CORTICOSTEROIDS Medium to Very High Potency (Topical)

Some commonly used brand names are:

In the U.S.?

• Alphatrex ³
• Aristocort ²⁰
• Aristocort A ²⁰
• Betatrex ³
• Beta-Val ³
• Bio-Syn ⁹
• Cordran ¹¹
• Cordran SP ¹¹
• Cormax ⁴
• Cutivate ¹²
• Cyclocort ¹
• Delta-Tritex ²⁰
• Dermabet ³
• Dermatop ¹⁹
• Diprolene ³
• Diprolene AF ³
• Diprosone ³
• Elocon ¹⁸
• Florone ⁷
• Florone E ⁷
• Fluocet ⁹
• Fluocin ¹⁰
• Fluonid ⁹
• Flurosyn ⁹
• Flutex ²⁰
• Halog ¹³
• Halog-E ¹³
• Kenac ²⁰
• Kenalog ²⁰
• Kenalog-H ²⁰
• Kenonel ²⁰
• Licon ¹⁰
• Lidex ¹⁰
• Lidex-E ¹⁰
• Locoid ¹⁵
• Luxiq ³
• Maxiflor ⁷
• Maxivate ³
• Olux ⁴
• Pandel ¹⁶
• Psorcon ⁷
• Synalar ⁹
• Synalar-HP ⁹
• Synemol ⁹
• Teladar ³
• Temovate ⁴
• Temovate E ⁴
• Temovate Scalp Application ⁴
• Topicort ⁶
• Topicort LP ⁶
• Triacet ²⁰
• Triderm ²⁰
• Ultravate ¹⁴
• Uticort ³
• Valisone ³
• Valisone Reduced Strength ³
• Valnac ³
• Vanos ¹⁰
• Westcort ¹⁷

In Canada?

• Aristocort C ²⁰
• Aristocort D ²⁰
• Aristocort R ²⁰
• Beben ³
• Betacort Scalp Lotion ³
• Betaderm ³
• Betaderm Scalp Lotion ³
• Betnovate ³
• Betnovate-1/2 ³
• Celestoderm-V ³
• Celestoderm-V/2 ³
• Cyclocort ¹
• Dermovate ⁴
• Dermovate Scalp Lotion ⁴
• Diprolene ³
• Diprosone ³
• Drenison ¹¹
• Ectosone Mild ³
• Ectosone Regular ³
• Ectosone Scalp Lotion ³
• Elocom ¹⁸
• Eumovate ⁵
• Florone ⁷
• Fluoderm ⁹
• Fluolar ⁹
• Fluonide ⁹
• Halog ¹³
• Kenalog ²⁰
• Lidemol ¹⁰
• Lidex ¹⁰
• Lyderm ¹⁰
• Metaderm Mild ³
• Metaderm Regular ³
• Nerisone ⁸
• Nerisone Oily ⁸
• Novobetamet ³
• Occulocort ³
• Prevex B ³
• Propaderm ²
• Synalar ⁹
• Synamol ⁹
• Topicort ⁶
• Topicort Mild ⁶
• Topilene ³
• Topisone ³
• Topsyn ¹⁰
• Triaderm ²⁰
• Trianide Mild ²⁰
• Trianide Regular ²⁰
• Valisone Scalp Lotion ³
• Westcort ¹⁷

Other commonly used names are:

• Beclometasone
• Fludroxycortide
• Ulobetasol

Category

• Anti-inflammatory, steroidal,topical
• Corticosteroid, topical

Description

Topical corticosteroids (kor-ti-ko-STER-oyds)are used to help relieve redness, swelling, itching, and discomfort of manyskin problems. These medicines are like cortisone. They belong to the generalfamily of medicines called steroids.

These corticosteroids are available only with your doctor's prescription.Topical corticosteroids are available in the following dosage forms:

