Amcinonide

PHARMACOLOGIC CATEGORY
Corticosteroid, Topical

DOSING: ADULTS — Steroid-responsive dermatoses: Topical: Apply in a thin film 2-3 times/day. Therapy should be discontinued when control is achieved; if no improvement is seen, reassessment of diagnosis may be necessary.

DOSING: ELDERLY — Refer to adult dosing.

DOSAGE FORMS — Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Cream: 0.1% (15 g, 30 g, 60 g) [contains benzyl alcohol]

Lotion: 0.1% (60 mL)

Ointment: 0.1% (30 g, 60 g) [contains benzyl alcohol]

DOSAGE FORMS: CONCISE
Cream: 0.1% (15 g, 30 g, 60 g)

Lotion: 0.1% (60 mL)

Ointment: 0.1% (30 g, 60 g)

GENERIC EQUIVALENT AVAILABLE — Yes

USE — Relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses (high potency corticosteroid)

ADVERSE REACTIONS SIGNIFICANT — Frequency not defined.

Dermatologic: Acne, hypopigmentation, allergic dermatitis, maceration of the skin, miliaria, skin atrophy, striae, telangiectasia

Endocrine & metabolic: Cushing's syndrome, growth retardation (long-term use), HPA suppression, hyperglycemia; these reactions occur more frequently with occlusive dressings

Local: Burning, dryness, folliculitis, hypertrichosis, itching, irritation

Miscellaneous: Secondary infection

CONTRAINDICATIONS — Hypersensitivity to amcinonide or any component of the formulation; use on the face, groin, or axilla

WARNINGS / PRECAUTIONS
Concerns related to adverse effects: Adrenal suppression: Systemic absorption of topical corticosteroids may cause hypothalamic-pituitary-adrenal (HPA) axis suppression (reversible) particularly in younger children. HPA axis suppression may lead to adrenal crisis. Risk is increased when used over large surface areas, for prolonged periods, or with occlusive dressings. Contact dermatitis: Allergic contact dermatitis can occur, it is usually diagnosed by failure to heal rather than clinical exacerbation. Kaposi's sarcoma: Prolonged treatment with corticosteroids has been associated with the development of Kaposi's sarcoma (case reports); if noted, discontinuation of therapy should be considered. Systemic effects: Adverse systemic effects including hyperglycemia, glycosuria, fluid and electrolyte changes, and HPA suppression may occur when used on large surface areas, for prolonged periods, or with an occlusive dressing.

Disease-related concerns: Infected/weeping lesions: Occlusive dressings should not be used in presence of infection or weeping lesions.

Special populations: Pediatrics: Chronic use of corticosteroids in children may interfere with growth and development.

DRUG INTERACTIONS
Corticorelin: Corticosteroids may diminish the therapeutic effect of Corticorelin. Specifically, the plasma ACTH response to corticorelin may be blunted by recent or current corticosteroid therapy. Risk C: Monitor therapy

PREGNANCY RISK FACTOR — C (show table)

PRICING — (data from drugstore.com)
Cream (Amcinonide)
0.1% (15): $20.99
0.1% (30): $26.99
0.1% (60): $45.99

Cream (Cyclocort)
0.1% (30): $32.99
0.1% (60): $53.99

Lotion (Cyclocort)
0.1% (60): $47.99

Ointment (Amcinonide)
0.1% (60): $43.99

Ointment (Cyclocort)
0.1% (15): $24.99
0.1% (60): $53.99

CANADIAN BRAND NAMES — Amcort®; Cyclocort®; ratio-Amcinonide; Taro-Amcinonide

INTERNATIONAL BRAND NAMES — Amciderm (DE, TH); Amcinil (IT); Amicla (BE, LU, NL); Penticort (FR, IT); Visderm (AR, JP)

MECHANISM OF ACTION — Stimulates the synthesis of enzymes needed to decrease inflammation, suppress mitotic activity, and cause vasoconstriction

PHARMACODYNAMICS / KINETICS
Absorption: Adequate through intact skin; increases with skin inflammation or occlusion

Metabolism: Hepatic

Excretion: Urine and feces

PATIENT INFORMATION — Before applying, gently wash area to reduce risk of infection. Apply a thin film to cleansed area and rub in gently and thoroughly until medication vanishes. Avoid exposure to sunlight; severe sunburn may occur.