Carrington Oral Wound Rinse

Generic Name: aloe vera topical (AL oe VER a TOP ik al)

Brand Names: Carrington Oral Wound Rinse, OraMagic Rx

What is Carrington Oral Wound Rinse (aloe vera topical)?

Aloe vera topical is also known as cape, zanzibar, socotrine, curacao, and Barbados aloes.

Aloe vera topical has been used in alternative medicine as an aid in treating minor wounds, burns, eczema, and psoriasis.

Not all uses for aloe vera topical have been approved by the FDA. Aloe vera topical should not be used in place of medication prescribed for you by your doctor.

There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Aloe vera topical may also be used for other purposes not listed in this product guide.

What is the most important information I should know about Carrington Oral Wound Rinse (aloe vera topical)?

Not all uses for aloe vera topical have been approved by the FDA. Aloe vera topical should not be used in place of medication prescribed for you by your doctor.

There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Use aloe vera topical as directed on the label, or as your healthcare provider has prescribed. Do not use this product in larger amounts or for longer than recommended.

What should I discuss with my health care provider before using Carrington Oral Wound Rinse (aloe vera topical)?

Before using aloe vera topical, talk to your doctor, pharmacist, or health care professional if you have any other medical conditions, allergies, or if you use other medicines or other herbal/health supplements. Aloe vera topical may not be recommended in some situations.

Although the topical use of aloe vera is not expected to be harmful during pregnancy or breast-feeding, talk to your doctor before using aloe vera topical if you are pregnant or breast-feeding a baby. Talk to the child's doctor before using aloe vera topical to treat a child.

How should I use Carrington Oral Wound Rinse (aloe vera topical)?

When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

If you choose to use aloe vera topical, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label.

Store aloe vera topical as directed on the package. In general, aloe vera topical should be protected from light and moisture and stored in a sealed container.

What happens if I miss a dose?

Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

An overdose of aloe vera topical is unlikely to occur.

What should I avoid while using Carrington Oral Wound Rinse (aloe vera topical)?

Follow your healthcare provider's instructions about any restrictions on food, beverages, or activity.

Carrington Oral Wound Rinse (aloe vera topical) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Less serious side effects are more likely to occur, and you may have none at all. Tell your doctor, pharmacist, herbalist, or other healthcare provider about any unusual or bothersome side effect.

What other drugs will affect Carrington Oral Wound Rinse (aloe vera topical)?

It is not likely that other drugs you take orally or inject will have an effect on topically applied aloe vera topical. But many drugs can interact with each other. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Compare Carrington Oral Wound Rinse with other medications

• Burns, External
• Eczema
• Psoriasis
• Skin and Structure Infection
• Sunburn

Where can I get more information?

• Consult with a licensed healthcare professional before using any herbal/health supplement. Whether you are treated by a medical doctor or a practitioner trained in the use of natural medicines/supplements, make sure all your healthcare providers know about all of your medical conditions and treatments.

QVAR

Generic Name: Beclomethasone Dipropionate
Class: Adrenals
VA Class: NT200
Molecular Formula: C₂₈H₃₇ClO₇
CAS Number: 5534-09-8

Introduction

Synthetic corticosteroid;^{2 149} minimal mineralocorticoid activity.^{149 a}

Uses for QVAR

Asthma

Used for the long-term prevention of bronchospasm in patients with asthma.^{1 2 8 21 24 25 26 103 112 113 116 144 147 149 152}

Should not be used in the treatment of nonasthmatic bronchitis.^{1 28 112 113 144}

Chronic Obstructive Pulmonary Disease

Efficacy in patients with chronic obstructive pulmonary disease (e.g., bronchitis)† who are stabilized with oral corticosteroids^{33 34 37 117} or whose disease is corticosteroid responsive^{117 118} remains to be fully evaluated.

Inflammatory Conditions of the GI Tract

Has been used as an oral solution³⁵ or rectal suspension³⁶ (these dosage forms not commercially available in the US) in the management of inflammatory diseases of the GI tract† (e.g., inflammatory bowel disease†, eosinophilic gastroenteritis†).^{35 36} However, the role of beclomethasone dipropionate in the management of inflammatory conditions of the GI tract remains to be established.^{35 36}

QVAR Dosage and Administration

General

• 
  

  Adjust dosage carefully according to individual requirements and response.^{1 2 61 83 112 113 144 149}

  
  


• 
  

  After a satisfactory response is obtained, decrease dosage gradually to the lowest dosage that maintains an adequate clinical response.^{149 150} Achieve the lowest effective dosage, particularly in children, since inhaled corticosteroids have the potential to affect growth. (See Pediatric Use under Cautions.)^{149 150}

  
  

Conversion to Orally Inhaled Therapy in Patients Receiving Systemic Corticosteroids

• 
  

  When switching from systemic corticosteroids to orally inhaled beclomethasone dipropionate, asthma should be reasonably stable before initiating treatment with the oral inhalation.^{1 2 112 113 144 149}

  
  


• 
  

  Initially, administer the aerosol concurrently with the maintenance dosage of the systemic corticosteroid.^{1 2 112 113 144 149} After about 1 week, gradually withdraw the systemic corticosteroid.^{1 2 112 113 144 149}

  
  


• 
  

  Death has occurred in some individuals in whom systemic corticosteroids were withdrawn too rapidly.^{1 2 112 113 144 149} (See Withdrawal of Systemic Corticosteroid Therapy under Warnings.)

  
  


• 
  

  If exacerbations of asthma occur after transfer to oral inhalation therapy, administer short courses of systemic corticosteroids, then taper dosage as symptoms subside.^{1 2 112 113 144 149}

  
  

Administration

Oral Inhalation

Administer by oral inhalation using an oral aerosol inhaler.¹⁴⁹

Test-spray inhalation aerosol (2 times) before first use or whenever the aerosol has not been used for prolonged periods (>10 days).^{149 b}

Oral inhalation aerosol is formulated as a solution, which does not require shaking.¹⁴⁹

Exhale slowly and completely and place the mouthpiece of the inhaler well into the mouth with the lips closed firmly around it; keep the tongue below the mouthpiece.^b Inhale slowly and deeply through the mouth while actuating the inhaler.^b Hold the breath for as long as possible (about 5–10 seconds), withdraw the mouthpiece, and exhale gently.^b If additional inhalations are required, repeat the procedure.^b

Rinse the mouth thoroughly with water to remove drug deposited in the oropharyngeal area.^{33 48 49 52 59 149 b}

Clean the mouthpiece weekly^b using a clean, dry tissue or cloth.^b Do not wash or place any part of the inhaler canister in water.^b

Dosage

Available as beclomethasone dipropionate; dosage expressed in terms of the salt.^{b 149}

Oral inhalation aerosol releases 50 or 100 mcg of beclomethasone dipropionate, and delivers 40 or 80 mcg, respectively, from the actuator (mouthpiece) per metered spray.¹⁴⁹

Pediatric Patients

Asthma

Oral Inhalation

Children 5–11 years of age receiving bronchodilators alone or inhaled corticosteroids previously: Initially, 40 mcg twice daily.¹⁴⁹ If required, dosage may be increased to a maximum 80 mcg twice daily.¹⁴⁹

Children ≥12 years of age receiving bronchodilators alone previously: Initially, 40–80 mcg twice daily.¹⁴⁹ If required, dosage may be increased to a maximum 320 mcg twice daily.¹⁴⁹

Children ≥12 years of age receiving inhaled corticosteroids previously: Initially, 40–160 mcg twice daily. If required, dosage may be increased to a maximum 320 mcg twice daily.

