Can you take Epifoam with Troglitazone?
1 drug interaction and 14 additional warnings found for the following 2 drugs:
- Epifoam (hydrocortisone/pramoxine topical)
- troglitazone
Drug interactions
Moderate drug interactions
Moderate:
hydrocortisone topical troglitazone
Applies to: Epifoam (hydrocortisone / pramoxine topical) and troglitazone
Some of the medication in hydrocortisone topical may be absorbed into the bloodstream following application to your skin. When present in sufficient concentrations in the blood, steroids like hydrocortisone topical can interfere with blood sugar control and reduce the effectiveness of troglitazone and other diabetic medications. Although the absorption of most steroid preparations is limited when used as recommended in the product labeling, absorption may be increased under certain circumstances, such as: when the steroid is strong or highly potent; when the steroid is used for a longer duration; the person being treated is an infant or young child; or the area of skin being treated is large, inflamed, damaged (cut, scraped), thin (like the face), and/or covered with a dressing, wrapping or clothing. Blood sugar should be monitored closely in these situations. You may need a dose adjustment of troglitazone and/or other diabetic medications if your blood sugar is affected. Talk to your health care provider if you have any questions or concerns. Do not exceed the recommended dose or frequency and duration of use when treated with products that contain steroids, including some over-the counter products. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
troglitazone Food/Lifestyle
Applies to: troglitazone
Alcohol may affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink. You should avoid using alcohol if your diabetes is not well controlled or if you have high triglycerides, neuropathy (nerve damage), or pancreatitis. Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. However, it may be best to limit alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with your normal meal plan. Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
13 potential interactions Applies to: 11 conditions, including Diabetes Mellitus, Cataract, Liver Disease, Infection, and Glaucoma/Intraocular Hypertension.
Abnormal Glucose Tolerance
Moderate:
Epifoam
The hydrocortisone topical in Epifoam has a moderate potential interaction with Abnormal Glucose Tolerance.
Corticosteroids can raise blood glucose level by antagonizing the action and suppressing the secretion of insulin, which results in inhibition of peripheral glucose uptake and increased gluconeogenesis. Therapy with topical corticosteroids rarely produces these effects but should be administered cautiously nonetheless in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Systemic absorption of topical corticosteroids may occur depending on the vehicle and concentration of the preparation, the size of the application area, the integrity of the skin, and the duration of administration. Use of occlusive dressings over the applied areas may also increase percutaneous absorption. Given equivalent doses, small children are generally at the greatest risk because of their larger skin surface to body mass ratios. If possible, the use of highly potent agents (e.g., augmented betamethasone, clobetasol, diflorasone, and halobetasol) should be avoided in children and limited to small areas for 2 weeks in adults.
Alcoholism
Major:
troglitazone
Troglitazone has a major potential interaction with Alcoholism.
The initiation of troglitazone therapy is contraindicated in patients who have a history of liver disease or alcohol abuse; exhibit clinical evidence of active liver disease; or demonstrate increased serum transaminase levels (ALT > 1.5 times the upper limit of normal). The use of troglitazone has been associated with significant elevations in serum ALT levels as well as severe idiosyncratic hepatocellular injury, which has generally been reversible but, in a few cases, led to liver transplant or death. Injury has occurred after both short- and long-term treatment. Patients who receive troglitazone therapy should have serum transaminase levels checked at the start of therapy, at least monthly for the first year, and at least quarterly thereafter. If signs or symptoms suggestive of liver injury occur, liver function tests should be performed. Moderate elevations (ALT > 1.5 to 2 times ULN) require immediate re-testing and weekly monitoring until levels return to normal. Troglitazone should be withdrawn if ALT rises above 3 times ULN or jaundice develops.
Cataract
Moderate:
Epifoam
The hydrocortisone topical in Epifoam has a moderate potential interaction with Cataract.
Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with topical corticosteroids rarely produces these effects but should be administered cautiously nonetheless in patients with a history of cataracts, glaucoma, or increased intraocular pressure, especially when potent agents (e.g., augmented betamethasone, clobetasol, diflorasone, and halobetasol) are used in the periorbital area. Topical corticosteroids may be systemically absorbed, depending on the vehicle and concentration of the preparation, the size of the application area, the duration of administration, and whether or not occlusive dressings are used. Given equivalent doses, small children are generally at the greatest risk because of their larger skin surface to body mass ratios.
Diabetes Mellitus
Moderate:
Epifoam
The hydrocortisone topical in Epifoam has a moderate potential interaction with Diabetes Mellitus.
