fluocinonide (Rx)

Brand and Other Names:Lidemol, Lidex, more...Lyderm, Tiamol, Topactin, Topsyn, Vanos
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

cream

  • 0.05%
  • 0.1%

ointment/gel/topical solution

  • 0.05%

Corticosteroid Responsive Dermatoses

Apply thin layer topically qDay or q12hr to affected areas

Psoriasis

Apply thin layer topically qDay or q12hr to affected areas

Atopic Dermatitis

Apply thin layer topically qDay to affected areas

Dosage Forms & Strengths

cream

  • 0.05%
  • 0.1%

ointment/gel/topical solution

  • 0.05%

Corticosteroid Responsive Dermatoses

Apply thin layer topically qDay or q12hr to affected areas; limit to the minimum amount necessary for therapeutic efficacy

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Adverse Effects

Frequency Not Defined

Skin atrophy

Striae

Acneform lesions

Pigmentation changes

HPA suppression (with higher potency used >2 wk)

Intracranial hypertension

Hypopigmentation

Maceration of the skin

Miliaria

Folliculitis

Hyperglycemia

Cushing's syndrome

Telangiectasia

Hyperglycemia

Burning

Irritation

Glycosuria

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Warnings

Contraindications

Underlying infection (fungal, viral, or tubercular skin lesions, herpes simplex)

Hypersensitivity

Ophthalmic use

Cautions

Chronic topical corticosteroid 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

Kaposi's sarcoma reported with prolonged corticosteroid therapy

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

If possible, use lower potency for children (ie, increase BSA/kg, therefore increase systemic absorption)

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

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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.

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Pharmacology

Potency

High

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

Absorption: Minimal (~1%); nature of skin at application; occlusion and inflammation may increase absorption

Distribution: Throughout local skin

Metabolism: Skin (primarily)

Excretion: Urine (glucuronide and sulfate, also as unconjugated products); feces (small amounts as metabolites)

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Images

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Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

Adding plans allows you to:

  • View the formulary and any restrictions for each plan.
  • Manage and view all your plans together – even plans in different states.
  • Compare formulary status to other drugs in the same class.
  • Access your plan list on any device – mobile or desktop.

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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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.