Topical
• Amcinonide
  • Cream (U.S. and Canada)
  • Lotion (U.S. and Canada)
  • Ointment (U.S. and Canada)
• Beclomethasone
  • Cream (Canada)
  • Lotion (Canada)
• Betamethasone
  • Cream (U.S. and Canada)
  • Foam (U.S.)
  • Gel (U.S. and Canada)
  • Lotion (U.S. and Canada)
  • Ointment (U.S. and Canada)
  • Topical aerosol (U.S.)
• Clobetasol
  • Cream (U.S. and Canada)
  • Foam (U.S.)
  • Ointment (U.S. and Canada)
  • Topical solution (U.S. and Canada)
• Clobetasone
  • Cream (Canada)
  • Ointment (Canada)
• Desoximetasone
  • Cream (U.S. and Canada)
  • Gel (U.S. and Canada)
  • Ointment (U.S.)
• Diflorasone
  • Cream (U.S. and Canada)
  • Ointment (U.S. and Canada)
• Diflucortolone
  • Cream (Canada)
  • Ointment (Canada)
• Fluocinolone
  • Cream (U.S. and Canada)
  • Ointment (U.S. and Canada)
  • Topical solution (U.S. and Canada)
• Fluocinonide
  • Cream (U.S. and Canada)
  • Gel (U.S. and Canada)
  • Ointment (U.S. and Canada)
  • Topical solution (U.S. and Canada)
• Flurandrenolide
  • Cream (U.S. and Canada)
  • Lotion (U.S.)
  • Ointment (U.S. and Canada)
  • Tape (U.S. and Canada)
• Fluticasone
  • Cream (U.S.)
  • Ointment (U.S.)
• Halcinonide
  • Cream (U.S. and Canada)
  • Ointment (U.S. and Canada)
  • Topical solution (U.S. and Canada)
• Halobetasol
  • Cream (U.S.)
  • Ointment (U.S.)
• Hydrocortisone butyrate
  • Cream (U.S.)
  • Ointment (U.S.)
• Hydrocortisone probutate
  • Cream (Canada)
• Hydrocortisone valerate
  • Cream (U.S. and Canada)
  • Ointment (U.S. and Canada)
• Mometasone
  • Cream (U.S. and Canada)
  • Lotion (U.S. and Canada)
  • Ointment (U.S. and Canada)
• Prednicarbate
  • Cream (U.S.)
• Triamcinolone
  • Cream (U.S. and Canada)
  • Lotion (U.S.)
  • Ointment (U.S. and Canada)
  • Topical aerosol (U.S.)

Before Using This Medicine

In deciding to use a medicine,the risks of taking the medicine must be weighed against the good it willdo. This is a decision you and your doctor will make. For corticosteroids,the following should be considered:

Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to corticosteroids. Also tell your health care professionalif you are allergic to any other substances, such as foods, preservatives,or dyes.

Pregnancy?When used properly, these medicines have not beenshown to cause problems in humans. Studies on birth defects have not beendone in humans. However, studies in animals have shown that topical corticosteroids,when applied to the skin in large amounts or used for a long time, could causebirth defects.

Breast-feeding?Topical corticosteroids have not been reportedto cause problems in nursing babies when used properly. However, corticosteroidsshould not be applied to the breasts before nursing.

Children?Children and teenagers who must use this medicineshould be checked often by their doctor since this medicine may be absorbedthrough the skin and can affect growth or cause other unwanted effects.

Older adults?Certain side effects may be more likely to occurin elderly patients since the skin of older adults may be naturally thin.These unwanted effects may include tearing of the skin or blood-containingblisters on the skin.

Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. Tell your health careprofessional if you are using any other topical prescription or nonprescription(over-the-counter [OTC]) medicine that is to be applied to the same area ofthe skin.

Other medical problems?The presence of other medicalproblems may affect the use of topical corticosteroids. Make sure you tellyour doctor if you have any other medical problems, especially:

• Cataracts or
• Glaucoma?Corticosteroids may make these medical problems worse,especially when stronger corticosteroids are used in the eye area

• Diabetes mellitus (sugar diabetes)?Too much use of corticosteroidsmay cause a loss of control of diabetes by increasing blood and urine glucose.However, this is not likely to happen when topical corticosteroids are usedfor a short time

• Infection or sores at the place of treatment (unless your doctoralso prescribed medicine for the infection) or
• Tuberculosis?Corticosteroids may make existing infections worseor cause new infections

• Skin conditions that cause thinning of skin with easy bruising?Corticosteroidsmay make thinning of the skin worse

Proper Use of This Medicine

Be very carefulnot to get this medicine in your eyes. Wash your hands after using your fingerto apply the medicine. If you accidentally get this medicine in your eyes,flush them with water.

Do not bandage or otherwise wrap the skin being treated unless directed to do so by your doctor.

If your doctor has ordered an occlusive dressing (airtight covering, suchas kitchen plastic wrap or a special patch) to be applied over this medicine,make sure you know how to apply it. Since occlusive dressings increase theamount of medicine absorbed through your skin and the possibility of sideeffects, use them only as directed. If you have any questions about this,check with your doctor.