Corticosteroids can raise blood glucose level by antagonizing the action and suppressing the secretion of insulin, which results in inhibition of peripheral glucose uptake and increased gluconeogenesis. Therapy with topical corticosteroids rarely produces these effects but should be administered cautiously nonetheless in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Systemic absorption of topical corticosteroids may occur depending on the vehicle and concentration of the preparation, the size of the application area, the integrity of the skin, and the duration of administration. Use of occlusive dressings over the applied areas may also increase percutaneous absorption. Given equivalent doses, small children are generally at the greatest risk because of their larger skin surface to body mass ratios. If possible, the use of highly potent agents (e.g., augmented betamethasone, clobetasol, diflorasone, and halobetasol) should be avoided in children and limited to small areas for 2 weeks in adults.
Moderate:
troglitazone
Troglitazone has a moderate potential interaction with Diabetes Mellitus.
New onset or worsening diabetic macular edema with decreased visual acuity have been reported in postmarketing reports in some diabetic patients who were taking thiazolidinedione drugs. Some patients presented with blurred vision or decreased visual acuity, but some patients appear to have been diagnosed on routine ophthalmologic examination. Most patients had peripheral edema at the time macular edema was diagnosed. Some patients had improvement in their macular edema after discontinuation of their thiazolidinedione. Patients with diabetes should have regular eye exams by an ophthalmologist according to current standards of care. Additionally, any diabetic who reports any kind of visual symptom should be promptly referred to an ophthalmologist, regardless of the patient's underlying medications or other physical findings.
Diabetic Macular Edema
Moderate:
troglitazone
Troglitazone has a moderate potential interaction with Diabetic Macular Edema.
New onset or worsening diabetic macular edema with decreased visual acuity have been reported in postmarketing reports in some diabetic patients who were taking thiazolidinedione drugs. Some patients presented with blurred vision or decreased visual acuity, but some patients appear to have been diagnosed on routine ophthalmologic examination. Most patients had peripheral edema at the time macular edema was diagnosed. Some patients had improvement in their macular edema after discontinuation of their thiazolidinedione. Patients with diabetes should have regular eye exams by an ophthalmologist according to current standards of care. Additionally, any diabetic who reports any kind of visual symptom should be promptly referred to an ophthalmologist, regardless of the patient's underlying medications or other physical findings.
Diaper Rash
Moderate:
Epifoam
The hydrocortisone topical in Epifoam has a moderate potential interaction with Diaper Rash.
Topical corticosteroids, especially the potent agents (e.g., augmented betamethasone, clobetasol, diflorasone, and halobetasol), are generally not recommended for use in the treatment of diaper rash. Topical corticosteroids may be systemically absorbed, depending on the vehicle and concentration of the preparation, the size of the application area, the duration of administration, and whether or not occlusive dressings are used. Given equivalent doses, small children are usually at the greatest risk for systemic toxicity such as adrenal suppression, Cushing's syndrome and intracranial hypertension because of their larger skin surface to body mass ratios. If topical corticosteroids are necessary to treat diaper rash, medium- to low-potency agents should preferably be used, and parents should be advised not to put tight-fitting diapers or plastic pants over the rash, since occlusion of treated area may increase percutaneous drug absorption.
Glaucoma/Intraocular Hypertension
Moderate:
Epifoam
The hydrocortisone topical in Epifoam has a moderate potential interaction with Glaucoma/Intraocular Hypertension.
Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with topical corticosteroids rarely produces these effects but should be administered cautiously nonetheless in patients with a history of cataracts, glaucoma, or increased intraocular pressure, especially when potent agents (e.g., augmented betamethasone, clobetasol, diflorasone, and halobetasol) are used in the periorbital area. Topical corticosteroids may be systemically absorbed, depending on the vehicle and concentration of the preparation, the size of the application area, the duration of administration, and whether or not occlusive dressings are used. Given equivalent doses, small children are generally at the greatest risk because of their larger skin surface to body mass ratios.
Hyperadrenocorticism
Moderate:
Epifoam
The hydrocortisone topical in Epifoam has a moderate potential interaction with Hyperadrenocorticism.
The use of topical corticosteroids may precipitate or aggravate conditions of hyperadrenocorticism. Systemic absorption of these agents can produce reversible hypothalamic-pituitary-adrenal axis suppression. Systemic absorption, depends on the vehicle and concentration of the preparation, the size of the application area, the duration of administration, and whether or not occlusive dressings are used. Given equivalent doses, small children are generally at the greatest risk because of their larger skin surface to body mass ratios. Patients with an altered skin barrier or liver failure are also at increased risk. If possible, the use of highly potent agents (e.g., augmented betamethasone, clobetasol, diflorasone, and halobetasol) should be avoided in children and limited to small areas for 2 weeks in adults. The development of symptoms such as menstrual irregularities, acneiform lesions, cataracts and cushingoid features during topical corticosteroid therapy may indicate excessive use.
