Class: Topical Corticosteroid
Dosage Forms. Rectal Cream: 1%, 2.5%; Topical Cream: 0.5%, 1%, 2.5%; Topical Lotion: 1%, 2.5%; Topical Ointment: 0.5%, 1%, 2.5%
Common FDA Label Indication, Dosing, and Titration.
1. Skin disorders, corticosteroid responsive: Apply thin layer topically to affected area daily to bid
Off-Label Uses. None
MOA. Hydrocortisone 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: Hydrocortisone Topical
Medication Safety Issues: Hydrocortisone Topical
Drug Interactions: Hydrocortisone Topical. None known
Adverse Reactions: Hydrocortisone Topical
Efficacy Monitoring Parameters. Improvement in clinical signs of skin disorder.
Toxicity Monitoring Parameters. Seek medical attention if 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. Large number of dosage presentations (foams, gels, shampoos, etc), both by prescription and over-the-counter, are available. Oral and rectal formulations, administered for systemic action, also available and used for similar indications as other oral corticosteroids (eg, prednisone). Application to large surface areas, prolonged use, and occlusive dressings may increase risk of systemic absorption and toxicity; pediatric patients are more susceptible to systemic absorption.