fluocinonide (Lidemol, Lidex, Lyderm, Tiamol, Topactin, Topsyn, Vanos)
Classes: Corticosteroids, Topical
Dosing and uses of Lidemol, Lidex (fluocinonide)
Adult dosage forms and strengths
cream
- 0.05%
- 0.1%
ointment/gel/topical solution
- 0.05%
Corticosteroid Responsive Dermatoses
Apply thin layer topically qDay or BID to affected areas
Psoriasis
Apply thin layer topically qDay or BID to affected areas
Atopic Dermatitis
Apply thin layer topically qDay to affected areas
Other Indications & Uses
Inflammatory/pruritic dermatoses, eczemas, lichen planus, burns (1st and 2nd degree
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
- 0.05%
- 0.1%
ointment/gel/topical solution
- 0.05%
Corticosteroid Responsive Dermatoses
Limit to the minimum amount necessary for therapeutic efficacy
Other Indications and 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
Lidemol, Lidex (fluocinonide) 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
If possible, 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 Lidemol, Lidex (fluocinonide)
Absorption: yes
Potency
High
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
