Suspension for injections "Kenalogum 40" is recommended for treatment:

• allergic states, including seasonal and constant allergic rhinitises, atopic and contact dermatitis, reactions to medicines, a serum disease and sharp non-infectious laryngeal edema (at anaphylactic reactions the corticosteroids are not useful to treatment of the sharp phenomenon, however they are useful to prevention of approach of the last phase of allergic reaction);
• rheumatic violations: corticosteroids should be applied to patients with a heavy pseudorheumatism who wait for useful effects of antirheumatic medicines of the prolonged action; they are intended for short-term treatment of sharp gout, a sharp nonspecific ankylosing spondylitis, a bursitis, an epicondylitis, a posttraumatic osteoarthritis, psoriasis arthritis and a synovitis at an osteoarthritis;
• dermatological diseases: corticosteroids are recommended at herpetiform violent dermatitis, exfoliative dermatitis, a heavy polymorphic erythema, heavy psoriasis, heavy seborrheal dermatitis, eczema, atopic dermatitis, a diskoidny lupus, contact dermatitis, a nested alopecia, a pempigus and at various sharp and chronic dermatosis;
• diseases of eyes: corticosteroids are recommended at serious acute and chronic allergic and inflammatory conditions, including allergic conjunctivitis, allergic extreme helcomas, inflammation of a front segment, a chorioretinitis, the diffusion back uveitis also horoidit, the surrounding eye herpes, an iritis and an iridocyclitis, a keratitis, neuritis of an eye and a sympathetic ophthalmia;
• endocrine diseases: corticosteroids are recommended for treatment of primary and secondary adrenocortical insufficiency, a congenital hyperplasia, a hypercalcemia that is associated with a malignant tumor, at De Quervin's disease and Addison's disease;
• respiratory diseases: to apply corticosteroids to treatment of an aspiration pneumonitis, a berylliosis, Leffler's syndrome;
• other diseases: tubercular meningitis, a polymorphic sclerosis (corticosteroids should be applied to treatment of aggravation of a polymorphic sclerosis, they reduce duration of exacerbation of a disease, but they do not stop progressing of a disease).

Structure

Active ingredient - Triamcinolonum acetonide (1 ml of suspension for injections contains Triamcinolonum of acetonide 40 mg).

Excipients: sodium carboxymethylcellulose, sodium chloride, benzyl alcohol, polysorbate 80, water for injections.

Contraindication

1. Hypersensitivity to active agent or to any excipient.
2. System infections, except cases of application of specific antibacterial therapy.
3. Chronic primary hemorrhagic diathesis caused by insufficiency of a platelet link of a hemostasis with hypodermic hemorrhages and hemorrhages from mucous membranes in natural cavities (Vergolf's disease).
4. Intravenous, intrathecal and epidural or intraocular administration.
5. Proximal myopathy caused by corticosteroids in the anamnesis.

Route of administration

that requirements for Triamcinolonum dosage different, and its dose it is necessary to select individually depending on a disease and reaction of the patient. The smallest possible doses of corticosteroids should be applied to control of states which are treated and if the dose decline is possible, then it has to be gradual.

according to the sizes of a joint and severity of symptoms and reactions of the patient.

Therapeutic results should be observed in 2-3 weeks. However in certain cases can pass even more than 6 weeks before certain positive takes begin to be observed.

Drug cannot be administered intravenously.

Intramuscular introduction

intramusculary in a dose from 4-ka0 to 80 mg.

Recommended initial dose for adults and children is more senior than 12 years makes 60 mg.

If necessary can enter at once a dose of 100-120 mg.

Recommended initial dose for children of 6-12 years makes 0.03-0.2 mg/kg in a muscle with intervals of 1-7 days.

initial oral therapy.

Dose should be entered deeply into a gluteus.

As a rule, it is possible to expect that there will be enough single parenteral dose for 4-7-day and before 3-4 weeks control of a disease. The single dose of 40-60 mg can cause remission of symptoms during the season in patients with allergic rhinitis or asthma caused by pollen.

useful effects, for example, at asthma, but it can be associated with side effects of type of fever that is typical for chronic application of corticosteroids.

