Kenacort Warnings

Persons on drugs eg, corticosteroids that suppress the immune system are more susceptible to infections than other individuals. Chicken pox (varicella) and measles eg, can have a more serious or even fatal course in non-immune children or adults on corticosteroids. In children or adults who have not had chicken pox or measles, particular care should be taken to avoid exposure. If exposed to chicken pox, prophylaxis with varicella zoster immune globulin (VZIG) may be indicated. If exposed to measles, prophylaxis with pooled IM immunoglobulin (IG) may be indicated. If chicken pox develops, treatment with antiviral agents should be considered.
Corticosteroids may mask some signs of infection and new infections may appear during their use. There may be decreased resistance and inability to localize infection when corticosteroids are used. If an infection occurs during corticosteroid therapy, it should be promptly controlled by suitable antimicrobial therapy. Prolonged use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves and may enhance the establishment of secondary ocular infections due to fungi or viruses.
Salt and water retention as well as increased excretion of potassium can occur, although they are less likely to occur with the synthetic derivatives eg, triamcinolone than with hydrocortisone or cortisone, except when they are used in large doses; dietary salt restriction and potassium supplementation may be necessary. All corticosteroids increase calcium excretion.
Patient should not be vaccinated against smallpox while on corticosteroid therapy. Other immunization procedures should not be undertaken in patients who are on corticosteroids, especially on high dose because of possible hazards of neurological complications and a lack of antibody response.
The use of triamcinolone in patients with active tuberculosis should be restricted to those cases of fulminating or disseminated tuberculosis in which the corticosteroid is used for the management of the disease in conjunction with an appropriate antituberculous regimen. If corticosteroids are indicated in patients with latent tuberculosis or tuberculin reactivity, close observation is necessary since re-activation of the disease may occur. During prolonged corticosteroid therapy, these patients should receive chemotherapy.