Dexamethasone/Fluclorolone Acetonide 1529 UK: Dexa-Rhinaspray Duo†; Maxitrol; Otomize; Sofradex; Tobradex; described on p.1492. For recommendations concerning the cor- Malaysia: Isoradin; Travocort; Mex.: Bi-Nerisona; Scheriderm; NZ: USA: Ak-Neo-Dex; Ak-Trol†; Ciprodex; Dexacidin†; Dexacine†; Dexas- rect use of corticosteroids on the skin, and a rough guide to the Nerisone C; Philipp.: Nerisona Combi; Travocort; Pol.: Travocort; Port.: porin; Maxitrol; Neo-Dexameth†; NeoDecadron†; Neodexasone; Ne- Nerisona C; Travocort; Rus.: Travocort (Травокорт); S.Afr.: Travocort; opolydex; Ocu-Trol; Poly-Dex; Tobradex; Venez.: Baycuten N; Cipromet†; clinical potencies of topical corticosteroids, see p.1497. Singapore: Nerisone C†; Travocort; Spain: Claral Plus; Switz.: Travocort; Cyprodex; Decadron†; Decaven; Deicol†; Dexaneol†; Dexapostafen; Gen- Preparations Thai.: Travocort; Turk.: Impetex; Nerisona C; Travazol; Travocort; Venez.: tidexa; Kanasone†; Maxicort; Maxitrol; Otocort; Poentobral Plus; Poli-Oti- Binerisona. co; Quinocort; Tobracort; Tobradex; Tobragan D; Todex; Trazidex. USP 31: Diflorasone Diacetate Cream; Diflorasone Diacetate Ointment. Proprietary Preparations (details are given in Part 3) Ger.: Florone; Ital.: Dermaflor†; Mex.: Diasorane; Spain: Murode; USA: ApexiCon; Florone; Maxiflor; Psorcon. Difluprednate (USAN, rINN) ⊗ Dichlorisone Acetate (rINNM) ⊗ Multi-ingredient: Arg.: Filoderma; Filoderma Plus; Griseocrem; Novo CM-9155; Difluprednato; Difluprednatum; W-6309. 6α,9α-Dif- Acetato de diclorisona; Dichlorisone, Acétate de; Dichlorisoni Bacticort Complex†; Novo Bacticort†. luoro-11β,17α,21-trihydroxypregna-1,4-diene-3,20-dione 21-ac- Acetas; Diclorisone Acetate. 9α,11β-Dichloro-17α,21-dihydrox- etate 17-butyrate. ypregna-1,4-diene-3,20-dione 21-acetate. Дифлупреднат Дихлоризона Ацетат Diflucortolone (BAN, USAN, rINN) ⊗ C H F O = 508.6. C H Cl O = 455.4. Diflucortolona; Diflucortolonum; Diflukortolon; Diflukortoloni. 27 34 2 7 23 28 2 5 CAS — 23674-86-4. CAS — 7008-26-6 (dichlorisone); 79-61-8 (dichlorisone 6α,9α-Difluoro-11β,21-dihydroxy-16α-methylpregna-1,4-diene- acetate). 3,20-dione. ATC — D07AC19. ATC Vet — QD07AC19. Дифлукортолон OH C22H28F2O4 = 394.5. CAS — 2607-06-9. O O ATC — D07AC06. ATC Vet — QD07AC06; QD07XC04. H H3C OH O CH Cl 3 O H3C H OH H H3C O CH3 O HO Cl H H H C H 3 H3C H O O HO CH3 (dichlorisone) H3C H H F H O Profile F H F Dichlorisone acetate is a corticosteroid used topically for its glu- O cocorticoid activity (p.1490) in the treatment of various skin dis- orders. It is usually used as a cream containing 0.25 or 1%. F Profile When applied topically, particularly to large areas, when the skin Difluprednate is a corticosteroid used topically for its glucocorti- is broken, or under occlusive dressings, corticosteroids may be coid activity (p.1490) in the treatment of various skin disorders. absorbed in sufficient amounts to cause systemic effects (see Diflucortolone Pivalate (BANM, USAN, rINNM) ⊗ It is usually used as a cream or gel; concentrations used are 0.02 p.1490). The effects of topical corticosteroids on the skin are de- Diflucortolone, Pivalate de; Diflucortoloni Pivalas; Pivalato de di- or 0.05%. scribed on