Adults

Asthma

Oral Inhalation

In adults receiving bronchodilators alone previously: Initially, 40–80 mcg twice daily.^{149 149} If required, dosage may be increased to a maximum 320 mcg twice daily.¹⁴⁹

Adults receiving inhaled corticosteroids: Initially, 40–160 mcg twice daily. If required, dosage may be increased to a maximum of 320 mcg twice daily.

Prescribing Limits

Pediatric Patients

Asthma

Oral Inhalation

Children 5–11 years of age: Maximum 80 mcg twice daily.¹⁴⁹

Children ≥12 years of age: Maximum 320 mcg twice daily.¹⁴⁹

Adults

Asthma

Oral Inhalation

Maximum 320 mcg twice daily.¹⁴⁹

Special Populations

Geriatric Patients

Consider initial dosages at the lower end of the usual range due to possible age-related decrease in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.¹⁴⁹

Cautions for QVAR

Contraindications

• 
  

  Primary treatment of severe acute asthmatic attacks or status asthmaticus when intensive measures^{1 2 29 112 113 149} (e.g., oxygen, parenteral bronchodilators, IV corticosteroids)¹⁴⁷ are required.

  
  


• 
  

  Known hypersensitivity to the drug or any ingredient in the formulation.^{1 2 112 113 144 149}

  
  

Warnings/Precautions

Warnings

Withdrawal Of Systemic Corticosteroid Therapy

Possible corticosteroid withdrawal symptoms (e.g., joint pain, muscular pain, lassitude, depression);^{1 2 112 113 144 149} acute adrenal insufficiency;^{1 2 112 113 144} life-threatening exacerbation of asthma;^{1 2 112 113 144 149} pulmonary infiltrates with eosinophilia;^{1 112 113} or symptomatic exacerbation of allergic conditions^{1 2 27 44 52 58 70 112 113 144} if prolonged systemic corticosteroid therapy is replaced with oral inhalation corticosteroid therapy.^{1 2 112 113 144 149} Such symptoms may be observed especially in patients maintained on ≥20 mg of prednisone (or its equivalent) daily and particularly during the later part of the transfer.¹⁴⁹

In general, the greater the dosage and duration of systemic corticosteroid therapy, the greater the time required for withdrawal of systemic corticosteroids and replacement by orally inhaled corticosteroids.⁷³

Taper the dosage of the systemic corticosteroid, and carefully monitor patients during dosage reduction for objective signs of adrenal insufficiency (e.g., hypotension, weight loss).^{1 2 112 113 144 149}

Immunosuppressed Patients

Increased susceptibility to infections in patients who are taking immunosuppressant drugs compared with healthy individuals.^{113 134 135 136 137 138 139 140 141 142 143 144} Certain infections (e.g., varicella [chickenpox], measles) can have a more serious or even fatal outcome in such patients, particularly in children.^{113 134 135 136 137 138 139 140 141 142 143 144}

Exposure to varicella and measles should be avoided in previously unexposed patients.^b If exposure to varicella (chickenpox) or measles occurs in susceptible patients, consider administering varicella zoster immune globulin (VZIG) or immune globulin (IG) respectively.^b Consider treatment with an antiviral agent if varicella develops.^b

Concomitant Therapy

Use with caution in patients receiving systemic prednisone for any disease.^{45 47} Concomitant use with prednisone in an alternate-day or daily dosing regimen could increase the likelihood of HPA-axis suppression compared with therapeutic dosages of either drug alone.^{45 47}

Resume systemic corticosteroids during periods of stress (e.g., infection, trauma, surgery) or a severe asthma exacerbation in patients who were attempting a switch from systemic to orally inhaled corticosteroid therapy.¹⁴⁹

Hypothalamic-Pituitary-Adrenal (HPA) Axis Suppression

Avoid higher than recommended dosages of the drug, since suppression of HPA function may occur.¹⁴⁹ If higher than recommended dosages are used, carefully consider the relative risks of adrenal suppression and potential therapeutic benefits.¹⁴⁹ Recommended dosages of orally inhaled drug provide less than normal physiologic amounts of glucocorticoid systemically and do not provide mineralocorticoid activity.¹⁴⁹ Orally inhaled drug will not compensate for insufficient endogenous cortisol production caused by previous systemic corticosteroid therapy.¹⁴⁹

Respiratory Effects

Bronchospasm,^{1 2 57 112 113 133 149} cough,^{20 25 58 131 132 149} and/or wheezing^{57 58 131 132 133 149} may occur, especially in asthmatic patients with hyperactive airways.^{20 25 57 58 101 131 132 133}

If bronchospasm occurs, treat immediately with a short-acting bronchodilator, and discontinue treatment with beclomethasone dipropionate and institute alternative therapy.¹⁴⁹

Infection

Use with caution, if at all, in patients with clinical tuberculosis or latent M. tuberculosis infection of the respiratory tract; untreated systemic fungal, bacterial, or parasitic infections; or ocular herpes simplex or untreated, systemic viral infections.^{1 2 100 144 149}

Sensitivity Reactions

Immediate or delayed hypersensitivity reactions, including bronchospasm, anaphylactic/anaphylactoid reactions,² urticaria, angioedema, and rash reported rarely.^{1 2 112 113 149}

General Precautions

Systemic Corticosteroid Effects

Possible signs and symptoms of Cushing’s syndrome (e.g., hypertension, glucose intolerance, cushingoid features) in patients who are particularly sensitive to corticosteroid effects or when usual dosages of the drug are exceeded.^{100 149}

Carefully monitor neonates exposed to prenatal corticosteroids for manifestations of hypoadrenalism.^{2 61 112 144 149}

Ocular Effects

Glaucoma, increased intraocular pressure, and cataracts reported rarely.¹⁴⁹

Other Effects

Unknown long-term, systemic, and local effects of the drug in humans, particularly developmental or immunologic processes in the mouth, pharynx, trachea, and lung.¹⁴⁹

Specific Populations

Pregnancy

Category C.¹⁴⁹ (See Systemic Corticosteroid Effects under Cautions.)

Lactation

Distributed into milk.^{144 149} Discontinue nursing or the drug.^{144 149}

Pediatric Use

Safety and efficacy not established in children <5 years of age.¹⁴⁹ No overall differences in the pattern, severity, or frequency of adverse events in children 5–12 years of age compared with those in adults.¹⁴⁹ Monitor periodically children receiving prolonged therapy for possible adverse effects on growth and development.^{62 149}

Geriatric Use

Insufficient experience in patients ≥65 years of age to determine whether geriatric patients respond differently than younger adults.¹⁴⁹

Use caution due to the greater frequency of decreased hepatic, renal, and/or cardiac function and of concomitant disease and drug therapy in geriatric patients.¹⁴⁹ (See Geriatric Patients under Dosage and Administration.)

