Hydrocortisone Information
Hydrocortisone () Description
The topical corticosteroids constitute a class of primarily synthetic steroids used as anti-inflammatory and anti-pruritic agents. Hydrocortisone () Cream 2.5% and Hydrocortisone () Ointment 2.5% contain Hydrocortisone () . Hydrocortisone () is a white to practically white crystalline powder. Chemically, Hydrocortisone () is pregn-4-ene-3,20-dione, 11,17,21-trihydroxy-, (11β)-. The structural formula of Hydrocortisone () is:
Each gram of the 2.5% Cream contains 25 mg of Hydrocortisone () in a base of glyceryl monostearate, polyoxyl 40 stearate, glycerin, paraffin, stearyl alcohol, isopropyl palmitate, sorbitan monostearate, benzyl alcohol, potassium sorbate, lactic acid and purified water.
Each gram of the 2.5% Ointment contains 25 mg of Hydrocortisone () in a base of white petrolatum and mineral oil.
Hydrocortisone () Clinical Pharmacology
Topical corticosteroids share anti-inflammatory, anti-pruritic and vasoconstrictive actions.
The mechanism of anti-inflammatory activity of the topical corticosteroids is unclear. Various laboratory methods, including vasoconstrictor assays, are used to compare and predict potencies and/or clinical efficacies of the topical corticosteroids. There is some evidence to suggest that a recognizable correlation exists between vasoconstrictor potency and therapeutic efficacy in man.
Hydrocortisone () Indications And Usage
Topical corticosteroids are indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses.
Hydrocortisone () Contraindications
Topical corticosteroids are contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation.
Hydrocortisone () Precautions
General:
Conditions which augment systemic absorption include the application of the more potent steroids, use over large surface areas, prolonged use, and the addition of occlusive dressings.
Therefore, 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 the frequency of application, or to substitute a less potent steroid.
Recovery of HPA axis function is generally prompt and complete upon discontinuation of the drug.
Infrequently, signs and symptoms of steroid withdrawal may occur, requiring supplemental systemic corticosteroids.
Children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity (See ).
If irritation develops, topical corticosteroids should be discontinued and appropriate therapy instituted.
In the presence of dermatological infections, the use of an appropriate antifungal or antibacterial agent should be instituted. If a favorable response does not occur promptly, the corticosteroid should be discontinued until the infection has been adequately controlled.
Information for the Patient:
Laboratory tests:
Urinary free cortisol test; ACTH stimulation test.
Carcinogenesis, Mutagenesis and Impairment of Fertility:
Studies to determine mutagenicity with prednisolone and Hydrocortisone () have revealed negative results.
Pregnancy:
Teratogenic Effects
Pregnancy Category C
Nursing Mothers:
not
Hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome, and intracranial hypertension have been reported in pediatric patients receiving topical corticosteroids. Manifestations of adrenal suppression in pediatric patients include linear growth retardation, delayed weight gain, low plasma cortisol levels, and absence of response to ACTH stimulation. Manifestations of intracranial hypertension include bulging fontanelles, headaches, and bilateral papilledema.
Administration of topical corticosteroids to pediatric patients should be limited to the least amount compatible with an effective therapeutic regimen. Chronic corticosteroid therapy may interfere with the growth and development of pediatric patients.
Hydrocortisone () Adverse Reactions
The following local adverse reactions are reported infrequently with topical corticosteroids, but may occur more frequently with the use of occlusive dressings. These reactions are listed in an approximate decreasing order of occurrence: burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, secondary infection, skin atrophy, striae and miliaria.
Hydrocortisone () Overdosage
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects (See ).
Hydrocortisone () Dosage And Administration
Apply to the affected area as a thin film 2 to 4 times daily depending on the severity of the condition.
Occlusive dressings may be used for the management of psoriasis or recalcitrant conditions. If an infection develops, the use of occlusive dressings should be discontinued and appropriate antimicrobial therapy instituted.
Hydrocortisone () How Supplied
Store at controlled room temperature 15° - 30°C (59° - 86°F).
A division of Nycomed US Inc.
MELVILLE, NEW YORK 11747
Repackaged by:
REBEL DISTRIBUTORS CORP
THOUSAND OAKS, CA 91320
Hydrocortisone ()
