Class: Topical Corticosteroid
Dosage Forms. Topical Cream: 0.05%, 0.1%; Topical Ointment: 0.05%; Topical Solution: 0.05%; Topical Gel: 0.05%
Common FDA Label Indication and Dosing.
1. Skin disorders, corticosteroid responsive: Children 12 y of age and older and Adults, apply thin layer topically to affected area daily to qid for a max of 2 wk
2. Plaque psoriasis: Children 12 y of age and older and Adults, apply thin layer topically to affected area daily to qid for a max of 2-4 wk
3. Atopic dermatitis: Children 12 y of age and older and Adults, apply thin layer topically to affected area daily to qid for a max of 2 wk
Off-Label Uses.
1. Oral lichen planus: Apply thin layer topically bid with antimycotics
MOA. Fluocinonide has anti-inflammatory, antipruritic, and vasoconstrictive properties. Corticosteroids are thought to act by the induction of phospholipase A2-inhibitory proteins, lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
Drug Characteristics: Fluocinonide
Medication Safety Issues: Fluocinonide
Drug Interactions: Fluocinonide. None known
Adverse Reactions: Fluocinonide
Efficacy Monitoring Parameters. Improvement in clinical signs of skin disorder (reduced inflammation, pruritis).
Toxicity Monitoring Parameters. Severe skin irritation or symptoms worsen after administration.
Key Patient Counseling Points. Apply thin layer to affected area of skin. Skin should be clean and intact at site of application. Avoid contact with eyes and do not ingest by mouth. Avoid occlusive dressings or tight-fitting clothes over site of administration.
Clinical Pearls. High-potency corticosteroid. Application to large surface areas, prolonged use, and use of occlusive dressings increases risk of systemic absorption and toxicity; pediatric patients are more susceptible to systemic absorption.