"Allergy Shot" Caveat

What is your opinion of using intramuscular (IM) injections of corticosteroids, such as triamcinolone( acetonide, for seasonal allergies?
—David Araujo, MD
  Merced, Calif

This practice should be avoided. Intramuscular triamcinolone acetonide can last for 4 to 6 weeks in the body and can inhibit normal adrenal function. If the injection is given in hip fat tissue, it can cause subcutaneous fat necrosis.

Safe and effective low-dose topical nasal corticosteroids are now available for first-line treatment of seasonal allergies. They can be used regularly to control nasal symptoms for the entire pollen season without the adverse effects seen with IM triamcinolone acetonide.

—Donald Pulver, Jr, MD
   Assistant Clinical Professor of Medicine
   University of Rochester
   Rochester, NY