Kenacort Special Precautions

As with all corticosteroids, patients should be observed for increased weight, edema, hypertension and excessive potassium excretion as well as less obvious signs of adrenocortical steroid untoward effects. A liberal protein intake is essential during prolonged therapy.
Drug-induced secondary adrenocortical insufficiency may be minimized by a gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress (eg, trauma, surgery or severe illness) occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently.
There is an enhanced corticosteroid effect in patients with hypothyroidism and in those with cirrhosis.
Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
The lowest possible dose of corticosteroid should be used to control the condition being treated. A gradual reduction in dosage should be made when possible.
Psychic derangements may appear when corticosteroids are used. These may range from euphoria, insomnia, mood swings, personality changes and severe depression to frank psychotic manifestations. Existing emotional instability or psychotic tendencies may also be aggravated by corticosteroids.
Salicylates should be used cautiously in conjunction with corticosteroids in patients with hypoprothrombinemia.
Corticosteroids should be used with caution in patients with nonspecific ulcerative colitis if there is a probability of impending perforation, abscess or other pyogenic infection. Corticosteroids should also be used cautiously in patients with diverticulitis, fresh intestinal anastomoses, active or latent peptic ulcer, renal insufficiency, hypertension, osteoporosis, acute glomerulonephritis, vaccinia, varicella, exanthema, Cushing's syndrome, antibiotic-resistant infections, diabetes mellitus, congestive heart failure, chronic nephritis, thromboembolitic tendencies, thrombophlebitis, convulsive disorders, metastatic carcinoma and myasthenia gravis.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.
Menstrual irregularities may occur and this possibility should be mentioned to female patients past menarche.
Triamcinolone, like other glucocorticoids, may aggravate diabetes so that higher dosages of insulin or hypoglycemic agents may become necessary. Triamcinolone may also precipitate the manifestations of diabetes mellitus from a previously latent state. Continued supervision of the patient after termination of corticosteroid therapy is essential since there may be a sudden reappearance of severe manifestations of the disease for which the patient was treated.
Use in pregnancy & lactation: Since adequate human reproduction studies have not been done with corticosteroids, the use of these drugs in pregnancy, nursing mothers or women of childbearing potential requires that the possible benefits of the drug be weighed against the potential hazards to the mother and the embryo, fetus or nursing infant. Infants born of mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism. It is not known whether Kenacort is excreted in breast milk. However, the other corticosteroids have been shown to be excreted in small quantities in human breast milk.