Now Triamcinolonum acetonide is seldom used by

for symptomatic treatment of a pseudorheumatism; it can be entered vnutrisustavno for easing of pain and inflammation at a pseudorheumatism, gouty arthritis (gout), psoriasis arthritis and an osteoarthritis. Patients should not overload joints after achievement of symptomatic improvement. The intra articulate injections repeating during the long span can cause heavy destruction of joints and necrosis of bones.

Usual intra articulate doses of Triamcinolonum of acetonide for adults make 5-10 mg for smaller joints and 20-60 mg for big joints. However successfully applied doses of 6-10 mg on an injection to smaller joints and 40 mg on an injection to big joints. At injections in several joints the introduction of 80 mg of Triamcinolonum of acetonide becomes.

Recommended initial dose for children of 12-18 years makes 2.5-40 mg. Considering clinical reaction, the subsequent doses can be increased.

Triamcinolonum acetonide can be entered locally for simplification of a bursitis and the tendosinovit. It is necessary to be careful at an injection in space between a tendinous vagina and a sinew, but not in a sinew, because of a possibility of its gap. The dose depends on the size of a joint or synovial space and extent of inflammation.

Introduction to the place of defeat

Dose for introduction to area of defeat of injections of Triamcinolonum of acetonide, as a rule, has range from 5 to 10 mg. This dose is divided into parts according to the struck area.

Recommended initial dose for children of 12-18 years makes 2.5-40 mg. Considering clinical reaction, the subsequent doses can be increased.

As a rule, big squares demand several injections and smaller doses to the place of an injection. Usually 2-3 injections are required every 2-3 week. Introduction to an affected area is suitable for treatment of big defeats, for example psoriasis and a nested alopecia.

Feature of application

Pregnant

Probability of penetration of corticosteroids through a placental barrier different at different medicines and their forms. Long-term treatment or repeated appointment during pregnancy of corticosteroids can increase risk of a delay of pre-natal development. Emergence of a hypnoadrenalism at impact of corticosteroids on a fruit during the prenatal or neonatal periods is theoretically possible.

, only if the advantage for mother and the child exceeds possible risk.

by

Triamcinolonum for children up to 6 years. The intra articulate injection or introduction to area of defeat for children up to 12 years is not recommended if on that there are no accurate indications. During treatment it is necessary to watch growth and development of the child carefully.

Drivers

Kenalogum 40 Drug treatment insignificantly or moderately affects ability of the patient to drive the car and other mechanisms. In the first or second week of treatment there can be such undesirable reactions from the central nervous system: sedation, depression, headache, insomnia, changes of the personality, mania, hallucinations and psychoses. At emergence of such symptoms it is necessary to refrain from control of motor transport or work with mechanisms until they disappear.

Overdose

single messages about a lethal outcome because of sharp overdose Exist.

As a rule, only after several weeks of application of very high doses the majority of undesirable effects, first of all Cushing's syndrome and also concern, nervousness, depressions, gastrointestinal colic or bleeding, ecchymomas, arterial hypertension, a hyperglycemia can arise.

Specific antidote. To perform the supporting and symptomatic treatment.

Hemodialysis is not an effective method of the accelerated removal of Triamcinolonum from an organism.

Side effects which can take place at use of the medicine "Kenalogum 40" are given by

according to classification by bodies and the systems of bodies.

Laboratory indicators: the increased level of the general content of cholesterol, the increased level of lipoproteins of low density and triglycerides, changes of indicators of the ECG owing to deficiency of potassium, a gipokaliyemichesky Alkalosis, the increased calcium removal.

from a cardiovascular system: deterioration in warm function, liquid delay, cardiac arrhythmia, hypertensia, necrotic vasculitis / lymphangitis, thrombophlebitis, obliterating endarteritis.

from blood and lymphatic systems: granulocytosis, lymphopenia, monocytopenia, leukocytosis.

from nervous system: headache, benign intracranial hypertensia (brain pseudoneoplasm), vertigo, loss of consciousness, neuritis or paresthesia.

from organs of sight: a back podkapsulyarna a cataract, glaucoma, injury of an optic nerve with hypostasis of an optic nerve (connected with a brain pseudoneoplasm), increase in intraocular pressure, an exophthalmos, thinning of a cornea or sclera, exacerbation of viral or fungal diseases of an eye, violation of clearness of sight.

