Dosing and uses of Cordran, Cordran SP (flurandrenolide)
Adult dosage forms and strengths
lotion
- 0.05%
cream
- 0.025%
- 0.05%
ointment
- 0.05%
tape
- 4mcg/cm²
Inflammatory/Pruritic Dermatoses
Tape: Apply qDay-q12hr
Cream/Lotion: apply qDay-q6hr (typically q8-12hr)
Pediatric dosage forms and strengths
lotion
- 0.05%
ointment/cream
- 0.025%
- 0.05%
tape
- 4mcg/cm²
Inflammatory/Pruritic Dermatoses
Tape: Apply qDay-q12hr
Cream/Lotion: apply qDay-q6hr (typically q8-12hr)
Limit to minimum amount necessary for therapeutic efficacy
Cordran, Cordran SP (flurandrenolide) adverse (side) effects
Frequency not defined
Skin atrophy
Striae
Acneform lesions
Eruptions
Miliaria
Burning
Irritation
Secondary infection
Hypertrichosis
Acne
Pigmentation changes
HPA suppression (with higher potency used >2 wk)
Postmarketing Reports
Skin: Skin striae, hypersensitivity, skin atrophy, contact dermatitis, skin discoloration
Warnings
Contraindications
Lesions exuding serum
Intertriginous areas (tape)
Hypersensitivity
Ophthalmic use
Cautions
Chronic topical corticosteroid therapy may interfere with growth and development in children
Children may exhibit greater susceptibility to corticosteroid-induced HPA axis suppression and Cushing's syndrome due to larger skin surface area to body weight ratio
Use med to very high potency for <2 wk to reduce local and systemic side effects
Use low potency for chronic therapy
Kaposi's sarcoma reported with prolonged corticosteroid 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: 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 Cordran, Cordran SP (flurandrenolide)
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
Pharmacokinetics
Absorption: Minimal (~1%); nature of skin at application; occlusion and inflammation may increase absorption
Distribution: Throughout local skin
Metabolism: Liver
Excretion: Urine; feces (small amounts)