Topicort


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desoximetasone

(des-ox-i-met-a-sone) ,

Topicort

(trade name),

Topicort-LP

(trade name)

Classification

Therapeutic: anti inflammatories steroidal
Pharmacologic: corticosteroids
Pregnancy Category: C

Indications

Management of inflammation and pruritis associated with various allergic/immunologic skin problems.Topical spray: Plaque psoriasis

Action

Suppresses normal immune response and inflammation.

Therapeutic effects

Suppression of dermatologic inflammation and immune processes.
Clearing of plaques

Pharmacokinetics

Absorption: Minimal. Prolonged use on large surface areas or large amounts applied or use of occlusive dressings may increase systemic absorption.
Distribution: Remains primarily at site of action.
Metabolism and Excretion: Usually metabolized in skin.
Half-life: Unknown.

Time/action profile (response depends on condition being treated)

ROUTEONSETPEAKDURATION
Topicalmin–hrshrs–dayshrs–days

Contraindications/Precautions

Contraindicated in: Hypersensitivity or known intolerance to corticosteroids or components of vehicles (ointment or cream base, preservative, alcohol); Untreated bacterial or viral infections.
Use Cautiously in: Hepatic dysfunction; Diabetes mellitus, cataracts, glaucoma, or tuberculosis (use of large amounts of high-potency agents may worsen condition); Patients with pre-existing skin atrophy; Obstetric / Lactation: Chronic high-dose usage may result in adrenal suppression in mother, growth suppression in children; Pediatric: Children <10 yr (cream, gel, ointment); Children <18 yr (spray) (safety not established); children may be more susceptible to adrenal and growth suppression.

Adverse Reactions/Side Effects

Dermatologic

  • allergic contact dermatitis
  • atrophy
  • burning
  • dryness
  • edema
  • folliculitis
  • hypersensitivity reactions
  • hypertrichosis
  • hypopigmentation
  • irritation
  • maceration
  • miliaria
  • perioral dermatitis
  • secondary infection
  • striae

Miscellaneous

  • adrenal suppression (use of occlusive dressings, long-term therapy)

Interactions

Drug-Drug interaction

None significant.

Route/Dosage

Topical (Adults) Cream, gel, or ointment—Apply to affected area(s) twice daily; Spray—Apply to affected area(s) twice daily; do not use for longer than 4 wk.
Topical (Children ≥10 yr) Cream, gel, or ointment—Apply to affected area(s) once daily.

Availability (generic available)

Cream: 0.25%, 0.05%
Gel: 0.05%
Ointment: 0.25%
Spray: 0.25%

Nursing implications

Nursing assessment

  • Assess affected skin before and daily during therapy. Note degree of inflammation, pruritus, and/or plaques. Notify health care professional if symptoms of infection (increased pain, erythema, purulent exudate) develop.
  • Lab Test Considerations: Periodic adrenal function tests may be ordered to assess degree of hypothalamic-pituitary-adrenal (HPA) axis suppression in chronic topical therapy if suspected. Children and patients with dose applied to a large area, using an occlusive dressing, or using high-potency products are at highest risk for HPA suppression.
    • May cause increased serum and urine glucose concentrations if significant absorption occurs.

Potential Nursing Diagnoses

Risk for impaired skin integrity (Indications)
Risk for infection (Side Effects)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

  • Choice of vehicle depends on site and type of lesion. Ointments are more occlusive and preferred for dry, scaly lesions. Creams should be used on oozing or intertriginous areas, where the occlusive action of ointments might cause folliculitis or maceration. Creams may be preferred for aesthetic reasons even though they may be more drying to skin than ointments. Gel is useful in hairy areas.
  • Topical: Apply ointments, creams, orgels sparingly as a thin film to clean, slightly moist skin. Wear gloves. Apply occlusive dressing only if specified by physician or other health care professional.
    • Apply gel to hair by parting hair and applying a small amount to affected area. Rub in gently. Protect area from washing, clothing, or rubbing until medication has dried. Hair may be washed as usual but not right after applying medication.

Patient/Family Teaching

  • Instruct patient on correct technique of medication administration. Emphasize importance of avoiding the eyes. If a dose is missed, it should be applied as soon as remembered unless almost time for the next dose.
  • Caution patient to use only as directed. Avoid using cosmetics, bandages, dressings, or other skin products over the treated area unless directed by health care professional.
  • Advise parents of pediatric patients not to apply tight-fitting diapers or plastic pants on a child treated in the diaper area; these garments work like an occlusive dressing and may cause more of the drug to be absorbed.
  • Caution women that medication should not be used extensively, in large amounts, or for protracted periods if they are pregnant or planning to become pregnant.
  • Advise patient to consult health care professional before using medicine for condition other than indicated.
  • Instruct patient to inform health care professional if symptoms of underlying disease return or worsen or if symptoms of infection develop.

Evaluation/Desired Outcomes

  • Resolution of skin inflammation, pruritus, or other dermatologic conditions.
  • Clearing of plaques in plaque psoriasis.

Topicort

(tŏp′ĭ-kôrt′)
A trademark for the drug desoximetasone.

Topicort

a trademark for a topical glucocorticoid (desoximetasone).
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References in periodicals archive ?
M2 PHARMA-April 15, 2013-Taro Pharmaceutical Industries Ltd awarded FDA approval for Topicort Topical Spray, 0.
Pharmaceutical company Taro Pharmaceutical Industries Ltd (NYSE:TARO) announced on Friday the receipt of approval for its New Drug Application (NDA) Topicort (desoximetasone) Topical Spray, 0.
M2 EQUITYBITES-April 15, 2013-Taro Pharmaceutical Industries Ltd awarded FDA approval for Topicort Topical Spray, 0.
25%, a generic equivalent of leading dermatology medicine Topicort 0.
by TaroPharma, Taro's branded dermatology and pediatrics division, includes the brands Ovide (malathion) lotion; the Topicort (desoximetasone) line of products, including Topicort cream, Topicort gel, Topicort ointment and Topicort LP cream; and the Lustra (hydroquinone) line of products, including Lustra, Lustra-AF and Lustra-Ultra.
In addition, the supplier has won FDA approval for desoximetasone ointment, a topical corticosteroid that is formulated to be equivalent to Topicort from Hoechst Marion Roussel.
Another topical corticosteroid for which the company has received FDA approval is desoximetasone ointment, an equivalent of Topicort from Hoechst Marion Roussel.
The firm is best known for its dermatological creams, and has already brought the first generic versions of Topicort, Tridesilon and Mycostatin cream to the marketplace.