Common Adverse Effects

Headache, pharyngitis, upper respiratory tract infection, rhinitis.¹⁴⁹

Interactions for QVAR

Metabolized by CYP3A4.¹⁴⁹

Drugs Affecting Hepatic Microsomal Enzymes

Inhibitors of CYP3A4: potential pharmacokinetic interaction (increased plasma beclomethasone dipropionate concentrations).^a

Inducers of CYP3A4: potential pharmacokinetic interaction (decreased plasma beclomethasone dipropionate concentrations).^a

Specific Drugs

Drug	Interaction	Comments
Antidiabetic agents	May increase blood glucose concentrations in patients with diabetes mellitus	Adjust insulin and/or oral hypoglycemic dosages as needed
NSAIAs	Possible increased risk of GI ulcerationa Decreased serum salicylate concentrationsa When corticosteroids are discontinued, serum salicylate concentration may increase possibly resulting in salicylate intoxicationa	Use salicylates and corticosteroids concurrently with cautiona Observe patients receiving both drugs closely for adverse effects of either druga May be necessary to increase salicylate dosage when corticosteroids are administered concurrently or decrease salicylate dosage when corticosteroids are discontinueda
Vaccines and Toxoids	May cause a diminished response to toxoids and live or inactivated vaccinesa May potentiate replication of some organisms contained in live, attenuated vaccinesa Can aggravate neurologic reactions to some vaccines (supraphysiologic dosages) a	Generally defer routine administration of vaccines or toxoids until corticosteroid therapy is discontinueda May need serologic testing to ensure adequate antibody response for immunizationa Additional doses of the vaccine or toxoid may be necessarya May undertake immunization procedures in patients receiving nonimmunosuppressive doses of glucocorticoids or in patients receiving glucocorticoids as replacement therapy (e.g., Addison’s disease)a

QVAR Pharmacokinetics

Absorption

Bioavailability

Absorbed into circulation following oral inhalation, ¹⁴⁹ with peak plasma concentrations usually attained at 0.5 hour.¹⁴⁹ After oral inhalation, 51–60% of the dose is deposited in the respiratory tract.¹⁵⁴

Onset

Relief of respiratory symptoms usually is evident within 24 hours; however, about 1–4 weeks of continuous therapy may be required for optimum effectiveness.¹⁴⁹

Distribution

Extent

Glucocorticoids cross the placenta and are distributed into milk.^{144 149 a} No evidence of tissue storage of parent drug or metabolites.¹⁴⁹

Elimination

Metabolism

Metabolized to active metabolites via CYP3A4.¹⁴⁹

Elimination Route

Beclomethasone dipropionate and its metabolites eliminated principally in feces and to a lesser extent in the urine (<10%).¹⁴⁹

Half-life

2.8 hours.¹⁴⁹

Stability

Storage

Oral Inhalation

25°C (may be exposed to 15–30°C).¹⁴⁹

Do not puncture aerosol containers, use or store near heat or an open flame, expose to temperatures >49°C, or place into a fire or incinerator for disposal.^{1 112 113 144 149}

ActionsActions

• 
  

  Potent glucocorticoid and minimal mineralocorticoid activity.^{149 a c} At recommended dosages, provides less than normal physiologic amounts of glucocorticoid systemically.¹⁴⁹

  
  


• 
  

  Inhibits inflammatory cells and release of inflammatory mediators in the respiratory tract.¹⁴⁹ Improves lung function (e.g., forced expiratory volume in 1 second [FEV₁], morning peak expiratory flow).¹⁴⁹

  
  


• 
  

  Principal sites of action are the bronchi and bronchioles.¹⁴⁹

  
  


• 
  

  May reduce the following: number of mediator cells (basophils, leukocytes, and mast cells) at the epithelial level, number of eosinophils, sensitivity of sensory nerves to mechanical stimuli, secretory response to cholinergic receptor stimulation, and fibroblast activity.^c

  
  


• 
  

  May inhibit capillary dilation and permeability, stabilize lysosomal membranes, and prevent subsequent release of proteolytic enzymes.^c

  
  

Advice to Patients

• 
  

  Importance of providing the patient a copy of the manufacturer's patient information.¹⁴⁹

  
  


• 
  

  Importance of understanding of proper storage, preparation, and administration techniques.^{149 b}

  
  


• 
  

  Advise that oral inhalation must be used at regular intervals to be therapeutically effective.^{100 103 144 149}

  
  


• 
  

  Importance of understanding that although improvement may occur within the first 24 hours, at least 1–4 weeks of continuous therapy may be required for optimal effectiveness.^{1 2 61 77 100 112 113 144 149}

  
  


• 
  

  Importance of rinsing the mouth after inhalation and not exceeding the recommended dosage.^{1 2 71 112 113 144 149 b}

  
  


• 
  

  Importance of not using orally inhaled beclomethasone dipropionate as a bronchodilator or for emergency use (e.g., relief of acute bronchospasm).^{1 2 103 112 113 144 149}

  
  


• 
  

  Importance of contacting a clinician immediately when asthmatic attacks that are not controlled by bronchodilator therapy occur.^{1 2 112 113 149}

  
  


• 
  

  Advise patients being transferred from systemic corticosteroid to beclomethasone dipropionate oral inhalation therapy to carry special identification (e.g., card, bracelet) indicating the need for supplementary systemic corticosteroids during periods of stress. (See Concomitant Therapy under Cautions.)^{1 2 112 113 144 149}

  
  


• 
  

  Importance of immunosuppressed patients avoiding exposure to certain infections (e.g., chickenpox, measles) and if exposed, of immediately consulting their clinician.^{113 134 135 136 142 143 144 149}

  
  


• 
  

  Importance of women informing clinicians if they are or plan to become pregnant or to breast-feed.¹⁴⁹

  
  


• 
  

  Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses.¹⁴⁹

  
  


• 
  

  Importance of advising patients of other important precautionary information.¹⁴⁹ (See Cautions.)

  
  

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Beclomethasone Dipropionate

Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral Inhalation	Aerosol	40 mcg/metered spray	QVAR Oral Inhaler (with fluoroethane propellants and ethanol)	IVAX
		80 mcg/metered spray	QVAR Oral Inhaler (with fluoroethane propellants and ethanol)	IVAX

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Beconase AQ 42MCG/SPRAY Suspension (GLAXO SMITH KLINE): 25/$149.99 or 75/$415.97

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions July 2005. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

1. Schering Corporation. Vanceril 42 mcg (beclomethasone dipropionate, 42 mcg) inhalation aerosol prescribing information. Kenilworth, NJ; 2000 Aug.

2. Glaxo Wellcome. Beclovent (beclomethasone dipropionate) inhalation aerosol prescribing information. Research Triangle Park, NC; 1997 Dec.

3. Schering Corporation. Vanceril basic data book. Kenilworth, NJ; 1976 May.

4. Harris DM. Clinical pharmacology of beclomethasone dipropionate. In: Mygind N, Clark TJH, eds. Topical steroid treatment for asthma and rhinitis. London: Bailliere Tindall; 1980:34-47.

5. Wade A, ed. Martindale: the extra pharmacopeia. 27th ed. London: The Pharmaceutical Press; 1977:401-2.

6. Bondarevsky E, Shapiro MS, Schey G et al. Beclomethasone dipropionate use in chronic asthmatic patients: effect on adrenal function after substitution for oral glucocorticoids. JAMA. 1976; 236:1969-71. [IDIS 64768] [PubMed 989561]

7. Smith AP, Booth M, Davey AJ. A controlled trial of beclomethasone dipropionate for asthma. Br J Dis Chest. 1973; 67:208-14. [PubMed 4580987]

8. Harvey LL, Nair SV, Kass I. Beclomethasone dipropionate aerosol in the treatment of steroid-dependent asthma. Chest. 1976; 70:345-50. [IDIS 77953] [PubMed 782796]

9. Pines A. Beclomethasone dipropionate used as an aerosol in the treatment of asthma. Practitioner. 1975; 211:86-90.

10. Cayton RM, Soutar CA, Stanford CF et al. Double-blind trial comparing two dosage schedules of beclomethasone dipropionate aerosol in the treatment of chronic bronchial asthma. Lancet. 1974; 2:303-7. [PubMed 4136046]

11. Brown HM, Storey G. Beclomethasone dipropionate steroid aerosol in the treatment of perennial allergic asthma in children. Br Med J. 1973; 3:161-4. [IDIS 37188] [PubMed 4352726]

12. Dickson W, Hall CE, Ellis M et al. Beclomethasone dipropionate aerosol in childhood asthma. Arch Dis Child. 1973; 48:671-5. [IDIS 47206] [PubMed 4354778]

13. Gwynn CM, Smith JM. A one year follow-up of children and adolescents receiving regular beclomethasone dipropionate. Clin Allergy. 1974; 4:325-30.

