Dosing & Uses
Dosage Forms & Strengths
cream/ointment/lotion
- 0.1%
Corticosteroid-Responsive Dermatoses
Applied sparingly in a thin film to the affected area q8-12hr
Dosage Forms & Strengths
cream/ointment/lotion
- 0.1%
Corticosteroid-Responsive Dermatoses
Apply sparingly to affected area(s) q12hr
Limit to minimum amount necessary for therapeutic efficacy
Avoid face
Adverse Effects
Frequency Not Defined
Skin atrophy
Striae
Burning
Dryness
Irritation
Itching
Hypertrichosis
Acneform lesions
Secondary infection
Pigmentation changes
HPA suppression (with higher potency used >2 wk)
Warnings
Contraindications
Underlying infection
Hypersensitivity
Use on groin, face, or axila
Ophthalmic use
Cautions
Chronic therapy may interfere with growth and development in children
Use med to very high potency for <2 wk to reduce local and systemic side effects
Use low potency for chronic therapy
Allergic contact dermatitis may occur
Should not use occlusive dressings in presence of infection or weeping lesions
Adrenal suppression may occur in younger patients or patients receiving high doses for prolonged periods
Development of Kaposi's sarcoma with prolonged use reported (discontinue therapy if it occurs)
Avoid medium to very high potency on face, folds, groin because can increase steroid absorption
Use lower potency for peds (ie, increase BSA/kg, therefore increase systemic absorption)
Pregnancy & Lactation
Pregnancy Category: C
Lactation: It is not known whether topical administration of topical corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk. 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.Pharmacology
Absorption: yes
Potency
High potency
Relative potency: ointment >cream >lotion >solution
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
Metabolism: Liver
Excretion: Urine; feces
Absorption: Absorbed through intact skin; increases absorption with kin oclusion or inflammation
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Formulary
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