fluocinonide (Lidemol, Lidex, Lyderm, Tiamol, Topactin, Topsyn, Vanos)

Dosing and uses of Lidemol, Lidex (fluocinonide)

• Adult
• Pediatric

 

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