Fluocinolone

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Toxicological Effects
  • Genes that may be involved
  • Inhibits
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Belgium: Synalar; Bulgaria: Abricort, Flucinar; Cyprus: Synalar; Czech Republic: Flucinar, Gelargin; Denmark: Synalar; France: Synalar; Germany: Flucinar, Jellin; Greece: Synalar Simple; Hungary: Flucinar; Italy: Dermolin, Fluomix, Fluovitef, Localyn Glicole, Omniderm, Sterolone, Ultraderm; Latvia: Flucinar, Sinaflāna; Lithuania: Flucinar; Luxembourg: Synalar; Poland: Flucinar; Portugal: Synalar; Romania: Fluocinolon; Slovakia: Flucinar, Gelargin; Spain: Co Fluocin Fuerte, Cortiespec, Flusolgen, Gelidina, Synalar; Sweden: Synalar; UK: Synalar.

North America

Canada: Capex, Derma-Smoothe/FS, Fluoderm, Synalar; USA: Capex, Derma-Smoothe/FS, Dermotic, Retisert, Synalar.

Latin America

Argentina: Duoflu Shampoo, Flulone; Mexico: Cortifung-S, Cortilona, Cremisona, Farmacorti, Flumicin, Fluocinolona, Fluomex, Fusalar, Lonason, Naflucen, Synalar Simple.

Asia

Japan: Flucort, Flupollon, Fluvean, Fluzon, Polysiral.

Drug combinations

Fluocinolone and Ciprofloxacin

Fluocinolone and Lidocaine

Fluocinolone and Neomycin

Fluocinolone, Bismuth, and Lidocaine

Fluocinolone, Hydroquinone, and Tretinoin

Fluocinolone, Neomycin, and Polymyxin B

Chemistry

Fluocinolone Acetonide: C~24~H~30~F~2~O~6~. Mw: 452.49. (1) Pregna-1,4-diene-3,20-dione, 6,9-difluoro-11,21-dihydroxy-16,17-[(1-methylethylidene)bis(oxy)]-, (6α,11β,16α)-; (2) 6α,9-Difluoro-11 β,16α,17,21-tetrahydroxypregna-1,4-diene-3,20-dione, cyclic 16,17-acetal with acetone. CAS-67-73-2 (1962).

Pharmacologic Category

Skin and Mucous Membrane Agents; Anti-inflammatory Agents. EENT Preparations; Anti-inflammatory Agents; Corticosteroids. Ophthalmic Corticosteroid. Topical Corticosteroid. (ATC-Code: C05AA10; D07AC04; S01BA15; S02BA08).

Mechanism of action

A synthetic fluorinated corticosteroid. Corticosteroids inhibit edema, fibrin deposition, capillary dilation, leukocyte migration, capillary and fibroblast proliferation, deposition of collagen, and scar formation associated with inflammation. Mechanism of ocular effects unknown. Corticosteroids may induce phospholipase A~2~ (PLA2G4A) inhibitory proteins; these proteins may inhibit release of arachidonic acid, thus controlling biosynthesis of potent inflammation mediators (e.g. prostaglandins, leukotrienes).

Therapeutic use

Relief of susceptible inflammatory dermatosis, dermatitis or psoriasis of the scalp, or atopic dermatitis in adults and children ≥3 months of age. Treatment of chronic, noninfectious uveitis affecting posterior segment of eye. Relief of chronic eczematous external otitis in adults and children ≥2 years of age.

Pregnancy and lactiation implications

There are no adequate, well-controlled studies in pregnant women. Intrauterine growth retardation in infant reported (rare). Use of large amounts or for prolonged periods of time should be avoided. Hypertension in nursing infant reported following corticosteroid ointment applied to nipples. Use with caution.

Unlabeled use

Contraindications

Hypersensitivity to fluocinolone or any component of the formulation. Tuberculosis of skin, herpes (including varicella). Ocular implant: Additional contraindications include ocular infections of viral, bacterial, or fungal origin. Hypersensitivity to other corticosteroids.

Warnings and precautions

May cause hypercorticism or suppression of HPA axis (may lead to adrenal crisis). Withdrawal and discontinuation of a corticosteroid should be carried out slowly. Allergic contact dermatitis can occur. Steroids may mask infection or enhance existing ocular infection. Secondary infections might occur with prolonged use. Prolonged use may result in glaucoma and injury to optic nerve (use with caution in presence of glaucoma). Steroid use may delay healing after cataract surgery. Adverse systemic effects may occur when used on large areas of the body, denuded areas, for prolonged periods of time, or with an occlusive dressing (infants and children may be more susceptible).

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