My past doctor in another state had me on Kenalog shot 80 mg, every 3.5 months. I have since moved to another state bringing along my past medical records for my new doctor. He said his program does not provide him with Kenalog and so he gave me a shot of Decadron 4 mg every three months. It has been a week since my shot and my allergies are starting to return. What is the difference between the two, and which one is better? Should I seek another doctor or can I go to a clinic and get my shots there since I have my past medical records with me?
Decadron® (dexamethasone) 4 mg is not the therapeutic equivalent of Kenalog® (triamcinolone acetonide) 80 mg. Using the Lexi-Calc corticosteroid conversion formula, the ratio of the 2 would be close to 5:1. So it would take Decadron® (dexamethasone) 16 mg to be approximately the equivalent of Kenalog® (triamcinolone acetonide) 80 mg.
Decadron® (dexamethasone) is characterized as a "long-acting" steroid and Kenalog® (triamcinolone acetonide) is an "intermediate-acting" steroid. Thus duration of action of Decadron® (dexamethasone) is somewhat longer than that of Kenalog® (triamcinolone acetonide). Along with the lower Decadron® (dexamethasone) dosage at 4 mg vs 80 mg, this may account for the resurgence of your symptoms. You may want to ask your doctor if he can special-order the Kenalog® (triamcinolone acetonide) or would he be willing to increase the dose of Decadron® (dexamethasone).
Finally, both of you may want to consider the substitution of a prescription steroid spray, be it for nose/sinuses or lungs, to provide the same benefit with less risk of side effects.
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