DOCSLIB.ORG

13.4: Topical Corticosteroids

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
13.4: Topical Corticosteroids Doncaster & Bassetlaw Medicines Formulary Section 13.4: Topical Corticosteroids Potency: Mild Hydrocortisone 1% cream & ointment Moderate Betamethasone 0.025% cream & ointment Clobetasone 0.05% cream & ointment Potent Betamethasone 0.1% cream, ointment & scalp application WITH SALICYLIC ACID Betamethasone 0.05% plus Salicylic Acid 3% ointment (Diprosalic) Betamethasone 0.05% plus Salicylic Acid 2% scalp Application (Diprosalic) Approved by Drug and Therapeutics Committee: March 2018 Review Date: March 2021 Prescribing Guidance: Topical corticosteroids are used for the treatment of inflammatory conditions of the skin. They are not curative and on stopping treatment a rebound exacerbation of the condition may occur. Choice of formulation Corticosteroids are categorised as mild, moderate, potent and very potent (see above); the least potent preparation which is effective should be used. Water miscible creams are suitable for moist or weeping lesions. Ointments are used for dry lichenified or scaly lesions where a more occlusive effect is required. Occlusion under polythene or a hydrocolloid dressing increases the absorption of the corticosteroid and thus the risk of side effects. Side effects can occur particularly with the potent/very potent preparations. These include thinning of the skin, irreversible striae atrophicae, contact and perioral dermatitis, and acne or worsening acne. To minimise side effects it is important to apply the topical steroid thinly to the affected area only no more than twice a day. KEY: [UL] Unlicensed Preparation; Drug – first line choice; Drug – hospital only; Drug – Amber (TLS), Drug – Red (TLS), see http://medicinesmanagement.doncasterpct.nhs.uk/ Contra-indications Use in untreated bacterial, fungal or viral skin lesions, acne rosacea, and perioral dermatitis. Potent corticosteroids are contraindicated in widespread plaque psoriasis. The combining of a topical steroid with an anti-infective drug should be used regularly for a short period of time (i.e. twice daily for one week) to minimise resistance and sensitisation. Prescribing outside this formulary should only take place via a New Product Request Doncaster & Bassetlaw Medicines Formulary Items for Restricted Prescribing Potency: Moderate Alclometasone 0.05% cream & ointment (Modrasone) Fludroxycortide 4micrograms/cm2 tape (Haelan) Potent Hydrocortisone Butyrate 0.1% cream, lipocream, ointment & lotion (Locoid) Fluocinolone Acetonide 0.025% cream & ointment (Synalar) Mometasone Furoate cream, ointment & lotion (Elocon) Very potent Clobetasol Proprionate 0.05% cream, ointment & scalp application (Dermovate) WITH UREA Hydrocortisone 1% plus Urea 10% cream (Alphaderm) Hydrocortisone 1% plus Urea 10% plus Lactic Acid 5% Cream (Calmurid HC) WITH ANTIMICROBIALS Mild Hydrocortisone 1% plus Clotrimazole 1% cream (Canesten HC) Hydrocortisone 1% plus Miconazole 2% cream (Daktacort) Moderate Clobetasone 0.05% plus Oxytetracycline 3% plus Nystatin 100,000units/g cream (Trimovate) Potent Fluocinolone 0.025% plus Clioquinol 3% cream & ointment (Synalar C) Betamethasone 0.1% plus Neomycin 0.5% cream & ointment Hydrocortisone Butyrate 0.1% plus Clioquinol 3% cream & ointment (Locoid C) Approved by Drug and Therapeutics Committee: March 2018 Review Date: March 2021 Prescribing outside this formulary should only take place via a New Product Request .
