• Each Kenalog injection contains Triamcinolone acetonide 40mg/1ml as the active ingredient.
• Triamcinolone acetonide belongs to a group of medicines called corticosteroids (steroids).
• The principal effect of corticosteroids is to reduce the body’s inflammatory & allergic response and they are used very commonly for many serious medical conditions.
• An injection of Kenalog is approximately equivalent to the effects you would get from taking a 5mg tablet of Prednisolone every day for about 3 weeks.
• Kenalog injections, like all steroids can cause unwanted side-effects although these are rare at the dose levels administered for the treatment of hay fever.
• The unique issue with a Kenalog injection that differentiates it from oral steroids is that once the injection is administered the effects can last for 3 weeks or more, whereas with tablets the effects are gone within 24 hours or less.
• This is the main reason NHS guidelines have identified this method of administering steroids as a problem, as there are occasions when the body needs its immune system at full strength.
• Kenalog is still officially licensed for the treatment of severe hay fever in the UK (even though it is no longer used in the NHS) and continues to be routinely administered to patients in most other countries around the world.
• A Kenalog injection does not cure hay fever. It temporarily suppresses the immune system enough to take away the symptoms in most people who need it.
• Relief from symptoms will last between 3 - 8 weeks.
• Treatment can be repeated up to three times a year, with a minimum of 40-days in between.

Serious possible adverse effects

Anaphylactic allergic reactions are very rarely reported

You must contact a doctor IMMEDIATELY (by going to an Accident & Emergency department) if you notice any of the following symptoms of an anaphylactic reaction

• Swelling of the face, lips or throat
• Breathing difficulties
• Skin itching, redness or a rash
• Sticky black stools
• Severe abdominal pain
• Vomiting blood

 

Common potential side effects

• Reduced immunity, leaving you more susceptible to infections - please social distance for 5 days following treatment
• Injection site reactions - redness, tenderness, bruising or infection
• Headache
• Joint stiffness

 

Rare potential side effects

• 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
• Sleep problems (insomnia)
• A wound that is slow to heal
• Sweating more than usual
• Changes in your menstrual periods
• Sterile abscess formation at the site of injection
• Skin colour changes (hypopigmentation) at the site of injection (see image below)
• Dimpling of skin caused by loss of fat under the skin at the site of injection (see image below)

 

 

Possible psychological effects of all steroids

All steroids, including Kenalog, can occasionally cause mental health problems although this is usually associated with much higher doses of steroid than what is given in a Kenalog injection.

If you experience any of the symptoms listed below, please contact your doctor straight away.

• Feeling depressed, including thinking about suicide
• Feeling high (mania), or moods that go up and down
• Feeling anxious, or having problems sleeping, difficulty in thinking or being confused and losing your memory
• Feeling, seeing or hearing things which do not exist

 

NB: This list of potential side effects is not exhaustive for more information please visit medicines.org

Non-Prescription treatments

There are a number of effective over-the-counter medications that should be explored before considering a Kenalog injection.

• Antihistamines tablets such as Loratadine, Cetirizine and Acravastine
• Eye drops such as Sodium Cromoglycate
• Nasal sprays such as Beclometasone & Fluticasone

 

Prescription treatments

There are a number of effective over-the-counter medications that should be explored before considering a Kenalog injection.

• Prednisolone oral tablets
• Antihistamine nasal sprays (Rhinolast) or combination antihistamine with steroids (Dymista)
• Fexofenadine antihistamine tablets
• Montelukast tablets
• Ranitidine tablets

If you choose to go ahead with the treatment this is the procedure 

• You will be asked to either lay down, or lean slightly forward on the couch (the choice is yours)
• Kenalog is given as an intramuscular injection into the upper-outer quadrant of your buttock. 
• The area is cleansed with a pre-injection swab to disinfect the skin and reduce the risk of infection.
• The injection is given slowly to reduce any discomfort or trauma to the area.
• A small sterile spot plaster will be placed over the site of injection.
• The dose for allergic disorders is 40mg-100mg (depending on your weight)
• Treatment may last between 2-4 months, but ultimately this is not guaranteed, as there are too many factors out of our control including the weather and pollen count.
• You must have at least a 40 day interval between injections, any further injections will be charged at the normal price.

• I have read and understood all the information above.
• I have given truthful answers to all questions, and I undestand that giving misleading responses may put my health at risk.
• I consent to treatment for allergic rhinitis and hayfever symptoms by an intramuscular injection of Kenalog 40-100mg if I am found to be suitable.