hydrocortisone acetate: clinical use

Prescribing considerations

• Confirm an appropriate non-infected inflammatory dermatosis.
• Children younger than 10 years require medical advice for this product.
• Reassess deterioration, treatment failure or rapid recurrence rather than automatically restarting or escalating treatment.
• Consider contact sensitivity to cetostearyl alcohol if dermatitis worsens.

Contraindications and cautions

• Hypersensitivity to hydrocortisone acetate or an excipient
• Application to the eyes, face or anogenital area
• Broken or infected skin, including impetigo, cold sores, acne, athlete's foot or infected bites
• Untreated bacterial, viral, tuberculous or fungal infection
• Use under an occlusive dressing or over a large body area

Monitoring

• Clinical response and signs of secondary infection or an alternative diagnosis
• Local atrophy, striae, telangiectasia and pigment changes
• Withdrawal-type inflammation following inappropriate or continuous use
• Visual disturbance requiring ophthalmological assessment
• Features of systemic corticosteroid exposure where absorption or misuse is a concern

Clinical pharmacology

A weak dermatological corticosteroid whose receptor-mediated activity reduces inflammatory mediator release, capillary permeability, oedema and macrophage accumulation.

Formulation and product differences

• The selected cream contains white soft paraffin, liquid paraffin, phenoxyethanol and cetomacrogol emulsifying wax.
• Cetomacrogol emulsifying wax contains cetostearyl alcohol, which can cause local contact dermatitis.
• The paraffin-containing formulation can increase the flammability of contaminated clothing and bedding.

Cream

Route: Cutaneous

Strengths: 1%