BNF for Children (BNFC) 2018-2019

.Bettamousse

.Betnovate

.Cutivate

.Diprosone

.Elocon

.Hydrocortisone butyrate

.Locoid

.Locoid Crelo

.Metosyn

.Mometasone furoate 0. 1 %

.Nerisone

.Synalar

Potent with antimicrobials

.Aureocort

.Betamethasone and clioquinol

.Betamethasone and neomycin

.Fucibet

.Lotriderm

.Synalar C

.Synalar N

Potent with salicylic acid

.Diprosalic

Very potent

.Dermovate

.Nerisone Forte

Very potent with antimicrobials

.Clobetasol propionate 0. 05 % with neomycin and nystatin

Corticosteroids (topical) f

IMPORTANT SAFETY INFORMATION

MHRA/CHM ADVICE: CORTICOSTEROIDS: RARE RISK OF CENTRAL

SEROUS CHORIORETINOPATHY WITH LOCAL AS WELL AS SYSTEMIC

ADMINISTRATION (AUGUST 2017)

Central serous chorioretinopathy is a retinal disorder

that has been linked to the systemic use of

corticosteroids. Recently, it has also been reported after

local administration of corticosteroids via inhaled and

intranasal, epidural, intra-articular, topical dermal, and

periocular routes. The MHRA recommends that patients

should be advised to report any blurred vision or other

visual disturbances with corticosteroid treatment given

by any route; consider referral to an ophthalmologist for

evaluation of possible causes if a patient presents with

vision problems.

lCONTRA-INDICATIONSAcne.perioral dermatitis.potent

corticosteroids in widespread plaque psoriasis.untreated

bacterial, fungal or viral skin lesions

lCAUTIONSAvoid prolonged use (particularly on the face).

cautions applicable to systemic corticosteroids may also

apply if absorption occurs following topical and local use.

dermatoses of infancy, including nappy rash (extreme

caution required—treatment should be limited to

5 – 7 days).infection.keep away from eyes.use potent or

very potent topical corticosteroids under specialist

supervision

lSIDE-EFFECTS

▶UncommonAdrenal suppression.skin reactions.

telangiectasia

▶Rare or very rareHypertrichosis.skin depigmentation

(may be reversible)

▶Frequency not knownLocal reaction.telangiectasia.

vasodilation

SIDE-EFFECTS, FURTHER INFORMATIONSide-effects

applicable to systemic corticosteroids may also apply if

absorption occurs following topical and local use. In order

to minimise the side-effects of a topical corticosteroid, it is

important to apply it thinly to affected areas only, no more

frequently than twice daily, and to use the least potent

formulation which is fully effective.

lDIRECTIONS FOR ADMINISTRATIONTopical corticosteroid

preparations should be applied no more frequently than

twice daily; once daily is often sufficient. Topical

corticosteroids should be spread thinly on the skin but in

sufficient quantity to cover the affected areas. The length

of cream or ointment expelled from a tube may be used to

specify the quantity to be applied to a given area of skin.

This length can be measured in terms of afingertip unit

(the distance from the tip of the adult indexfinger to the

first crease). Onefingertip unit (approximately 500 mg

from a tube with a standard 5 mm diameter nozzle) is

sufficient to cover an area that is twice that of theflat adult

handprint (palm andfingers). Mixing topical preparations

on the skin should be avoided where possible; several

minutes should elapse between application of different

preparations.

‘Wet-wrap bandaging’increases absorption into the

skin, but should be initiated only by a dermatologist and

application supervised by a healthcare professional trained

in the technique.

lPRESCRIBING AND DISPENSING INFORMATIONThe potency

of each topical corticosteroid should be included on the

label with the directions for use. The label should be

attached to the container (for example, the tube) rather

than the outer packaging.

lPATIENT AND CARER ADVICEPatients or carers should be

given advice on how to administer corticosteroid creams

and ointments. If a patient is using topical corticosteroids

of different potencies, the patient should be told when to

use each corticosteroid. Patients and their carers should be

reassured that side effects such as skin thinning and

systemic effects rarely occur when topical corticosteroids

are used appropriately.

eiiiiFabove

Alclometasone dipropionate 21-Dec-2017

lINDICATIONS AND DOSE

Inflammatory skin disorders such as eczemas

▶TO THE SKIN

▶Child:Apply 1 – 2 times a day, to be applied thinly

POTENCY

▶Alclometasone dipropionate cream 0. 05 %: moderate

lUNLICENSED USELicensed for use in children (age range

not specified by manufacturer).

lPATIENT AND CARER ADVICEPatients or carers should be

counselled on the application of alclometasone

dipropionate cream.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Cream

CAUTIONARY AND ADVISORY LABELS 28

EXCIPIENTS:May contain Cetostearyl alcohol (including cetyl and

stearyl alcohol), chlorocresol, propylene glycol

▶Alclometasone dipropionate (Non-proprietary)

Alclometasone dipropionate 500 microgram per 1 gramBoots

Derma Care Eczema & Dermatitis Flare-Up 0. 05 % cream|

15 gramps

734 Inflammatory skin conditions BNFC 2018 – 2019

Skin

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