Load more

Recommended publications
  • (CD-P-PH/PHO) Report Classification/Justifica
    COMMITTEE OF EXPERTS ON THE CLASSIFICATION OF MEDICINES AS REGARDS THEIR SUPPLY (CD-P-PH/PHO) Report classification/justification of medicines belonging to the ATC group D07A (Corticosteroids, Plain) Table of Contents Page INTRODUCTION 4 DISCLAIMER 6 GLOSSARY OF TERMS USED IN THIS DOCUMENT 7 ACTIVE SUBSTANCES Methylprednisolone (ATC: D07AA01) 8 Hydrocortisone (ATC: D07AA02) 9 Prednisolone (ATC: D07AA03) 11 Clobetasone (ATC: D07AB01) 13 Hydrocortisone butyrate (ATC: D07AB02) 16 Flumetasone (ATC: D07AB03) 18 Fluocortin (ATC: D07AB04) 21 Fluperolone (ATC: D07AB05) 22 Fluorometholone (ATC: D07AB06) 23 Fluprednidene (ATC: D07AB07) 24 Desonide (ATC: D07AB08) 25 Triamcinolone (ATC: D07AB09) 27 Alclometasone (ATC: D07AB10) 29 Hydrocortisone buteprate (ATC: D07AB11) 31 Dexamethasone (ATC: D07AB19) 32 Clocortolone (ATC: D07AB21) 34 Combinations of Corticosteroids (ATC: D07AB30) 35 Betamethasone (ATC: D07AC01) 36 Fluclorolone (ATC: D07AC02) 39 Desoximetasone (ATC: D07AC03) 40 Fluocinolone Acetonide (ATC: D07AC04) 43 Fluocortolone (ATC: D07AC05) 46 2 Diflucortolone (ATC: D07AC06) 47 Fludroxycortide (ATC: D07AC07) 50 Fluocinonide (ATC: D07AC08) 51 Budesonide (ATC: D07AC09) 54 Diflorasone (ATC: D07AC10) 55 Amcinonide (ATC: D07AC11) 56 Halometasone (ATC: D07AC12) 57 Mometasone (ATC: D07AC13) 58 Methylprednisolone Aceponate (ATC: D07AC14) 62 Beclometasone (ATC: D07AC15) 65 Hydrocortisone Aceponate (ATC: D07AC16) 68 Fluticasone (ATC: D07AC17) 69 Prednicarbate (ATC: D07AC18) 73 Difluprednate (ATC: D07AC19) 76 Ulobetasol (ATC: D07AC21) 77 Clobetasol (ATC: D07AD01) 78 Halcinonide (ATC: D07AD02) 81 LIST OF AUTHORS 82 3 INTRODUCTION The availability of medicines with or without a medical prescription has implications on patient safety, accessibility of medicines to patients and responsible management of healthcare expenditure. The decision on prescription status and related supply conditions is a core competency of national health authorities.
    [Show full text]
  • )&F1y3x PHARMACEUTICAL APPENDIX to THE
    )&f1y3X PHARMACEUTICAL APPENDIX TO THE HARMONIZED TARIFF SCHEDULE )&f1y3X PHARMACEUTICAL APPENDIX TO THE TARIFF SCHEDULE 3 Table 1. This table enumerates products described by International Non-proprietary Names (INN) which shall be entered free of duty under general note 13 to the tariff schedule. The Chemical Abstracts Service (CAS) registry numbers also set forth in this table are included to assist in the identification of the products concerned. For purposes of the tariff schedule, any references to a product enumerated in this table includes such product by whatever name known. Product CAS No. Product CAS No. ABAMECTIN 65195-55-3 ACTODIGIN 36983-69-4 ABANOQUIL 90402-40-7 ADAFENOXATE 82168-26-1 ABCIXIMAB 143653-53-6 ADAMEXINE 54785-02-3 ABECARNIL 111841-85-1 ADAPALENE 106685-40-9 ABITESARTAN 137882-98-5 ADAPROLOL 101479-70-3 ABLUKAST 96566-25-5 ADATANSERIN 127266-56-2 ABUNIDAZOLE 91017-58-2 ADEFOVIR 106941-25-7 ACADESINE 2627-69-2 ADELMIDROL 1675-66-7 ACAMPROSATE 77337-76-9 ADEMETIONINE 17176-17-9 ACAPRAZINE 55485-20-6 ADENOSINE PHOSPHATE 61-19-8 ACARBOSE 56180-94-0 ADIBENDAN 100510-33-6 ACEBROCHOL 514-50-1 ADICILLIN 525-94-0 ACEBURIC ACID 26976-72-7 ADIMOLOL 78459-19-5 ACEBUTOLOL 37517-30-9 ADINAZOLAM 37115-32-5 ACECAINIDE 32795-44-1 ADIPHENINE 64-95-9 ACECARBROMAL 77-66-7 ADIPIODONE 606-17-7 ACECLIDINE 827-61-2 ADITEREN 56066-19-4 ACECLOFENAC 89796-99-6 ADITOPRIM 56066-63-8 ACEDAPSONE 77-46-3 ADOSOPINE 88124-26-9 ACEDIASULFONE SODIUM 127-60-6 ADOZELESIN 110314-48-2 ACEDOBEN 556-08-1 ADRAFINIL 63547-13-7 ACEFLURANOL 80595-73-9 ADRENALONE
    [Show full text]
  • St John's Institute of Dermatology
