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Fluocinolone (Otic)

Pronunciation

(floo oh SIN oh lone)

Index Terms

  • Fluocinolone Acetonide

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Oil, Otic, as acetonide:

DermOtic: 0.01% (20 mL) [contains isopropyl alcohol, peanut oil]

Generic: 0.01% (20 mL)

Brand Names: U.S.

  • DermOtic

Pharmacologic Category

  • Corticosteroid, Otic

Pharmacology

A synthetic fluorinated corticosteroid of low-to-moderate potency. The mechanism of action for all topical corticosteroids is not well defined, however, is believed to be a combination of anti-inflammatory, antipruritic, and vasoconstrictive properties.

Use: Labeled Indications

Relief of chronic eczematous external otitis

Contraindications

Hypersensitivity to fluocinolone or any component of the formulation; Note: Contains peanut oil

Dosing: Adult

Chronic eczematous external otitis: Otic: 5 drops into the affected ear twice daily for 1-2 weeks

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Chronic eczematous external otitis: Otic: Children ≥2 years: Refer to adult dosing.

Storage

Store a controlled room temperature of 20°C to 25°C (68°F to 77°F).

Drug Interactions

There are no known significant interactions.

Adverse Reactions

Frequency not defined.

Dermatologic: Acneiform eruptions, allergic contact dermatitis, burning, dryness, erythema, folliculitis, irritation, itching, hypopigmentation, keratosis pilaris, miliaria, skin atrophy, striae

Otic: Ear infection

Warnings/Precautions

Concerns related to adverse effects:

• Adrenal suppression: May cause hypercorticism or suppression of hypothalamic-pituitary-adrenal (HPA) axis, particularly in younger children or in patients receiving high doses for prolonged periods. HPA axis suppression may lead to adrenal crisis. Withdrawal and discontinuation of a corticosteroid should be done slowly and carefully. Particular care is required when patients are transferred from systemic corticosteroids to inhaled products due to possible adrenal insufficiency or withdrawal from steroids, including an increase in allergic symptoms. Adult patients receiving >20 mg per day of prednisone (or equivalent) may be most susceptible. Fatalities have occurred due to adrenal insufficiency in asthmatic patients during and after transfer from systemic corticosteroids to aerosol steroids; aerosol steroids do not provide the systemic steroid needed to treat patients having trauma, surgery, or infections.

• Contact dermatitis: Allergic contact dermatitis can occur, it is usually diagnosed by failure to heal rather than clinical exacerbation.

• Infection: Steroids may mask infection; prolonged use may result in secondary infections due to immunosuppression.

• Systemic effects: Adverse systemic effects may occur when used on large areas of the body, denuded areas, or for prolonged periods of time. Infants and children may be more susceptible to systemic toxicity from equivalent doses due to larger skin surface to body mass ratio.

Dosage form specific issues:

• Peanut oil: DermOtic Oil contains peanut oil; use caution in peanut-sensitive individuals.

Monitoring Parameters

Signs of bacterial or fungal infection

Pregnancy Risk Factor

C

Pregnancy Considerations

Adverse events have been observed with corticosteroids in animal reproduction studies. In general, the use of topical corticosteroids during pregnancy is not considered to have significant risk; however, intrauterine growth retardation in the infant has been reported (rare). The use of large amounts or for prolonged periods of time should be avoided.

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience burning or itching. Have patient report immediately to prescriber signs of high blood sugar (confusion, feeling sleepy, more thirst, hunger, passing urine more often, flushing, fast breathing, or breath that smells like fruit) or severe skin irritation (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.

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