Product Elements:
Hydrocortisone valerate hydrocortisone valerate hydrocortisone valerate hydrocortisone carbomer homopolymer type c (allyl pentaerythritol crosslinked) sodium phosphate, dibasic, anhydrous methylparaben steareth-2 propylene glycol water sodium lauryl sulfate steareth-100 stearyl alcohol petrolatum white to off-white
Indications and Usage:
Indications and usage hydrocortisone valerate cream usp is a medium potency corticosteroid indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid responsive dermatoses in adult patients.
Dosage and Administration:
Dosage and administration hydrocortisone valerate cream should be applied to the affected area as a thin film two or three times daily depending on the severity of the condition. as with other corticosteroids, therapy should be discontinued when control is achieved. if no improvement is seen within 2 weeks, reassessment of the diagnosis may be necessary. hydrocortisone valerate cream should not be used with occlusive dressings unless directed by a physician. hydrocortisone valerate cream should not be applied in the diaper area if the patient requires diapers or plastic pants as these garments may constitute occlusive dressing.
Contraindications:
Contraindications hydrocortisone valerate cream is contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation.
Adverse Reactions:
Adverse reactions the following local adverse reactions have been reported with topical corticosteroids, and they may occur more frequently with the use of occlusive dressings. these reactions are listed in an approximate decreasing order of occurrence: burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, secondary infection, skin atrophy, striae, and miliaria. in controlled clinical studies involving pediatric patients one month to 2 years of age (n=29), the incidence of adverse experiences, regardless of relationship to the use of hydrocortisone valerate cream, was approximately 21%. reported reactions included stinging (10%), eczema (7%), fungal infection (3%), and gastrointestinal disorder (3%). in controlled clinical studies involving pediatric patients 2 to 12 years of age (n=153), the incidence of adverse experiences, regardless of relationship to the
Read more...use of hydrocortisone valerate cream, was approximately 10%. reported reactions included stinging (3%), burning skin (2%), infection (body as a whole) (2%). skin irritation, eczema, pruritus, application site reaction, rash, rash maculopapular, and dry skin were all reported at incidences of approximately 1%.
Use in Pregnancy:
Pregnancy teratogenic effects pregnancy category c: corticosteroids have been shown to be teratogenic in laboratory animals when administered systemically at relatively low dosage levels. some corticosteroids have been shown to be teratogenic after dermal application in laboratory animals. dermal embryofetal developmental studies were conducted in rabbits and rats with hydrocortisone valerate cream, 0.2%. hydrocortisone valerate cream, 0.2%, was administered topically for 4 hours/day, rather than the preferred 24 hours/day, during the period of organogenesis in rats (gestational days 5 to 16) and rabbits (gestational days 6 to 19). topical doses of hydrocortisone valerate up to 9 mg/kg/day (54 mg/m 2 /day) were administered to rats and 5 mg/kg/day (60 mg/m 2 /day) were administered to rabbits. in the absence of maternal toxicity, a significant increase in delayed skeletal ossification in fetuses was noted at 9 mg/kg/day [2.5x the maximum recommended human dose (mrhd) based on body surf
Read more...ace area (bsa) comparisons] in the rat study. no malformations in the fetuses were noted at 9 mg/kg/day (2.5x mrhd based on bsa comparisons) in the rat study. indicators of embryofetal toxicity, significant decrease in fetal weight at 2 mg/kg/day (1x mrhd based on bsa) and a significant increase in post-implantation loss and embryo resorption at 5 mg/kg (3x mrhd based on bsa), were noted in the rabbit study. a significant increase in delayed skeletal ossification in fetuses was noted at 5 mg/kg/day (3x the mrhd based on bsa comparisons) in the rabbit study.increased numbers of fetal malformations (e.g., cleft palate, omphalocele and clubbed feet) were noted at 5 mg/kg/day (3x mrhd based on bsa comparisons) in the rabbit study. there are no adequate and well-controlled studies in pregnant women. hydrocortisone valerate cream should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Pediatric Use:
Pediatric use safety of this product in pediatric patients has not been established. there is no data on adrenal suppression and/or growth suppression. because of a higher ratio of skin surface area to body mass, pediatric patients are at a greater risk than adults of hpa axis suppression and cushing's syndrome when they are treated with topical corticosteroids. they are therefore also at a greater risk of adrenal insufficiency during and/or after withdrawal of treatment. adverse effects including striae have been reported with inappropriate use of topical corticosteroids in infants and children ( see precautions ). hpa axis suppression, cushing's syndrome, linear growth retardation, delayed weight gain, and intracranial hypertension have been reported in children receiving topical corticosteroids. manifestations of adrenal suppression in children include low plasma cortisol levels, and an absence of response to acth stimulation. manifestations of intracranial hypertension include bulg
Read more...ing fontanelles, headaches, and bilateral papilledema.