    St John’s Institute of Dermatology Topical steroids This leaflet explains more about topical steroids and how they are used to treat a variety of skin conditions. If you have any questions or concerns, please speak to a doctor or nurse caring for you. What are topical corticosteroids and how do they work? Topical corticosteroids are steroids that are applied onto the skin and are used to treat a variety of skin conditions. The type of steroid found in these medicines is similar to those produced naturally in the body and they work by reducing inflammation within the skin, making it less red and itchy. What are the different strengths of topical corticosteroids? Topical steroids come in a number of different strengths. It is therefore very important that you follow the advice of your doctor or specialist nurse and apply the correct strength of steroid to a given area of the body. The strengths of the most commonly prescribed topical steroids in the UK are listed in the table below. Table 1 - strengths of commonly prescribed topical steroids Strength Chemical name Common trade names Mild Hydrocortisone 0.5%, 1.0%, 2.5% Hydrocortisone Dioderm®, Efcortelan®, Mildison® Moderate Betamethasone valerate 0.025% Betnovate-RD® Clobetasone butyrate 0.05% Eumovate®, Clobavate® Fluocinolone acetonide 0.001% Synalar 1 in 4 dilution® Fluocortolone 0.25% Ultralanum Plain® Fludroxycortide 0.0125% Haelan® Tape Strong Betamethasone valerate 0.1% Betnovate® Diflucortolone valerate 0.1% Nerisone® Fluocinolone acetonide 0.025% Synalar® Fluticasone propionate 0.05% Cutivate® Hydrocortisone butyrate 0.1% Locoid® Mometasone furoate 0.1% Elocon® Very strong Clobetasol propionate 0.1% Dermovate®, Clarelux® Diflucortolone valerate 0.3% Nerisone Forte® 1 of 5 In adults, stronger steroids are generally used on the body and mild or moderate steroids are used on the face and skin folds (armpits, breast folds, groin and genitals).
    [Show full text]
  • OUH Formulary Approved for Use in Breast Surgery
    Oxford University Hospitals NHS Foundation Trust Formulary FORMULARY (Y): the medicine can be used as per its licence. RESTRICTED FORMULARY (R): the medicine can be used as per the agreed restriction. NON-FORMULARY (NF): the medicine is not on the formulary and should not be used unless exceptional approval has been obtained from MMTC. UNLICENSED MEDICINE – RESTRICTED FORMULARY (UNR): the medicine is unlicensed and can be used as per the agreed restriction. SPECIAL MEDICINE – RESTRICTED FORMULARY (SR): the medicine is a “special” (unlicensed) and can be used as per the agreed restriction. EXTEMPORANEOUS PREPARATION – RESTRICTED FORMULARY (EXTR): the extemporaneous preparation (unlicensed) can be prepared and used as per the agreed restriction. UNLICENSED MEDICINE – NON-FORMULARY (UNNF): the medicine is unlicensed and is not on the formulary. It should not be used unless exceptional approval has been obtained from MMTC. SPECIAL MEDICINE – NON-FORMULARY (SNF): the medicine is a “special” (unlicensed) and is not on the formulary. It should not be used unless exceptional approval has been obtained from MMTC. EXTEMPORANEOUS PREPARATION – NON-FORMULARY (EXTNF): the extemporaneous preparation (unlicensed) cannot be prepared and used unless exceptional approval has been obtained from MMTC. CLINICAL TRIALS (C): the medicine is clinical trial material and is not for clinical use. NICE TECHNOLOGY APPRAISAL (NICETA): the medicine has received a positive appraisal from NICE. It will be available on the formulary from the day the Technology Appraisal is published. Prescribers who wish to treat patients who meet NICE criteria, will have access to these medicines from this date. However, these medicines will not be part of routine practice until a NICE TA Implementation Plan has been presented and approved by MMTC (when the drug will be given a Restricted formulary status).
