Trade Names:Capex- Shampoo 0.01%
Trade Names:Derma-Smoothe/FS- Oil 0.01%
Trade Names:Retisert- Implant 0.59 mg
Trade Names:Synalar- Solution 0.01%- Cream 0.025%- Ointment 0.025%Fluoderm (Canada)
Low- to medium-potency topical corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictive properties. Thought to act by induction of phospholipase A2 inhibitory proteins (lipocortins). Lipocortins appear to control biosynthesis of potent mediators of inflammation (prostaglandins, leukotrienes) by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
Treatment of seborrheic dermatitis of the scalp.Derma-Smoothe/FS
Treatment of scalp psoriasis.Retisert intravitreal implant
Treatment of chronic noninfectious uveitis affecting the posterior segment of the eye.Synalar
Relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatosis.
Hypersensitivity to any component of the product. Retisert : Most viral diseases of cornea and conjunctiva, including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella, and also mycobacterial infections of the eye and fungal diseases of ocular structures.
Topical Apply sparingly to affected areas 2 to 4 times daily (once daily for medicated shampoo and topical oil).Chronic Non-Infectious Uveitis ( Retisert only)Adults
Intravitreal implant Surgically inserted into posterior segment of affected every 30 mo.
Store solution, cream, ointment, shampoo, and oil below 86°F. Protect from freezing. Store intravitreal implants at controlled room temperature (59° to 77°F). Protect from freezing.
None well documented.
None well documented.
Headache (31%); dizziness (5% to 15%).
Burning; itching; irritation; dryness; folliculitis; hypertrichosis; acneiform eruptions; hypopigmentation; perioral dermatitis; allergic contact dermatitis; maceration of the skin; secondary infection; skin atrophy; striae; miliaria.Retisert
Rash (5% to 15%).
Elevated IOP with possible development of glaucoma, eye pain, procedural complications (including cataract fragments, implant expulsion, injury, mechanical complications of implant, migration of implant, post-op complications, post-op wound complication, wound dehiscence [50% to 90%]); within 2 yr post-implant, nearly all phakic eyes are expected to develop cataracts and require surgery; within 34 wk post-implantation, about 60% of patients will require IOP-lowering medication to control IOP; within an average post-implantation period of about 2 yr, approximately 32% of patients are expected to require filtering procedures to control IOP; reduced visual acuity, conjunctival hemorrhage, conjunctival hyperemia, glaucoma, blurred vision, abnormal sensation in the eye, eye irritation, hypotony, pruritus, vitreous floaters, maculopathy, vitreous hemorrhage, ptosis, eye inflammation, eyelid edema, increased tearing, dry eye (10% to 35%); macular edema, visual disturbances, eye discharge, conjunctival edema/chemosis, photophobia, blepharitis, corneal edema, photopsia, retinal hemorrhage, choroidal detachment, vitreous opacities, eye swelling (5% to 9%); nasopharyngitis (5% to 15%); optic nerve damage, visual acuity and field defects; posterior subcapsular cataract formation; delayed wound healing; perforation of the globe where there is thinning of the sclera; development of secondary ocular infections (including bacterial, fungal, and viral).
Nausea, vomiting (5% to 15%).
Arthralgia, back pain, limb pain (5% to 15%).
Cough, sinusitis, upper respiratory tract infection (5% to 15%).
Systemic absorption may produce reversible hypothalamic pituitary adrenal (HPA) axis suppression, manifestations of Cushing syndrome, hyperglycemia, and glycosuria.Retisert
Influenza, pain, pyrexia (5% to 15%).
Assess and document skin condition before initial topical application and periodically throughout treatment. Inform health care provider if condition does not improve, worsens, or if application site reactions develop. Periodically evaluate patient applying medication to a large surface area, or to areas under occlusion, for evidence of HPA axis suppression (eg, ACTH stimulation, A.M. plasma cortisol, urinary free cortisol tests). If HPA axis suppression is noted, ensure that attempts are made to discontinue the drug, reduce frequency of application, or substitute a less potent corticosteroid. Be prepared to supplement with systemic corticosteroids if symptoms of glucocorticosteroid insufficiency occur. Monitor IOP following implantation of vitreal implant.
Category C .
Safety and efficacy not established. Children may be more susceptible to systemic toxicity from equivalent doses because of their larger skin surface to body mass ratios. Safety and efficacy of intravitreal implant has not been established in children younger than 12 years of age.
Ensure that appropriate antifungal or antibacterial therapy is used in a patient who has a concomitant skin infection.Systemic effects
Systemic absorption may produce reversible HPA axis suppression, manifestations of Cushing syndrome, hyperglycemia, and glucosuria. Prolonged application or application to large surface areas or areas under occlusion increase risk of systemic effects.
Potential complications accompanying intraocular surgery may include: cataract formation, choroidal detachment, temporary decreased visual acuity, endophthalmitis, hypotony, increased IOP, exacerbation of intraocular inflammation, retinal detachment, vitreous hemorrhage, vitreous loss, wound dehiscence.Glaucoma
Use with caution in presence of glaucoma. Prolonged use of corticosteroids may result in glaucoma with damage to the optic nerve, defects in visual acuity and fields of vision, and in posterior subcapsular cataract formation.Decreased visual acuity
Following implantation nearly all patients will experience an immediate and temporary decrease in visual acuity in the implanted eye which lasts for approximately 1 to 4 wk.Viral infection of the eye
Ocular steroids may prolong the course and may exacerbate severity of many viral infections of the eye. Use with great caution in patients with viral disease of the cornea and conjunctiva or in patients with history of herpes simplex infection.Secondary ocular infections
Ocular corticosteroids may suppress host response and increase the hazard of secondary ocular infections.Cataract surgery
Use of corticosteroids after cataract surgery may delay healing and increase incidence of bleb formation.
Absorption may be sufficient to produce systemic effects.
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