Fluocinolone (Synalar) Indications and Dosage
- alopecia
- atopic dermatitis
- contact dermatitis
- dermatitis
- discoid lupus erythematosus
- eczema
- exfoliative dermatitis
- granuloma annulare
- lichen planus
- lichen simplex
- otitis externa
- pompholyx
- prurigo
- pruritus
- psoriasis
- Rhus dermatitis
- seborrheic dermatitis
- uveitis
- xerosis
Fluocinolone (Synalar) Indications and Dosage
®General Comparative Topical Corticosteroid Potency:
NOTE: The following is a general representation. Check specific product formulations prior to making potency decisions.
Very High Potency
Betamethasone dipropionate (augmented)
Clobetasol
Diflorasone diacetate ointment
Halobetasol
High Potency
Amcinonide
Betamethasone dipropionate
Desoximetasone gel or ointment, or cream >= 0.25%
Diflorasone diacetate cream
Fluocinolone cream >= 0.2%
Fluocinonide
Halcinonide
Triamcinolone >= 0.5%
Medium Potency
Beclomethasone
Betamethasone benzoate
Betamethasone valerate
Clobetasone
Desoximetasone cream < 0.25%
Diflucortolone
Fluocinolone ointment or topical solution or cream < 0.2%
Flurandrenolide >= 0.025%
Fluticasone
Hydrocortisone butyrate
Hydrocortisone valerate
Mometasone
Triamcinolone < 0.5%
Low Potency
Alclometasone
Clocortolone
Desonide
Dexamethasone
Flumethasone
Flurandrenolide < 0.025%
Hydrocortisone base
Hydrocortisone acetate
For the treatment of mild to moderate inflammatory manifestations of corticosteroid-responsive dermatitis such as alopecia areata, atopic dermatitis, contact dermatitis, exfoliative dermatitis, Rhus dermatitis due to plants like poison ivy, or seborrheic dermatitis (facial and intertriginous areas), discoid lupus erythematosus (facial and intertriginous areas), eczema, granuloma annulare, intertrigo, cutaneous lichen planus, lichen simplex chronicus, polymorphous light eruption, pompholyx (dyshidrosis), nodular prurigo, anogenital or senilis pruritus, psoriasis (facial and intertriginous areas), or xerosis (inflammatory phase):
NOTE: Occlusive dressings may be required for chronic or severe cases of lichen simplex chronicus, psoriasis, eczema, atopic dermatitis, or chronic hand eczema. More potent topical corticosteroids and/or occlusive dressings may be necessary for the treatment of discoid lupus erythematosus, lichen planus, granuloma annulare, psoriatic plaques, and psoriasis of the palms, soles, elbows, or knees.
Topical dosage (cream, ointment, or topical solution):
Adults and children: Apply sparingly to the affected area two to four times per day, depending on the severity of the condition. In hairy sites, the hair should be parted to allow direct contact with the lesion. Occlusive dressings may be used for the management of recalcitrant conditions.
Topical dosage (Derma-Smoothe/FS® oil):
Adults: Apply topically as a thin film to the affected area three times per day.
Children >= 2 years: Apply topically as a thin film to the affected areas twice daily. Do not treat longer than 4 weeks continuously. Do not apply to the face or diaper area. Avoid application to intertriginous areas.
Children < 2 years: Safe and effective use is not established.
- for psoriasis of the scalp:
Topical dosage (Derma-Smoothe/FS® oil):
Adults: Wet or dampen hair and scalp thoroughly prior to use. Apply a thin film of oil once daily, massage well and cover the scalp with the supplied shower cap. Leave on overnight or for a minimum of 4 hours before washing off. Wash hair with regular shampoo and rinse thoroughly. In a vehicle-controlled study, after 21 days of treatment 60% of patients receiving fluocinolone topical oil and 21% of patients receiving drug vehicle achieved a good to excellent clinical response.
Children: Safe and effective use has not been established.
- for seborrheic dermatitis of the scalp:
Topical dosage (FS® shampoo):
Adults: No more than one (1) ounce of shampoo should be applied to the scalp area once daily, worked into a lather and allowed to remain on the scalp for approximately 5 minutes. Rinse the hair and scalp completely twice. In vehicle-controlled studies, after 14 days of treatment, 84% of patients on fluocinolone and 29% of patients on drug vehicle had cleared or markedly improved.
Children: Safe and effective use has not been established.
- for chronic eczematous otitis externa:
Topical dosage (Derma-Smooth/FS® otic oil):
Adults, adolescents, and children >= 2 years: 5 drops instilled into the affected ear(s) twice daily for 7 to 14 days; not to exceed 14 consecutive days of treatment.
For the treatment of chronic non-infectious uveitis affecting the posterior segment of the eye:
Intravitreal implant dosage (Retisert™):
Adults: One implant containing one tablet of 0.59 mg fluocinolone acetonide is surgically implanted into the posterior segment of the affected eye. Fluocinolone acetonide is initially released at a rate of 0.6 mcg/day, decreasing over the first month to a steady state of 0.3 - 0.4 mcg/day and continues at this rate for approximately 30 months. If there is a recurrence of uveitis after the fluocinolone acetonide has been depleted from the implant, the implant may be replaced.
Children: Safe and effective use have not been established.
Maximum Dosage Limits:
NOTE: In general, corticosteroid dosage must be individualized and is highly variable depending on the nature and severity of the disease, dosage form selected, and patient age and response.
- Adults: 4 applications/day cream, ointment or topical solution, 3 applications/day Derma-Smoothe/FS® oil, shampoo 1 ounce/day topically, 1 Retisert™ implant approximately every 30 months.
- Elderly: 4 applications/day cream, ointment or topical solution, 3 applications/day Derma-Smoothe/FS® oil, shampoo 1 ounce/day topically, 1 Retisert™ implant approximately every 30 months.
- Adolescents: 4 applications/day cream, ointment or topical solution, 2 applications/day Derma-Smoothe/FS® oil. Some dosage forms not indicated.
- Children >=2 years: 4 applications/day cream, ointment or topical solution, 2 applications/day Derma-Smoothe/FS® oil. Some dosage forms not indicated.
- Children < 2 years: Safe and effective use have not been established.
Patients with hepatic impairment:
Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no topical dosage adjustments are needed.
Patients with renal impairment:
Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.
[ Last revised: 11/21/2005 11:39:00 AM ]
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