Do not use on face, groin, or armpits unless directed to do so by yourdoctor.

For patients using the foam form of this medicine:

• This medicine usually comes with patient directions. Read them carefullybefore using this medicine.
• Do not use near heat, near an open flame, or while smoking.

For patients using the topical aerosol formof this medicine:

• This medicine usually comes with patient directions. Read them carefullybefore using this medicine.
• It is important to avoid breathing in the vapors from the spray orgetting them in your eyes. If you accidentally get this medicine in your eyes,flush them with water.
• Do not use near heat, near an open flame, or while smoking.

For patients using flurandrenolide tape:

• This medicine usually comes with patient directions. Read them carefullybefore using this medicine.

Do not use this medicine more often or for a longertime than your doctor ordered. To do so may increase the chance ofabsorption through the skin and the chance of side effects. In addition, toomuch use, especially on areas with thinner skin (for example, face, armpits,groin), may result in thinning of the skin and stretch marks or other unwantedeffects.

Do not use this medicine for other skin problems withoutfirst checking with your doctor. Topical corticosteroids should notbe used on many kinds of bacterial, viral, or fungal skin infections.

Dosing?The dose of topical corticosteroid will bedifferent for different patients and products. Followyour doctor's orders or the directions on the label.

Missed dose?If your doctor has ordered you to use this medicineon a regular schedule and you miss a dose, apply it as soon as possible. However,if it is almost time for your next dose, skip the missed dose and apply itat the next regularly scheduled time.

Storage?To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing.
• Do not puncture, break, or burn aerosol containers, even after theyare empty.
• Do not keep outdated medicine or medicine no longer needed. Be surethat any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

Check with your doctor if your symptoms do not improvewithin 1 week or if your condition gets worse.

Avoid using tight-fitting diapers or plastic pants on a child if this medicineis being used on the child's diaper area. Plastic pants or tight-fitting diapersmay increase the chance of absorption of the medicine through the skin andthe chance of side effects.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects.Although not all of these side effects may occur, if they do occur they mayneed medical attention.

Check with your doctor as soon as possibleif any of the following side effects occur:

Less frequent or rare

Blood-containing blisters on skin; burning and itching of skin; increased skin sensitivity(for some brands of betamethasone lotion); lack ofhealing of skin condition; loss of top skin layer(for tape dosage forms); numbness in fingers; painful, red or itchy, pus-containing blisters in hair follicles; raised, dark red, wart-like spots on skin, especiallywhen used on the face; skin infection; thinning of skin with easy bruising

Additional side effects mayoccur if you use this medicine improperly or for a long time. Check with yourdoctor if any of the following side effects occur:

Rare

Acne or oily skin; backache; blurring or loss of vision (occurs gradually if certain productshave been used near the eye); burning and itchingof skin with pinhead-sized red blisters; eye pain(if certain products have been used near the eye); filling or rounding out of the face; increased bloodpressure; irregular heartbeat; irregular menstrual periods; irritability; irritation of skin around mouth; lossof appetite; mental depression; muscle cramps, pain, or weakness; nausea; rapid weight gain or loss; reddish purplelines (stretch marks) on arms, face, legs, trunk, or groin; skin color changes; softening of skin; stomach bloating, burning, cramping, or pain; swelling of feet or lower legs; tearing of the skin; unusual bruising; unusualdecrease in sexual desire or ability (in men); unusualincrease in hair growth, especially on the face; unusual loss of hair, especially on the scalp; unusualtiredness or weakness; vomiting; weakness of the arms, legs, or trunk (severe); worseningof infections

Some side effects may occur that usually donot need medical attention. These side effects may go away during treatmentas your body adjusts to the medicine. However, check with your doctor if anyof the following side effects continue or are bothersome:

Less frequent or rare?usually mild and transient

Burning, dryness, irritation, itching, or redness of skin; increased redness or scaling of skin sores; skin rash

When the foam,gel, lotion, solution, or aerosol form of this medicine is applied, a mild,temporary stinging may be expected.

Other side effects not listed above may also occur in some patients. Ifyou notice any other effects, check with your doctor.

Additional Information

Once a medicine has been approved for marketingfor a certain use, experience may show that it is also useful for other medicalproblems. Although this use is not included in product labeling, topical corticosteroidsmay be used in certain patients with the following medical conditions:

• Phimosis