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Class: Corticosteroid, Topical
- Ointment 0.1%
- Cream 0.1%
- Solution 0.1%
Mechanism of Action
Produces anti-inflammatory, antipruritic, and vasoconstrictive
effects by an unknown mechanism.
Topical steroids can be absorbed from intact skin. Occlusive
dressings, inflammation, and other disease processes in the skin
increase percutaneous absorption of topical steroids.
Once absorbed, corticosteroids are variably bound to plasma
Corticosteroids are metabolized primarily in the liver.
Corticosteroids are excreted primarily by the kidneys and to
varying amounts into the bile.
Indications and Usage
Relief of inflammation and pruritus caused by
Dosage and Administration
Adults and Children
Topical Apply thin film to affected area bid to tid.
- For topical use only. Not for
ophthalmic, oral, or intravaginal use.
- Do not apply to face, groin, or
axillae unless directed by health care provider.
- Apply medication sparingly but in
sufficient quantity to cover affected area(s); rub in gently.
- If using solution on scalp, part the
hair, apply a small amount of the medicine on the affected area,
rub it in gently, and protect the area from washing and rubbing
until the solution dries. Advise patient that they may wash hair as
usual but not immediately after applying the medicine.
- Avoid contact with the eyes. If
medication does come into contact with the eyes, wash them with
large amounts of cool water.
Store at room temperature, away from excessive heat. Avoid
freezing and refrigeration.
None well documented.
Laboratory Test Interactions
None well documented.
Acneiform eruptions; allergic contact dermatitis; burning;
dryness; folliculitis; hypertrichosis; hypopigmentation; itching;
irritation; maceration of the skin; miliaria; perioral dermatitis;
secondary infection; skin atrophy; striae.
Assess and document skin condition before initial application
and periodically throughout treatment. Inform health care provider
if condition does not improve, worsens, or if application site
Category C .
Undetermined effect. Exercise caution when topical
corticosteroids are administered to a breastfeeding woman.
Safety and efficacy not established for children younger than 12
yr of age. Because of higher ratio of skin surface area to body
mass, children are at higher risk than adults for
hypothalamic-pituitary-adrenal (HPA) axis suppression and Cushing
syndrome when they are treated with topical corticosteroids.
Large doses applied to large surface area or under an occlusive
dressing may lead to HPA suppression. If HPA axis suppression is
noted, consider drug withdrawal, reduced frequency of application,
or substitution of a less potent steroid. Recovery of HPA axis
function is generally prompt and complete upon discontinuation of
the corticosteroid. Signs and symptoms of withdrawal may require
supplemental systemic corticosteroids.
Prolonged use of topical corticosteroids may produce atrophy of
the skin and subcutaneous tissues.
Adverse effects are more common when occlusive dressings are
- Explain name, action, and potential
side effects of drug.
- Advise patient to apply medication bid
to tid as directed by health care provider.
- Caution patient not to apply in
greater quantity or more frequently than prescribed by health care
- Teach patient or caregiver following
application technique: wash or soak the affected area before
applying medication, unless it irritates the affected area(s); wash
hands; apply sufficient cream, ointment, or solution to cover
affected area(s) sparingly, then gently massage into skin; wash
hands after applying.
- Advise patient using solution on scalp
to part the hair, apply a small amount of the medicine on the
affected area, rub it in gently, then protect the area from washing
and rubbing until the solution dries. Patient may wash hair as
usual but not immediately after applying the medicine.
- Advise patient who has been advised to
use an occlusive dressing to cover the area with plastic wrap (such
as Saran Wrap or Handi-Wrap ) after applying medication to affected
area(s). The plastic may be held in place with a gauze or elastic
bandage or adhesive tape on the normal skin beside the treated
area. Advise patient that instead of using plastic wrap, plastic
gloves may be used for the hands, plastic bags for the feet, or a
shower cap for the scalp; leave the plastic wrapping or covering in
place as long as instructed by health care provider. Instruct
patient to cleanse the skin and reapply the medication each time a
new plastic wrapping is applied.
- Advise patient that if an application
is missed, to apply it as soon as remembered and then continue on
regular schedule. If it is almost time for the next application,
instruct patient to skip the application and continue on regular
schedule. Caution patient not to apply double doses.
- Caution patient not to apply to face,
underarms, or groin area unless directed by health care
- Caution caregiver of pediatric patient
not to use tight-fitting diapers or plastic pants on a child being
treated in the diaper area.
- Caution patient not to bandage, cover,
or wrap treated skin areas or use cosmetics or other skin products
over treated areas unless advised by health care provider.
- Caution patient to avoid contact with
the eyes. Advise patient that if medication does come into contact
with the eyes to wash them with large amounts of cool water and to
contact health care provider if eye irritation occurs.
- Advise patient that symptoms should
begin to improve fairly soon after starting treatment and to notify
health care provider if condition does not improve, worsens, or if
application site reactions (eg, burning, stinging, redness,
- Advise patient that therapy is usually
discontinued when control has been achieved.
- Advise women to notify health care
provider if pregnant, planning to become pregnant, or
- Caution patient not to take any
prescription or OTC drugs, herbal preparations, or dietary
supplements without consulting health care provider.
- Advise patient that follow-up visits
to monitor response to treatment may be required and to keep
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