Triamcinolone Acetonide Injectable Suspension Shortage

• • Kenalog-40 injection, Bristol-Myers Squibb, 40 mg/mL, 1 mL vial, 1 count, NDC 00003-0293-05
  • Kenalog-80 injection, Bristol-Myers Squibb, 80 mg/mL, 5 mL vial, 1 count, NDC 00003-0315-20
  • Triamcinolone acetonide injection, Eugia US, 40 mg/mL, 10 mL vial, 1 count, NDC 55150-0385-01
  • Triamcinolone acetonide injection, Eugia US, 40 mg/mL, 5 mL vial, 1 count, NDC 55150-0384-01
  • Triamcinolone acetonide injection, Hikma, 40 mg/mL, 1 mL vial, 25 count, NDC 00143-9387-25
  • Triamcinolone acetonide injection, Long Grove Pharmaceuticals, 40 mg/mL, 10 mL vial, 1 count, NDC 81298-5783-03
  • Triamcinolone acetonide injection, Long Grove Pharmaceuticals, 40 mg/mL, 5 mL vial, 1 count, NDC 81298-5785-03
  • Triamcinolone acetonide injection, Mylan (Viatris), 40 mg/mL, 1 mL vial, 25 count, NDC 67457-0621-99
  • Triamcinolone acetonide injection, Mylan (Viatris), 40 mg/mL, 10 mL vial, 25 count, NDC 67457-0623-99
  • Triamcinolone acetonide injection, Mylan (Viatris), 40 mg/mL, 5 mL vial, 25 count, NDC 67457-0622-99
  • Triamcinolone acetonide injection, Teva, 40 mg/mL, 1 mL vial, 1 count, NDC 00703-0241-01
  • Triamcinolone acetonide injection, Teva, 40 mg/mL, 10 mL vial, 1 count, NDC 00703-0245-01
  • Triamcinolone acetonide injection, Teva, 40 mg/mL, 5 mL vial, 1 count, NDC 00703-0243-01

• • Amneal has triamcinolone acetonide injectable suspension available.
  • Eugia did not provide a reason for the shortage.
  • Hikma did not provide a reason for the shortage.
  • Long Grove has triamcinolone acetonide injectable suspension on shortage due to increased demand.
  • Teva did not provide a reason for the shortage.
  • Viatris did not provide a reason for the shortage.
  • BMS did not provide a reason for the shortage of Kenalog injectable suspension. The company is expecting a disruption this fall.

• • Kenalog-10 injection, Bristol-Myers Squibb, 10 mg/mL, 5 mL vial, 1 count, NDC 00003-0494-20
  • Kenalog-40 injection, Bristol-Myers Squibb, 40 mg/mL, 10 mL vial, 1 count, NDC 00003-0293-28
  • Kenalog-40 injection, Bristol-Myers Squibb, 40 mg/mL, 5 mL vial, 1 count, NDC 00003-0293-20
  • Kenalog-80 injection, Bristol-Myers Squibb, 80 mg/mL, 1 mL vial, 1 count, NDC 00003-0315-05
  • Triamcinolone acetonide injection, Amneal, 40 mg/mL, 1 mL vial, 25 count, NDC 70121-1049-05
  • Triamcinolone acetonide injection, Amneal, 40 mg/mL, 10 mL vial, 1 count, NDC 70121-1169-01
  • Triamcinolone acetonide injection, Amneal, 40 mg/mL, 5 mL vial, 1 count, NDC 70121-1168-01

Estimated Resupply Dates

• • BMS has Kenalog-40 1 mL vials on back order and the company cannot estimate a release date. Kenalog-80 in 5 mL vials are available in limited supply.
  • Eugia has triamcinolone acetonide injectable suspension in 40 mg/mL 5 mL and 10 mL vials on intermittent back order and the company is releasing product as it becomes available.
  • Hikma has triamcinolone acetonide injectable suspension in 40 mg/mL 1 mL vials on back order and the company estimates a release date in late-September to early-October 2025.
  • Long Grove has triamcinolone acetonide injectable suspension in 40 mg/mL 5 mL and 10 mL vials on allocation.
  • Teva has triamcinolone acetonide injectable suspension in 40 mg/mL 1 mL, 5 mL, and 10 mL vials on back order and the company cannot estimate a release date.
  • Viatris has triamcinolone acetonide injectable suspension in 40 mg/mL 1 mL, 5 mL, and 10 mL vials on back order and the company estimates a release date of early-August 2025 for the 1 mL and 5 mL vials and mid-August 2025 for the 10 mL vials.

