Adult Dosing

Mild to moderate atopic dermatitis [hydrocortisone butyrate]

• Apply to affected area(s) as a thin film bid, (Max: 4 wks)

Corticosteroid-responsive dermatoses

• Apply to affected area(s) as a thin film bid-tid, (Max: 2 wks)[hydrocortisone butyrate/hydrocortisone valerate]
• Apply to affected area(s) as a thin film bid-qid [hydrocortisone]

Note:

• Do not use occlusive dressing

Pediatric Dosing

Mild to moderate atopic dermatitis (>3 months) [hydrocortisone butyrate]

• Apply to affected area(s) as a thin film bid, (Max: 4 wks)

Corticosteroid-responsive dermatoses

• Pediatric dosing not available

Note:

• Do not use occlusive dressing

[Outline]

• Adult Dosing
• Pediatric Dosing

• Mild-moderate atopic dermatitis [hydrocortisone butyrate]
• Inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses in adult patients

• Hypersensitivity to any of the ingredients of the product

• N/A

Renal Dose Adjustment

• Renal impairment: No dose adjustments

Hepatic Dose Adjustment

• Hepatic impairment: No dose adjustments

See Supplemental Patient Information

• Reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome, hyperglycemia and glucosuria may occur due to systemic absorption of topical hydrocortisone, application of the more potent steroids over large surface areas, prolonged use and occlusive dressing increase systemic absorption. Monitor the patient periodically for HPA axis suppression, discontinue or reduce the frequency of application, or substitute with a less potent steroid, if HPA-axis suppression is noted
• Pediatric patients are more susceptible to systemic toxicity (HPA axis suppression, Cushing's syndrome and intracranial hypertension) as proportionally larger amounts of topical corticosteroid is absorbed. Limit the use to the least amount compatible with an effective therapeutic regimen
• If dermatological infection occurs, provide appropriate antifungal or antibacterial therapy, temporarily discontinue topical hydrocortisone until the infection has been adequately controlled
• Can cause local skin adverse reactions, if irritation develops, discontinue the drug and start appropriate therapy

Cautions: Use cautiously in

• Skin infection
• Pediatric patients

Supplemental Patient Information

• Patients should be advised not to bandage or otherwise cover or wrap the affected area(s) unless directed by their physician
• Parents of pediatric patients should be advised not to use tight-fitting diapers or plastic pants on a child being treated in the diaper area, as these garments may constitute occlusive dressings

Ala-Cort, Anusol HC, Aveeno Hydrocortisone Anti-Itch Cream, Cortaid Advanced, Cortaid Maximum Strength, Cortef, Cortizone-10, Cortizone-10 Hydratensive, Cortizone-10 Intensive Healing Eczema, Cortizone-10 Plus, Locoid, Locoid lipocream, Micort-HC, Monistat Soothing Care Itch Relief Cream, Nutracort, Orabase HCA, Pandel, Preparation H Anti-Itch Cream, Stie-Cort, Synacort, Texacort, U-Cort, Westcort interacts with :

	Barbiturates
	Bosentan
	Carbamazepine
	Carbatrol
	Dilantin
	Dilantin Infatabs
	Dilantin-125
	Efavirenz
	Epitol
	Equetro
	Mycobutin
	Mysoline
	Nevirapine
	Oxcarbazepine
	Oxtellar XR
	Phenytek
	Phenytoin
	Priftin
	Primidone
	Qudexy XR
	Rifabutin
	Rifadin
	Rifampin
	Rifapentine
	Rimactane
	St. John's Wort
	Sustiva
	Tegretol
	Tegretol XR
	Teril
	Topamax
	Topiramate
	Tracleer
	Trileptal
	Trokendi XR
	Viramune
	Viramune XR

Pregnancy Category:C

Breastfeeding: No studies conducted during breastfeeding; short-term application of topical corticosteroids is not expected to pose a risk to the breastfed infant by passage into breastmilk. Use of the least potent drug on the smallest area of skin of mother is recommended. Ensure that the infant's skin does not come into direct contact with the areas treated with this drug. Use of lower potency corticosteroids, water-miscible cream products on the nipple or areola is recommended. Any topical corticosteroid should be wiped off thoroughly prior to nursing if it is applied to the nipple or areola. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 1 April 2011). However manufacturer advises caution while administering to nursing mothers.