14. Kerrebijn KF. Beclomethasone dipropionate in long-term treatment of asthma in children. J Pediatr. 1976; 89:821-6. [IDIS 79822] [PubMed 789844]

15. Vogt F, Chervinsky P, Dwek J et al. Beclomethasone dipropionate aerosol in the treatment of chronic bronchial asthma. J Allergy Clin Immunol. 1976; 58:316-21. [IDIS 75020] [PubMed 780407]

16. Choovoravech P, Preeyasombat C. Trial of beclomethasone dipropionate aerosol in the treatment of severe chronic asthma. Practitioner. 1978; 220:639-42. [IDIS 99093] [PubMed 349536]

17. Klein R, Waldman D, Kershnar H et al. Treatment of chronic childhood asthma with beclomethasone dipropionate aerosol. Part I: a double-blind crossover trial in nonsteroid-dependent patients. Pediatrics. 1977; 60:7-13. [IDIS 89666] [PubMed 327424]

18. Mackay JB. The impact of beclomethasone dipropionate aerosol on patients with reversible airways obstruction attending a chest clinic. Postgrad Med J. 1975; 51(Suppl 4):37-41. [PubMed 812073]

19. Zwi S, Van As A, Goldman HI et al. The measurement of response to beclomethasone dipropionate treatment for asthma. Postgrad Med J. 1975; 51(Suppl 4):64-7. [PubMed 1105521]

20. Johannessen H, Halvorsen FJ, Kommedal TM. Long-term treatment of patients with perennial bronchial asthma with beclomethasone dipropionate aerosol: a 24 month follow-up study. Curr Ther Res. 1979; 26:592-600.

21. Vandenberg R, Tovey E, Love I et al. Beclomethasone dipropionate: trial of a new inhalational steroid preparation in the treatment of steroid-dependent chronic asthmatics. Med J Aust. 1975; 1:189-93. [IDIS 51266] [PubMed 1128399]

22. Webb DR. Corticosteroid aerosols in the treatment of asthma. Bull Mason Clin. 1975; 29:98-106.

23. Brown HM, Storey G, George WHS. Beclomethasone dipropionate: a new steroid aerosol for the treatment of allergic asthma. Br Med J. 1972; 1:585-90. [IDIS 24974] [PubMed 4335298]

24. Bacal E, Patterson R. Long-term effects of beclomethasone dipropionate on prednisone dosage in the corticosteroid asthmatic. J Allergy Clin Immunol. 1978; 62:72-5. [IDIS 115339] [PubMed 670607]

25. Richards W, Platzker A, Church JA et al. Steroid-dependent asthma treated with inhaled beclomethasone dipropionate in children. Ann Allergy. 1978; 41:274-7. [IDIS 118451] [PubMed 362991]

26. Toogood JH, Lefcoe NM, Haines DSM et al. Minimum dose requirements of steroid-dependent asthmatic patients for aerosol beclomethasone and oral prednisone. J Allergy Clin Immunol. 1978; 61:355-64. [IDIS 98988] [PubMed 659727]

27. Kershnar H, Klein R, Waldman D et al. Treatment of chronic childhood asthma with beclomethasone dipropionate aerosols. Part II: effect on pituitary-adrenal function after substitution for oral corticosteroids. Pediatrics. 1978; 62:189-97. [IDIS 115288] [PubMed 358120]

28. Anon. Beclomethasone dipropionate (Vanceril) for asthma. Med Lett Drugs Ther. 1976; 18:76. [PubMed 958155]

29. Anon. Steroid aerosols for asthma. Med Lett Drugs Ther. 1975; 17:88. [PubMed 1186604]

30. Ballin JC. Evaluation of a new aerosolized steroid for asthma therapy. JAMA. 1976; 236:2891-3. [IDIS 66616] [PubMed 1036594]

31. Willey RF, Godden DJ, Carmichael J et al. Comparison of twice daily administration of a new corticosteroid budesonide with beclomethasone dipropionate four times daily in the treatment of chronic asthma. Br J Dis Chest. 1982; 76:61-8. [PubMed 7037035]

32. Kennedy MCS, Posner E, Thursby-Pelham DC. Long-term treatment of asthma with beclomethasone dipropionate. Postgrad Med J. 1975; 51(Suppl 4):84-6. [PubMed 812075]

33. Williams MH Jr. Beclomethasone dipropionate. Ann Intern Med. 1981; 95:464-7. [IDIS 138411] [PubMed 6792963]

34. Shim C, Stover DE, Williams MH Jr. Response to corticosteroids in chronic bronchitis. J Allergy Clin Immunol. 1978; 62:363-7. [IDIS 120228] [PubMed 361794]

35. Elkon KB, Sher R, Seftel HC. Immunological studies of eosinophilic gastroenteritis and treatment with disodium cromoglycate and beclomethasone dipropionate. S Afr Med J. 1977; 52:834-41.

36. Kumana CR, Meghji M, Seaton T et al. Beclomethasone dipropionate enemas for treating inflammatory bowel disease without producing Cushing’s syndrome or hypothalamic-pituitary-adrenal suppression. Lancet. 1982; 1:579-83. [IDIS 146782] [PubMed 6121181]

37. Matthews JI, Hooper RG. Idiopathic bronchial stenosis in a young woman. Chest. 1978; 74:690-1. [IDIS 118949] [PubMed 738131]

38. Horton DJ, Spector SL. Clinical pulmonary tuberculosis in an asthmatic patient using a steroid aerosol. Chest. 1977; 71:540-2. [IDIS 84064] [PubMed 852327]

39. Andersson E, Smidt CM, Sikjaer B et al. Bronchial biopsies after beclomethasone dipropionate aerosol. Br J Dis Chest. 1977; 77:35-43.

40. Mellis CM, Phelan PD. Asthma deaths in children—a continuing problem. Thorax. 1977; 32:29-34. [PubMed 841530]

41. Bhan GL, Gwynn CM, Smith JM. Growth and adrenal function of children on prolonged beclomethasone dipropionate treatment. Lancet. 1980; 1:96-7. [IDIS 108713] [PubMed 6101444]

42. Smith JM. Hazards of prolonged use of beclomethasone spray. JAMA. 1982; 248:1449. [IDIS 156419] [PubMed 7109163]

43. Siegel SC, Katz RM, Rachelefsky GS. Prednisone and beclomethasone for treatment of asthma. N Engl J Med. 1979; 300:986. [IDIS 93832] [PubMed 431575]

44. Clark TJH. Beclomethasone dipropionate treatment of asthma in adults. In: Mygind N, Clark TJH, eds. Topical steroid treatment for asthma and rhinitis. London: Bailliere Tindall; 1980:94-106.

45. Wyatt R, Waschek J, Weinberger M et al. Effects of inhaled beclomethasone dipropionate and alternate-day prednisone on pituitary-adrenal function in children with chronic asthma. N Engl J Med. 1978; 299:1387-92. [IDIS 91444] [PubMed 362207]

46. Vaz R, Senior B, Morris M et al. Adrenal effects of beclomethasone inhalation therapy in asthmatic children. J Pediatr. 1982; 100:660-2. [IDIS 148471] [PubMed 7062222]

47. Toogood JH, Lefcoe NM, Haines DSM et al. A graded dose assessment of the efficacy of beclomethasone dipropionate aerosol for severe chronic asthma. J Allergy Clin Immunol. 1977; 59:298-308. [IDIS 86371] [PubMed 321503]

48. Toogood JH, Jennings B, Greenway RW et al. Candidiasis and dysphonia complicating beclomethasone treatment of asthma. J Allergy Clin Immunol. 1980; 65:145-53. [IDIS 113987] [PubMed 7351447]

49. Chiu JT, Wells I, Novey HS. Incidence of fungal precipitins in patients treated with beclomethasone dipropionate aerosol. Ann Allergy. 1981; 46:137-9. [IDIS 134708] [PubMed 7008662]

50. Milne LJR, Crompton GK. Beclomethasone dipropionate and oropharyngeal candidiasis. Br Med J. 1974; 3:797-8. [IDIS 47946] [PubMed 4606264]

51. Stein MR, Shay SS, Jacobson K. Monilial esophagitis in asthmatic patients treated with beclomethasone. J Allergy Clin Immunol. 1979; 63:172.