    [Show full text]
  • Topical Corticosteroids Available at Leeds Teaching Hospitals Information
    Medicines Management & Pharmacy Services (MMPS) Topical Corticosteroids Available at Leeds Teaching Hospitals Information Mild to Moderate Potency ( Potent and very potent on the following page) Mild Corticosteroids: Brand Name Active Ingredients Formulation Dioderm ® Hydrocortisone 0.1% Cream Hydrocortisone Hydrocortisone 0.5% Cream and Ointment Hydrocortisone Hydrocortisone 1% *suggested first line formulary choice* Cream and Ointment Hydrocortisone Hydrocortisone 2.5% Cream Mild Corticosteroids with Antimicrobials Brand Name Active Ingredients Formulation Canestan HC ® Hydrocortisone 1%, Clotrimazole 1% Cream Daktacort ® Hydrocortisone 1%, Miconazole nitrate 2% Cream and Ointment Fucidin H ® Hydrocortisone 1%, Fusidic acid 2% Cream Hydrocortisone 0.5%,Nystatin 100,000units/g, Benzalkonium Timodine ® chloride 0.2%, Dimeticone ‘350’ 10% Cream Moderate Corticosteroids Brand Name Active Ingredients Formulation Betnovate RD ® Betamethasone 0.025% *suggested first line formulary choice* Ointment Eumovate ® Clobetasone butyrate 0.05% Cream and Ointment Fludroxycortide Fludroxycortide 0.0125% Cream, Ointment, Tape Moderate Corticosteroids with Antimicrobials Brand Name Active Ingredients Formulation Trimovate ® Clobetasone butyrate 0.05%, Oxytetracycline 3%, Cream Nystatin 100,000 units/g Potent and Very Potent (mild and moderate potency on previous page) Potent Corticosteroids Brand Name Active Ingredients Formulation Betnovate ® Betamethasone valerate 0.1% *suggested first line formulary choice* Scalp application Betamethasone Betamethasone
    [Show full text]
  • United States Patent (10) Patent No.: US 9.447,027 B2 Milan Et Al
    US009447027B2 (12) United States Patent (10) Patent No.: US 9.447,027 B2 Milan et al. (45) Date of Patent: Sep. 20, 2016 (54) TREATING LONG QT SYNDROME 2004/O1972.71 A1* 10, 2004 Kunka et al. ................... 424/45 2006/0173058 A1* 8, 2006 Brown .................... CO7C 65/05 514,381 (75) Inventors: Es l, St. MS 2006/0173508 A1* 8, 2006 Stone ................. A61N 1,36085 aVId S. Peal, SomerV11 le. (US) 607/40 (73) Assignee: The General Hospital Corporation, FOREIGN PATENT DOCUMENTS Boston, MA (US) JP 11209328 A1 * 8, 1999 (*) Notice: Subject to any disclaimer, the term of this patent is extended or adjusted under 35 OTHER PUBLICATIONS U.S.C. 154(b) by 86 days. Nademanee, K. et al., Annals of the New York Academy of Sciences vol. 522, pp. 536-552, published 2006.* (21) Appl. No.: 13/822,264 Chouabe, C. et al., Molecular Pharmacology vol. 54 pp. 696-703, published 1998.* (22) PCT Filed: Oct. 20, 2011 Nishizawa, S., et al., (American Journal of Emergency Medicine vol. 27, pp. 1167.e1-1167.e3, published Nov. 2009).* (86). PCT No.: PCT/US2011/057087 Nishizawa et al., (American Journal of Emergency Medicine vol. 27, pp. 1167.el -1167.e3, published Nov. 2009).* S 371 (c)(1), Nishizawa et al (American Journal of Emergency Medicine vol. 27. (2), (4) Date: Jul. 22, 2013 pp. 1167.e1-1167.e3, published Nov. 2009).* Anderson et al., “Most LQT2 Mutations Reduce Kv11.1 (hERG) Current by a Class 2 (Trafficking-Deficient) Mechanism.” Circula (87) PCT Pub. No.: WO2012/054718 tion 113:365-373, 2006, 10 pages.
    [Show full text]
  • WHO-EMP-RHT-TSN-2018.1-Eng.Pdf
    WHO/EMP/RHT/TSN/2018.1 The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances FORMER DOCUMENT NUMBER: WHO/PHARM S/NOM 15 WHO/EMP/RHT/TSN/2018.1 © World Health Organization [2018] Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances. Geneva: World Health Organization; 2018 (WHO/EMP/RHT/TSN/2018.1). Licence: CC BY-NC-SA 3.0 IGO.