• DERM: Burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneform eruption, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration, secondary infection, skin atrophy, striae, miliaria
• METABOLIC: Hyperglycemia
• CNS: Intracranial hypertension (pediatric)
• MISC: Adrenal suppression, cushing syndrome

• Anti-inflammatory agent; exact mechanism of action unknown; induces phospholipase A2 inhibitory proteins (lipocortins). These proteins inhibit the release of their common precursor arachidonic acid, thereby controlling the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes
• Minimal systemic availability after topical application. Presence of inflammation and occlusive dressings increase systemic absorption
• Metabolized primarily by liver; CYP450: 3A4
• Renally excreted; minimally in bile
• Half-life: 8-12 hrs

US Trade Name(s)

• Ala-Cort
• Anusol HC
• Aveeno Hydrocortisone Anti-Itch Cream
• Cortaid Advanced
• Cortaid Maximum Strength
• Cortizone-10
• Cortizone-10 Hydratensive
• Cortizone-10 Intensive Healing Eczema
• Cortizone-10 Plus
• Locoid lipocream
• Locoid
• Micort-HC
• Monistat Soothing Care Itch Relief Cream
• Nutracort
• Orabase HCA (Discontinued)
• Pandel
• Preparation H Anti-Itch Cream
• Stie-Cort
• Synacort
• Texacort
• U-Cort
• Westcort (Discontinued)

US Availability

hydrocortisone (generic)

• LOTN: 1%, 2.5%
• OINT: 1%, 2.5%
• CRE: 1%, 2.5%

hydrocortisone acetate (generic)

• CRE: 2.5%

hydrocortisone butyrate (generic)

• SOLN: 0.1%
• CRE: 0.1%
• OINT: 0.1%

hydrocortisone valerate (generic)

• CRE: 0.2%
• OINT: 0.2%

Ala-Cort

• CRE: 1%
• LOTN: 1%

Anusol HC

• CRE: 2.5%

Aveeno Hydrocortisone Anti-Itch Cream

• OTC CRE: 1%

Cortaid Advanced

• OTC CRE: 1%

Cortaid Maximum Strength

• OTC CRE: 1%

Cortizone-10

• OTC CRE: 1%

Cortizone-10 Hydratensive

• OTC LOTN: 1%

Cortizone-10 Intensive Healing Eczema

• OTC LOTN: 1%

Cortizone-10 Plus

• OTC CRE: 1%

Locoid lipocream (hydrocortisone butyrate)

• CRE: 0.1%

Locoid (hydrocortisone butyrate)

• CRE: 0.1%
• OINT: 0.1%
• SOLN: 0.1%
• LOTN: 0.1%

Micort-HC (hydrocortisone acetate)

• CRE: 2%, 2.5%

Monistat Soothing Care Itch Relief Cream

• OTC CRE: 1%

Nutracort (hydrocortisone)

• LOTN: 1%, 2.5%

Orabase HCA (hydrocortisone acetate)

• PASTE: 0.5%

Pandel (hydrocortisone probutate)

• CRE: 0.1%

Preparation H Anti-Itch Cream

• OTC CRE: 1%

Stie-Cort (hydrocortisone)

• LOTN: 1%

• LOTN: 2.5%

Synacort (hydrocortisone)

• CRE: 1%, 2.5%

Texacort (hydrocortisone)

• SOLN: 2.5%

U-Cort

• CRE: 1%

Westcort (hydrocortisone valerate )

• CRE: 0.2%
• OINT: 0.2%

Canadian Trade Name(s)

