corticosteroids (topical)

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 use at high dosages may result in adrenal suppression in mother and growth suppression in children;
Pedi: Children may be more susceptible to adrenal and growth suppression. Clobetasol not recommended for children <18 yr (cream, lotion, shampoo, spray) or <12 yr (foam, gel, ointment, solution); desoximetasone not recommended for children <10 yr (cream, ointment, gel) or <18 yr (spray); halobetasol not recommended for children <12 yr.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: allergic contact dermatitis, atrophy, burning, dryness, edema, folliculitis, hypersensitivity reactions, hypertrichosis, hypopigmentation, irritation, maceration, miliaria, perioral dermatitis, secondary infection, striae

EENT: cataracts, glaucoma

Endo: adrenal suppression (↑ dose, long-term therapy)

Interactions ⬆ ⬇

Drug-drug:

None significant.

Availability ⬆ ⬇

Alclometasone

(Generic available)

Cream: 0.05%
Ointment: 0.05%

Amcinonide

(Generic available)

Cream: 0.1%
Lotion: 0.1%
Ointment: 0.1%

Betamethasone

(Generic available)

Aerosol foam: 0.12%
Cream: 0.05%; 0.1%
Gel: 0.05%
Lotion: 0.05%; 0.1%
Ointment: 0.05%; 0.1%
Spray: 0.05%
In combination with:
calcipotriene (Enstilar, Taclonex, Wynzora), clotrimazole (Lotrisone); see Combination Drugs.

Clobetasol

(Generic available)

Cream: 0.025%; 0.05%
Foam: 0.05%
Gel: 0.05%
Lotion: 0.05%
Ointment: 0.05%
Scalp solution: 0.05%
Shampoo: 0.05%
Spray: 0.05%

Clocortolone

(Generic available)

Cream: 0.1%

Desonide

(Generic available)

Cream: 0.05%
Foam: 0.05%
Gel: 0.05%
Lotion: 0.05%
Ointment: 0.05%

Desoximetasone

(Generic available)

Cream: 0.05%; 0.25%
Gel: 0.05%
Ointment: 0.05%; 0.25%
Spray: 0.25%

Diflorasone

(Generic available)

Cream: 0.05%
Ointment: 0.05%

Fluocinolone

(Generic available)

Cream: 0.01%; 0.025%
Oil: 0.01%
Ointment: 0.025%
Solution: 0.01%
In combination with:
hydroquinone and tretinoin (Tri-Luma); neomycin (Neo-Synalar). See Combination Drugs.

Fluocinonide

(Generic available)

Cream: 0.05%; 0.1%
Gel: 0.05%
Ointment: 0.05%
Solution: 0.05%

Flurandrenolide

(Generic available)

Lotion: 0.05%
Ointment: 0.05%
Tape: 4 mcg/cm²

Fluticasone

(Generic available)

Cream: 0.05%
Lotion: 0.05%
Ointment: 0.005%

Halcinonide

(Generic available)

Cream: 0.1%
Ointment: 0.1%
Solution: 0.1%

Halobetasol

(Generic available)

Cream: 0.05%
Foam: 0.05%
Lotion: 0.01%; 0.05%
Ointment: 0.05%
In combination with:
tazarotene (Duobrii). See Combination Drugs.

Hydrocortisone

(Generic available)

Cream: 0.1%; 0.2%; 0.5%^{Rx, OTC}; 1%^{Rx, OTC}; 2.5%
Gel: 2%^{Rx, OTC}
Lotion: 0.1%; 1%^{Rx, OTC}; 2%
Ointment: 0.1%; 0.2%; 0.5%^{Rx, OTC}; 1%^{Rx, OTC}; 2.5%
Rectal cream: 1%; 2.5%
Solution: 0.1%; 1%; 2.5%
In combination with:
acetic acid, antifungals, anti-infectives, antihistamines, urea, and benzoyl peroxide in various otic and topical preparations. See Combination Drugs.

Mometasone

(Generic available)

Cream: 0.1%
Ointment: 0.1%
Lotion: 0.1%
Solution: 0.1%

Triamcinolone

(Generic available)

Cream: 0.025%; 0.1%; 0.5%
Lotion: 0.025%; 0.1%
Ointment: 0.025%; 0.05%; 0.1%; 0.5%
Spray: 0.147 mg/g
In combination with:
acetic acid, antifungals, anti-infectives, antihistamines, urea, and benzoyl peroxide in various otic and topical preparations. See Combination Drugs.

Route/Dosage ⬆ ⬇

(Adults and Children ): 1–4 times daily (depends on product, preparation, and condition being treated).
Rect (Adults ): hydrocortisoneAerosol foam: 90 mg 1–2 times/day for 2–3 wk; then adjusted.

