KENACORT ® Triamcinolone acetonide

KENACORT ® is a drug based on Triamcinolone acetonide

THERAPEUTIC GROUP: Non-associated systemic corticosteroids

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications KENACORT ® Triamcinolone acetonide

KENACORT ® is used, in the form of intramuscular injections, in the treatment of both inflammatory and allergic diseases for which the administration of steroid drugs is required.

Furthermore, the possibility of resorting to intra-articular and intra-oral injections allows optimal management of joint and tendon inflammatory diseases.

Mechanism of action KENACORT ® Triamcinolone acetonide

The triamcinolone acetonide contained in KENACORT ® is a systemic corticosteroid that lends itself in this formulation, to its exclusive use intramuscularly and intraarticularly, guaranteeing a significantly longer duration of action than that of corticosteroids taken orally.

However, like these, it acts with the same mechanism of action, ie inducing the expression of the enzyme lipocortin, which is able to inhibit phospholipase A2 and consequently reduce the availability of arachidonic acid.

The reduced concentration of the starting substrate results in a modest synthesis of inflammatory mediators such as leukotrienes, prostaglandins and prostacyclins, with a consequent control of the entire inflammatory process and the related tissue damage.

After its activity the active principle is metabolised to the liver level, mainly by hydroxylation processes and subsequently excreted via the kidney.

Studies carried out and clinical efficacy

1. KENACORT AND CATARATTA

Intravitreal administration of triamcinolone has been shown to be particularly effective in controlling post-operative inflammation after cataract extraction in patients with uveitis, thus sparing the use of systemic steroids and related side effects.

2. TRIAMCINOLONE AND POST-OPERATIVE PAIN

The administration of triamcinolone acetonide has been shown to be useful in reducing post-operative pain and the associated need for opioids following lumbar dissectomy, significantly reducing hospitalization times.

3. TRIAMCINOLONE AND DERMATOLOGICAL DISEASES

From numerous clinical evidences it emerges how the intramuscular administration of triamcinolone acetonide should be considered primary therapy for many chronic dermatological pathologies, which require a systemic approach, given the good tolerability and the very high efficacy.

Method of use and dosage

KENACORT ® suspension for injection, 40 mg vials of triamcinolone acetonide per ml: the dosage to be used and the route of administration vary from patient to patient, adapting to therapeutic needs and clinical needs.

The difficulty in choosing the dosage and the complex inoculation maneuver, whether this is systemic (intramuscular) or local (intra-articular), require medical supervision throughout the treatment period.

Warnings KENACORT ® Triamcinolone acetonide

The particular formulation of KENACORT ® requires medical supervision throughout the treatment, both for the possible correction of the dosage and for the complex method of administration.

The prolonged action of triamcinolone evidently adapts to the treatment of inflammatory pathologies with chronic course, while it is not recommended in the acute ones.

The anti-inflammatory action of these active ingredients could reduce the preventive efficacy of immunization strategies and at the same time lower the immune surveillance by increasing the risk of reactivation of latent infectious diseases or new infections.

Particular attention should be given to patients suffering from liver, kidney, cardiovascular, gastro-intestinal, neurological, psychiatric and diabetes diseases due to the ability of these drugs to worsen their clinical manifestations.

It is recommended not to administer the drug under the age of 6 and to be assisted by a healthcare professional during the inoculation of KENACORT ®

Furthermore, the presence of nervous manifestations could make it dangerous to carry out activities that require an intellectual commitment.

PREGNANCY AND BREASTFEEDING

Several experimental studies conducted on laboratory guinea pigs show how corticosteroids can easily cross the blood-placental barrier causing serious repercussions on the health of the fetus.

These evidences and the absence of clinical trials able to clarify the safety profile of triamcinolone when taken during pregnancy, advise against the use of these drugs during the entire period of pregnancy and the subsequent period of breastfeeding.

The administration could be justified only in case of real need and under strict medical supervision, taking care to monitor the adrenal function of the newborn in order to exclude any hypoadrenalism.

Interactions

The efficacy of corticosteroid therapy can be seriously compromised by the concomitant intake of other active ingredients, able to vary the pharmacokinetic characteristics and the biological efficacy of Triamcinolone acetonide.

Relevant studies have been conducted on amphotericin B, anticholinesterases, cicolisporine, digitalis glycosides, estrogens, inducers of liver enzymes, ketoconazole, muscle relaxants and NSAIDs, with worrying results regarding the significant pharmacokinetic changes observed both for the drug in question and for the above principles active.

Contraindications KENACORT ® Triamcinolone acetonide

The use of KENACORT ® is contraindicated during systemic infections, idiopathic purpura thrombocytopenia, in pediatric patients and in case of hypersensitivity to the active ingredient or to one of its excipients.

Undesirable effects - Side effects

The use of KENACORT ® exposes the patient to the same risks as any anti-inflammatory therapy based on cortisone drugs.

To the complex symptomatological picture determined by the systemic effects of corticosteroids, a series of local reactions are added, characterized by redness, pain, hypopigmentation, atrophy and sterile abscesses, linked to the particular route of administration of the drug.

Similarly to any other cortisone therapy, the intake of KENACORT ® especially if continued for prolonged periods or carried out at high doses could determine alterations depending on:

- of the musculoskeletal system with an increased risk of osteoporosis, fractures and myopathies;

- of the nervous system with neurological and psychiatric manifestations;

- of the gastrointestinal tract subjected to failed protection of the mucosa, therefore to an increased risk of ulcers;

- of the endocrine-metabolic structure with alterations of the hypothalamic-pituitary axis, negativization of the nitrogen balance and alterations of the carbohydrate metabolism;

- electrolyte balance, with sodium retention and potentially dangerous hypertension for cardiovascular function.