prednicarbate

Absorption: Minimal. Prolonged use on large surface areas or large amounts applied or use of occlusive dressings may increase systemic absorption.

Distribution: Remains primarily at site of action.

Metabolism/Excretion: Usually metabolized in skin.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

(response depends on condition being treated)

ROUTE	ONSET	PEAK	DURATION
Topical	min–hrs	hrs–days	hrs–days

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity or known intolerance to corticosteroids or components of vehicles (ointment or cream base, preservative, alcohol);
Untreated bacterial or viral infections.

Use Cautiously in:

Hepatic impairment;
Diabetes mellitus, cataracts, glaucoma, or tuberculosis (use of large amounts of high-potency agents may worsen condition);
Patients with pre-existing skin atrophy;
OB: Chronic high-dose use may result in adrenal suppression in mother and low birth weight in infants;
Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
Pedi: Chronic use may result in adrenal suppression and growth suppression in children; not recommended for use in children 12 yr.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: allergic contact dermatitis, atrophy, burning, dryness, edema, pruritus, hypertrichosis, hypopigmentation, irritation, maceration

Endo: adrenal suppression (use of occlusive dressings, long-term therapy)

Interactions ⬆ ⬇

Drug-drug:

None significant.

Route/Dosage ⬆ ⬇

(Adults and Children ≥12 yr): Apply to affected area twice daily.

Availability ⬆ ⬇

Cream: 0.1%
Ointment: 0.1%

Assessment ⬆ ⬇

Assess affected skin prior to and daily during therapy. Note degree of inflammation and pruritus. Notify physician or other health care professional if symptoms of infection (increased pain, erythema, purulent exudate) develop.

Lab Test Considerations:

Periodic adrenal function tests may be ordered to assess for hypothalamic-pituitary-adrenal (HPA) axis suppression in chronic topical therapy if suspected. Children and patients with dose applied to a large area, using an occlusive dressing, or using high-potency products are at highest risk for HPA suppression.

Implementation ⬆ ⬇

Choice of vehicle depends on site and type of lesion. Ointments are more occlusive and preferred for dry, scaly lesions. Creams should be used on oozing or intertriginous areas, where the occlusive action of ointments might cause folliculitis or maceration. Creams may be preferred for aesthetic reasons even though they may be more drying to skin than ointments.
Apply ointment or cream sparingly as a thin film to clean, slightly moist skin. Wear gloves. Apply occlusive dressing only if specified by physician or other health care professional.

Patient/Family Teaching ⬆ ⬇

Instruct patient on correct technique of medication administration. Emphasize importance of avoiding the eyes. If a dose is missed, it should be applied as soon as remembered unless almost time for the next dose.
Caution patient to use only as directed. Avoid using cosmetics, bandages, dressings, or other skin products over the treated area unless directed by health care professional.
Advise parents of pediatric patients not to apply tight-fitting diapers or plastic pants on a child treated in the diaper area; these garments work like an occlusive dressing and may cause more of the drug to be absorbed.
Caution women that medication should not be used extensively, in large amounts, or for protracted periods in patients who are pregnant or planning to become pregnant.
Advise patient to consult health care professional before using medicine for condition other than indicated.
Instruct patient to inform health care professional if symptoms of underlying disease return or worsen or if symptoms of infection develop.
Rep: Advise patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