Triamcinolone

KENALOG

What it isGlucocorticoid-receptor agonist; intra-articular, intramuscular, intranasal and topical treatment of inflammation.

Why this oneA long-lived intra-articular depot effect is its distinguishing niche, while topical and nasal forms cover local inflammation.

What limits itRepeated joint injections can damage cartilage; systemic absorption can still suppress the adrenal axis and raise glucose.

FDA-approved for

FDA dosing	Population	Start	Target	Max
Nasal allergy symptoms (OTC triamcinolone acetonide nasal spray)	Adults & children ≥12 yr	2 sprays each nostril QD	1 spray each nostril QD after symptoms improve	2 sprays each nostril QD
Nasal allergy symptoms (OTC)	Children 6 to <12 yr	1 spray each nostril QD	1 spray each nostril QD after improvement	2 sprays each nostril QD
Nasal allergy symptoms (OTC)	Children 2 to <6 yr	1 spray each nostril QD	1 spray each nostril QD	1 spray each nostril QD

Renal Undefined

Hepatic Undefined

Intranasal use only; prime before first use and again if unused >2 weeks
Shake bottle before use
Do not spray into eyes or mouth
Children under 2 years: do not use
Stop and consult a doctor if no improvement after 1 week; consult if used more than 2 months/year in children

Pregnancy Undefined

Lactation Undefined

NO BOXED WARNINGS

Principal riskAdrenal suppression with prolonged systemic use

Cost, est. cash$4–$300/month

Generic entry1982

Therapeutic safety burden3 / 4

Overdose danger2 / 4

Weight-gain liability3 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryC

Defining liabilityHyperglycemia, infection, osteoporosis and potentially severe mood, sleep or psychotic effects.

Box: minimal PK interactions