NUTRACORT
Clinical safety rating: caution
Comprehensive clinical and safety monograph for NUTRACORT (NUTRACORT).
Corticosteroid receptor agonist; induces anti-inflammatory proteins and suppresses inflammatory mediators.
| Metabolism | Hepatic via CYP3A4. |
| Excretion | Renal (primarily as glucuronide and sulfate conjugates, <10% unchanged) and fecal (biliary excretion of metabolites). Approximately 70-80% renal, 20-30% fecal. |
| Half-life | Terminal half-life: 2-4 hours (mean 3 hours). Clinically, dosing every 6-8 hours maintains therapeutic levels. |
| Protein binding | Approximately 85-90%, primarily to albumin and corticosteroid-binding globulin. |
| Volume of Distribution | Vd: 0.3-0.5 L/kg, indicating distribution primarily into extracellular fluid. |
| Bioavailability | Oral: 60-70% (first-pass metabolism); Topical: <1% systemically absorbed (intact skin). |
| Onset of Action | Oral: 30-60 minutes; Topical: 1-2 hours for anti-inflammatory effect. |
| Duration of Action | Oral: 6-8 hours; Topical: 8-12 hours. Duration is dose-dependent; higher doses prolong effect. |
One capsule (200 mg) orally twice daily with meals.
| Dosage form | GEL |
| Renal impairment | GFR >30 mL/min: no adjustment. GFR 15-30 mL/min: 200 mg once daily. GFR <15 mL/min or dialysis: 200 mg every 48 hours. |
| Liver impairment | Child-Pugh A: no adjustment. Child-Pugh B: 200 mg once daily. Child-Pugh C: not recommended. |
| Pediatric use | Weight <40 kg: not established. Weight >40 kg: same as adult. |
| Geriatric use | No dose adjustment required. Caution in patients with decreased renal function. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for NUTRACORT (NUTRACORT).
| Breastfeeding | Enters breast milk; M/P ratio ~0.2-0.5. Avoid high doses; use lowest effective dose. Monitor infant for adrenal suppression. |
| Teratogenic Risk | First trimester: Increased risk of cleft palate (odds ratio ~1.3-3.3). Second/third trimester: Fetal growth restriction, adrenal suppression, oligohydramnios. Chronic use: Risk of preterm birth and low birth weight. |
| Fetal Monitoring |
■ FDA Black Box Warning
None.
| Serious Effects |
["Hypersensitivity to any component","Untreated nasal infections"]
| Precautions | ["Nasal irritation","Epistaxis","Risk of adrenal suppression with prolonged high-dose use","Potential for growth retardation in children","Increased susceptibility to infections"] |
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| Maternal: Blood pressure, blood glucose. Fetal: Ultrasound for growth restriction and amniotic fluid index; fetal heart rate monitoring if prolonged use. |
| Fertility Effects | May impair ovulation with high doses. Reversible upon discontinuation. |