Geriatric Use:
Geriatric use clinical studies of hydrocortisone valerate cream did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. other reported clinical experience has not identified differences in responses between the elderly and younger patients.
Overdosage:
Overdosage topically applied hydrocortisone valerate cream can be absorbed in sufficient amounts to produce systemic effects ( see precautions ).
Description:
Description hydrocortisone valerate cream usp contain hydrocortisone valerate, 11β,17,21-trihydroxypregn-4-ene-3,20-dione 17-valerate, a synthetic corticosteroid for topical dermatologic use. the corticosteroids constitute a class of primarily synthetic steroids used topically as anti-inflammatory and antipruritic agents. chemically, hydrocortisone valerate is c 26 h 38 o 6 . it has the following structural formula: hydrocortisone valerate has a molecular weight of 446.58. it is a white to off-white crystalline powder, soluble in ethanol and methanol, sparingly soluble in propylene glycol and insoluble in water. each gram of hydrocortisone valerate cream usp contains 2 mg hydrocortisone valerate usp in a hydrophilic base composed of carbomer homopolymer type c, dibasic sodium phosphate, methylparaben, polyoxyl 2 stearyl ether, propylene glycol, purified water, sodium lauryl sulfate, steareth-100, stearyl alcohol and white petrolatum. hydrocortisone valerate
Clinical Pharmacology:
Clinical pharmacology like other topical corticosteroids, hydrocortisone valerate has anti-inflammatory, antipruritic and vasoconstrictive properties. the mechanism of the anti-inflammatory activity of the topical steroids, in general, is unclear. however, corticosteroids are thought to act by the induction of phospholipase a 2 inhibitory proteins, collectively called lipocortins. it is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. arachidonic acid is released from membrane phospholipids by phospholipase a 2 . pharmacokinetics the extent of percutaneous absorption of topical corticosteroids is determined by many factors including the vehicle and the integrity of the epidermal barrier. occlusive dressings with hydrocortisone for up to 24 hours have not been demonstrated to increase penetration; however, occlusion of hydrocortisone fo
Read more...r 96 hours markedly enhances penetration. topical corticosteroids can be absorbed from normal intact skin. inflammation and/or other disease processes in the skin may increase percutaneous absorption. studies performed with hydrocortisone valerate cream indicate that it is in the medium range of potency as compared with other topical corticosteroids.
Pharmacokinetics:
Pharmacokinetics the extent of percutaneous absorption of topical corticosteroids is determined by many factors including the vehicle and the integrity of the epidermal barrier. occlusive dressings with hydrocortisone for up to 24 hours have not been demonstrated to increase penetration; however, occlusion of hydrocortisone for 96 hours markedly enhances penetration. topical corticosteroids can be absorbed from normal intact skin. inflammation and/or other disease processes in the skin may increase percutaneous absorption. studies performed with hydrocortisone valerate cream indicate that it is in the medium range of potency as compared with other topical corticosteroids.
How Supplied:
How supplied hydrocortisone valerate cream usp, 0.2%, is supplied in 15 g (ndc 68180-954-01), 45 g (ndc 68180-954-02) and 60 g (ndc 68180-954-03) tube sizes. storage store at 25°c (77°f); excursions permitted to 15° to 30°c (59° to 86°f) [see usp controlled room temperature].
Information for Patients:
Information for patients patients using topical corticosteroids should receive the following information and instructions: this medication is to be used as directed by the physician. it is for external use only. avoid contact with the eyes. this medication should not be used for any disorder other than that for which it was prescribed. the treated skin area should not be bandaged, otherwise covered or wrapped, so as to be occlusive unless directed by the physician. patients should report to their physician any signs of local adverse reactions. hydrocortisone valerate cream should not be applied in the diaper areas as diapers or plastic pants may constitute occlusive dressings ( see dosage and administration ). this medication should not be used on the face, underarms, or groin areas unless directed by the physician. as with other corticosteroids, therapy should be discontinued when control is achieved. if no improvement is seen within 2 weeks, contact the physician.
Package Label Principal Display Panel:
Hydrocortisone valerate cream usp, 0.2% 15 g ndc 68180-954-01 rx only for topical use only. not for ophthalmic use. keep this and all medications out of the reach of children. hydrocortisone valerate cream usp, 0.2% 15 g tube label ndc 68180-954-01 rx only hydrocortisone valerate cream usp, 0.2% 15 g carton label ndc 68180-954-01 rx only