Dosing and uses of Psorcon, ApexiCon (diflorasone)
Adult dosage forms and strengths
cream/ointment
- 0.05%
Dermatoses
Apply sparingly to affected area(s) qDay-QId
Other Indications & Uses
Inflammatory/pruritic dermatoses, eczemas, lichen planus, burns (1st and 2nd degree)
Adjunctive treatment for: alopecia areata, chronic discoid lupus erythematosus, dysidrosis, familial benign pemphigus, mycosis fungoides, nodular prurigo, psoriasis, seborrheic dermatitis
Pediatric dosage forms and strengths
Safety and efficacy not established
Psorcon, ApexiCon (diflorasone) adverse (side) effects
Frequency not defined
Skin atrophy
Striae
Acneform lesions
Pigmentation changes
HPA suppression (with higher potency used >2 wk)
Warnings
Contraindications
Underlying infection
Hypersensitivity
Ophthalmic use
Cautions
Chronic topical corticosteroid therapy may interfere with growth and development in children
Use med to very high potency for <2 wk to reduce local and systemic side effects
Use low potency for chronic therapy
Avoid medium to very high potency on face, folds, groin because can increase steroid absorption
Use lower potency for children (ie, increase BSA/kg, therefore increase systemic absorption)
Pregnancy and lactation
Pregnancy category: C
Lactation: It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in milk. Use with caution.
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Psorcon, ApexiCon (diflorasone)
Absorption: yes
Potency
Very high: diflorasone ointment 0.05%
High: diflorasone emollient 0.05%
Relative potency: ointment >cream >lotion >solution
Mechanism of action
Corticosteroids decrease inflammation by stabilizing leukocyte lysosomal membranes, preventing release of destructive acid hydrolases from leukocytes; inhibiting macrophage accumulation in inflamed areas; reducing leukocyte adhesion to capillary endothelium; reducing capillary wall permeability and edema formation; decreasing complement components; antagonizing histamine activity and release of kinin from substrates; reducing fibroblast proliferation, collagen deposition, and subsequent scar tissue formation