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Isotretinoin and Kenalog-40

Determining the interaction of Isotretinoin and Kenalog-40 and the possibility of their joint administration.

Check result:

Isotretinoin <> Kenalog-40

Relevance: 12.09.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Both ISOtretinoin and triamcinolone can weaken bones during prolonged use, and combining these medications may increase the risk of osteoporosis and bone fractures. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Theoretical concerns exist that isotretinoin and corticosteroids may have additive effects on bone loss. Decreased bone mineral density (osteomalacia, osteopenia, osteoporosis) and bone fractures have been reported with either treatment alone during prolonged administration. Avascular necrosis has also been reported with corticosteroids, particularly when given in high dosages or for prolonged periods. However, no formal clinical trials have been conducted to evaluate whether there is an interactive effect on bone loss during coadministration.

MANAGEMENT: Caution is advised when isotretinoin is used in combination with corticosteroids, particularly in patients with a history of osteomalacia, osteoporosis, or other disorders of bone metabolism. Bone-related laboratory and radiological tests should be considered.

References

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Ledford D, Apter A, Brenner AM, Rubin K, Prestwood K, Frieri M, Lukert B "Osteoporosis in the corticosteroid-treated patient with asthma." J Allergy Clin Immunol 102 (1998): 353-62
Fast A, Alon M, Weiss S, Zer-Aviv FR "Avascular necrosis of bone following short-term dexamethasone therapy for brain edema. Case report." J Neurosurg 61 (1984): 983-5
Need AG, Philcox JC, Hartley TF, Nordin BE "Calcium metabolism and osteoporosis in cortiscosteroid-treated postmenopausal women." Aust N Z J Med 16 (1986): 341-6
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McCluskey J, Gutteridge DH "Avascular necrosis of bone after high doses of dexamethasone during neurosurgery." Br Med J (Clin Res Ed) 284 (1982): 333-4
Mizuta H, Kubota K, Shiraishi M, Kai K, Nakamura E, Takagi K "Steroid-related bilateral osteonecrosis of the patella." Arthroscopy 9 (1993): 114-6
Goldstein MF, Fallon JJ, Harning R "Chronic glucocorticoid therapy-induced osteoporosis in patients with obstructive lung disease." Chest 116 (1999): 1733-49
Cruess RL "Experience with steroid-induced avascular necrosis of the shoulder and etiologic considerations regarding osteonecrosis of the hip." Clin Orthop Jan-Feb(13 (1978): 86-93
Anderton JM, Helm R "Multiple joint osteonecrosis following short-term steroid therapy. Case report." J Bone Joint Surg Am 64 (1982): 139-41
Williams IA, Mitchell AD, Rothman W, Tallett P, Williams K, Pitt P "Survey of the long term incidence of osteonecrosis of the hip and adverse medical events in rheumatoid arthritis after high dose intravenous methylprednisolone." Ann Rheum Dis 47 (1988): 930-3
Archer AG, Nelson MC, Abbondanzo SL, Bogumill GP "Case report 554: Osteonecrosis at multiple sites as noted." Skeletal Radiol 18 (1989): 380-4
Marystone JF, Barrettconnor EL, Morton DJ "Inhaled and oral corticosteroids: their effects on bone mineral density in older adults." Am J Public Health 85 (1995): 1693-5
Black KA, Khangure MS, Owen ET "Dexamethasone and osteonecrosis." Aust N Z J Med 11 (1981): 521-5
Bijlsma JW, Duursma SA, Bosch R, Raymakers JA, Huber-Bruning O "Acute changes in calcium and bone metabolism during methylprednisolone pulse therapy in rheumatoid arthritis." Br J Rheumatol 27 (1988): 215-9
Mitchison HC, Bassendine MF, Malcolm AJ, et al "A pilot, double-blind, controlled 1-year trial of prednisolone treatment in primary biliary cirrhosis: hepatic improvement but greater bone loss." Hepatology 10 (1989): 420-9
"Product Information. Accutane (isotretinoin)." Roche Laboratories, Nutley, NJ.
Sambrook PN, Hassall JE, York JR "Osteonecrosis after high dosage, short term corticosteroid therapy." J Rheumatol 11 (1984): 514-6

Isotretinoin

Generic Name: isotretinoin

Brand name: Absorica, Amnesteem, Claravis, Myorisan, Sotret, Zenatane, Accutane

Synonyms: ISOtretinoin (Systemic)

What is Isotretinoin?

Kenalog-40

Generic Name: triamcinolone

Brand name: Kenalog-40, Zilretta, Aristocort, Azmacort

Synonyms: Kenalog-40 (injection)

What is Kenalog-40?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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