hydrocortisone topical (Westcort, Locoid, Aquanil, Calmurid Cream, Cetacort, Claritin Skin Itch Relief, Coraz, CortaGel, Cortaid, Cortate, Cortisone-10 Poison Ivy Relief Pads, Cortisone-10 Quick Shot, Cortizone, Cortoderm, Dermacort, Dermazene Cream, DermiCort, Emo Cort, Hyderm, Hydrocort, HydroSKIN, HydroVal, Hytone, LactiCare, AlaCort, Locoid Lipocream, Massengill, Neosporin Eczema Essentials Anti-Itch Cream, Nutracort, Pediaderm HC, Penecort, Preparation H Anti-Itch Cream, Prevex HC, Proctocort, Proctocream, Sarna HC, Sarnol, Texacort, Timodine, Uniroid HC, AlaScalpt)

Dosing and uses of Westcort, Locoid (hydrocortisone topical)

• Adult
• Pediatric

 

Adult dosage forms and strengths

topical cream

• 0.1%
• 0.2%
• 0.5%
• 1%
• 2%
• 2.5%

topical lotion

• 1%
• 2%
• 2.5%

topical geL

• 1%

topical solution

• 1%
• 2.5%

topical ointment

• 0.2%
• 0.5%
• 1%
• 2.5%

 

Corticosteroid-responsive Dermatoses

Relief of inflammatory and pruritic manifestations

Apply q8-12hr

 

Pediatric dosage forms and strengths

topical cream

• 0.1%
• 0.2%
• 0.5%
• 1%
• 2.5%

topical lotion

• 0.5%
• 1%
• 2%
• 2.5%

topical geL

• 1%

topical solution

• 1%
• 2.5%

topical ointment

• 0.2%
• 0.5%
• 1%
• 2.5%

 

Corticosteroid-responsive Dermatoses

Relief of inflammatory and pruritic manifestations

Apply q6-12hr

Dosing considerations

• Limit to the minimum amount necessary for therapeutic efficacy

 

Atopic Dermatitis

<3 months: Safety and efficacy not established

>3 months: Apply film to affected area q12hr

 

Westcort, Locoid (hydrocortisone topical) adverse (side) effects

Frequency not defined

Skin atrophy

Striae

Acneform lesions

Perioral dermatitis

Folliculitis

Itching

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 lower potency in children; may absorb proportionally larger amounts after topical application and may cause systemic effects

Prolonged use may increase risk of secondary infections and Kaposi's sarcoma

Acute myopathy reported with high dose corticosteroids, especially patients with neuromuscular transmission disorders

Psychiatric disturbances including euphoria, insomnia, mood swings, and personality changes reported with corticosteroid use

 

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 Westcort, Locoid (hydrocortisone topical)

Mechanism of action

Decreases inflammation by stabilizing leukocyte lysosomal membranes, preventing release of destructive acid hydrolases from leukocytes

Inhibits macrophage accumulation in inflamed areas

Reduces leukocyte adhesion to capillary endothelium

Reduces capillary wall permeability and edema formation

Decreases complement components and antagonizes histamine activity and release of kinin from substrates

Reduces fibroblast proliferation, collagen deposition, and subsequent scar tissue formation

 

Absorption

Percutaneous; extent of absorption in dependent on formulation, epidermal integrity (intact vs abrated), and the use of occlusive dressings