    [Show full text]
  • Topical Corticosteroids Used at Leeds Teaching Hospitals Information
    Medicines Management & Pharmacy Services (MMPS) Topical Corticosteroids used at Leeds Teaching Hospitals Information Mild and moderate potency (potent and very potent on following page) Mild Corticosteroids Brand Name Active Ingredients Formulation Dioderm ® Hydrocortisone 0.1% Cream Hydrocortisone Hydrocortisone 0.5% Cream and Ointment Hydrocortisone Hydrocortisone 1% Cream and Ointment Hydrocortisone Hydrocortisone 2.5% Cream Mild Corticosteroids with Antimicrobials Brand Name Active Ingredients Formulation Canestan HC ® Hydrocortisone 1%, Clotrimazole 1% Cream Daktacort ® Hydrocortisone 1%, Miconazole nitrate 2% Cream and Ointment Fucidin H ® Hydrocortisone 1%, Fusidic Acid 2% Cream Timodine ® Hydrocortisone 0.5%,Nystatin 100,000units/Chlorhexidine 1% Cream Other Mild Corticosteroid Combination Preparations Brand Name Active Ingredients Formulation Eurax-HC ® Hydrocortisone 0.25%, Crotamiton 10% Cream Moderate Corticosteroids Brand Name Active Ingredients Formulation Betnovate RD ® Betamethasone 0.025% Cream and Ointment Eumovate ® Clobetasone Butyrate 0.05% Cream and Ointment Cream, Ointment, Haelan ® Fludroxycortide 0.0125% Tape Moderate Corticosteroids with Antimicrobials Brand Name Active Ingredients Formulation Trimovate ® Clobetasone Butyrate 0.05%, Oxytetracycline 3% Cream Nystatin 100 000 units/g Other Moderate Corticosteroid Combination Preparations None stocked at LTHT References and Provenance Date Produced: 14/12/2011 Valid until: 14/12/2013 Review Date: Author: Nora Sadiq, pharmacist Quality Assurance Check by: Steve Ashmore,
    [Show full text]
  • Guide to Treatments Used for Atopic Dermatitis in Adults
    ■ THERAPY REVIEW Guide to treatments used for atopic dermatitis in adults STEVE CHAPLIN Atopic dermatitis, or eczema, usually begins in childhood but adults can also 20 be affected due to either persistence of symptoms or late-onset disease. This 15 article provides a guide to the topical and systemic treatments used for 10 atopic dermatitis in adults, including administration, adherence and primary % Prevalence care prescribing data. 5 0 30s 40s 50s 60s 70s 80s Age group (years) Figure 1. One-year prevalence of atopic dermatitis in adults according to age, Denmark (n=16,507)7 ccording to surveys of the prevalence of atopic dermatitis, A3–17 per cent of adults self-report having the condition,1-9 though estimates are lower when confirmed by a medical diag- nosis (1.6–10 per cent4,10-12). The reported prevalence over longer time periods, eg eight years10 or lifetime,1 ranges more widely, from about 3 per cent to 40 per cent. Most of those affected had atopic dermatitis during childhood or had a family history of the condition,1,2 though onset during adulthood is also described.6 In one study in which dermatologists graded atopic dermatitis severity, 71 per cent of cases were mild, 26 per cent were moderate and 4 per cent were severe.4 It has been assumed that children with atopic dermatitis ‘grow out’ of the condition but, by young adulthood, about 80 per cent have persistent symptoms.13 A large survey in Denmark (n=16,507) found that one-year prevalence of atopic dermatitis among adults declined with age but it was still common among people in their 80s (see Figure 1).7 Two large (n=833 and n=955) studies reported follow-up of at least 24–25 years in cohorts who had attended dermatology clinics during childhood.