52. Imbeau SA, Geller M. Aerosol beclomethasone treatment of chronic severe asthma—a one-year experience. JAMA. 1978; 240:1260-2. [IDIS 85908] [PubMed 682308]

53. Klotz LR, Klotz SD, Moeller RK. The use of beclomethasone dipropionate inhaler complicated by the development of an eosinophilic pneumonia reaction. Ann Allergy. 1977; 39:133-6. [IDIS 90762] [PubMed 889156]

54. Hudgel DW, Spector SL. Pulmonary infiltration with eosinophilia—recurrence in an asthmatic patient treated with beclomethasone dipropionate. Chest. 1977; 72:359-60. [IDIS 92254] [PubMed 891289]

55. Friedman H, Tworag JF, Voss HE et al. Eosinophilic pneumonia in association with the use of beclomethasone dipropionate aerosol. J Allergy Clin Immunol. 1978; 61:150.

56. Brogden RN, Pinder RM, Sawyer PR et al. Beclomethasone dipropionate inhaler: a review of its pharmacology, therapeutic value and adverse effects. Part I: asthma. Drugs. 1975; 10:166-210. [IDIS 62498] [PubMed 172309]

57. Bryant DH, Pepys J. Bronchial reactions to aerosol inhalant vehicle. Br Med J. 1976; 1:1319-20. [PubMed 1268679]

58. Kass I, Nair SV, Patil KD. Beclomethasone dipropionate aerosol treatment of steroid-dependent asthmatic patients: an assessment of 18 months of therapy. Chest. 1977; 71:703-7. [IDIS 81635] [PubMed 405181]

59. Lee-Hong E, Collins-Williams C. The long-term use of beclomethasone dipropionate for the control of severe asthma in children. Ann Allergy. 1977; 38:242-4. [PubMed 851256]

60. Cooper EJ, Grant IWB. Beclomethasone dipropionate aerosol in treatment of chronic asthma. Q J Med. 1977; 46:295-308. [IDIS 90416] [PubMed 918249]

61. USPDI: 1983 drug information for the health care provider. Johnson KW, ed. Rockville, MD: The United States Pharmacopeial Convention, Inc; 1983; I:177-8.

62. Freigang B. New method of beclomethasone aerosol administration to children under 4 years of age. Can Med Assoc J. 1977; 117:1308-9. [IDIS 75131] [PubMed 922624]

63. Freigang B. Long-term follow-up of infants and children treated with beclomethasone aerosol by a special inhalation device. Ann Allergy. 1980; 45:13-7. [IDIS 119650] [PubMed 6773446]

64. Soderberg-Warner M, Siegel S, Katz R et al. Treatment of chronic childhood asthma with beclomethasone dipropionate aerosols (BDP). IV. long-term effects on growth. J Allergy Clin Immunol. 1979; 63:164.

65. Godfrey S, Balfour-Lynn L, Tooley M. A three- to five-year follow-up of the use of the aerosol steroid beclomethasone dipropionate, in childhood asthma. J Allergy Clin Immunol. 1978; 62:335-9. [IDIS 120226] [PubMed 712019]

66. Godfrey S. Beclomethasone dipropionate treatment of childhood asthma. In: Mygind N, Clark TJH, eds. Topical steroid treatment for asthma and rhinitis. London: Bailliere Tindall; 1980:123-36.

67. Anon. Management of asthma in the child aged under 6 years. BMJ. 1981; 283:863-4.

68. Schering Corporation. Vancenase prescribing information. Kenilworth, NJ; 1981 Sep.

69. Glaxo Inc. Beconase prescribing information. Fort Lauderdale, FL; 1981 Aug.

70. Brown HM, Storey G. Beclomethasone dipropionate aerosol in long-term treatment of perennial and seasonal asthma in children and adults: a report of five-and-half years experience in 600 asthmatic patients. Br J Clin Pharmacol. 1977; 3(Suppl):259-67S.

71. Schering Corporation. Vanceril oral inhaler patient instructions. Kenilworth, NJ; 1978 Aug.

72. Iezzoni DG (Schering Corporation, Kenilworth, NJ): Personal communication; 1982 Jul.

73. Gregg I. The importance of patient education in the

Cortaid

Generic Name: hydrocortisone (Topical application route)

hye-droe-KOR-ti-sone

Commonly used brand name(s)

In the U.S.

• Ala-Cort


• Ala-Scalp HP


• Anusol HC


• Aquanil HC


• Beta HC


• Caldecort


• Cetacort


• Corta-Cap


• Cortagel Extra Strength


• Cortaid


• CortAlo With Aloe


• Corticaine


• Corticool Maximum Strength


• Cortizone-10


• Cortizone-5


• Cotacort


• Delacort


• Dermarest


• Dermtex-HC


• Foille Cort


• Gly-Cort


• Hydrozone Plus


• Hytone


• Instacort-10


• Ivy Soothe


• IvyStat


• Keratol HC


• Kericort 10


• Lacticare-HC


• Locoid


• Locoid Lipocream


• Medi-Cortisone Maximum Strength


• Microcort


• Mycin Scalp


• Neutrogena T/Scalp


• NuCort


• Nupercainal HC


• Nutracort


• Pandel


• Pediaderm HC Kit


• Preparation H Hydrocortisone


• Proctocream-HC


• Recort Plus


• Sarnol-HC Maximum Strength


• Scalacort


• Scalpcort


• Summer's Eve Specialcare


• Texacort


• Therasoft Anti-Itch & Dermatitis


• U-Cort


• Westcort

In Canada

• Barriere-Hc


• Cortate


• Cort-Eze


• Cortoderm Mild Ointment


• Cortoderm Regular Ointment


• Emo-Cort


• Emo-Cort Scalp Solution


• Hydrocortisone Cream


• Novo-Hydrocort


• Novo-Hydrocort Cream


• Prevex Hc


• Sarna Hc

Available Dosage Forms:

• Solution


• Cream


• Spray


• Lotion


• Ointment


• Pad


• Liquid


• Gel/Jelly


• Kit


• Foam


• Stick


• Paste

Therapeutic Class: Corticosteroid, Weak

Pharmacologic Class: Adrenal Glucocorticoid

Uses For Cortaid

Hydrocortisone topical is used to help relieve redness, itching, swelling, or other discomfort caused by skin conditions. This medicine is a corticosteroid (cortisone-like medicine or steroid).

This medicine is available both over-the-counter (OTC) and with your doctor's prescription.

Before Using Cortaid

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of hydrocortisone topical in the pediatric population. However, because of this medicine's toxicity, it should be used with caution. Children may absorb large amounts through the skin, which can cause serious side effects. If your child is using this medicine, follow your doctor's instructions very carefully.

Geriatric

No information is available on the relationship of age to the effects of hydrocortisone topical in geriatric patients.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Cushing's syndrome (adrenal gland disorder) or


• Diabetes or


• Hyperglycemia (high blood sugar) or


• Intracranial hypertension (increased pressure in the head)—Use with caution. May make these conditions worse.

