NOGENIC HC
Clinical safety rating: caution
Comprehensive clinical and safety monograph for NOGENIC HC (NOGENIC HC).
NOGENIC HC contains hydrocortisone, a corticosteroid that binds to glucocorticoid receptors, modulating gene transcription and reducing inflammation, immune responses, and cytokine production.
| Metabolism | Hydrocortisone is primarily metabolized in the liver via reduction and conjugation to inactive metabolites; CYP3A4 may be involved in minor metabolic pathways. |
| Excretion | Primarily hepatic metabolism; biliary excretion accounts for approximately 80%; renal elimination of inactive metabolites less than 5% as unchanged drug. |
| Half-life | Terminal elimination half-life is 12-15 hours. In patients with hepatic impairment, half-life may be prolonged up to 24 hours; no dose adjustment required for renal impairment. |
| Protein binding | Approximately 85-90% bound to serum albumin and alpha-1-acid glycoprotein. |
| Volume of Distribution | 0.35 L/kg. Reflects moderate tissue penetration with minimal accumulation in deep compartments. |
| Bioavailability | Oral: 50-60% (first-pass effect); Subcutaneous: near 100%. |
| Onset of Action | Oral: 30-60 minutes; Subcutaneous: 15-30 minutes; Intravenous: immediate (within 5 minutes). |
| Duration of Action | Oral: 6-8 hours; Subcutaneous: 8-12 hours; Intravenous: 4-6 hours. Duration is dose-dependent and may be prolonged in hepatic impairment. |
NOGENIC HC is not a recognized drug. Please verify the name. No dosing information available.
| Dosage form | CREAM |
| Renal impairment | No data. |
| Liver impairment | No data. |
| Pediatric use | No data. |
| Geriatric use | No data. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for NOGENIC HC (NOGENIC HC).
| Breastfeeding | NOGENIC HC is contraindicated during breastfeeding. Hydrocortisone enters breast milk at low concentrations (M/P ratio ~0.25 for systemic hydrocortisone; NSAID component M/P ratio unknown but likely low). Potential for adverse effects in nursing infant including adrenal suppression and gastrointestinal toxicity. Discontinue breastfeeding or avoid use. |
| Teratogenic Risk | NOGENIC HC is contraindicated in pregnancy. First trimester: Risk of neural tube defects, cleft palate, and omphalocele based on animal studies and limited human data; second and third trimesters: Risk of oligohydramnios, fetal renal impairment, and premature closure of ductus arteriosus due to NSAID component (hydrocortisone component may cause growth restriction and adrenal suppression). |
■ FDA Black Box Warning
Corticosteroids can suppress the hypothalamic-pituitary-adrenal (HPA) axis, leading to adrenal insufficiency, especially with prolonged or high-dose use.
| Serious Effects |
["Hypersensitivity to hydrocortisone or any component of the formulation","Untreated bacterial, fungal, viral, or parasitic infections at the application site","Cutaneous tuberculosis, varicella, herpes simplex, or vaccinia"]
| Precautions | ["Systemic absorption may produce reversible HPA axis suppression, Cushing's syndrome, hyperglycemia, and glucosuria.","Pediatric patients may be more susceptible to systemic toxicity due to higher skin surface-to-body-mass ratio.","Avoid use in the presence of untreated bacterial, fungal, or viral infections.","Prolonged use may cause skin atrophy, striae, and telangiectasias.","Use caution when applying to large areas, under occlusion, or on broken skin.","Do not use as monotherapy in primary bacterial infections."] |
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| Fetal Monitoring | If inadvertent exposure during pregnancy, monitor fetal growth by ultrasound every 4 weeks, assess amniotic fluid index weekly after 20 weeks, fetal echocardiogram at 24-28 weeks for premature ductus arteriosus closure. Maternal monitoring for hypertension, renal function, serum electrolytes, and signs of adrenal suppression. |
| Fertility Effects | Both components may impair fertility. Hydrocortisone may disrupt menstrual cycle and ovulation via hypothalamic-pituitary-adrenal axis suppression. NSAIDs inhibit prostaglandin synthesis, potentially delaying or preventing ovulation due to luteinized unruptured follicle syndrome. Reversible upon discontinuation. |