Kenalog (Triamcinolone Acetonide) Injection: Kenalog-10 vs. -40 vs. -80, the Routes That Don't Overlap, and What to Check Before You Order

Kenalog is triamcinolone acetonide injectable suspension, and Bristol Myers Squibb makes it in three products: Kenalog-10, Kenalog-40, and Kenalog-80. They aren't interchangeable, because their approved routes don't fully overlap. Kenalog-10 isn't for intramuscular use. Kenalog-40 and -80 aren't for intradermal use. And none of them is for intravenous, intraocular, epidural, or intrathecal use (BMS).

That's why "just send Kenalog" is a bad order. Here's what to check.

What's the difference between Kenalog-10, -40, and -80?

The number is the concentration in mg/mL. The routes are what really separate them. From BMS's prescribing resources (BMS):

So a dermatology practice doing intralesional injections and an orthopedic practice doing IM injections are buying different products, even though both call it "Kenalog." Generic triamcinolone acetonide injectable suspensions exist too, each with its own label and NDC.

What does the Kenalog-40 label say about the vial?

From the Kenalog-40 label on Drugs@FDA (FDA label, rev. 2014):

• 40 mg/mL, in 1 mL, 5 mL, and 10 mL vials.
• It's a suspension: "Because Kenalog-40 Injection is a suspension, it should not be administered intravenously."
• It contains 0.99% benzyl alcohol as a preservative, and the label says "NOT FOR USE IN NEONATES."
• The label's capitalized warning: "NOT FOR INTRAVENOUS, INTRADERMAL, INTRAOCULAR, EPIDURAL, OR INTRATHECAL USE."
• On epidural use specifically: "Serious neurologic events, some resulting in death, have been reported with epidural injection of corticosteroids," and corticosteroids "are not approved for this use."

That label is from 2014. Check the current label for the NDC you buy.

Why does storage matter so much for a suspension?

Because freezing ruins it, and you can see it when it's ruined. The label says to shake the vial before use for a uniform suspension, check for clumping, and not to use product that has clumped from freezing: an "agglomerated product results from exposure to freezing temperatures and should not be used" (FDA label).

Storage per the label: 20°C to 25°C (68°F to 77°F), avoid freezing, protect from light, and don't refrigerate.

Two purchasing consequences:

• Winter shipping is a real question. Ask your supplier how it protects room-temperature products from freezing in transit.
• Don't keep it in the drug fridge with everything else. It isn't a refrigerated product.

Single vial or bigger vial?

The label doesn't call the Kenalog-40 vials multiple-dose. Your clinicians and your policy decide how a vial is used, so ask before you buy the 10 mL vials to save money. If the vials are used as single-dose in practice, the bigger size is mostly waste. Our single-dose vs. multiple-dose vials guide covers the rules.

Ordering checklist

• Order by product name *and* NDC: Kenalog-10, -40, or -80, or the exact generic. If you're not sure what an NDC is, look it up.
• Keep -10 and -40/-80 in separate, labeled bins. Their routes don't overlap, and the vials look alike.
• Store at room temperature, out of the fridge, in the carton.
• Inspect on receipt. Clumped suspension after shipping is a return, not a shake-harder.
• Ask before a substitute ships. A generic triamcinolone can have a different concentration, vial size, or label.

Order triamcinolone from Premier

Premier Pharma supplies licensed orthopedic, dermatology, and primary care practices, clinics, and pharmacies, and every invoice lists the lot number and expiration date for each item. Want to order Kenalog or generic triamcinolone? Contact our team for current availability and pricing. Open a free account. Credential review typically takes 1–2 business days.

Sources

• Bristol Myers Squibb. Kenalog-10, Kenalog-40, and Kenalog-80 prescribing resources for healthcare professionals.
• Bristol-Myers Squibb. Kenalog-40 Injection (triamcinolone acetonide injectable suspension, USP) label. Rev. July 2014. Drugs@FDA.