Hydrocortisone butyrate

Source: eMC SPC for Locoid Cream (hydrocortisone butyrate), §4.2. The same dose is used for adults and older people — clinical evidence indicates no special dosage regimen is necessary in older people. Application may be made under occlusion in the more resistant lesions such as thickened psoriatic plaques on elbows and knees, but occlusion should be restricted to dermatoses involving limited areas. PAEDIATRIC: no numeric or per-kg paediatric dose is stated. The SPC states that in the paediatric population long-term treatment, large amounts and occlusion should be avoided, and that in infants therapy should be limited to a maximum of seven days. Verify paediatric use against a children's formulary. Do not apply to the eyelids (risk of glaucoma simplex or subcapsular cataract) and keep away from the eyes. Avoid application to the face, genitals, flexures and other areas of thin skin (skin atrophy and increased absorption). Wash hands after each application unless treating the hands. Increased risk of systemic and local adverse reactions when treating intertriginous areas or large areas of skin, under occlusion, with frequent dosing, or with long treatment periods — including adrenocortical suppression. Contraindicated on infected skin; use with particular caution at sites of previous or suspected infection. Topical steroid withdrawal syndrome may follow long-term use — suspect if the condition recurs within days to weeks of successful treatment. Refer to an ophthalmologist if blurred vision or other visual disturbance occurs. Fire risk: instruct patients not to smoke or go near naked flames. The bundle also contains a US label for Hydrocortisone Butyrate Lotion 0.1% (apply a thin layer twice daily for up to 2 weeks; reassess if no improvement at 2 weeks; weigh benefit against risk before extending to 4 weeks; avoid occlusion and the diaper area; US paediatric use established from 3 months of age) — a different formulation, not used for this dose.