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Halcinonide

Medically reviewed by Drugs.com. Last updated on Jul 26, 2020.

Pronunciation

(hal SIN oh nide)

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Cream, External:

Halog: 0.1% (30 g, 60 g, 216 g) [contains cetyl alcohol, propylene glycol]

Generic: 0.1% (30 g, 60 g)

Ointment, External:

Halog: 0.1% (30 g [DSC], 60 g)

Solution, External:

Halog: 0.1% (120 mL) [contains edetate disodium, polyethylene glycol 300]

Brand Names: U.S.

  • Halog

Pharmacologic Category

  • Corticosteroid, Topical

Pharmacology

Topical corticosteroids have anti-inflammatory, antipruritic, and vasoconstrictive properties. May depress the formation, release, and activity of endogenous chemical mediators of inflammation (kinins, histamine, liposomal enzymes, prostaglandins) through the induction of phospholipase A2 inhibitory proteins (lipocortins) and sequential inhibition of the release of arachidonic acid. Halcinonide has high range potency.

Absorption

Dependent on strength of preparation, amount applied, integrity of skin at application site, vehicle, and use of occlusive dressing; increased in areas of skin damage, inflammation, or occlusion.

Metabolism

Primarily hepatic

Excretion

Urine

Use: Labeled Indications

Steroid-responsive dermatoses: Relief of inflammatory and pruritic effects of corticosteroid-responsive dermatoses (high potency topical corticosteroid)

Contraindications

Hypersensitivity to halcinonide or any component of the formulation

Dosing: Adult

Steroid-responsive dermatoses: Topical: Apply to affected area sparingly 2 to 3 times daily. Therapy should be discontinued when control is achieved; if no improvement is seen, reassessment of diagnosis may be necessary.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Note: Dosage should be based on severity of disease and patient response; use smallest amount for shortest period of time to avoid hypothalamic-pituitary-adrenal (HPA) axis suppression. Therapy should be discontinued when control is achieved.

Dermatoses (corticosteroid-responsive, including contact/atopic dermatitis):

Infants, Children, and Adolescents: Cream, ointment, or solution: 0.1% strength: Topical: Apply to affected area 1 to 3 times daily; most experts suggest once or twice daily application; suggested maximum duration of therapy for high potency agents: 14 days (AAP [Eichenfield 2015]; NICE 2007). Note: Halcinonide 0.1% (cream/ointment/solution) is a group/class 2 highly potent topical corticosteroid; use should be reserved for severe cases; it should not be routinely used on the face or neck (AAP [Eichenfield 2015]; AAP [Tollefson 2014]; NICE 2007; Waldman 2018).

Administration

Topical: For external use only; not for oral, ophthalmic, or intravaginal use. Wash hands before and after use. Avoid use of topical preparations on weeping or exudative lesions.

Occlusive dressings may be used for the management of psoriasis or other recalcitrant conditions. Gently rub or apply a small amount of cream, ointment, or solution to the affected area. Cover with a pliable nonporous film and seal the edges. If additional moisture is needed on the affected area, it may be moistened with water prior to applying medication; a damp cloth may also be applied to the lesion before the dressing is applied. Cream, ointment, or solution should be reapplied at each dressing change. Discontinue use of occlusive dressings if an infection develops.

Storage

Store at room temperature; avoid excessive heat ≥40°C (≥104°F)

Drug Interactions

Aldesleukin: Corticosteroids may diminish the antineoplastic effect of Aldesleukin. Avoid combination

Adverse Reactions

Frequency not defined. Adverse reactions reported with topical corticosteroids; may occur more frequently with occlusive dressing.

Central nervous system: Intracranial hypertension (children), localized burning

Dermatologic: Acneiform eruption, allergic contact dermatitis, atrophic striae, folliculitis, hypertrichosis, hypopigmentation, maceration of the skin, miliaria, perioral dermatitis, pruritus, skin atrophy, xeroderma

Endocrine & metabolic: Cushing syndrome, glycosuria, growth suppression (children), HPA-axis suppression, hyperglycemia

Infection: Secondary infection

Local: Local irritation

Warnings/Precautions

Concerns related to adverse effects:

• Adrenal suppression: May cause hypercortisolism 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.

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

• Immunosuppression: Prolonged use may result in fungal or bacterial superinfection; discontinue if dermatological infection persists despite appropriate antifungal or antimicrobial therapy.

• Kaposi's sarcoma: Prolonged treatment with corticosteroids has been associated with the development of Kaposi's sarcoma (case reports); if noted, discontinuation of therapy should be considered.

• Sensitization: Topical use has been associated with local sensitization (redness, irritation); discontinue if sensitization is noted.

• Systemic effects: Topical corticosteroids may be absorbed percutaneously. Absorption of topical corticosteroids may cause manifestations of Cushing's syndrome, hyperglycemia, or glycosuria. Absorption is increased by the use of occlusive dressings, application to denuded skin, or application to large surface areas.

Special populations:

• Elderly: Because of the risk of adverse effects associated with systemic absorption, topical corticosteroids should be used cautiously in the elderly in the smallest possible effective dose for the shortest duration.

• Pediatric: Infants and children may absorb proportionally larger amounts after topical application and may be more prone to systemic effects. HPA axis suppression, intracranial hypertension, and Cushing's syndrome have been reported in children receiving topical corticosteroids. Prolonged use may affect growth velocity; growth should be routinely monitored in pediatric patients.

Dosage form specific issues:

• Propylene glycol: Some dosage forms may contain propylene glycol; large amounts are potentially toxic and have been associated hyperosmolality, lactic acidosis, seizures and respiratory depression; use caution (AAP ["Inactive" 1997]; Zar 2007).

Other warnings/precautions:

• Appropriate use: For external use only; not for oral, ophthalmic, or intravaginal use. Avoid use of topical preparations with occlusive dressings or on weeping or exudative lesions.

Monitoring Parameters

Evaluate for HPA axis suppression by using the following tests: ACTH stimulation test, urinary free cortisol test; growth (adolescents/children); presence of infection

Pregnancy Considerations

Teratogenic effects have been observed in animals administered potent topical corticosteroids. Topical products are not recommended for extensive use, in large quantities, or for long periods of time in pregnant women (Reed, 1997).

Patient Education

What is this drug used for?

• It is used to treat skin irritation.

• It is used to treat skin rashes.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Dry skin

• Itching

• Burning

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Cushing disease like weight gain in upper back or abdomen; moon face; severe headache; or slow healing.

• Adrenal gland problems like severe nausea, vomiting, severe dizziness, passing out, muscle weakness, severe fatigue, mood changes, lack of appetite, or weight loss.

• High blood sugar like confusion, fatigue, increased thirst, increased hunger, passing a lot of urine, flushing, fast breathing, or breath that smells like fruit.

• Skin changes like acne, stretch marks, slow healing, or hair growth.

• Skin discoloration

• Skin thinning

• Severe skin irritation

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine’s uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.