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Hydrocortisone butyrate

Class
Steroid hormones
Subclass
Glucocorticoids
Generic name
Hydrocortisone butyrate
Brand names
Aquax-H®, Locoid®
Common formulations
Cream, Lotion
Dosage and administration
Adults patients
Treatment
Atopic dermatitis • Mild-to-moderate
•
0.1% TOP BID
Consider reassessment of the diagnosis if no improvement is seen within 2 weeks.
Symptomatic relief
Symptomatic relief of corticosteroid-responsive dermatoses
•
0.1% TOP BID-TID
Indications for use
Labeled indications
Adults
•
Treatment of atopic dermatitis (mild-to-moderate)
•
Treatment of seborrheic dermatitis
•
Symptomatic relief of corticosteroid-responsive dermatoses
Safety risks
Contraindications
Hypersensitivity to hydrocortisone or its components
Warnings and precautions
Allergic contact dermatitis
•
Use caution in all patients, especially pediatric patients.
Exacerbation of skin infection
•
Maintain a high level of suspicion for concurrent skin infections, which should be treated appropriately with an antibiotic, antiviral or antifungal topical agent. If response is inadequate, discontinue hydrocortisone butyrate until infection is resolved.
Hypothalamic-pituitary-adrenal axis suppression, folliculitis, dermatitis, erythema, telangiectasia
•
Maintain a high level of suspicion, as hydrocortisone has been found to be associated with these adverse reactions.
Specific populations
Renal impairment
eGFR 0-90 mL/min/1.73 m²
•
Use acceptable. No dose adjustment required.
Renal replacement therapy
Any modality
•
Use acceptable. No dose adjustment required.
Hepatic impairment
Any severity
•
Use acceptable. No dose adjustment required.
Pregnancy and breastfeeding
Pregnancy
All trimesters
•
Use only if benefits outweigh potential risks. Evidence of fetal harm in animals. Drugs of this class should not be used extensively on pregnant patients, in large amounts, or for prolonged periods of time. Consider use in patients who have failed first-line non-pharmacological options such as emollients.
Breastfeeding
Acceptable for use during breastfeeding.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Unlikely to cause adverse effects in breastfed infants.
Adverse reactions
Common 1-10%
•
Acne, application site reactions, hypopigmentation
Rare < 0.1%
•
Telangiectasia
Unknown frequency
•
Allergic contact dermatitis, cataract, Cushing's syndrome, dry skin patches, folliculitis, glaucoma, hypertrichosis, hypothalamic-pituitary-adrenal axis suppression, ↑ ICP, ↑ blood glucose, ↑ intraocular pressure, ↑ urine glucose, infections, perioral dermatitis, poor weight gain and growth, blurred vision, burning sensation, generalized pruritus, skin irritation, skin atrophy
Interactions
Drug(s)
Check Interactions
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