DERMACORT
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DERMACORT (DERMACORT).
Corticosteroid that binds to glucocorticoid receptors, modulating gene expression to reduce inflammation and immune response.
| Metabolism | Hepatic via CYP3A4 |
| Excretion | Primarily hepatic metabolism; metabolites are excreted renally (~75% as glucuronide and sulfate conjugates) and fecally (~25%). Less than 5% of the dose is excreted unchanged in urine. |
| Half-life | Terminal elimination half-life is approximately 2-3 hours for hydrocortisone, the active component. Due to its short half-life, it requires multiple daily doses for sustained effect. |
| Protein binding | Hydrocortisone is 90-95% bound to plasma proteins, primarily corticosteroid-binding globulin (CBG) and albumin. |
| Volume of Distribution | Vd is approximately 0.3-0.5 L/kg for hydrocortisone, indicating distribution primarily into extracellular fluid. |
| Bioavailability | Bioavailability for topical application is variable and minimal systemically (<1% for intact skin, but can increase up to 30-40% with compromised skin barrier or occlusive dressings). |
| Onset of Action | Topical: Onset of anti-inflammatory action is within minutes to hours, with visible improvement often seen within 24-48 hours. No systemic routes are used; topical application only. |
| Duration of Action | Duration of action is approximately 4-8 hours after topical application, depending on formulation and skin condition. Frequent reapplication is needed for chronic conditions. |
Apply a thin film to affected area twice daily (every 12 hours) for up to 2 weeks.
| Dosage form | CREAM |
| Renal impairment | No dose adjustment required for renal impairment. |
| Liver impairment | No dose adjustment required for hepatic impairment. |
| Pediatric use | Apply a thin film to affected area once daily for no more than 2 weeks; avoid use in children under 2 years. |
| Geriatric use | Use with caution; apply sparingly to limited areas due to increased risk of skin atrophy and systemic absorption. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DERMACORT (DERMACORT).
| Breastfeeding | Likely safe in limited, low-potency topical use; systemic absorption minimal. M/P ratio unknown. Avoid application to breast area to prevent infant ingestion. Discontinue if infant exposed to large areas or prolonged treatment. |
| Teratogenic Risk | Insufficient human data; animal studies show fetal risk from repeated systemic exposure. Topical use minimizes absorption but avoid prolonged use in first trimester. Corticosteroids may cause intrauterine growth restriction with continuous high-dose therapy. |
■ FDA Black Box Warning
None
| Serious Effects |
["Untreated bacterial, fungal, or viral infections","Hypersensitivity to any component"]
| Precautions | ["Systemic absorption can cause reversible HPA axis suppression","Local irritation","Secondary infection","Skin atrophy with prolonged use"] |
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| Fetal Monitoring |
| Monitor maternal blood pressure, blood glucose, and signs of infection with prolonged use. Assess fetal growth via ultrasound if high-potency or extensive area use. |
| Fertility Effects | No known impact on fertility with topical use. Systemic corticosteroids may disrupt menstrual cycles; topical unlikely to affect fertility. |