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Why Is Kenalog Contraindicated For IM Injection?

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Posted on Tue, 2 Apr 2024
Question: Why is Kenalog 10 mg contraindicated for IM injection? My GP gave me two huge injections IM in my bottom containing a total of 25 cc. That gave me horrible side effects, many trips to ER with Tachycardia. I have not felt normal since. It has been 3 months since I got the shots and Yesterday I got a fast pulse and very high Blood Pressure. I am so sad. My doctor told me not to discuss this with anyone. I am so afraid. I want to know who knows why Kenalog 10 mg is contraindicated, what is different because Kenalog 40 mg is approved for IM. What can I do? I do not want to pay unless you can specifically answer these questions.
doctor
Answered by Dr. Dr. Muhammad Sareer Khalil (5 hours later)
Brief Answer:
Not contraindicated, higher doses in M.S are used

Detailed Answer:
Hello and Welcome

I appreciate your concern

From the date of the shot, triamcinolone will have its effect for a further 6 weeks. A repeat complete blood count canbbe done to look for any significant platelet lowering though kenalog is not usually associated with thrombocytopenia. There is no specific antidote to reverse it's effects. If you were not willing for this injection then it should not have been administered without your proper informed consent. You can discuss the case again with your physician or chose another doctor.

There is no need to be scared here. I want you to know that I am here to help. You have the right to be fully informed about the decisions that you take regarding your health.

No, the 10 mg injection is not contraindicated for IM administration. The only absolute contraindication of steroids is Herpes Simples Keratitis. In ITP (Immune Thrombocytopenic Purpura), IM shots in general are contraindicated.

In all other conditions, the decision to administer steroids is based on the presenting condition and weighing the pros and cons in the specific case.

The 10 mg injection is usually reserved for intra articular or intra lesion administration. Not more than 20 mg should be given in such cases.

The higher doses 60 to 80 mg are administered via deep I/M injection in various inflammatory conditions, usually on a weekly basis.

In Multiple Sclerosis the starting dose is higher i.e 160 mg on day. So such doses are indicated in patients with M.S.

In summary, the 10 mg injection though reserved for joint shots , can also be given as IM and higher doses of kenalog are used in M.S as described above.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

Dr. M.S. Khalil
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Dr. Muhammad Sareer Khalil (16 hours later)
The FDA prescribing guide states that Kenalog 10 mg is not to be used IM. Regardless, I was given in one dose, two shots containing a total of 25cc. That is 25 ML... or a total of 250 mg of active ingredient. I do not have MS. I had a slight cold. I think this was dramatic action for no reason and I cannot understand a dose of 25 cc... 25 x 10 mg per ml =250 mg.... It sent me to the IR... and the only thing I could do was take Metoprolol. That was 3 months ago... I thought the reaction was finished... and it still came back again. Did you mean I still might have some reaction to it for another six weeks? This has had more dramatic side effects for me than any other medical problem, getting stents was nothing compared to this shot.
doctor
Answered by Dr. Dr. Muhammad Sareer Khalil (12 hours later)
Brief Answer:
Explained

Detailed Answer:
Hello again

I am sorry for your distress

The effect would last for 6 weeks from the day of the shot so if its been 3 months then it has been eliminated from your body.

Kenalog shot is not indicated for cold. The indications are quite clear.

They include

Rheumatic/ arthritic painful conditions
Dermatoses
Inflammatory / allergic conditions that require extended anti-inflammatory effect
Multiple sclerosis

Beyond these indications, triamcinolone is not used as an IM shot.

You may ask your doctor about the specific indication as to why it was administered.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

For future follow up / correspondence you may ask me directly at the link given below

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107

Dr. M.S. Khalil

Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Dr. Muhammad Sareer Khalil (48 minutes later)
There was no reason to give it to me. He said that because i had just received stents in my heart and I had a slight cold I was at risk for a heart attack. I reviewed this with my cardiologist and she could think of no reason to give me the steroid. It only risked my life. After I had a bad reaction to the shot the doctor that gave it to me told me to be careful because I was very fragile. I told him that I was not fragile before he gave me the shot. He had no reply. I also cannot understand the dose. 25 cc is a lot... 250 mg of the actual drug. I think my reaction to in might have been predictable. My pulse shot up to 147 and my cardiologist told me to go to the ER. I just feel like that shot destroyed me. I do not feel like I recovered from it.
doctor
Answered by Dr. Dr. Muhammad Sareer Khalil (10 minutes later)
Brief Answer:
Explained

Detailed Answer:
I feel, its a matter of judgment. But I do not agree with the reason that a cold can predispose to a myocardial infarct.

I would also like to tell you that a single shot even though the dose was quite high, is unlikely to lead to have caused any significant or permanent damage.

As I stated before the only two absolute contraindications are herpes simplex keratitis and ITP. Thankfully , you didn't have either. So most likely , you are going to recover as its been 3 months.

A severe allergic reaction would include a generalized rash, pruritis, shortness of breath, hypotension and confusion. If it was tachycardia alone then it cant be termed anaphylaxis.

Wishing you best of health

Thanks

Let me know if you have any query
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2906 Questions

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Why Is Kenalog Contraindicated For IM Injection?

Brief Answer: Not contraindicated, higher doses in M.S are used Detailed Answer: Hello and Welcome I appreciate your concern From the date of the shot, triamcinolone will have its effect for a further 6 weeks. A repeat complete blood count canbbe done to look for any significant platelet lowering though kenalog is not usually associated with thrombocytopenia. There is no specific antidote to reverse it's effects. If you were not willing for this injection then it should not have been administered without your proper informed consent. You can discuss the case again with your physician or chose another doctor. There is no need to be scared here. I want you to know that I am here to help. You have the right to be fully informed about the decisions that you take regarding your health. No, the 10 mg injection is not contraindicated for IM administration. The only absolute contraindication of steroids is Herpes Simples Keratitis. In ITP (Immune Thrombocytopenic Purpura), IM shots in general are contraindicated. In all other conditions, the decision to administer steroids is based on the presenting condition and weighing the pros and cons in the specific case. The 10 mg injection is usually reserved for intra articular or intra lesion administration. Not more than 20 mg should be given in such cases. The higher doses 60 to 80 mg are administered via deep I/M injection in various inflammatory conditions, usually on a weekly basis. In Multiple Sclerosis the starting dose is higher i.e 160 mg on day. So such doses are indicated in patients with M.S. In summary, the 10 mg injection though reserved for joint shots , can also be given as IM and higher doses of kenalog are used in M.S as described above. Wishing you best of health Thanks Let me know if you have any query Please consult your doctor before deciding on any further course of action. Dr. M.S. Khalil