Infection
Moderate:
Epifoam
The hydrocortisone topical in Epifoam has a moderate potential interaction with Infection.
Topical corticosteroids may be systemically absorbed, depending on the vehicle and concentration of the preparation, the size of the application area, the duration of administration, and whether or not occlusive dressings are used. Clinically significant local as well as systemic immunosuppressant and anti-inflammatory effects may occur, which can cause or exacerbate an infection. Given equivalent doses, small children are generally at the greatest risk because of their larger skin surface to body mass ratios. Therapy with topical corticosteroids should be administered cautiously in patients with latent or active infections, particularly if a potent agent is used on a large area for prolonged periods or if occlusive dressings are used. Effective antimicrobial therapy or other appropriate treatment should be instituted to treat the infection. If possible, the use of highly potent agents (e.g., augmented betamethasone, clobetasol, diflorasone, and halobetasol) should be avoided in children and limited to small areas for 2 weeks in adults. Occlusive dressings should not be used in patients with skin infection.
Liver Disease
Major:
troglitazone
Troglitazone has a major potential interaction with Liver Disease.
The initiation of troglitazone therapy is contraindicated in patients who have a history of liver disease or alcohol abuse; exhibit clinical evidence of active liver disease; or demonstrate increased serum transaminase levels (ALT > 1.5 times the upper limit of normal). The use of troglitazone has been associated with significant elevations in serum ALT levels as well as severe idiosyncratic hepatocellular injury, which has generally been reversible but, in a few cases, led to liver transplant or death. Injury has occurred after both short- and long-term treatment. Patients who receive troglitazone therapy should have serum transaminase levels checked at the start of therapy, at least monthly for the first year, and at least quarterly thereafter. If signs or symptoms suggestive of liver injury occur, liver function tests should be performed. Moderate elevations (ALT > 1.5 to 2 times ULN) require immediate re-testing and weekly monitoring until levels return to normal. Troglitazone should be withdrawn if ALT rises above 3 times ULN or jaundice develops.
Moderate:
Epifoam
The hydrocortisone topical in Epifoam has a moderate potential interaction with Liver Disease.
The use of topical corticosteroids may precipitate or aggravate conditions of hyperadrenocorticism. Systemic absorption of these agents can produce reversible hypothalamic-pituitary-adrenal axis suppression. Systemic absorption, depends on the vehicle and concentration of the preparation, the size of the application area, the duration of administration, and whether or not occlusive dressings are used. Given equivalent doses, small children are generally at the greatest risk because of their larger skin surface to body mass ratios. Patients with an altered skin barrier or liver failure are also at increased risk. If possible, the use of highly potent agents (e.g., augmented betamethasone, clobetasol, diflorasone, and halobetasol) should be avoided in children and limited to small areas for 2 weeks in adults. The development of symptoms such as menstrual irregularities, acneiform lesions, cataracts and cushingoid features during topical corticosteroid therapy may indicate excessive use.
Tuberculosis, Latent
Moderate:
Epifoam
The hydrocortisone topical in Epifoam has a moderate potential interaction with Tuberculosis, Latent.
Topical corticosteroids may be systemically absorbed, depending on the vehicle and concentration of the preparation, the size of the application area, the duration of administration, and whether or not occlusive dressings are used. Clinically significant local as well as systemic immunosuppressant and anti-inflammatory effects may occur, which can cause or exacerbate an infection. Given equivalent doses, small children are generally at the greatest risk because of their larger skin surface to body mass ratios. Therapy with topical corticosteroids should be administered cautiously in patients with latent or active infections, particularly if a potent agent is used on a large area for prolonged periods or if occlusive dressings are used. Effective antimicrobial therapy or other appropriate treatment should be instituted to treat the infection. If possible, the use of highly potent agents (e.g., augmented betamethasone, clobetasol, diflorasone, and halobetasol) should be avoided in children and limited to small areas for 2 weeks in adults. Occlusive dressings should not be used in patients with skin infection.
More resources
Epifoam
A total of 56 drugs are known to interact with Epifoam.
- Epifoam is in the drug class anorectal preparations.
- Epifoam is used to treat the following conditions:
troglitazone
A total of 580 drugs are known to interact with troglitazone.
- Troglitazone is in the drug class thiazolidinediones.
- Troglitazone is used to treat Type 2 Diabetes.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.