Respiratory, thoracic and mediastinal violations: hoarseness of a voice, irritation and dryness in a throat (after application of oral corticosteroid inhalers), activization of a pulmonary tuberculosis.

from digestive tract: dryness in a mouth, a duodenum ulcer (including gastrointestinal bleeding), perforation, dyspepsia, pancreatitis, an abdominal distension, an ulcer esophagitis.

from skin and hypodermic fabrics: acne rash, defeat, bruises, ecchymomas, face reddening, atrophy, excess pilosis, bad healing of wounds, increase in sweating, striya, teleangiectasia and thinning of skin, dermatitis, petechias and ecchymomas, changes characteristic of a system lupus erythematosus, lack of reaction to skin tests, changes in the injection site.

from the musculoskeletal device and connective tissue: a myopathy, an osteonecrosis, osteoporosis (the greatest loss of a bone tissue is observed in the first 6 months of treatment), muscle weakness, fatigue, loss of muscle bulk, compression spinal fractures, aseptic necrosis of femoral and humeral heads, pathological fractures of tubular bones and spontaneous fractures, ruptures of sinews.

from closed glands: a sodium delay in an organism that leads to a hypopotassemia, oppression of function of adrenal glands, Cushing's syndrome, delay of growth of children, aggravation of symptoms at the patients sick with diabetes, a hypoglycemia, violation of a menstrual cycle and an amenorrhea, increase in body weight, negative nitrogenous and calcic balances, the increased appetite.

from metabolism and digestion: porphyria.

Infection and invasion: oropharyngeal candidiasis, septic necrosis (especially at patients with a system lupus erythematosus or a pseudorheumatism).

General violations and violations of conditions of introduction: avascular necrosis, local decolouration of skin, an atrophy of skin, damage of a sinew at topical administration.

from the immune system: anaphylactoid reactions, an anaphylaxis, including anaphylactic reactions and an acute anaphylaxis, a Quincke's disease (Quincke's edema), rash, an itch and a small tortoiseshell, especially in the presence at the patient of a medicinal allergy in the anamnesis.

from reproductive function and mammary glands: violations of a menstrual cycle and vasomotorial symptoms, violations of a menstrual cycle, amenorrhea, postclimacteric vaginal bleeding.

Mental violations: euphoria, mental dependence, a depression, insomnia, spasms, complications of the available mental disorders and epilepsy, psychiatric reactions (including affective disorders, such as irritability, euphoric, depressive and labile mood and suicide thoughts), mental reactions (including a mania, nonsense, hallucinations, schizophrenia complications), behavior disorders, irritability, fear, a sleep disorder, cognitive dysfunction, including amnesia and confusion of consciousness.

Withdrawal (abstinence syndrome): at cancellation the fever, myalgia, arthralgia, rhinitis, conjunctivitis, pain in certain sites of skin with an itch, loss of body weight can be observed. Very sharp dose decline at long-term treatment can result in sharp insufficiency of adrenal glands, hypotension and a lethal outcome.

Intra articulate introduction: absorptions of Triamcinolonum after an injection an intra articulate method of administration is appropriate. However at application the patient has to be under observation of the doctor.

Intramuscular introduction: at intramuscular introduction the sharp pain was noted. Also sterile abscess, a skin and hypodermic atrophy, a hyperpegmentation, hypopigmentation and Sharko's arthropathy were observed.

At emergence of heavy side effects treatment should be stopped.

Storage conditions

to Store

at a temperature from 8 °C to 25 °C. Not to freeze. To store in vertical position and out of children's reach.

Expiration date - 3 years.