Kenalog Injections

I am posting this on behalf of a friend who for some reason isnt a member but would like a couple of questions answered. She has recieved kenalog injections from her GP as an alternative to a course of pred and she is a little confused by this. She has never been on long term pred or high doses of pred for a prolonged period of time.

She would like to know:

* Has this happened to anyone else in a similar situation?

*Is it usual for kenalog to be initiated by a GP rather than a consultant?

Thanks for any help/replies in advance

Em & Friend

xxxxx

Her other meds are: Bricanyl qds, Fexofenadine, serevent and Pulmicort 800mcg bd

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Hi

Not really sure if this is normal.

I had kenalog injections after being on 40mg of pred for a year, it was initialted by my consultant, not sure my GP would of given it.

I thought they only gave it for people who were on high dose or long term steroids.

My own consultant won't give it me again as he now says the effects are only short term therfore you'd need an injection every week/ 2 weeks making the side effects even worse than oral pred.

Truly x

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Hi wherrers,

Kenalog injection contains a steroid, triamcinolone, and is given intra-muscularly to give a duration of action of approximately six to eight weeks (it is apparently quite variable from person to person).

There is very limited evidence for its use in asthma, and there is especially a lack of direct comparative data between Kenalog and prednisolone. It acts in a slightly different way to prednisolone, so that it may be more effective as an anti-inflammatory. It may have a slightly different side effect profile, although it would be expected to have roughly the same quite significant side effects as six to eight weeks of prednisolone.

Some specialist asthma centres do use Kenalog as an alternative to prednisolone in people who are on long term high dose steroids, and are having difficulty reducing, particularly if there are potential issues with absorption from the gut of oral steroids or queries about whether a patient is complying (this is not the only reason for using Kenalog, so if it is suggested, you should not automatically assume your consultant thinks you are non-compliant!).

It would not be usual for a GP to use Kenalog as an alternative to short courses of pred - apart from anything else, the duration of action is a lot longer than the usual duration of a short course of pred (typically 5 to 7 days). Once given, a Kenalog injection cannot be 'taken back' part way through its action, so you are in effect 'stuck with it' for the entire six to eight weeks. It would be far more usual to give a short course of pred, which can be adjusted on a day-to-day basis as needed.

Hope this helps

Em H

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Kenalog - personal experience

I have been on Kenalog for many years, using it up to 4 times a year and now have ceased its use as my current GP does not approve of it.

I have Samter's syndrome, atopic eczema, allergy to aspirin and NSAIDS, aspirin linked asthma, nasal blockage, no sense of smell (polyps) and severe difficulties with sleeping due to blocked and weeping nasal passages (not at all good for sociability!). About 10% of asthmatics might fall into this category.

Kenalog gave complete remission of all symptoms for about one month with slow recurrence to full symptoms by the end of month 2. The wait for month 3 to pass to be permitted a new Kenalog injection was miserable and often reduced my ability to work.

Slowly over three years the symptoms reduced and so did the Kenalog to twice yearly. Subsequently my GP sent me to check on osteporosis, a known side effect, and my check-up produced no clear picture - a generally acceptable result for my age (59).

Many GP's do not differentiate between asthmatics and having moved house to a new GP, I am unable to access Kenalog today. No explanation as to the non-use of Kenalog is available to me (""We don't use it"", being my only information from my GP).

I have also begun taking a statin for a family history of cardiovascular disease (being a Glaswegian Scot, it goes with the territory) and this is thought to have a similar, but weaker, anti-inflammatory effect to Kenalog as a side effect of its anti-cholesterol activity. My asthma and nasal problems are continuing their slow decline in severity with 2 years absence of Kenalog.

I hope that this personal account gives one reasonably good history of Kenalog use over time, although, of course, it is just one story.

Good luck in the experiment.

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My GP gave me the injection to avoid my usual crashes with asthma probs due to hayfever.....

Though this was frowned upon by many other med practitioners....

It worked for me - but resulted in more probs the last time so shall refrain from having it again....

I also know that other that have also been rpescribed it mentioned terrible side effects!

Hope this helps.

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I was given kenalog last june after a very severe attack (ended up on vent and in itu for a while) as my dose of pred was too high as far as my con was concerned it was agreed by my Con at RBH, i had 3 doses over as very short period of time. During the following few weeks i was able to reduce pred from 100mg to 50mg but one of the worst side effects were horrendously heavy and very long periods.I was unable reduce much more before the effects wore off noticably after about 7-8 weeks.

It was mentioned again during this last admission but as i already have osteonecrosis from steriod use and because of the side effects and limited period of use it was decided against.

i have never heard of anyone being given it unless already on pred. If i was your friend i would certainly question this decision as im sure there are less potent drugs that would be suitable.

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I was given 2 kenalog injections a year as a child by my GP to ""get me through the summer"" when hayfever and asthma appalling. however this was 20 years ago and I was still given pred on top if asthma worsened. I have heard of it being given to people by my GP to control major hayfever symptoms despite nasal spray, eye drops and antihistamines but not for asthma.