• Infection of the skin at or near the place of application or


• Large sores, broken skin, or severe skin injury at the place of application—The chance of side effects may be increased.

Proper Use of hydrocortisone

This section provides information on the proper use of a number of products that contain hydrocortisone. It may not be specific to Cortaid. Please read with care.

It is very important that you use this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may cause unwanted side effects or skin irritation.

This medicine is for use on the skin only. Do not get it in your eyes. Do not use it on skin areas that have cuts, scrapes, or burns. If it does get on these areas, rinse it off right away with water.

This medicine should only be used for skin conditions that your doctor is treating. Check with your doctor before using it for other conditions, especially if you think that a skin infection may be present. This medicine should not be used to treat certain kinds of skin infections or conditions, such as severe burns.

To use:

• Wash your hands with soap and water before and after using this medicine.


• Apply a thin layer of this medicine to the affected area of the skin. Rub it in gently.


• With the lotion, shake it well before using.


• Do not bandage or otherwise wrap the skin being treated unless directed to do so by your doctor.


• If the medicine is applied to the diaper area of an infant, do not use tight-fitting diapers or plastic pants unless directed to do so by your doctor.


• If your doctor ordered an occlusive dressing or airtight covering to be applied over the medicine, make sure you know how to apply it. Occlusive dressings increase the amount of medicine absorbed through your skin, so use them only as directed. If you have any questions about this, check with your doctor.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For redness, itching, and swelling of the skin:
  
  • For topical dosage form (cream):
    
    • Adults—Apply to the affected area of the skin two or three times per day.
    
    
    • Children—Apply to the affected area of the skin two or three times per day.
    
    
  
  
  • For topical dosage form (lotion):
    
    • Adults—Apply to the affected area of the skin two to four times per day.
    
    
    • Children—Apply to the affected area of the skin two to four times per day.
    
    
  
  
  • For topical dosage form (ointment):
    
    • Adults—Apply to the affected area of the skin three or four times per day.
    
    
    • Children—Apply to the affected area of the skin three or four times per day.
    
    
  
  
  • For topical dosage form (solution):
    
    • Adults—Apply to the affected area of the skin three or four times per day.
    
    
    • Children—Apply to the affected area of the skin three or four times per day.
    
    
  
  

Missed Dose

If you miss a dose of this medicine, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Cortaid

It is very important that your doctor check your or your child's progress at regular visits for any unwanted effects that may be caused by this medicine.

If your or your child's symptoms do not improve within a few days, or if they become worse, check with your doctor.

Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems. The risk is greater for children and patients who use large amounts for a long time. Talk to your doctor right away if you or your child have more than one of these symptoms while you are using this medicine: blurred vision; dizziness or fainting; a fast, irregular, or pounding heartbeat; increased thirst or urination; irritability; or unusual tiredness or weakness.

Stop using this medicine and check with your doctor right away if you or your child have a skin rash, burning, stinging, swelling, or irritation on the skin.

Do not use cosmetics or other skin care products on the treated areas.

Cortaid Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

• Blistering, burning, crusting, dryness, or flaking of the skin


• irritation


• itching, scaling, severe redness, soreness, or swelling of the skin


• redness and scaling around the mouth


• thinning of the skin with easy bruising, especially when used on the face or where the skin folds together (e.g. between the fingers)


• thinning, weakness, or wasting away of the skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

• Acne or pimples


• burning and itching of the skin with pinhead-sized red blisters


• burning, itching, and pain in hairy areas, or pus at the root of the hair


• increased hair growth on the forehead, back, arms, and legs


• lightening of normal skin color


• lightening of treated areas of dark skin


• reddish purple lines on the arms, face, legs, trunk, or groin


• softening of the skin

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Cortaid side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Cortaid resources

• Cortaid Side Effects (in more detail)
• Cortaid Use in Pregnancy & Breastfeeding
• Cortaid Drug Interactions
• Cortaid Support Group
• 0 Reviews for Cortaid - Add your own review/rating

• Cortaid Concise Consumer Information (Cerner Multum)


• Anucort-HC cream, ointment, suppository Concise Consumer Information (Cerner Multum)


• Anusol-HC Cream MedFacts Consumer Leaflet (Wolters Kluwer)


• Carmol HC Prescribing Information (FDA)


• Carmol HC Concise Consumer Information (Cerner Multum)


• Carmol HC MedFacts Consumer Leaflet (Wolters Kluwer)


• Cortizone-10 Cream MedFacts Consumer Leaflet (Wolters Kluwer)


• Hydrocortisone Acetate Monograph (AHFS DI)


• Hydrocortisone with Aloe Cream MedFacts Consumer Leaflet (Wolters Kluwer)


• Hytone Prescribing Information (FDA)


• Instacort Gel MedFacts Consumer Leaflet (Wolters Kluwer)


• Locoid Cream MedFacts Consumer Leaflet (Wolters Kluwer)


• Locoid Lipocream Prescribing Information (FDA)


• Locoid Lotion Prescribing Information (FDA)


• Nutracort Concise Consumer Information (Cerner Multum)


• Nutracort Lotion MedFacts Consumer Leaflet (Wolters Kluwer)


• Pandel Prescribing Information (FDA)


• Pediaderm HC Lotion MedFacts Consumer Leaflet (Wolters Kluwer)


• ProctoCream-HC Cream MedFacts Consumer Leaflet (Wolters Kluwer)


• Proctocort Prescribing Information (FDA)


• Texacort Prescribing Information (FDA)


• U-cort Prescribing Information (FDA)


• Westcort Prescribing Information (FDA)

Compare Cortaid with other medications

• Anal Itching
• Aphthous Stomatitis, Recurrent
• Atopic Dermatitis
• Dermatitis
• Eczema
• Gingivitis
• Proctitis
• Pruritus
• Psoriasis
• Seborrheic Dermatitis
• Skin Rash

Cimzia

Generic Name: certolizumab (SER toe LIZ oo mab)

Brand Names: Cimzia

What is certolizumab?

Certolizumab reduces the effects of a substance in the body that can cause inflammation.

Certolizumab is used to treat the symptoms of Crohn's disease after other drugs have been tried without successful treatment of symptoms. Certolizumab is also used to treat moderate to severe rheumatoid arthritis in adults.

Certolizumab may also be used for purposes not listed in this medication guide.

What is the most important information I should know about certolizumab?

Some people using certolizumab have developed a rare fast-growing type of lymphoma (cancer). This condition affects the liver, spleen, and bone marrow, and it can be fatal. This has occurred mainly in teenagers and young adults using certolizumab or similar medicines to treat Crohn's disease or ulcerative colitis. Call your doctor at once if you have any of the following symptoms: fever, night sweats, itching, loss of appetite, weight loss, tiredness, feeling full after eating only a small amount, pain in your upper stomach that may spread to your shoulder, nausea, easy bruising or bleeding, pale skin, feeling light-headed or short of breath, rapid heart rate, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). Certolizumab can lower blood cells that help your body fight infections. Your blood may need to be tested often. Avoid being near people who are sick or have infections. Avoid activities that may increase your risk of bleeding injury. Serious and sometimes fatal infections may occur during treatment with certolizumab. Contact your doctor right away if you have signs of infection such as: fever, cough, sweating, tired feeling, or if you feel short of breath.

Before you start treatment with certolizumab, your doctor may perform tests to make sure you do not have tuberculosis or other infections. Tell your doctor if you have any signs of infection or if you have recently received any vaccines.

Tell your doctor if you are allergic to any drugs, or if you have lupus, diabetes, HIV/AIDS, hepatitis B, a seizure disorder, congestive heart failure, a history of cancer, or a disease that affects the nerves or muscles (such as multiple sclerosis or myasthenia gravis).

