Lidemol, Lidex (fluocinonide) dosing, indications, interactions, adverse effects, and more

Sections

Sections fluocinonide
Dosing & Uses
Adverse Effects
Warnings
Pregnancy
Pharmacology
Images
Patient Handout
Formulary

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

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

Contraindications

Hypersensitivity to drug or excipients

Cautions

Chronic topical corticosteroid therapy may interfere with growth and development in children

Use high potency med 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

Systemic absorption of topical corticosteroids has produced reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, manifestations of Cushing's syndrome, hyperglycemia, and glucosuria in some patients

Conditions which augment systemic absorption include application of potent steroids, use over large surface areas, prolonged use, and addition of occlusive dressings

Patients receiving a large dose of a potent topical steroid applied to a large surface area or under an occlusive dressing should be evaluated periodically for evidence of HPA axis suppression by using the urinary free cortisol and ACTH stimulation tests; if HPA axis suppression is noted, an attempt should be made to withdraw the drug, to reduce frequency of application, or to substitute a less potent steroid

Recovery of HPA axis function is generally prompt and complete upon discontinuation of drug; infrequently, signs and symptoms of steroid withdrawal may occur, requiring supplemental systemic corticosteroids

Prolonged use may produce atrophy of skin and subcutaneous tissues; when used on intertriginous or flexor areas, or on face, this may occur even with short-term use

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

In presence of dermatological infections, the use of an appropriate antifungal or antibacterial agent should be instituted; if a favorable response does not occur promptly, corticosteroid should be discontinued until infection has been adequately controlled

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

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.

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)

BRAND	FORM.	UNIT PRICE	PILL IMAGE
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.05 % gel
fluocinonide topical -	0.05 % solution
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.05 % solution
fluocinonide topical -	0.05 % gel
fluocinonide topical -	0.05 % solution
fluocinonide topical -	0.05 % solution
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.05 % cream
fluocinonide topical -	0.05 % cream
fluocinonide topical -	0.05 % cream
fluocinonide topical -	0.05 % cream
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.05 % gel
fluocinonide topical -	0.05 % solution
fluocinonide topical -	0.05 % solution
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.05 % gel
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.05 % cream
fluocinonide topical -	0.05 % cream
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.05 % gel
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.05 % solution
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.05 % cream
fluocinonide topical -	0.05 % cream
fluocinonide topical -	0.05 % cream
fluocinonide topical -	0.05 % cream
fluocinonide topical -	0.05 % cream
fluocinonide topical -	0.05 % gel
fluocinonide topical -	0.05 % gel
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.05 % solution
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.05 % solution
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.05 % solution
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.05 % gel
fluocinonide topical -	0.05 % gel
fluocinonide topical -	0.05 % gel
fluocinonide topical -	0.1 % cream
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.05 % ointment
fluocinonide topical -	0.05 % cream
Vanos topical -	0.1 % cream
Vanos topical -	0.1 % cream
Vanos topical -	0.1 % cream

Patient Handout

FLUOCINONIDE - TOPICAL

(FLOO-oh-SIN-oh-nide)

COMMON BRAND NAME(S): Fluovix, Lidex, Vanos

USES: This medication is used to treat a variety of skin conditions (such as eczema, dermatitis, psoriasis, allergies, rash). Fluocinonide reduces the swelling, itching, and redness that can occur in these types of conditions. This medication is a strong corticosteroid.

HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start using fluocinonide and each time you get a refill. If you have any questions, ask your doctor or pharmacist.This medication is for use on the skin only. Do not use it on the face, groin, or underarms unless directed to do so by your doctor.Wash and dry your hands before applying the medication, then clean and dry the affected area. Apply a thin film of the medication to the affected area and gently rub in as directed by your doctor, usually 1 to 4 times daily depending on your brand. Follow your doctor's instructions carefully. Do not cover, bandage, or wrap the area unless directed to do so by your doctor.After applying the medication, wash your hands unless you are using this medication to treat the hands. If applying this medication near the eyes, avoid getting it in the eyes as this may worsen or cause glaucoma. Also avoid getting this medication in the nose or mouth. If you get the medication in these areas, rinse with plenty of water.Use this medication only for the condition prescribed. Do not use it for longer than 2 weeks in a row or use more than 60 grams per week unless directed to do so by your doctor.Tell your doctor if your condition lasts or gets worse after 2 weeks of treatment.

SIDE EFFECTS: Burning, stinging, itching, dryness, or redness may occur when this medication is first applied to the skin. This should disappear in a few days as your body adjusts to the medication. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: stretch marks, skin thinning/discoloration, acne, extreme/unwanted hair growth, small red bumps on the skin (folliculitis).Skin infections can become worse when this medication is used. Tell your doctor if redness, swelling, or irritation do not get better.Rarely, it is possible this medication will be absorbed from the skin into the bloodstream. This can lead to side effects of too much corticosteroid. These side effects are more likely in children, and in people who use this medication for a long time or over large areas of the skin. Tell your doctor right away if any of the following side effects occur: unusual/extreme tiredness, weight loss, headache, swelling ankles/feet, increased thirst/urination, vision problems.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using fluocinonide, tell your doctor or pharmacist if you are allergic to it; or to other corticosteroids (such as hydrocortisone, prednisone); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: poor blood circulation, immune system problems.Do not use if there is an infection or sore present in the area to be treated.Rarely, using corticosteroid medications for a long time or over large areas of skin can make it more difficult for your body to respond to physical stress. Before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used this medication within the past few months.Though it is unlikely, this medication may temporarily slow down a child's growth if used for a long time. See the doctor regularly so your child's height can be checked.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk when applied to the skin. Similar medications pass into breast milk when taken by mouth. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

OVERDOSE: This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for another condition unless your doctor tells you to.Lab tests (such as adrenal gland function tests) should be done while you are using this medication, especially if you use this medication for an extended period of time or apply it over large areas of the body. Consult your doctor for more details. Keep all medical and lab appointments.

MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

STORAGE: Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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.

View explanations for tiers and restrictions

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.

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

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