lesion on the skin. A healthcare provider will give you this injection.

Not every brand of Kenalog-40 is used for the same conditions or injected into the same body areas. Some brands are given only one time as needed. Others may be given at regular intervals. Carefully follow your doctor’s dosing instructions.

Kenalog-40 can weaken (suppress) your immune system, and you may get an infection more easily. Call your doctor if you have unusual bruising or bleeding, or signs of infection (fever, weakness, cold or flu symptoms, skin sores, diarrhea, frequent or recurring illness).

Long-term use of steroids can cause harmful effects on the eyes. If you receive Kenalog-40 for longer than 6 weeks, your doctor may want you to have regular eye exams.

Your doctor may instruct you to limit your salt intake while you are receiving Kenalog-40. You may also need to take potassium supplements. Follow all instructions.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using Kenalog-40.

You should not stop using Kenalog-40 suddenly after long-term repeated use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for a scheduled Kenalog-40.

When Kenalog-40 is used as a single dose, you will not be on a regular dosing schedule.

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.

What should I avoid while receiving Kenalog-40?

After injection of triamcinolone into a joint, avoid overusing that joint through strenuous activity or high-impact sports. You could cause damage to the joint.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chickenpox or measles. These conditions can be serious or even fatal in people who are using Kenalog-40.

Do not receive a “live” vaccine or a toxoid vaccine while using Kenalog-40, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine. Toxoid vaccines include diphtheria-tetanus toxoid (DT or Td).

Kenalog-40 side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Kenalog-40 may cause serious side effects. Call your doctor at once if you have:

• (after injection into a joint space) increased pain or swelling, joint stiffness, fever, and general ill feeling;
• blurred vision, tunnel vision, eye pain, or seeing halos around lights;
• unusual changes in mood or behavior;
• swelling, rapid weight gain, feeling short of breath;
• stomach cramps, vomiting, diarrhea, bloody or tarry stools, rectal irritation;
• sudden numbness or weakness (especially on one side of the body);
• a seizure (convulsions);
• severe headache, blurred vision, pounding in your neck or ears;
• increased pressure inside the skull–severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes; or
• signs of low adrenal gland hormones–flu-like symptoms, headache, depression, weakness, tiredness, diarrhea, vomiting, stomach pain, craving salty foods, and feeling light-headed.

Certain side effects may be more likely with long-term use or repeated doses of triamcinolone injection.

Steroids can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using Kenalog-40.

Common side effects of Kenalog-40 may include:

• skin changes (acne, dryness, redness, bruising, discoloration);
• increased hair growth, or thinning hair;
• nausea, bloating, appetite changes;
• stomach or side pain;
• cough, runny or stuffy nose;
• headache, sleep problems (insomnia);
• a wound that is slow to heal;
• sweating more than usual; or
• changes in your menstrual periods.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Kenalog-40?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your current medicines. Many drugs can affect Kenalog-40, especially:

• an antibiotic or antifungal medication;
• birth control pills or hormone replacement therapy;
• a blood thinner (warfarin, Coumadin, and others);
• a diuretic or “water pill”;
• insulin or oral diabetes medicine;
• medicine to treat tuberculosis;
• a nonsteroidal anti-inflammatory drug or NSAID (aspirin, ibuprofen, naproxen, diclofenac, indomethacin, Advil, Aleve, Celebrex, and many others); or
• seizure medication.

This list is not complete and many other drugs may affect Kenalog-40. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Popular FAQ

Topical clobetasol and triamcinolone are both classified as super-high to high potency topical corticosteroid (“steroid”) medicines used on the skin. They are used to treat skin conditions that are responsive to topical corticosteroids, such as dermatitis, eczema (atopic dermatitis) and serious allergic reactions. ​​Most products are available as a generic option. Continue reading

Which topical corticosteroid (“steroid”) product is best for you depends upon what skin condition you have, your symptoms and where it is located on your body. Other selection factors may include availability, cost and if the medicine is covered by your insurance. After examination, your doctor will be able to determine which topical steroid is best to treat your skin condition. Continue reading

More FAQ

• What causes Plaque Psoriasis?
• Can triamcinolone acetonide B be used to treat severe diaper rash on a little girl?

More about Kenalog-40 (triamcinolone)

• Check interactions
• Compare alternatives
• Pricing & coupons
• Reviews (83)
• Side effects
• Dosage information
• During pregnancy
• Generic availability
• Drug class: glucocorticoids
• Breastfeeding
• En español

Patient resources

Kenalog-40 Side Effects

Medically reviewed by Drugs.com. Last updated on Feb 24, 2023.

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

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

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

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

Frequency not reported: Abdominal distention, nausea [Ref]

Endocrine

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

Frequency not reported: Hirsutism

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

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

Frequency not reported: Weight gain [Ref]

Other

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

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

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

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

Oncologic

Frequency not reported: Kaposi’s sarcoma

Respiratory

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

Uncommon (0.1% to 1%): Rhinitis

Frequency not reported: Hiccups

Frequently asked questions

• What causes Plaque Psoriasis?
• Clobetasol vs. triamcinolone – how do they compare?
• Can triamcinolone acetonide B be used to treat severe diaper rash on a little girl?
• Halobetasol vs triamcinolone: which is better?

More about Kenalog-40 (triamcinolone)

• Check interactions
• Compare alternatives
• Pricing & coupons
• Reviews (83)
• Dosage information
• During pregnancy
• Generic availability
• Drug class: glucocorticoids
• Breastfeeding
• En español

Patient resources

• Drug Information
• Kenalog-40 (Advanced Reading)

Other brands

Professional resources

Other formulations

Related treatment guides

• Allergic Rhinitis
• Allergic Reactions
• Alopecia
• Adrenocortical Insufficiency

References

1. Cerner Multum, Inc. “Australian Product Information.” O 0

2. “Product Information. Zilretta (triamcinolone).” Flexion Therapeutics, Inc (2017):

3. “Product Information. Aristospan Injection (triamcinolone).” Fujisawa

4. Burge S “Should inhaled corticosteroids be used in the long term treatment of chronic obstructive pulmonary disease?” Drugs 61 (2001): 1535-44

5. Israel E, Banerjee TR, Fitzmaurice GM, Kotlov TV, LaHive K, LeBoff MS “Effects of inhaled glucocorticoids on bone density in premenopausal women.” N Engl J Med 345 (2001): 941-7

6. Moshfeghi DM, Lowder CY, Roth DB, Kaiser PK “Retinal and choroidal vascular occlusion after posterior sub-tenon triamcinolone injection.” Am J Ophthalmol 134 (2002): 132-4

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.