Eldercoid

Eldercoid Lipocream:

Each 10 gm contains:

Hydrocortisone 17 butyrate U.S.P. 0.1% In lipocream base

ELDERCOID contains the topical corticosteroid, hydrocortisone butyrate 0.1% which is a 17 ester of butyric acid and hydrocortisone.

Superior efficacy than hydrocortisone in eczema and psoriasis.
No local side effects like skin atrophy and telangectasia.
Extremely safe in children, face, genitocrural areas and large body areas.
Unique Lipocream formulation with benefits of ointment and cosmeticappeal of cream.

Corticosteroids diffuse across cell membranes and complex with specific cytoplasmic receptors. These complexes then enter the cell nucleus, bind to DNA, and stimulate protein synthesis of various inhibitory enzymes like phospholipase A2, which is responsible for the anti-inflammatory effects of topical corticosteroids.

Topically applied corticosteroids have an antimitotic effect on epidermal cells. This property is useful in proliferative disorders such as psoriasis.

Hydrpcortisone 17 butyrate has high affinity to receptors in the epidermal cells and low affinity to receptors in fibroblasts. Therefore, it has low potency for dermal atrophy.

The extent of percutaneous absorption of topical corticosteroids is determined by many factors including the vehicle, the integrity of the epidermal barrier, and the use of occlusive dressings.

Occlusive dressings or widespread application may increase the possibility of hypothalamic-pituitary-adrenal (HPA) axis suppression.

The vasoconstrictor assay showed that ELDERCOID Lipocream® Cream has a more pronounced skin blanching effect than ELDERCOID® Cream, suggesting greater percutaneous absorption from the former.

Once absorbed through the skin, topical corticosteroids are handled through pharmacokinetic pathways similar to systemically administered corticosteroids.

Corticosteroids are bound to plasma proteins in varying degrees.

Corticosteroids are metabolized primarily in the liver and are then excreted by the kidneys. Some of the topical corticosteroids and their metabolites are also excreted in the bile.

ELDERCOID Lipocream & Lotion 0.1% is indicated for the relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses.

Topical corticosteroids are contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation.

In general, systemic absorption of topical corticosteroids has produced reversible HPA axis suppression, which is augmented by prolong use and addition of occlusive dressing.

Conditions which increase the risk of systemic toxicity include the application of the more potent steroids, use over large surface areas, prolonged use, and the addition of occlusive dressings.

If irritation develops, topical corticosteroids should be discontinued and appropriate therapy instituted. In the presence of dermatological infections, the use of an appropriate antifungal or antibacterial agent should be instituted. If a favorable response does not occur promptly, the corticosteroid should be discontinued until the infection has been adequately controlled.

Laboratory Tests

The following tests may be helpful in evaluating the HPA axis suppression:

Urinary free cortisol test
ACTH stimulation test

There are no adequate and well-controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids. Therefore, topical corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. ELDERCOID Lipocream® Cream 0.1% (hydrocortisone butyrate cream) should not be used extensively on pregnant patients, in large amounts, or for longer than two weeks.

It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk. Caution should be exercised when topical corticosteroids are administered to a nursing woman

Pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced HPA axis suppression and Cushing's syndrome than older patients because of a larger skin surface area to body weight ratio and less developed, thinner skin.

Manifestations of adrenal suppression in children include linear growth retardation, delayed weight gain, low plasma cortisol levels, and absence of response to ACTH stimulation. Manifestations of intracranial hypertension include bulging fontanelles, and headaches.

Absorption is also greater in premature infants than in full term newborns, due to inadequate development of the stratum corneum.

The following local adverse reactions are reported infrequently with topical corticosteroids but may occur more frequently with the use of occlusive dressings.

These reactions are listed in an approximate decreasing order of occurrence: burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, secondary infection, skin atrophy, striae and miliaria.

ELDERCOID Lipocream & Lotion (hydrocortisone butyrate 0.1%) should be applied to the affected area as a thin film two or three times daily (depending on the severity of the condition) and for no longer than two weeks.or as indicated by the physician.

If an infection develops, appropriate antimicrobial therapy should be instituted.

Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.