    [Show full text]
  • Steroid Ladder
    Formulary (GMMMG) | 1‐ First choice | 2‐ Second choice STEROID LADDER DO NOT Very Potent USE ON • Eyelids • Face See Drug safety update Dermovate (clobetasol proprionate 0.05%) • Groin Corticosteroids: rare risk of • Armpits Dermovate scalp lotion (clobetasol proprionate 0.05%) central serous chorioretinopathy • Genitals Etrivex shampoo (clobetasol proprionate 500 micrograms/g) with local as well as systemic • Children • Psoriasis administration Potent Betnovate (betamethasone valerate 0.1% in a water miscible With salicylic acid base) Diprosalic DO NOT Betacap (betamethasone valerate 0.1% containing coconut oil (betamethasone diproprionate 0.05%, USE ON derivative) salicylic acid 3%) • Eyelids Locoid (hydrocortisone butyrate 0.1%) • Face Synalar (fluocinolone acetonide 0.025%) With vitamin D (for use in psoriasis only) • Groin Elocon (mometasone furoate 0.1%) Dovobet • Armpits (betamethasone diproprionate 0.05%, • Genitals • Children With antibacterial calcipotriol 50micrograms/g) without Fucibet (betamethasone valerate 0.1%, fusidic acid 2%) Enstilar expert Synalar C (fluocinolone acetonide 0.025%, clioquinol 3%) (betamethasone diproprionate 0.05%, opinion Synalar N (fluocinolone acetonide 0.025%, neomycin sulfate calcipotriol 50micrograms/g) 0.5%) Moderate Betnovate RD (betamethasone valerate 0.25%) With Urea Eumovate (clobetasone butyrate 0.05%) Alphaderm (hydrocortisone 1%, urea 10%) DO NOT USE ON 2 Fludroxycortide Tape (4 micrograms/cm ) With antifungal and antibacterial Modrasone (Alclometasone dipropionate 0.05%) Trimovate Eyelids
    [Show full text]
  • Steroid Treatments for Eczema
    STEROID TREATMENTS FOR ECZEMA Millions of people suffer from “atopic” eczema. This is the most common type of eczema. It causes dry skin that‟s prone to flare-ups of a very itchy rash. When the eczema flares up, a steroid cream or ointment is the recommended treatment. However, many people worry about steroids because of possible side-effects. This issue of Treatment Notes is for anyone concerned about using steroids for atopic eczema – either on themselves or their child. It explains how, used correctly, these steroids are very effective and rarely cause problems. What‟s Inside . Atopic eczema . How do steroids fit in? . Pros and cons of steroids . Treating a flare-up . What if it doesn‟t clear up? Atopic eczema There are several types of eczema – also known as dermatitis. The most common type is called „atopic‟ eczema. „Atopic‟ means a problem caused by an allergy to certain common things, such as house dust, animal hair or some foods. The cause of atopic eczema isn‟t fully understood, but seems to involve the immune system. People who have it often also have other atopic problems such as hay fever or asthma. Eczema typically flares up in skin creases, such as at the elbows and knees and around the neck. It can affect large areas of skin, and make it crack or bleed. Eczema, particularly when severe, can also make the skin prone to infection. Even though most people have quite mild eczema, the itching, pain and loss of sleep can be very upsetting and disrupt school, work or other activities.
    [Show full text]
  • 03. Steroid Ladder
    Greater Manchester Medicines Management Group (GMMMG) 1 = Recommended GMMMG 1st Choice 2 = Recommended GMMMG 2nd Choice STEROID LADDER© To be used in conjunction with the latest local formulary, BNF, BNFc and the Tier Two Eczema and Psoriasis Guidelines (Available from the Intranet) Alternative if formulary options unsuccessful / unsuitable Very Potent 1 Dermovate (clobetasol propionate 0.05%) Halciderm Topical (halcinonide 0.1%) DO NOT 1 Nerisone Forte (diucortolone valerate 0.3%) Clarelux Foam (clobetasol propionate 0.05%) USE ON: 1 Etrivex Shampoo (clobetasol propionate 0.05%) • Face With antifungal & antibacterial • Groins • Armpits Clobetasol Propionate 0.05%, Neomycin Sulfate 0.5%, • Genitals Nystatin 100,000 units/g • Children • Psoriasis Potent 1 Betnovate (betamethasone (as valerate) 0.1% in a water miscible basis) Bettamousse (betamethasone valerate 0.12%) 1 Betacap (betamethasone (as valerate) 0.1% containing coconut oil derivative) Cutivate (uticasone propionate 0.05%) 2 Elocon (mometasone furoate 0.1%) Diprosone (betamethasone (as dipropionate) 0.05%) 2 Locoid (hydrocortisone butyrate 0.1%) Metosyn (uocinonide 0.05%) 2 Synalar (uocinolone acetonide 0.025%) Nerisone (diucortolone valerate 0.1%) Betesil Plasters (betamethasone (as valerate) 2.25mg) DO NOT With antibacterial Locoid Crelo (hydrocortisone butyrate 0.1%) USE ON 1 Fucibet (betamethasone (as valerate) 0.1%, fusidic acid 2%) Beclometasone Dipropionate 0.025% 1 Synalar C (uocinolone acetonide 0.025%, clioquinol 3%) • Face 1 • Groins Synalar N (uocinolone acetonide 0.025%,
    [Show full text]