US Brand Names ⬆ ⬇

alclometasone: ~~Aclovate,~~

betamethasone: Diprolene, ~~Diprolene AF,~~ Sernivo,

clobetasol: Clobex, Clodan, Impoyz, Olux-E, ~~Temovate,~~ ~~Temovate E,~~ Tovet,

clocortolone: Cloderm,

desonide: Tridesilon, Verdeso,

desoximetasone: Topicort,

diflorasone: Apexicon E,

fluocinolone: Derma-Smoothe/FS, Synalar,

fluocinonide: Vanos,

flurandrenolide: Cordran, ~~Cordran SP,~~

fluticasone: ~~Cutivate,~~

halcinonide: Halog,

halobetasol: Bryhali, Ultravate,

hydrocortisone: Ala-Cort, Ala-Scalp, Anusol HC, Cortaid, Cortifoam, Locoid, Texacort,

mometasone: ~~Elocon,~~

triamcinolone: Kenalog, Triderm, Tritocin

Action ⬆ ⬇

Suppress normal immune response and inflammation.

Therapeutic effects:

Suppression of dermatologic inflammation and immune processes.
Clearing of plaques

Classifications ⬆ ⬇

Therapeutic Classification: corticosteroids

Pharmacologic Classification: corticosteroids (topical)

Pharmacokinetics ⬆ ⬇

Absorption: Minimal. Prolonged use on large surface areas, application of large amounts, or use of occlusive dressings may ↑ systemic absorption.

Distribution: Remain primarily at site of action.

Metabolism/Excretion: Usually metabolized in skin; some have been modified to resist local metabolism and have a prolonged local effect.

Half-Life: Betamethasone: 3–5 hr (plasma), 36–54 hr (tissue); dexamethasone: 3–4.5 hr (plasma), 36–54 hr (tissue); hydrocortisone: 1.5–2 hr (plasma), 8–12 hr (tissue); triamcinolone: 2–>5 hr (plasma), 18–36 hr (tissue).

Canadian Brand Names ⬆ ⬇

betamethasone: Betaderm, Beteflam, Celestoderm V, Celestoderm V/2, Diprosone,

clobetasol: Dermovate,

fluocinonide: Lidemol, Lyderm, Tiamol,

hydrocortisone: Barriere-HC, Cortoderm, Hyderm, Hydroval, Sarna HC,

mometasone: Elocom,

triamcinolone: Aristocort C, Aristocort R, Triaderm

Time/Action Profile ⬆ ⬇

( response depends on condition being treated)

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

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication to patient. Advise patient to read Patient Information before starting therapy.
Advise patient to notify health care provider of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care provider before taking other medications.
Advise patient on correct technique of medication administration. Emphasize importance of avoiding the eyes. Apply missed doses as soon as remembered unless almost time for the next dose.
Advise patient to use only as directed. Avoid using cosmetics, bandages, dressings, or other skin products over the treated area unless directed by health care provider.
Advise patient to consult health care provider before using medicine for condition other than indicated.
Advise patient to inform health care provider if symptoms of underlying disease return or worsen or if symptoms of infection develop.
Fluticasone: Advise patient to avoid excessive natural or artificial exposure (tanning booth, sun lamp) to areas where lotion is applied.
Pedi: Advise parents/caregivers of pediatric patients not to apply tight-fitting diapers or plastic pants on a child treated in the diaper area; these garments work as an occlusive dressing and may cause more of the drug to be absorbed.
Rep: Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or if breastfeeding. Advise women of reproductive potential that medication should not be used extensively, in large amounts, or for protracted periods if they are pregnant or planning to become pregnant.

Pronunciation ⬆

alclometasone: al-kloe-MET-a-sone

amcinonide: am-SIN-oh-nide

betamethasone: bay-ta-METH-a-sone

clobetasol: kloe-BAY-ta-sol

clocortolone: kloe-KORE-toe-lone

desonide: DES-oh-nide

desoximetasone: dess-ox-i-MET-a-sone

diflorasone: dye-FLOR-a-sone

fluocinolone: floo-oh-SIN-oh-lone

fluocinonide: floo-oh-SIN-oh-nide

flurandrenolide: flure-an-DREN-oh-lide

fluticasone: floo-TI-ka-sone

halcinonide: hal-SIN-oh-nide

halobetasol: hal-oh-BAY-ta-sol

hydrocortisone: hye-droe-KOR-ti-sone

mometasone: moe-MET-a-sone

triamcinolone: trye-am-SIN-oh-lone

section name header

Indications ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇

Availability ⬆ ⬇

Route/Dosage ⬆ ⬇

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Classifications ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Canadian Brand Names ⬆ ⬇

Time/Action Profile ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Pronunciation ⬆