Some infections are more likely to occur in certain areas of the world. Tell your doctor where you live and where you have recently traveled or plan to travel to during treatment.

Do not receive a "live" vaccine while you are being treated with certolizumab.

What should I discuss with my healthcare provider before I receive certolizumab?

You should not receive this medication if you have active but untreated tuberculosis. Tell your doctor if you have ever had tuberculosis, if anyone in your household has tuberculosis, or if you have recently traveled to an area where tuberculosis is common. Some people using certolizumab have developed a rare fast-growing type of lymphoma (cancer). This condition affects the liver, spleen, and bone marrow, and it can be fatal. This has occurred mainly in teenagers and young adults using certolizumab or similar medicines to treat Crohn's disease or ulcerative colitis.

However, people with autoimmune disorders (including rheumatoid arthritis, Crohn's disease, ankylosing spondylitis, and psoriasis) may have a higher risk of lymphoma. Talk to your doctor about your individual risk.

To make sure you can safely use certolizumab, tell your doctor if you have any of these other conditions:

• 
  

  an active or recent infection;

  
  


• 
  

  signs of infection such as fever, chills, cough, or flu symptoms;

  
  


• 
  

  open sores or skin wounds;

  
  


• 
  

  lupus;

  
  


• 
  

  diabetes;

  
  


• 
  

  HIV or AIDS;

  
  


• 
  

  hepatitis B (or if you are a carrier of the virus);

  
  


• 
  

  a history of cancer;

  
  


• 
  

  epilepsy or seizure disorder;

  
  


• 
  

  congestive heart failure;

  
  


• 
  

  a disease that affects the nerves or muscles, such as multiple sclerosis, myasthenia gravis, Guillain-Barre syndrome;

  
  


• 
  

  if you have recently been vaccinated with BCG (Bacille Calmette-Guerin); or

  
  


• 
  

  if you are scheduled to receive any vaccines.

  
  

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether certolizumab passes into breast milk. Before you receive certolizumab, tell your doctor if you are breast-feeding a baby.

How is certolizumab given?

Before you start treatment with certolizumab, your doctor may perform tests to make sure you do not have tuberculosis or other infections.

Some infections are more likely to occur in certain areas of the world. Tell your doctor where you live and where you have recently traveled or plan to travel to during treatment.

Certolizumab is given as two injections under the skin of your stomach or thigh.

This medication is usually given every 2 to 4 weeks.

Certolizumab can lower blood cells that help your body fight infections. Your blood may need to be tested often. Avoid being near people who are sick or have infections. Avoid activities that may increase your risk of bleeding injury. Serious and sometimes fatal infections may occur during treatment with certolizumab. Contact your doctor right away if you have signs of infection such as: fever, cough, sweating, tired feeling, or if you feel short of breath.

Use certolizumab regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

If you need surgery, tell the surgeon ahead of time that you are using certolizumab.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using certolizumab.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your certolizumab injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving certolizumab?

Do not receive a "live" vaccine while using certolizumab, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you. Live vaccines include measles, mumps, rubella (MMR), Bacillus Calmette-Guérin (BCG), oral polio, rotavirus, smallpox, typhoid, yellow fever, varicella (chickenpox), H1N1 influenza, and nasal flu vaccine.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Certolizumab side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor right away if you have any of these symptoms of lymphoma:

• 
  

  fever, night sweats, weight loss, tiredness;

  
  


• 
  

  feeling full after eating only a small amount;

  
  


• 
  

  pain in your upper stomach that may spread to your shoulder;

  
  


• 
  

  easy bruising or bleeding, pale skin, feeling light-headed or short of breath, rapid heart rate; or

  
  


• 
  

  nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

  
  

Call your doctor at once if you have any of these other serious side effects:

• 
  

  signs of infection (fever, chills, sore throat, vomiting, diarrhea, flu symptoms);

  
  


• 
  

  shortness of breath with swelling of your ankles or feet;

  
  


• 
  

  chest pain, ongoing cough, coughing up blood or mucus;

  
  


• 
  

  swollen glands in your neck, armpits, or groin;

  
  


• 
  

  fast or slow heart rate;

  
  


• 
  

  pain or burning when you urinate;

  
  


• 
  

  confusion, neck stiffness, seizure (convulsions);

  
  


• 
  

  severe blistering, peeling, and red skin rash;

  
  


• 
  

  vision problems, dizziness, numbness or tingly feeling, muscle weakness in your arms or legs;

  
  


• 
  

  joint pain or swelling with fever, muscle aches, nausea, vomiting, unusual thoughts or behavior, and/or seizure (convulsions); or

  
  


• 
  

  patchy skin color, red spots, or a butterfly-shaped skin rash over your cheeks and nose (worsens in sunlight).

  
  

Less serious side effects may include:

• 
  

  stuffy nose, sinus pain;

  
  


• 
  

  stomach pain, mild diarrhea, constipation; or

  
  


• 
  

  pain, redness, itching, swelling, or bleeding where the medicine was injected.

  
  

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect certolizumab?

Tell your doctor about all other medications you use, especially:

• 
  

  anakinra (Kineret); or

  
  


• 
  

  other drugs that weaken your immune system (such as cancer medicine or steroids).

  
  

This list is not complete and other drugs may interact with certolizumab. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More Cimzia resources

• Cimzia Side Effects (in more detail)
• Cimzia Use in Pregnancy & Breastfeeding
• Cimzia Drug Interactions
• Cimzia Support Group
• 6 Reviews for Cimzia - Add your own review/rating

• Cimzia Prescribing Information (FDA)


• Cimzia Monograph (AHFS DI)


• Cimzia Advanced Consumer (Micromedex) - Includes Dosage Information


• Cimzia MedFacts Consumer Leaflet (Wolters Kluwer)


• Cimzia Consumer Overview

Compare Cimzia with other medications

• Crohn's Disease
• Crohn's Disease, Acute
• Crohn's Disease, Maintenance
• Rheumatoid Arthritis

Where can I get more information?

• Your doctor or pharmacist can provide more information about certolizumab.

See also: Cimzia side effects (in more detail)

Citracal Petites/Vitamin D

Pronunciation: KAL-see-um SIT-rate with VYE-ta-min D
Generic Name: Calcium Citrate
Brand Name: Examples include Citracal+D and Citracal Petites/Vitamin D

Citracal Petites/Vitamin D is used for:

Treating or preventing calcium deficiency. It may also be used for other conditions as determined by your doctor.

Citracal Petites/Vitamin D is a dietary supplement. It works by providing extra calcium to the body.

Do NOT use Citracal Petites/Vitamin D if:

• you are allergic to any ingredient in Citracal Petites/Vitamin D


• you have high blood calcium levels or high blood vitamin D levels


• you take aluminum salts (eg, aluminum chloride)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Citracal Petites/Vitamin D:

Some medical conditions may interact with Citracal Petites/Vitamin D. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have high blood phosphate levels or high levels of calcium in the urine


• if you have dehydration, heart problems, hardening of the arteries, kidney problems, kidney stones, or sarcoidosis


• if you take digoxin

Some MEDICINES MAY INTERACT with Citracal Petites/Vitamin D. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Iron, quinolones (eg, ciprofloxacin), sodium polystyrene sulfonate, tetracyclines (eg, doxycycline), thyroid hormones, or verapamil because their effectiveness may be decreased by Citracal Petites/Vitamin D

This may not be a complete list of all interactions that may occur. Ask your health care provider if Citracal Petites/Vitamin D may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Citracal Petites/Vitamin D:

Use Citracal Petites/Vitamin D as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Citracal Petites/Vitamin D by mouth with or without food.


