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Drug Safety-related Labeling Changes (SrLC)

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KENALOG-40 (NDA-014901)

(TRIAMCINOLONE ACETONIDE)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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06/22/2018 (SUPPL-45)

Approved Drug Label (PDF)

5 Warnings and Precautions

PRECAUTIONS

Adverse Reactions

Addition of the following to the Endocrine listing:

postmenopausal vaginal hemorrhage,

 

Drug Interactions

Addition of the following:

CYP3A4 inhibitors: Triamcinolone acetonide is a substrate of CYP3A4. Ketoconazole has been reported to decrease the metabolism of certain corticosteroids by up to 60%, leading to an increased risk of corticosteroid side effects. Co-administration of other strong CYP3A4 inhibitors (e.g., ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, telithromycin, cobicistat-containing products) with Kenalog-10 Injection may cause increased plasma concentration of triamcinolone leading to adverse reactions. During postmarketing use, there have been reports of clinically significant drug interactions in patients receiving triamcinolone acetonide and strong CYP3A4 inhibitors (e.g., ritonavir). Consider the benefit-risk of concomitant use and monitor for systemic corticosteroid side effects.