Hydrocortisone Cream 0.5% can be used as continuation therapy in mild cases of seborrhoeic or atopic eczema once the acute inflammatory phase has passed. 4.2 Posology and method of administration Posology. Nov 01, 2019 Hydrocortisone 0.5%. Iodochlorhydroxyquin 3% Cream. 1 oz (28.4 grams) WARNING: Keep out of reach of children. For external use only. Not for ophthalmic use. Usual Dosage: Apply as a thin film to the affected areas 2 to 4 times daily or as directed by physician. See package insert for full prescribing information.
If you’ve ever had poison ivy or a very itchy rash, you may have used hydrocortisone cream to reduce the irritation. But there’s a lot more to that you need to know.
Hydrocortisone is not a drug, it is a hormone. Your adrenal glands make it every minute of your life. You already have blood levels of this hormone. The problem is that you may not have enough. Many doctors and pharmacists mistakenly equate it with steroid drugs like prednisone. They also attribute the same list of side effects that are seen with these synthetic steroids. This is a poor comparison, because unlike these drugs, hydrocortisone is something your body needs to function well.
Since hydrocortisone is natural and your body makes it every day, the question then becomes, “Is your body making enough?” If it is, then there is no need to give it to you. But if your body cannot make enough, then the appropriate dose will dramatically improve your health.
You may have heard of hydrocortisone by a different name: cortisol. This is just a different term for the same hormone. And here’s what you need to know about this hormone.
Cortisol is the master anti-stress hormone. Stress refers to any influence on the body that it has to adapt to. This includes mental stress, such as anxiety and depression. But it also refers to physical stresses like allergies, infections, pain, not enough sleep, drugs, excesses, etc. When the body faces stress, it must adapt in order to maintain balance (homeostasis). The key to maintaining this balance is the hormone hydrocortisone. As long as the body can manufacture enough, it will continue to maintain balance in the face of stress.
Jun 01, 2020 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. Clioquinol-hydrocortisone 3%-0.5% topical cream. Hydrocortisone is a mild corticosteroid that works by reducing the swelling, redness, and itching that occurs.
In normal situations, the body makes about 20-30 mg of it per day. But in stressful situations, it needs much more – often in the order of 80-300 mg per day. As long as the adrenal glands can keep on manufacturing the needed amount, the body will be able to deal with its stressors.
However, with persistent stress, for example a long-term illness, the adrenal glands will often become exhausted, and will not be able to keep up with the body’s needs. It is at this point that the stressors become overwhelming, and the body loses its potential to heal. This is often the point at which people first see the doctor. Here are several things you need to know about it.
Hydrocortisone/Cortisol:
Maintains a healthy mood in the face of stress — One of the surest ways to diagnose if a patient needs it is if their mood is changing. People with insufficient hydrocortisone levels often complain of a feeling of being easily overwhelmed. This can lead to depression, anxiety, frustration, and other emotional symptoms.
Maintains a normal blood sugar and blood pressure --It is the primary hormone that maintains healthy blood sugar and blood pressure levels. So two common signs of a deficiency are low blood pressure, which manifests as dizziness, and low blood sugar, which manifests as fatigue. The fatigue of hydrocortisone deficiency is one that is usually much worse in the afternoon than it is in the morning.
Is instrumental in the breakdown and burning of fat — Without an adequate amount of hydrocortisone, the body will not be able to break down fat for energy production. This will lead to an over dependence on sugar metabolism, which leads to energy drops, and a marked craving for sugar and carbohydrates.
Is instrumental in energy production — Without it, the body would not be able to produce the energy it needs to live, and it would quickly die. The organ most dependent on it is the brain. So when hydrocortisone levels are low, some of the first symptoms reflect decreased brain metabolism. This includes mental fatigue, along with a decreased ability to concentrate, remember, and focus.
Is instrumental for thyroid metabolism — The thyroid hormones cannot function without enough it. So many times, when the patient has symptoms of low thyroid function, the real problem is a deficiency of hydrocortisone. Likewise, it cannot function without an adequate amount of the thyroid hormones. Because of this, most doctors usually give it with thyroid replacement.
Hydrocortisone is instrumental for immune system function — A deficiency of it is the major reason why many people cannot stop getting repeated colds and flus. It is also the single most common cause of allergies and chronic infections.
It protects against inflammation, allergies, fatigue, autoimmune diseases, infectious diseases, cancer, and cardiovascular disease — virtually any disease you can think of.
Is often needed on a continuous basis — In many cases, after a combination of using hydrocortisone for several months, along with eliminating the stresses that depleted the adrenal gland in the first place, the adrenal gland will be able to manufacture enough hydrocortisone by itself, and there will be no need to continue taking the hormone. However, it is also quite common for many people to need to take it for the rest of their lives in order to be optimally healthy. This lifetime need is something that is very common with all hormones.