• Take Citracal Petites/Vitamin D with a full glass of water (8 oz/240 mL).


• Do not take an antacid that has aluminum in it within 1 hour before or 2 hours after you take Citracal Petites/Vitamin D.


• If you miss a dose of Citracal Petites/Vitamin D, take it as soon as you remember. Continue to take it as directed by your doctor or on the package label.

Ask your health care provider any questions you may have about how to use Citracal Petites/Vitamin D.

Important safety information:

• Do not take large doses of vitamins while you use Citracal Petites/Vitamin D unless your doctor tells you to.


• Tell your doctor or dentist that you take Citracal Petites/Vitamin D before you receive any medical or dental care, emergency care, or surgery.


• This product may contain tartrazine dye (FD&C Yellow No. 5). This may cause an allergic reaction in some patients. If you have ever had an allergic reaction to tartrazine, ask your pharmacist if your product has tartrazine in it.


• Lab tests, including serum calcium levels, may be performed while you use Citracal Petites/Vitamin D. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Citracal Petites/Vitamin D should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Citracal Petites/Vitamin D while you are pregnant. It is not known if Citracal Petites/Vitamin D is found in breast milk. If you are or will be breast-feeding while you use Citracal Petites/Vitamin D, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Citracal Petites/Vitamin D:

All medicines may cause side effects, but many people have no, or minor side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; headache.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); loss of appetite; nausea; severe or persistent constipation; vomiting.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Citracal Petites/Vitamin D side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include confusion; delirium; loss of consciousness; mood or mental changes.

Proper storage of Citracal Petites/Vitamin D:

Store Citracal Petites/Vitamin D at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Citracal Petites/Vitamin D out of the reach of children and away from pets.

General information:

• If you have any questions about Citracal Petites/Vitamin D, please talk with your doctor, pharmacist, or other health care provider.


• Citracal Petites/Vitamin D is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Citracal Petites/Vitamin D. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Citracal Petites/Vitamin D resources

• Citracal Petites/Vitamin D Side Effects (in more detail)
• Citracal Petites/Vitamin D Use in Pregnancy & Breastfeeding
• Citracal Petites/Vitamin D Drug Interactions
• 0 Reviews for Citracal Petites/Vitamin D - Add your own review/rating

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Hetacin-K Infusion

Dosage Form: FOR ANIMAL USE ONLY
Hetacin-K®

(hetacillin potassium)

Intramammary Infusion

For lactating cows only

NADA 55-054, Approved by FDA

CAUTION

Federal law restricts this drug to use by or on the order of a licensed veterinarian.

Hetacin-K Infusion Description

Hetacin-K (hetacillin potassium) is a broad-spectrum agent which provides bactericidal activity against a wide range of common gram-positive and gram-negative bacteria. It is derived from 6-aminopenicillanic acid and is chemically related to ampicillin.

Each 10 mL disposable syringe contains hetacillin potassium equivalent to 62.5 mg ampicillin activity in a stable peanut oil gel. This product was manufactured by a non-sterilizing process.

ACTION

Hetacillin provides bactericidal levels of the active antibiotic, ampicillin. In vitro studies have demonstrated susceptibility of the following organisms to ampicillin: Streptococcus agalactiae, Streptococcus dysgalactiae, Staphylococcus aureus and Escherichia coli.

INDICATIONS

For the treatment of acute, chronic or subclinical bovine mastitis. Hetacin-K (hetacillin potassium) for Intramammary Infusion should be used at the first signs of inflammation or at the first indication of any alteration in the milk. Subclinical infections should be treated immediately upon determining, by C.M.T. or other tests, that the leukocyte count is elevated, or that a susceptible pathogen has been cultured from the milk.

Hetacin-K for Intramammary Infusion has been shown to be efficacious in the treatment of mastitis in lactating cows caused by susceptible strains of Streptococcus agalactiae, Streptococcus dysgalactiae, Staphylococcus aureus and Escherichia coli.

Polycillin® (ampicillin) Susceptibility Test Discs, 10 mcg, should be used to estimate the in vitro susceptibility of bacteria to hetacillin.

Hetacin-K Infusion Dosage and Administration

Infuse the entire contents of one syringe (10 mL) into each infected quarter. Repeat at 24-hour intervals until a maximum of three treatments has been given.

If definite improvement is not noted within 48 hours after treatment, the causal organism should be further investigated.

Wash the udder and teats thoroughly with warm water containing a suitable dairy antiseptic and dry, preferably using individual paper towels. Carefully scrub the teat end and orifice with 70% alcohol, using a separate swab for each teat. Allow to dry.

Hetacin-K (hetacillin potassium) is packaged with the Opti-Sert® Protective Cap.

For partial insertion: Twist off upper portion of the Opti-Sert Protective Cap to expose 3–4 mm of the syringe tip.

For full insertion: Remove protective cap to expose the full length of the syringe tip.

Insert syringe tip into the teat canal and expel the entire contents of one syringe into each infected quarter. Withdraw the syringe and gently massage the quarter to distribute the medication.

Do not infuse contents of the mastitis syringe into the teat canal if the Opti-Sert Protective Cap is broken or damaged.

RESIDUE WARNINGS

Milk that has been taken from animals during treatment and for 72 hours (6 milkings) after the latest treatment must not be used for food. Treated animals must not be slaughtered for food until 10 days after the latest treatment.

Precautions

Because it is a derivative of 6-aminopenicillanic acid, Hetacin-K has the potential for producing allergic reactions. Such reactions are rare; however, should they occur, treatment should be discontinued and the subject treated with antihistamines, pressor amines, such as epinephrine or corticosteroids.

The drug does not resist destruction by penicillinase and, hence, is not effective against strains of staphylococcus resistant to penicillin G.

STORAGE

Do not store above 25°C (77°F). Do not freeze.

How is Hetacin-K Infusion Supplied

Hetacin-K (hetacillin potassium) Intramammary Infusion is supplied as 10 mL syringes containing 62.5 mg ampicillin activity per syringe. One display carton contains 12 syringes.

NDC 0010-4719-01 10 mL syringe

Opti-Sert is a registered trademark of Wyeth LLC - used under license.

Hetacin-K is a registered trademark of Boehringer Ingelheim Vetmedica, Inc.

© 2010 Boehringer Ingelheim Vetmedica, Inc. All Rights Reserved.

11890 D4340B

Manufactured for:

Boehringer Ingelheim Vetmedica, Inc.

St. Joseph, MO 64506 U.S.A.

SYRINGE LABEL

CARTON LABEL

HETACIN-K INTRAMAMMARY INFUSION  hetacillin potassium  liquid

Product Information Product Type PRESCRIPTION ANIMAL DRUG NDC Product Code (Source) 0010-4719 Route of Administration INTRAMAMMARY DEA Schedule

Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength HETACILLIN POTASSIUM (AMPICILLIN) AMPICILLIN 62.5 mg  in 10 mL

Inactive Ingredients Ingredient Name Strength No Inactive Ingredients Found

Product Characteristics Color      Score      Shape Size Flavor Imprint Code Contains

Packaging # NDC Package Description Multilevel Packaging 1 0010-4719-01 12 SYRINGE In 1 CARTON contains a SYRINGE, PLASTIC 1 10 mL In 1 SYRINGE, PLASTIC This package is contained within the CARTON (0010-4719-01)

Marketing Information
Marketing Category	Application Number or Monograph Citation	Marketing Start Date	Marketing End Date
NADA	NADA055054	11/12/1973

Labeler - Boehringer Ingelheim Vetmedica, Inc. (007134091)

Revised: 11/2010Boehringer Ingelheim Vetmedica, Inc.