Hydrocortisone

Therapeutic Area:

Generic Name:

Hydrocortisone

Dosage Form:

ointment

Drug Dose

Therapeutic Indications:

Anal and genital pruritus, external: Topical: Use in external genital and anal itching.

Corticosteroid-responsive dermatoses (eg, atopic dermatitis, contact dermatitis, vulvar dermatitis, psoriasis, seborrheic dermatitis): Topical: Relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses.

Mechanism of Action:

Topical corticosteroids have anti-inflammatory, antipruritic, and vasoconstrictive properties. May depress the formation, release, and activity of endogenous chemical mediators of inflammation (kinins, histamine, liposomal enzymes, prostaglandins) through the induction of phospholipase A inhibitory proteins (lipocortins) and sequential inhibition of the release of arachidonic acid.

Method of Administration:

Apply topical corticosteroids to moist skin immediately after bathing or after wet soaks. Occlusive dressings will also enhance drug absorption.

Notes

Hypersensitivity to hydrocortisone or any component of the formulation.

Interactions:

Calcipotriene: Hydrocortisone (Topical) may diminish the therapeutic effect of Calcipotriene. Management: Monitor for reduced calcipotriene efficacy if combined with hydrocortisone valerate. Consider separating the administration of these agents by 10 to 12 hours to minimize the risk of this potential interaction. Risk C: Monitor therapy

Pregnancy and Lactation:

In general, the use of topical corticosteroids is not associated with a significant risk of adverse pregnancy outcomes; however, there may be an increased risk of low birth-weight infants following maternal use of potent or very potent topical products, especially in high doses, although this risk is likely to be low.

Topical corticosteroids are generally considered acceptable for use in patients who are breastfeeding.

Warning and Precaution:

  • Adrenal suppression: May cause hypercortisolism or suppression of hypothalamic-pituitary-adrenal (HPA) axis, particularly in younger children or in patients receiving high doses for prolonged periods. HPA axis suppression may lead to adrenal crisis.
  • Anaphylactoid reactions: Rare cases of anaphylactoid reactions have been observed in patients receiving corticosteroids.
  • Contact dermatitis: Allergic contact dermatitis can occur and is usually diagnosed by failure to heal rather than clinical exacerbation; discontinue use if irritation occurs and treat appropriately.

Adverse Reactions:

Acneiform eruption, atrophic striae, burning sensation of skin, folliculitis, hypertrichosis, hypopigmentation, maceration of the skin, miliaria, perioral dermatitis, pruritus, secondary skin infection, skin atrophy, skin irritation, xeroderma

Storage:

Store below 30º and protect from freezing.