p.1492. For recommendations concerning the correct flucortolona; SH-968. Diflucortolone 21-pivalate. When applied topically, particularly to large areas, when the skin use of corticosteroids on the skin, see p.1497. Дифлукортолона Пивалат is broken, or under occlusive dressings, corticosteroids may be Preparations C H F O = 478.6. absorbed in sufficient amounts to cause systemic effects 27 36 2 5 (p.1490). The effects of topical corticosteroids on the skin are Proprietary Preparations (details are given in Part 3) CAS — 15845-96-2. described on p.1492. For recommendations concerning the cor- Spain: Dermaren; Dicloderm Forte. ATC — D07AC06. rect use of corticosteroids on the skin, see p.1497. ATC Vet — QD07AC06. Difluprednate is under investigation as a 0.05% ophthalmic emulsion for the treatment of inflammation following ocular sur- Diflorasone Diacetate (BANM, USAN, rINNM) ⊗ Diflucortolone Valerate (BANM, rINNM) ⊗ gery and uveitis. Diflucortolone, Valérate de; Diflucortoloni Valeras; Diflukorto- Diacetato de diflorasona; Diflorasone, Diacetate de; Diflorasoni Preparations Diacetas; U-34865. 6α,9α-Difluoro-11β,17α,21-trihydroxy-16β- lon Valerat; Valerato de diflucortolona. Diflucortolone 21-valer- (details are given in Part 3) methylpregna-1,4-diene-3,20-dione 17,21-diacetate. ate. Proprietary Preparations Fr.: Epitopic; Jpn: Myser†. Дифлоразона Диацетат Дифлукортолона Валерат C H F O = 478.6. C H F O = 494.5. 27 36 2 5 26 32 2 7 CAS — 59198-70-8. CAS — 2557-49-5 (diflorasone); 33564-31-7 (diflorasone diacetate). ATC — D07AC06. Fluclorolone Acetonide (BAN, rINN) ⊗ ATC Vet — QD07AC06. ATC — D07AC10. Acetónido de fluclorolona; Fluclorolone, Acétonide de; Flu- ATC Vet — QD07AC10. Pharmacopoeias. In Br. cloroloni Acetonidum; Flucloronide (USAN); Fluklorolonacetonid; BP 2008 (Diflucortolone Valerate). A white to creamy white Flukloroloniasetonidi; RS-2252. 9α,11β-Dichloro-6α-fluoro-21- crystalline powder. Practically insoluble in water; freely soluble hydroxy-16α,17α-isopropylidenedioxypregna-1,4-diene-3,20-di- OH in dichloromethane and in dioxan; sparingly soluble in ether; slightly soluble in methyl alcohol. Protect from light. one. O Profile Флуклоролона Ацетонид C24H29Cl2FO5 = 487.4. H H3C OH Diflucortolone is a corticosteroid used topically for its glucocor- HO CH3 ticoid activity (p.1490) in the treatment of various skin disorders. CAS — 3693-39-8. It is usually used as a cream or ointment containing 0.1 or 0.3% ATC — D07AC02. H C H H 3 of the valerate. ATC Vet — QD07AC02. When applied topically, particularly to large areas, when the skin F H is broken, or under occlusive dressings, corticosteroids may be absorbed in sufficient amounts to cause systemic effects OH O (p.1490). The effects of topical corticosteroids on the skin are described on p.1492. For recommendations concerning the cor- O F H3C rect use of corticosteroids on the skin, and a rough guide to the Cl O CH (diflorasone) clinical potencies of topical corticosteroids, see p.1497. 