CORDRAN N

Clinical safety rating: caution

Comprehensive clinical and safety monograph for CORDRAN N (CORDRAN N).

How it works

Cordran N contains flurandrenolide, a corticosteroid that exerts anti-inflammatory, antipruritic, and vasoconstrictive actions by inducing phospholipase A2 inhibitory proteins (lipocortins) and modulating gene expression; neomycin is an aminoglycoside antibiotic that inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit.

What the body does with it

Metabolism	Flurandrenolide: primarily hepatic via CYP450 enzymes; Neomycin: minimally absorbed through intact skin, but absorbed if applied to large areas or damaged skin; systemic neomycin is excreted renally unchanged.
Excretion	Primarily renal (biliary/fecal minimal). Unchanged drug and glucuronide metabolites excreted in urine.
Half-life	Approximately 1-2 hours. Short half-life consistent with topical use; systemic exposure minimal with proper application.
Protein binding	Corticosteroids: ~90% bound to corticosteroid-binding globulin (CBG) and albumin.
Volume of Distribution	Flurandrenolide (active component): Vd ~0.5-1 L/kg. Distributes into extracellular fluid; limited tissue binding.
Bioavailability	Topical: Systemic bioavailability low (≤5%) with intact skin; enhanced with occlusion or inflamed skin. No oral formulation available.
Onset of Action	Topical: Relief of pruritus within 24-48 hours; anti-inflammatory effect evident by 3-5 days.
Duration of Action	Topical: Duration of effect 6-8 hours per application. Clinical improvement sustained with regular use; effects reversible upon discontinuation.

Classification & Brands

Dosing & administration

Apply sparingly to affected area 2-3 times daily. Use for no longer than 2 weeks.

Dosage form	OINTMENT
Renal impairment	No dosage adjustment required for renal impairment.
Liver impairment	No dosage adjustment required for hepatic impairment.
Pediatric use	Use lowest potency formulation; limit to smallest amount and shortest duration necessary. Avoid in children <2 years.
Geriatric use	Use with caution due to thinner skin; apply sparingly and limit duration to minimize systemic absorption and adverse effects.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for CORDRAN N (CORDRAN N).

Breastfeeding	Caution: Topical corticosteroids may be absorbed systemically in amounts sufficient to appear in breast milk. However, with short-term, low-dose topical use, nursing is likely safe. M/P ratio not established. Apply sparingly to smallest area for shortest duration; avoid application to breast before nursing.
Teratogenic Risk	Pregnancy Category C. Topical corticosteroids should be used during pregnancy only if potential benefit justifies potential risk to fetus. Avoid prolonged use or use over large areas, especially in first trimester. Systemic absorption may cause fetal growth restriction, adrenal suppression. No adequate human studies; animal studies show teratogenicity with systemic corticosteroids.

Warnings & precautions

■ FDA Black Box Warning

None.

Side Effect Profile

Serious Effects

Absolute Contraindications

Known hypersensitivity to flurandrenolide, neomycin, or any component; viral, fungal, or tuberculous skin lesions; untreated bacterial infections; application to eyes or mucosal surfaces.

Clinical Precautions

Precautions

Prolonged use may cause hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome, or local atrophy. Avoid use in large quantities or on occluded areas. Neomycin may cause ototoxicity, nephrotoxicity, or neurotoxicity if significant systemic absorption occurs; avoid use in patients with renal impairment. Monitor for overgrowth of non-susceptible organisms.

Clinical Tips & Counseling

Drug interactions

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CORDRAN N

Clinical safety rating: caution

Comprehensive clinical and safety monograph for CORDRAN N (CORDRAN N).

How it works

What the body does with it

Metabolism	Flurandrenolide: primarily hepatic via CYP450 enzymes; Neomycin: minimally absorbed through intact skin, but absorbed if applied to large areas or damaged skin; systemic neomycin is excreted renally unchanged.
Excretion	Primarily renal (biliary/fecal minimal). Unchanged drug and glucuronide metabolites excreted in urine.
Half-life	Approximately 1-2 hours. Short half-life consistent with topical use; systemic exposure minimal with proper application.
Protein binding	Corticosteroids: ~90% bound to corticosteroid-binding globulin (CBG) and albumin.
Volume of Distribution	Flurandrenolide (active component): Vd ~0.5-1 L/kg. Distributes into extracellular fluid; limited tissue binding.
Bioavailability	Topical: Systemic bioavailability low (≤5%) with intact skin; enhanced with occlusion or inflamed skin. No oral formulation available.
Onset of Action	Topical: Relief of pruritus within 24-48 hours; anti-inflammatory effect evident by 3-5 days.
Duration of Action	Topical: Duration of effect 6-8 hours per application. Clinical improvement sustained with regular use; effects reversible upon discontinuation.

Classification & Brands

Dosing & administration

Apply sparingly to affected area 2-3 times daily. Use for no longer than 2 weeks.

Dosage form	OINTMENT
Renal impairment	No dosage adjustment required for renal impairment.
Liver impairment	No dosage adjustment required for hepatic impairment.
Pediatric use	Use lowest potency formulation; limit to smallest amount and shortest duration necessary. Avoid in children <2 years.
Geriatric use	Use with caution due to thinner skin; apply sparingly and limit duration to minimize systemic absorption and adverse effects.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for CORDRAN N (CORDRAN N).

Breastfeeding	Caution: Topical corticosteroids may be absorbed systemically in amounts sufficient to appear in breast milk. However, with short-term, low-dose topical use, nursing is likely safe. M/P ratio not established. Apply sparingly to smallest area for shortest duration; avoid application to breast before nursing.
Teratogenic Risk	Pregnancy Category C. Topical corticosteroids should be used during pregnancy only if potential benefit justifies potential risk to fetus. Avoid prolonged use or use over large areas, especially in first trimester. Systemic absorption may cause fetal growth restriction, adrenal suppression. No adequate human studies; animal studies show teratogenicity with systemic corticosteroids.

Warnings & precautions

■ FDA Black Box Warning

None.

Side Effect Profile

Serious Effects

Absolute Contraindications

Known hypersensitivity to flurandrenolide, neomycin, or any component; viral, fungal, or tuberculous skin lesions; untreated bacterial infections; application to eyes or mucosal surfaces.