Most doctors and pharmacists don’t know any of this — All of what you have just read here is unknown to most doctors and pharmacists. This is true for several reasons. First, they have never studied the physiological use of hydrocortisone. In school, they are only taught about the pharmaceutical use of synthetic cortisone steroids, and they don’t realize that hydrocortisone is different.
Second, they think that hydrocortisone is toxic in any dose. This is also because they keep thinking of hydrocortisone as a drug, and forget that it is a hormone that is naturally present in your body.
Third, they falsely believe that a deficiency of hydrocortisone is rare. They also believe the only time a deficiency occurs is when you have Addison’s disease. This is what they taught me in medical school. And like many of the things I learned there, it is wrong.
Hydrocortisone is safe — A deficiency of any hormone is dangerous, and an excess is also dangerous. This is also true. Getting the dose right is very important. Too little will not work. On the other hand, too much over too long a period of time is also bad. Fortunately, the doses that doctors use who are trained in the proper use of hydrocortisone are entirely safe.
So if you have any of the symptoms I’ve mentioned here, talk to your doctor about hydrocortisone therapy. Make sure you’re talking to a doctor who understands the proper use of this hormone. You can do this by asking if he’s ever prescribed it and what kind of success he’s seen. If he’s never prescribed it or seen any success, find another doctor. Many of the doctors at www.acam.org can help you.
You can also see a lecture I gave on hydrocortisone and adrenal function by going to the video page of the clinic website www.antiagingmedicine.com.
REFS: Jefferies, William McK. Safe Uses of Cortisol, 3rd Edition 2004, Charles C. Thomas, Publisher, Ltd. 2600 South First Street, Springfield, IL 62704.
Wilson, Jean, MD and Daniel Foster, MD (editors). Williams Textbook of Endocrinology, 8th Edition, W.B. Saunders Company, Philadelphia, PA.
Product releases lidocaine to stabilize the neuronal membrane by inhibiting the ionic fluxes required for initiation and conduction of impulses, thereby effecting local anesthetic action. Hydrocortisone acetate provides relief of inflammatory and pruritic manifestations of corticosteroid responsive dermatoses. Lidocaine is chemically designated as acetamide, 2-(diethylamino)-N-(2,6-dimethylphenyl), and has the following structure:
Hydrocortisone acetate has a chemical name pregn-4-ene-3, 20-dione, 21-(acetyloxy)-11,17- dihydroxy-(11ß)-. It has the following structural formula:
PHARMACOKINETICS:
Lidocaine may be absorbed following topical administration to mucous membranes, its rate and extent of absorption depending upon the specific site of application, duration of exposure, concentration, and total dosage. In general, the rate of absorption of local anesthetic agents following topical application occurs most rapidly after intratracheal administration. Lidocaine is also well-absorbed from the gastrointestinal tract, but little intact drug appears in the circulation because of biotransformation in the liver.
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Lidocaine is metabolized rapidly by the liver, and metabolites and unchanged drug are excreted by the kidneys. Biotransformation includes oxidative N-dealkylation, ring hydroxylation, cleavage of the amide linkage, and conjugation. N-dealkylation, a major pathway of biotransformation, yields the metabolites monoethylglycinexylidide and glycinexylidide. The pharmacological/toxicological actions of these metabolites are, similar to but less potent than, those of lidocaine. Approximately 90% of lidocaine administered is excreted in the form of various metabolites, and less than 10% is excreted unchanged. The primary metabolite in urine is a conjugate of 4-hydroxy-2, 6-dimethylaniline. The plasma binding of lidocaine is dependent on drug concentration, and the fraction bound decreases with increasing concentration. At concentrations of 1 to 4 g of free base per mL, 60 to 80 percent of lidocaine is protein bound. Binding is also dependent on the plasma concentration of the alpha-1-acid glycoprotein. Lidocaine crosses the blood-brain and placental barriers, presumably by passive diffusion.
Studies of lidocaine metabolism following intravenous bolus injections have shown that the elimination half-life of this agent is typically 1.5 to 2 hours. Because of the rapid rate at which lidocaine is metabolized, any condition that affects liver function may alter lidocaine kinetics. The half-life may be prolonged two-fold or more in patients with liver dysfunction. Renal dysfunction does not affect lidocaine kinetics but may increase the accumulation of metabolites. Factors such as acidosis and the use of CNS stimulants and depressants affect the CNS levels of lidocaine required to produce overt systemic effects. Objective adverse manifestations become increasingly apparent with increasing venous plasma levels above 6 g free base per mL. In the rhesus monkey arterial blood levels of 18-21 g/mL have been shown to be threshold for convulsive activity.
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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.
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Topical corticosteroids can be absorbed from normal intact skin. Inflammation and/or other disease processes in the skin increase percutaneous absorption. Occlusive dressings substantially increase the percutaneous absorption of topical corticosteroids. Thus, occlusive dressings may be a valuable therapeutic adjunct for treatment of resistant dermatoses.
Once absorbed through the skin, topical corticosteroids are handled through pharmacokinetic pathways similar to systemically administered corticosteroids. Corticosteroids are bound to plasma protein 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 into the bile.