3 Preparations H3C H CH Pharmacopoeias. In US. BP 2008: Diflucortolone Cream; Diflucortolone Oily Cream; Diflucortolo- O 3 USP 31 (Diflorasone Diacetate). A white to pale yellow, crystal- ne Ointment. Cl H line powder. Insoluble in water; soluble in acetone and in methyl (details are given in Part 3) Proprietary Preparations O alcohol; very slightly soluble in ether; sparingly soluble in ethyl Arg.: Nerisona; Austria: Neriforte; Nerisona; Belg.: Nerisona; Braz.: acetate; slightly soluble in toluene. Store in airtight containers. Nerisona; Canad.: Nerisone; Denm.: Nerisona; Fr.: Nerisone; Ger.: Nerisona; Hong Kong: Nerisone; Indon.: Nerilon; Nerisona; Valeron; Is- F Profile rael: Neriderm; Ital.: Cortical; Dermaval; Dervin; Dicortal†; Flu-Cortanest; Diflorasone diacetate is a corticosteroid used topically for its glu- Nerisona; Temetex; Malaysia: Nerisone†; Mex.: Nerisona; Neth.: Profile Nerisona; NZ: Nerisone; Philipp.: Nerisona; Port.: Nerisona; S.Afr.: cocorticoid activity (p.1490) in the treatment of various skin dis- Nerisone; Singapore: Nerisone†; Spain: Claral; Switz.: Nerisona†; Turk.: Fluclorolone acetonide is a corticosteroid used topically for its orders. It is usually used as a cream or ointment containing Temetex; UK: Nerisone. glucocorticoid activity (p.1490) in the treatment of various skin 0.05%. Multi-ingredient: Arg.: Diflunazol†; Nerisona C; Scheriderm; Austria: disorders. It is usually used as a cream containing 0.2%. When applied topically, particularly to large areas, when the skin Travocort; Belg.: Travocort; Braz.: Bi-Nerisona; Canad.: Nerisalic; Chile: When applied topically, particularly to large areas, when the skin is broken, or under occlusive dressings, corticosteroids may be Bi-Nerisona; Fr.: Nerisalic; Nerisone C; Ger.: Nerisona C†; Travocort; Gr.: is broken, or under occlusive dressings, corticosteroids may be Travocort; Hong Kong: Nerisone C; Travocort; Indon.: Nerisona Combi; absorbed in sufficient amounts to cause systemic effects Travocort; Irl.: Travocort; Israel: Isocort; Multiderm; Tevaderm; Ital.: absorbed in sufficient amounts to cause systemic effects (p.1490). The effects of topical corticosteroids on the skin are Corti-Fluoral; Dermaflogil; Impetex; Nerisalic; Nerisona C; Travocort; (p.1490). The effects of topical corticosteroids on the skin are The symbol † denotes a preparation no longer actively marketed The symbol ⊗ denotes a substance whose use may be restricted in certain sports (see p.vii) 1530 Corticosteroids described on p.1492. For recommendations concerning the cor- Fludrocortisone acetate may also be given with gluco- induce a pressor reaction is controversial. Most of these drugs rect use of corticosteroids on the skin, and a rough guide to the corticoid therapy in doses of up to 200 micrograms have potentially serious adverse effects and few are well evalu- clinical potencies of topical corticosteroids, see p.1497. daily in the salt-losing form of congenital adrenal hy- ated. 1. Ahmad RAS, Watson RDS. Treatment of postural hypotension: Preparations perplasia (p.1502). a review. Drugs 1990; 39: 74–85. Proprietary Preparations (details are given in Part 3) It is also given in the management of severe orthostatic 2. Tonkin AL, Wing LMH. Hypotension: assessment and manage- Spain: Cutanit. ment. Med J Aust 1990; 153: 474–85. hypotension (see below). 3. Schoenberger JA. Drug-induced orthostatic