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Pronunciation
(flure an DREN oh lide)
Generic Available (U.S.)
No
Index Terms
Brand Names: U.S.
Brand Names: Canada
Pharmacologic Category
Pharmacologic Category Synonyms
Use: Labeled Indications
Inflammation of corticosteroid-responsive dermatoses [medium potency topical corticosteroid]
Pregnancy Risk Factor
C
Pregnancy Considerations
Teratogenic effects have been observed in animals administered potent topical corticosteroids. Topical products are not recommended for extensive use, in large quantities, or for long periods of time in pregnant women.
Lactation
Excretion unknown/use caution
Breast-Feeding Considerations
It is not known if topical application will result in detectable quantities in breast milk.
Contraindications
Hypersensitivity to flurandrenolide or any component of the formulation; viral, fungal, or tubercular skin lesions
Warnings/Precautions
Concerns related to adverse effects:
• Adrenal suppression: May cause hypercorticism 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.
• Contact dermatitis: Allergic contact dermatitis can occur. It is usually diagnosed by failure to heal rather than clinical exacerbation.
• Kaposi's sarcoma: Prolonged treatment with corticosteroids has been associated with the development of Kaposi's sarcoma (case reports); if noted, discontinuation of therapy should be considered.
• Systemic effects: Topical corticosteroids may be absorbed percutaneously. Absorption of topical corticosteroids may cause manifestations of Cushing's syndrome, hyperglycemia, or glycosuria. Absorption is increased by the use of occlusive dressings, application to denuded skin, or application to large surface areas.
Special populations:
• Pediatrics: Children may absorb proportionally larger amounts after topical application and may be more prone to systemic effects. HPA axis suppression, intracranial hypertension, and Cushing's syndrome have been reported in children receiving topical corticosteroids. Prolonged use may affect growth velocity; growth should be routinely monitored in pediatric patients.
Adverse Reactions
Frequency not defined.
Cardiovascular: Intracranial hypertension
Dermatologic: Acne, acneiform eruptions, allergic contact dermatitis, dry skin, folliculitis, hypopigmentation, hypertrichosis, itching, maceration of the skin, miliaria, perioral dermatitis, skin atrophy, striae
Endocrine & metabolic: Cushing's syndrome, growth retardation, HPA axis suppression
Local: Burning, irritation
Miscellaneous: Secondary infection
Postmarketing and/or case reports: Hypersensitivity, skin discoloration
Metabolism/Transport Effects
None known.
Drug Interactions
Aldesleukin: Corticosteroids may diminish the antineoplastic effect of Aldesleukin. Risk X: Avoid combination
Corticorelin: Corticosteroids may diminish the therapeutic effect of Corticorelin. Specifically, the plasma ACTH response to corticorelin may be blunted by recent or current corticosteroid therapy. Risk C: Monitor therapy
Deferasirox: Corticosteroids may enhance the adverse/toxic effect of Deferasirox. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased. Risk C: Monitor therapy
Telaprevir: Corticosteroids may decrease the serum concentration of Telaprevir. Telaprevir may increase the serum concentration of Corticosteroids. Management: Concurrent use of telaprevir and systemic corticosteroids is not recommended. When possible, consider alternatives. If used together, employ extra caution and monitor closely for excessive corticosteroid effects and diminished telaprevir effects. Risk D: Consider therapy modification
Mechanism of Action
Decreases inflammation by suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability
Pharmacodynamics/Kinetics
Absorption: Adequate with intact skin; repeated applications lead to depot effects on skin, potentially resulting in enhanced percutaneous absorption
Metabolism: Hepatic
Excretion: Urine; feces (small amounts)
Dosage
Topical: Therapy should be discontinued when control is achieved; if no improvement is seen, reassessment of diagnosis may be necessary.
Children:
Cream: Apply sparingly 1-2 times/day
Tape: Apply once daily
Adults: Cream, lotion: Apply sparingly 2-3 times/day
Patient Education
A thin film is effective; do not overuse. Do not use tight-fitting diapers or plastic pants on children being treated in the diaper area. Apply sparingly in a light film and rub in lightly. Avoid contact with eyes. Notify prescriber if condition being treated persists or worsens.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
None reported
Mental Health: Effects on Psychiatric Treatment
None reported
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Cream, topical [emulsion-based]:
Cordran® SP: 0.05% (15 g, 30 g, 60 g)
Lotion, topical:
Cordran®: 0.05% (15 mL, 60 mL) [contains benzyl alcohol, menthol]
Tape, topical [roll]:
Cordran®: 4 mcg/cm2 (24 inch, 80 inch)
Pricing: U.S. (www.drugstore.com)
Tape (Cordran)
4 mcg/cm2 (1): $87.99
4 mcg/cm2 (1): $187.20
References
Goedert JJ, Vitale F, Lauria C, et al, “Risk Factors for Classical Kaposi's Sarcoma,” J Natl Cancer Inst, 2002, 94(22):1712-8.
International Brand Names
Lexi-Comp.com
Last full review/revision March 2012
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