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fluticasone topical (Rx)Brand and Other Names:Cutivate

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

cream

  • 0.05%

ointment

  • 0.005%

lotion

  • 0.05%
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Atopic Dermatitis

Cream/lotion: Apply qDay-q12hr; reassess diagnosis if no improvements within 2 weeks

Corticosteroid-responsive Dermatoses

Cream/lotion: Apply qDay or q12hr; reassess diagnosis if no improvements within 2 weeks

Dosage Forms & Strengths

cream

  • 0.05%

lotion

  • 0.05%
more...

Atopic Dermatitis

Lotion

  • <3 months: Safety & efficacy not established
  • >3 months: As adults; apply cream/lotion sparingly qDay-q12hr

Lotion

  • <1 year: Safety & efficacy not established
  • >1 year: As adults; apply sparingly qDay

Corticosteroid-responsive Dermatoses

Cream

  • <3 months: Safety & efficacy not established
  • >3 months: Apply qDay or q12hr; reassess diagnosis if no improvements within 2 weeks
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Adverse Effects

1-10%

Pruritus (2.9%)

Dryness (1.2%)

Skin irritation: (3%)

Eczema (1%)

Telangiectasia (2-5%)

Numbness of fingers (1%)

<1%

Burning

Folliculitis

Acneiform lesions

Urticaria

Hypertrichosis

Lightheadedness

Viral

Warts

Impetigo

Skin infection

Frequency Not Defined

Striae

Pigmentation changes

HPA suppression (with higher potency used >2 wk)

Erythema

Cushing syndrome

Sepsis

Hemorrhage reported

Edema/swelling

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Warnings

Contraindications

Hypersensitivity

Underlying infection

Skin atrophy

Perioral dermatitis

Rosacea

Ophthalmic use

Cautions

Safety/efficacy in peds use longer than 4 wk not established

Ointment not indicated for atopic dermatitis

Use med to very high potency for <2 wk to reduce local and systemic side effects

Use low potency for chronic therapy

Reversible HPA axis suppression and resulting clinical glucocorticoid insufficiency can occur during or after withdrawal of treatment; risk factors include use over large surface area, prolonged use, use under occlusion, altered skin barrier, liver failure, and young age; children may exhibit greater susceptibility to corticosteroid-induced HPA axis suppression and Cushing's syndrome due to larger skin surface area to body weight ratio; modify use if HPA axis suppression is suspected;

Avoid medium to very high potency on face, folds, groin because can increase steroid absorption

Use lower potency for children (ie, increase BSA/kg, therefore increase systemic absorption)

Contains imidurea as excipient which releases formaldehyde as a breakdown product; may cause allergic sensitization or irritation upon contact

May cause irritation, folliculitis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, secondary infection, skin atrophy, striae, hypertrichosis, and miliaria; especially with high-potency or occlusive dressings

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Pregnancy & Lactation

Pregnancy Category: C

Lactation: Excretion in milk unknown; use with caution

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

more...
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Pharmacology

Mechanism of Action

Corticosteroids decrease inflammation by stabilizing leukocyte lysosomal membranes, preventing release of destructive acid hydrolases from leukocytes; inhibiting macrophage accumulation in inflamed areas; reducing leukocyte adhesion to capillary endothelium; reducing capillary wall permeability and edema formation; decreasing complement components; antagonizing histamine activity and release of kinin from substrates; reducing fibroblast proliferation, collagen deposition, and subsequent scar tissue formation

Pharmacokinetics

Absorption: 6% (animal studies; 5% systemic, 1% in skin)

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Images

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Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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