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Pronunciation:

(floo oh SIN oh nide)

U.S. Brand Names:

Lidex®; Lidex-E®

Generic Available:

Yes

Canadian Brand Names:

Lidemol®; Lidex®; Lyderm®; Lydonide; Tiamol®; Topsyn®

Use:

Anti-inflammatory, antipruritic, relief of inflammatory and pruritic manifestations [high potency topical corticosteroid]

Pregnancy Risk Factor:

Contraindications:

Hypersensitivity to fluocinonide or any component of the formulation; viral, fungal, or tubercular skin lesions, herpes simplex

Warnings/Precautions:

Adverse systemic effects may occur when used on large areas of the body, denuded areas, for prolonged periods of time, with an occlusive dressing, and/or in infants or small children

Adverse Reactions:

Frequency not defined.

Cardiovascular: Intracranial hypertension

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

Endocrine & metabolic: HPA suppression, Cushing's syndrome, growth retardation

Local: Burning, itching, irritation, dryness,

Miscellaneous: Secondary infection

Drug Interactions:

No data reported

Mechanism of Action:

Fluorinated topical corticosteroid considered to be of high potency. The mechanism of action for all topical corticosteroids is not well defined, however, is felt to be a combination of three important properties: anti-inflammatory activity, immunosuppressive properties, and antiproliferative actions.

Pharmacodynamics/Kinetics:

Absorption: Dependent on strength of product, amount applied, and nature of skin at application site; ranges from ~1% in areas of thick stratum corneum (palms, soles, elbows, etc) to 36% in areas of thin stratum corneum (face, eyelids, etc); increased in areas of skin damage, inflammation, or occlusion

Distribution: Throughout local skin; absorbed drug into muscle, liver, skin, intestines, and kidneys

Metabolism: Primarily in skin; small amount absorbed into systemic circulation is primarily hepatic to inactive compounds

Excretion: Urine (primarily as glucuronide and sulfate, also as unconjugated products); feces (small amounts as metabolites)

Dosage:

Children and Adults: Topical: Apply thin layer to affected area 2-4 times/day depending on the severity of the condition. Therapy should be discontinued when control is achieved; if no improvement is seen, reassessment of diagnosis may be necessary.

Patient Education:

For external use only. Do not use for eyes, mucous membranes, or open wounds. Use exactly as directed and for no longer than the period prescribed. Before using, wash and dry area gently. Apply in a thin layer (may rub in lightly). Apply light dressing (if necessary) to area being treated. Do not use occlusive dressing unless so advised by prescriber. Avoid prolonged or excessive use around sensitive tissues, genital, or rectal areas. Avoid exposing treated area to direct sunlight. Inform prescriber if condition worsens (redness, swelling, irritation, signs of infection, or open sores) or fails to improve. Pregnancy precaution: Inform prescriber if you are or intend to become pregnant.

Nursing Implications:

Use sparingly

Dental Health: Effects on Dental Treatment:

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

No information available to require special precautions

Mental Health: Effects on Mental Status:

None reported

Mental Health: Effects on Psychiatric Treatment:

None reported

Dosage Forms:

Cream, anhydrous, emollient (Lidex®): 0.05% (15 g, 30 g, 60 g)

Cream, aqueous, emollient (Lidex-E®): 0.05% (15 g, 30 g, 60 g)

Gel (Lidex®): 0.05% (15 g, 30 g, 60 g)

Ointment (Lidex®): 0.05% (15 g, 30 g, 60 g)

Solution (Lidex®): 0.05% (20 mL [DSC], 60 mL) [contains alcohol 35%]

International Brand Names:

Biscosal® (JP); Flu-21® (IT); Glycobase® (JP); Hakelon® (JP); Klariderm® (ES); Lidemol® (CA); Lidex® (BE, CA, LU); Lyderm® (CA); Lydonide (CA); Medrexim® (JP); Metosyn® (DK, GB, HK); Novoter® (ES); Ruful® (JP); Simaron® (JP); Solunim® (JP); Supracort® (IL); Tiamol® (CA); Topsym® (AT, CH, DE, EC, JP); Topsymin® (AT, CH); Topsyn® (CA, IT, MX); Topsyne® (NL)

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