• Barriere HC
• Cortate
• Cortaderm
• Dermaflex HC
• Emo Cort
• Hydroval
• Hyderm
• Novo-Hydrocort
• Sarna HC
• Topiderm HC

Canadian Availability

Barriere HC, Prevex HC, Hyderm, Novo-Hydrocort

• CRE: 1%

Cortate

• CRE: 1%
• OINT: 1%

Cortaderm

• OINT: 1%

Dermaflex HC

• CRE: 1%
• LOTN: 1%

Emo Cort

• CRE: 1%, 2.5%
• LOTN: 1%, 2.5%
• SOLN: 2.5%

Hydroval (hydrocortisone valerate)

• CRE: 0.2%
• OINT: 0.2%

Sarna HC

• LOTN: 1%, 2.5%

Topiderm HC

• CRE: 2%

UK Trade Name(s)

• Boots Bite and Sting Relief
• Boots Derma Care
• Derma Care
• Dermacort
• Disoderm
• Hc45
• Lanacort
• Locoid
• Locoid Crelo
• Locoid lipocream
• Mildison Lipocream

UK Availability

hydrocortisone (generic)

• CRE: 0.5%, 1%
• OINT: 1%

Boots Bite and Sting Relief, Derma Care, Dermacort, Disoderm, Hc45, Mildison Lipocream

• CRE: 1%

Boots Derma Care

• CRE: 1%
• OINT: 1%

Lanacort

• OINT: 1%

Locoid (hydrocortisone butyrate)

• CRE: 0.1%
• OINT: 0.1%
• SCALP LOTN: 0.1%

Locoid Crelo(hydrocortisone butyrate)

• EMUL: 0.1%

Locoid lipocream (hydrocortisone butyrate)

• CRE: 0.1%

Australian Trade Name(s)

• Derm Aid
• Derm Aid Soft
• Egocort
• Cortef
• Cortic-DS
• Sigmacort

Australian Availability

Derm Aid, Derm Aid Soft, Egocort, Cortef, Cortic-DS

• CRE: 1%

Sigmacort

• CRE: 1%
• OINT: 1%

[Outline]

Dermatologic

Dermatologic Topical Agents

Steroids

Endocrine/Metabolic

Steroids; Adrenal Cortical

Corticosteroids

Pricing data from www.DrugStore.com in U.S.A.

• Anusol-HC 2.5 % CREA [Tube] (SALIX PHARMACEUTICALS)
  INC. % = $30
  % = $90
• Locoid Lipocream 0.1 % CREA [Tube] (TRIAX PHARMACEUTICALS)
  45 % = $230.98
  90 % = $448.97
• Pandel 0.1 % CREA [Tube] (PHARMADERM)
  15 % = $77.99
  45 % = $215.97
• Locoid Lipocream 0.1 % CREA [Tube] (TRIAX PHARMACEUTICALS)
  15 % = $86.51
  45 % = $239.55
• Locoid 0.1 % OINT [Tube] (TRIAX PHARMACEUTICALS)
  15 % = $62.04
  45 % = $171.18
• Locoid 0.1 % CREA [Tube] (TRIAX PHARMACEUTICALS)
  15 % = $67.49
  45 % = $180.77
• Locoid Lipocream 0.1 % CREA [Tube] (TRIAX PHARMACEUTICALS)
  60 % = $299.78
  180 % = $860.83
• Locoid 0.1 % OINT [Tube] (TRIAX PHARMACEUTICALS)
  45 % = $164.29
  135 % = $476.78
• Hydrocortisone 1 % CREA [Tube] (FOUGERA)
  28.35 % = $16.99
  85.05 % = $35.97
• Anusol-HC 25 MG SUPP [Box] (SALIX PHARMACEUTICALS)
  INC. mg = $12
  mg = $24
• Locoid 0.1 % CREA [Tube] (TRIAX PHARMACEUTICALS)
  45 % = $182.99
  135 % = $529.96
• Pandel 0.1 % CREA [Tube] (PHARMADERM)
  45 % = $139.99
  135 % = $381.95

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.