Is Kenalog Being Discontinued? A Regional Overview
The status of Kenalog, a brand name for the corticosteroid triamcinolone acetonide, is not uniform across all countries. The confusion stems from different announcements and supply issues in various regions, leading to widespread questions about its future availability.
The Situation in the UK and Canada
In the UK, health authorities like the NHS have issued medicine supply notifications confirming the discontinuation of both Kenalog (40mg/ml) and its counterpart, Adcortyl (10mg/ml) injectable suspensions. Stock was expected to be exhausted by early June 2025. A similar discontinuation of Kenalog-10 and Kenalog-40 was confirmed in Canada by August 2025, citing a disruption in manufacture with an estimated end date of December 30, 2025. This phased withdrawal means that a transition to alternative therapies has been necessary since mid-2025 for many.
The Situation in the United States
In the U.S., the situation is primarily one of widespread shortage rather than a definitive discontinuation of the entire Kenalog injectable line. As of September 2025, BMS reported Kenalog-40 injectable vials as being on backorder with no estimated release date, though limited supply of Kenalog-80 may be available. In addition to the branded product, generic triamcinolone acetonide injectable suspensions have also been reported on backorder from various manufacturers like Teva, Eugia, and Viatris, indicating a broader supply chain issue.
Why Is Kenalog Discontinued or in Shortage?
Several factors contribute to the regional discontinuation and ongoing shortages of Kenalog and its generic alternatives.
Commercial and Supply Chain Factors
Decisions to discontinue products, particularly in regions like the UK, are often based on commercial viability. If production costs or market trends make a specific formulation less profitable, manufacturers may withdraw it. Additionally, global supply chain disruptions have impacted the availability of raw materials and production, leading to both shortages and permanent market removal for some products.
Shifting Clinical Landscape
Evolving clinical practices and the increased use of alternative corticosteroids, newer delivery systems, or non-steroidal treatments like hyaluronic acid or biologics can also contribute to lower demand for older products like Kenalog.
What Are the Alternatives to Kenalog Injections?
Several alternatives are available for patients and clinicians facing Kenalog unavailability, with the best choice depending on the specific condition.
Alternative Corticosteroid Injections
Other injectable corticosteroids can serve as direct alternatives for conditions such as musculoskeletal issues, allergies, and certain skin conditions. These include:
- Methylprednisolone acetate (Depo-Medrone): Often considered a primary alternative for joint and soft-tissue injections due to comparable potency and duration, though with finer particles potentially safer for superficial use.
- Dexamethasone: Another alternative, particularly noted for ophthalmic conditions.
- Hydrocortisone: An available option to support increased demand for certain indications.
Oral Steroids and Other Alternatives
Oral corticosteroids like Prednisone and Methylprednisolone (Medrol) may be considered for systemic issues or severe allergic reactions. Non-steroidal options such as NSAIDs for pain and inflammation or hyaluronic acid injections for musculoskeletal conditions are also potential alternatives.
How to Manage the Transition: A Guide for Patients and Clinicians
Managing this change effectively requires communication and planning.
For clinicians:
- Review Stock and Plan: Check current Kenalog supply and plan for its depletion.
- Understand Alternatives: Familiarize yourself with alternative corticosteroids, including dosages and indications.
- Communicate: Explain the situation to patients, address concerns, and reassure them about alternative treatments.
For patients:
- Consult Your Doctor: Do not stop treatment suddenly. Talk to your healthcare provider about transitioning to a suitable alternative.
- Ask Questions: Learn about recommended alternatives, their potential side effects, and what to expect during the transition.
Comparison of Kenalog and Common Alternatives
| Feature | Kenalog (Triamcinolone) Injectable | Depo-Medrone (Methylprednisolone) Injectable | Dexamethasone Injectable |
|---|---|---|---|
| Potency | Intermediate-acting; about 5x hydrocortisone. | Intermediate-acting; about 5x hydrocortisone. | Long-acting; high potency. |
| Action | Slow-releasing depot injection; lasts weeks. | Slow-releasing depot injection; lasts weeks. | Faster onset, shorter duration for some effects. |
| Uses | Joints, soft tissues, skin. | Joints, soft tissues, skin. | Severe allergies, ophthalmic, inflammatory. |
| Particles | Larger crystal size than Depo-Medrone; increased risk of superficial side effects in some areas. | Finer particle size; less likely to cause superficial side effects like skin thinning. | Soluble, fast absorption. |
Conclusion: Navigating the End of an Era
The withdrawal of branded injectable Kenalog represents a notable change, but numerous alternatives are available to ensure continuous care. Both patients and healthcare providers must stay informed and adapt to the changing landscape of pharmaceutical supply. Consulting a doctor for personalized advice is essential for managing medication changes effectively.
For updated information on specific drug shortages in the U.S., you can refer to the American Society of Health-System Pharmacists (ASHP) Drug Shortages page: ASHP Drug Shortages.
