Dosing and uses of Synalar, Capex (fluocinolone)
Adult dosage forms and strengths
cream
- 0.025%
- 0.1%
ointment
- 0.025%
topical solution
- 0.01%
topical oiL
- 0.01%
Inflammatory/Pruritic Dermatoses, Eczemas, Lichen Planus, Burns
Apply BID-QId
Chronic Noninfectious Uveitis
Retisert: surgically implanted into posterior segment of eye
Other Indications & Uses
Adjunctive Tx for: alopecia areata, chronic discoid lupus erythematosus, disidrosis, familial benign pemphigus, mycosis fungoides, nodular prurigo, psoriasis, seborrheic dermatitis
Pediatric dosage forms and strengths
cream
- 0.025%
- 0.1%
ointment
- 0.025%
intravitreal implant
- 0.59mg
topical solution
- 0.01%
topical oiL
- 0.01%
Inflammatory/Pruritic Dermatoses, Eczemas, Lichen Planus, Burns
Limit to minimum amount necessary for therapeutic efficacy
Synalar, Capex (fluocinolone) 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 (products intended for topical use)
Retisert: viral disease of cornea and conjunctiva, mycobacterial eye infections, fungal disease of ocular structures
Cautions
Chronic topical corticosteroid therapy may interfere w/ growth & development in pediatric pts
Pregnancy and lactation
Pregnancy category: C
Lactation: excretion in milk unknown; 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 Synalar, Capex (fluocinolone)
Absorption: yes
Potency:
Medium: 0.025% cream/oint
Low: 0.01% cream/soln
Relative potency: ointment >cream >lotion >solution
Retisert Release Rate
Initial: 6 mcg/d
Decr over first mth to steady-state of 0.3-0.4 mcg/d over 30 mth
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
