Amcinonide cream - a high potency topical steroid

Amcinonide is a high potency steroid used as a topical steroid that is used to relieve the inflammatory and pruritic symptoms of corticosteroid-responsive dermatoses.

Amcinonide Dose in Adults

Apply in a thin film of topical amcinonide twice or thrice daily.
Discontinue therapy when symptoms resolve or there is no improvement.
Re-evaluation may be necessary in patients non-responsive to the therapy.

Amcinonide Dose in Childrens

Apply in a thin film of topical amcinonide twice or thrice daily.
Discontinue therapy when symptoms resolve or there is no improvement.
Re-evaluation may be necessary in patients non-responsive to the therapy.

Pregnancy Risk Factor C

AmcinonideUse during pregnancy has been linked to teratogenic effects if it is used for a prolonged period and in large amounts on the entire skin surface.

Use during breastfeeding:

It is unknown if breastmilk contains any excretion. Avoid applying near the areola.

Amcinonide Dose in Renal Disease:

No dosage adjustment required in renal disease.

Amcinonide Dose in Liver Disease:

No dosage adjustment required in liver disease.

Side Effects of Amcinonide Include:

Central nervous system: burning sensation at the site
Dermatologic: Acne vulgaris, allergic dermatitis, atrophic striae, hypertrichosis, folliculitis, , hypopigmentation, local dryness & maceration of the skin, miliaria, pruritus, skin atrophy, and telangiectasia
Endocrine & metabolic: Cushing's syndrome, growth suppression, secondary diabetes, and suppression of the hypothalamic pituitary axis.
Infection: Secondary infection
Local: Local irritation

Contraindications to Amcinonide include:

Severe allergic reactions to amcinonide and any component of this formulation.
The drug can be used on the face, groin and axilla.

Warnings and Precautions

Suppression of the adrenals:
- If taken in large doses or for a prolonged period of time, amcinonide can cause systemic absorption.
- This can cause adrenal insufficiency and suppress the HPA axis.
Contact dermatitis:
- Sometimes, paradoxical allergic contact dermatitis can occur.
Kaposi's Sarcoma
- In some cases, prolonged corticosteroids use has been linked to Kaposi's Sarcoma.
Systemic effects
- Patients who use higher levels of medication and for longer periods may experience systemic side effects.
- These include secondary diabetes, hypertension and Cushing's syndrome. Systemic absorption is more common in children.
Infected/ weeping lesions:
- Patients who have had occlusive dressings placed may develop secondary infections.

Amcinonide: Drug Interaction

Note: Drug Interaction Categories:

Risk Factor C: Monitor When Using Combination
Risk Factor D: Consider Treatment Modification
Risk Factor X: Avoid Concomitant Use

Risk Factor C (Monitor therapy).
Corticorelin	Corticosteroids can reduce the therapeutic effects of Corticorelin. Recent or current corticosteroid treatment may affect plasma ACTH responses to Corticorelin.
Deferasirox	Corticosteroids can increase the toxic/adverse effects of Deferasirox. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased.
Ritodrine	Ritodrine's toxic/adverse effects may be amplified by corticosteroids.
Risk Factor D (Consider therapy modifications)
Hyaluronidase	The therapeutic effects of Hyaluronidase may be diminished by corticosteroids. Management: Patients who are taking corticosteroids, especially at higher doses, may not have the desired clinical response to the standard doses Hyaluronidase. Higher doses of hyaluronidase might be necessary.
Risk Factor X (Avoid Combination)
Aldesleukin	Aldesleukin's antineoplastic effects may be diminished by corticosteroids.

Monitoring Parameters:

Monitor for response to therapy, blood sugars, growth velocity in children, and features of cushings syndrome.

How to Administer Amcinonide?

Apply a thin layer over the affected area twice or thrice daily.

Mechanism of Action of Amcinonide:

AmcinonideIt is a topical steroid of high potency with vasoconstrictive, antipruritic and anti-inflammatory properties. It is used in steroid-responsive dermatology.
AmcinonideThis reduces the production and release of chemical mediators that are responsible for the inflammation process. These mediators include prostaglandins, histamine and liposomal enzymes.

Absorption is adequate through intact skin and increases with occlusive dressing and skin inflammation.

Metabolism is via Hepatic

Excretion is via Urine and feces if systemic absorption occurs.