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Trade Names:
Topicort
- Ointment 0.25%
- Cream 0.25%
- Gel 0.05%

Trade Names:
Topicort LP
- Cream 0.05%

Mechanism of Action

Pharmacology

High-potency topical corticosteroid that depresses formation, release, and activity of endogenous mediators of inflammation including prostaglandins, kinins, histamine, liposomal enzymes, and complement system; modifies the body's immune response.

Indications and Usage

Relief of inflammation and pruritic manifestations of corticosteroid-responsive dermatoses.

Contraindications

Hypersensitivity to other corticosteroids; monotherapy in primary bacterial infections; ophthalmic use.

Dosage and Administration

Topical Apply sparingly to affected areas twice daily.

General Advice

• For topical use only.
• Avoid contact with the eyes.

Storage/Stability

Store cream, ointment, and gel at ambient room temperature (59° to 86°F). Keep tube tightly capped.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Dermatologic

Burning; itching; irritation; dryness; folliculitis; hypertrichosis; acneiform eruptions; hypopigmentation; perioral dermatitis; allergic contact dermatitis; maceration of the skin; secondary infection; skin atrophy; striae; miliaria.

EENT

Cataracts; glaucoma.

Precautions

Pregnancy

Category C .

Lactation

May be excreted in breast milk.

Children

Safety and efficacy is not determined in children younger than 10 yr of age. Children may be more susceptible to topical corticosteroid-induced hypothalamic-pituitary-adrenal (HPA) axis suppression and Cushing syndrome; conditions that may augment systemic absorption include use over large body surface areas, prolonged use, and occlusive dressings.

Infections

Use with appropriate antimicrobials in the presence of skin infections.

Occlusive dressings

Adverse reactions are more common when occlusive dressings are used.

Systemic

Systemic absorption may produce reversible HPA axis suppression, manifestations of Cushing syndrome, hyperglycemia, and glucosuria.

Patient Information

• Teach patient or caregiver proper technique for applying cream, ointment, or gel: Wash hands; apply sufficient cream or ointment to cover affected areas sparingly and then gently massage into skin; wash hands after applying cream, ointment, or gel.
• Advise patient to apply cream, ointment, or gel to affected areas twice daily as directed by health care provider.
• Advise patient that if a dose is missed, to apply it as soon as remembered and then continue on the regular schedule. If it is almost time for the next application, instruct patient to skip the dose and continue on the regular schedule. Caution patient not to apply double doses.
• Caution patient not to apply to face, underarms, or groin area unless directed by health care provider.
• Caution patient not to bandage, cover, or wrap treated skin areas, or use cosmetics or other skin products over treated areas unless advised by health care provider.
• Caution patient to avoid contact with eyes. Advise patient that if cream does come into contact with the eyes, to wash them with large amounts of cool water and contact health care provider if eye irritation occurs.
• Caution parents of children not to use tight-fitting diapers or plastic pants on child being treated in the diaper area.
• Advise patient that symptoms should begin to improve fairly soon after starting treatment and to notify health care provider if condition does not improve, worsens, or if application site reactions (eg, burning, stinging, redness, itching) develop.
• Advise patient that therapy is usually discontinued when control has been achieved.
• Advise patient that follow-up visits to monitor response to treatment may be required and to keep appointments.