Hydrocortisone Acetate 2.5% + Pramoxine 1% Topical

Indications

Hydrocortisone Acetate 2.5% + Pramoxine 1% Topical is used for: Hemorrhoids, Insect bites, Skin irritations, Corticosteroid-responsive dermatoses, Anal itching

Adult Dose

Topical Relief of inflammation and pruritus associated with corticosteroid-responsive dermatoses Apply to affected area three to four times daily depending on severity of condition Rectal Hemorrhoids Apply rectally three to four times daily

Child Dose

Renal Dose

Administration

Topical: Apply to the affected area as a thin film. 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. Rectal: Using rectal applicator, insert tip into anus and expel measured cream/foam

Contra Indications

Topical corticosteroids are contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation.

Precautions

Systemic absorption of topical corticosteroids has produced reversible hypothalamic-pituitary- adrenal (HPA) axis suppression, manifestations of Cushing's syndrome, hyperglycemia, and glucosuria in some patients. 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 and 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. If irritation develops, topical corticosteroids should be discontinued and appropriate therapy instituted. Lactation: excretion in milk unknown; use with caution 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.

Pregnancy-Lactation

Pregnancy Category: C Lactation: excretion in milk unknown; use with caution

Interactions

Side Effects

Side effects of Hydrocortisone Acetate 2.5% + Pramoxine 1% Topical : Burning, Itching, Irritation, Dryness, Folliculitis, Hypertrichosis, Acneiform eruptions, Hypopigmentation, Perioral dermatitis, Allergic contact dermatitis, Maceration of the skin, Secondary infection, Skin atrophy, Striae, Miliaria

Mode of Action

Hydrocortisone is a corticosteroid used for its anti-inflammatory and immunosuppressive effects. Its anti-inflammatory action is due to the suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It may also be used as replacement therapy in adrenocortical insufficiency. Local anesthetic; stabilizes neuronal membranes and prevent generation/conduction of nerve impulses by reducing sodium permeability and increasing action potential threshold.