Implications for Patient Care

• • Triamcinolone acetonide injection is commonly used as intralesional injections in dermatologic conditions and intraarticular injections for inflammatory joint diseases.[1]

Safety

• • Triamcinolone acetonide is available in 10 mg/mL, 40 mg/mL, and 80 mg/mL concentrations. Ensure adequate communication with administration staff when considering use of alternate product concentrations. [1]
  • Intralesional administration may require further dilution of triamcinolone acetate 40 mg/mL and 80 mg/mL products.[1]

Alternative Agents & Management

• • Refer to Table 1 for alternative corticosteroids available as depot injections. Alternative agents may also experience supply shortages.
  • Clinical guidelines from American Academy of Orthopaedic Surgeons (AAOS), American College of Rheumatology (ACR), European League Against Rheumatism (EULAR), and do not endorse one intraarticular corticosteroid over another for short-term pain relief in inflammatory joint diseases.[2-5]

  Table 1. Recommended Dosing of Corticosteroids Available as Depot Formulations [1 6 7]

  Agent	Intralesional Dosing	Large Joint Intraarticular Dosing	Medium Joint Intraarticular Dosing	Small Joint Intraarticular Dosing
  Triamcinolone acetonide	Maximum recommended dose: 40 mg per treatment sesison	20 - 40 mg	20 - 30 mg	8 - 10 mg
  Triamcinolone acetonide extended release	N/a	32 mg	32 mg	Not suitable
  Triamcinolone hexacetonide	N/a	10 - 20 mg	10 - 20 mg	2 - 6 mg
  Methylprednisolone acetate	20 - 40 mg distributed over 1-4 local injections, depending on lesion size	20 - 80 mg	10 - 20 mg	4 - 10 mg
  Betamethasone sodium phosphate/acetate	1.2 mg/cm2 Maximum dose: 6 mg	6 - 12 mg	3 - 6 mg	1.5 - 3 mg

  
  

References

• 1. Triamcinolone. UpToDate Lexidrug, Lexi-Drugs Online. Waltham, MA, 2023.
  2. Benzon HT, Provenzano DA, Nagpal A, et al. Use and safety of corticosteroid injections in joints and musculoskeletal soft tissue: guidelines from the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, the American Society of Interventional Pain Physicians, and the International Pain and Spine Intervention Society. Regional anesthesia and pain medicine 2025 doi: 10.1136/rapm-2024-105656[published Online First: Epub Date]|.
  3. Brophy RH, Fillingham YA. AAOS Clinical Practice Guideline Summary: Management of Osteoarthritis of the Knee (Nonarthroplasty), Third Edition. The Journal of the American Academy of Orthopaedic Surgeons 2022;30(9):e721-e29 doi: 10.5435/jaaos-d-21-01233[published Online First: Epub Date]|.
  4. Navani A, Manchikanti L, Albers SL, et al. Responsible, Safe, and Effective Use of Biologics in the Management of Low Back Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines. Pain physician 2019;22(1s):S1-s74
  5. Uson J, Rodriguez-Garc­a SC, Castellanos-Moreira R, et al. EULAR recommendations for intra-articular therapies. Annals of the rheumatic diseases 2021;80(10):1299-305 doi: 10.1136/annrheumdis-2021-220266[published Online First: Epub Date]|.
  6. Betamethasone. UpToDate Lexidrug, Lexi-Drugs Online. Waltham, MA, 2023.
  7. Methylprednisolone. UpToDate Lexidrug, Lexi-Drugs Online. Waltham, MA, 2023.