Desoxi

In the U.S.

• Topicort
• Topicort LP

In Canada

• Desoxi
• Taro-Desoximetasone
• Topicort Mild

Available Dosage Forms:

• Ointment
• Gel/Jelly
• Cream
• Spray

Therapeutic Class: Corticosteroid, Strong

Pharmacologic Class: Adrenal Glucocorticoid

Desoximetasone topical is used to help relieve redness, itching, swelling, or other discomfort caused by skin conditions. Desoximetasone topical spray is used to treat plaque psoriasis in adults. This medicine is a corticosteroid (cortisone-like medicine or steroid).

This medicine is available only with your doctor's prescription.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of desoximetasone topical spray in the pediatric population. Safety and efficacy have not been established.

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of desoximetasone in children 10 years of age or older. However, because of this medicine's toxicity, it should be used with caution. Children and teenagers who must use this medicine should be checked often by their doctor since desoximetasone topical may be absorbed through the skin and can affect growth or cause other unwanted effects. Safety and efficacy have not been established in children younger than 10 years of age.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of desoximetasone topical spray in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving desoximetasone topical spray.

No information is available on the relationship of age to the effects of desoximetasone topical in geriatric patients.

Pregnancy

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Cushing's syndrome (adrenal gland disorder) or
• Diabetes or
• Intracranial hypertension (increased pressure in the head)—Use with caution. May make these conditions worse.

• Infection of the skin at or near the place of application or
• Large sores, broken skin, or severe skin injury at the place of application or
• Liver failure—The chance of side effects may be increased.

Applies to desoximetasone topical: topical application cream, topical application gel/jelly, topical application ointment, topical application spray

Along with its needed effects, desoximetasone topical may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking desoximetasone topical:

• Flushing or redness of the skin
• redness, blistering, peeling, or loosening of the skin
• unusually warm skin

• Blistering, burning, crusting, dryness, or flaking of the skin
• irritation
• itching, scaling, severe redness, soreness, or swelling of the skin
• redness and scaling around the mouth
• thinning of the skin with easy bruising, especially when used on the face or where the skin folds together (eg, between the fingers)
• thinning, weakness, or wasting away of the skin

Some side effects of desoximetasone topical may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Burning, itching, and pain in hairy areas, or pus at the root of the hair

• Acne or pimples
• burning and itching of the skin with pinhead-sized red blisters
• increased hair growth on the forehead, back, arms, and legs
• lightening of normal skin color
• lightening of treated areas of dark skin
• reddish purple lines on the arms, face, legs, trunk, or groin
• softening of the skin

Applies to desoximetasone topical: compounding powder, topical cream, topical gel, topical ointment, topical spray

General

The most commonly reported side effects were application site dryness, application site irritation, and application site pruritus.[Ref]

Endocrine

Frequency not reported: Hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome[Ref]

Dermatologic

Frequency not reported: Folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, secondary infection, skin atrophy, striae, miliaria[Ref]

Local

Common (1% to 10%): Application site dryness, application site irritation, application site pruritus
Frequency not reported: Burning, itching[Ref]

Metabolic

Frequency not reported: Hyperglycemia, latent diabetes mellitus[Ref]

Some side effects of desoximetasone topical may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Cream, gel, ointment, spray: Apply a thin film to the affected areas twice a day

Comments:
-Treatment for longer than 4 weeks is not recommended.
-This topical drug should not be used if atrophy is present at the treatment site.
-The treated area should not be bandaged, covered, or wrapped unless directed by a healthcare provider.
-Topical spray should be discontinued when control is obtained.

Uses:
-Relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses
-Treatment of plaque psoriasis

Cream, gel, ointment, spray: Apply a thin film to the affected areas twice a day

Comments:
-Treatment for longer than 4 weeks is not recommended.
-This topical drug should not be used if atrophy is present at the treatment site.
-The treated area should not be bandaged, covered, or wrapped unless directed by a healthcare provider.
-Topical spray should be discontinued when control is obtained.

Uses:
-Relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses
-Treatment of plaque psoriasis

Summary of Use during Lactation

Desoximetasone has not been studied during breastfeeding. Since only extensive application of the most potent corticosteroids cause systemic effects in the mother, it is unlikely that short-term application of topical corticosteroids would pose a risk to the breastfed infant by passage into breastmilk. However, it would be prudent to use the least potent drug on the smallest area of skin possible. It is particularly important to ensure that the infant's skin does not come into direct contact with the areas of skin that have been treated. Only the lower potency corticosteroids should be used on the nipple or areola where the infant could directly ingest the drugs from the skin. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[1] Any topical corticosteroid should be wiped off thoroughly prior to nursing if it is being applied to the breast or nipple area.

Drug Levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Topical application of a corticosteroid with relatively high mineralocorticoid activity (isofluprednone acetate) to the mother's nipples resulted in prolonged QT interval, cushingoid appearance, severe hypertension, decreased growth and electrolyte abnormalities in her 2-month-old breastfed infant. The mother had used the cream since birth for painful nipples.[2]

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

Hydrocortisone, Topical

References

1. De Stefano B, Bongo IG, Borgna-Pignatti C et al. Factitious hypertension with mineralocorticoid excess in an infant. Helv Paediatr Acta. 1983;38:185-9. PMID: 6874387

2. Noti A, Grob K, Biedermann M et al. Exposure of babies to C(15)-C(45) mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003;38(3):317-25. PMID: 14623482

Substance Name

Desoximetasone

CAS Registry Number

382-67-2

Drug Class

Corticosteroids, Topical

Glucocorticoids

Anti-Inflammatory Agents