a petrol Westcort Generic Name: hydrocortisone valerate Dosage Form: cream Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings Breastfeeding Warnings User Reviews Support Group Q & A Pricing & Coupons (hydrocortisone valerate ointment) Ointment, 0.2% For Dermatologic Use Only. Not for Ophthalmic Use. Rx only Westcort Description Westcort (hydrocortisone valerate ointment) Ointment, 0.2% contains hydrocortisone valerate, 11,21-dihydroxy-17-[(1-oxopentyl)oxy]-(11β)-pregn-4-ene-3,20-dione, a synthetic corticosteroid for topical dermatologic use. The corticosteroids constitute a class of primarily synthetic steroids used topically as anti-inflammatory and antipruritic agents. Chemically, hydrocortisone valerate is C 26 H 38 O 6 . It has the following structural formula: Hydrocortisone valerate has a molecular weight of 446.58. It is a white, crystalline solid, soluble in ethanol and methanol, sparingly soluble in propylene glycol and insoluble in water. Each gram of Westcort Ointment contains 2 mg hydrocortisone valerate in a hydrophilic base composed of carbomer 934, dried sodium phosphate, mineral oil, propylene glycol, sodium lauryl sulfate, sorbic acid, steareth-2, steareth-100, stearyl alcohol, water, and white petrolatum. Slideshow Prednisone: 12 Things You Should Know Westcort - Clinical Pharmacology Like other topical corticosteroids, hydrocortisone valerate has anti-inflammatory, antipruritic and vasoconstrictive properties. The mechanism of the anti-inflammatory activity of the topical steroids, in general, is unclear. However, corticosteroids are thought to act by the induction of phospholipase A 2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A 2 . Pharmacokinetics The extent of percutaneous absorption of topical corticosteroids is determined by many factors including the vehicle and the integrity of the epidermal barrier. Occlusive dressings with hydrocortisone for up to 24 hours have not been demonstrated to increase penetration; however, occlusion of hydrocortisone for 96 hours markedly enhances penetration. Topical corticosteroids can be absorbed from normal intact skin. Inflammation and/or other disease processes in the skin may increase percutaneous absorption. Studies performed with Westcort Ointment indicate that it is in the medium range of potency as compared with other topical corticosteroids. Indications and Usage for Westcort Westcort Ointment is a medium potency corticosteroid indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid responsive dermatoses in adult patients. Contraindications Westcort Ointment is contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation. Precautions General Systemic absorption of topical corticosteroids can produce reversible hypothalamic-pituitary-adrenal (HPA) axis suppression with the potential for glucocorticosteroid insufficiency after withdrawal of treatment. Manifestations of Cushing s syndrome, hyperglycemia, and glucosuria can also be produced in some patients by systemic absorption of topical corticosteroids while on treatment. Patients applying a topical steroid to a large surface area or to areas under occlusion should be evaluated periodically for evidence of HPA axis suppression. This may be done by using the ACTH stimulation, A.M. plasma cortisol, and urinary free cortisol tests. Westcort Ointment has produced mild, reversible adrenal suppression in adult patients when used under occlusion for 5 days, 15 grams twice a day over 25 to 60% body surface area or when used three times a day over 20 to 30% body surface area to treat psoriasis for 3-4 weeks. If HPA axis suppression is noted, an attempt should be made to withdraw the drug, to reduce the frequency of application, or to substitute a less potent corticosteroid. Recovery of HPA axis function is generally prompt upon discontinuation of topical corticosteroids. Infrequently, signs and symptoms of glucocorticosteroid insufficiency may occur, requiring supplemental systemic corticosteroids. For information on systemic supplementation, see prescribing information for these products. Pediatric patients may be more susceptible to systemic toxicity from equivalent doses due to their larger skin surface to body mass ratios. (See PRECAUTIONS: Pediatric Use .) If irritation develops, Westcort (hydrocortisone valerate ointment) Ointment, 0.2% should be discontinued and appropriate therapy instituted. Allergic contact dermatitis with corticosteroids is usually diagnosed by observing a failure to heal rather than noting a clinical exacerbation, as with most topical products not containing corticosteroids. Such an observation should be corroborated with appropriate diagnostic patch testing. If concomitant skin infections are present or develop, an appropriate antifungal or antibacterial agent should be used. If a favorable response does not occur promptly, use of Westcort Ointment should be discontinued until the infection has been adequately controlled. Information for Patients Patients using topical corticosteroids should receive the following information and instructions: This medication is to be used as directed by the physician. It is for external use only. Avoid contact with the eyes. This medication should not be used for any disorder other than that for which it was prescribed. The treated skin area should not be bandaged, otherwise covered or wrapped, so as to be occlusive unless directed by the physician. Patients should report to their physician any signs of local adverse reactions. Westcort Ointment should not be applied in the diaper areas as diapers or plastic pants may constitute occlusive dressings. (See DOSAGE AND ADMINISTRATION .) This medication should not be used on the face, underarms, or groin areas unless directed by the physician. As with other corticosteroids, therapy should be discontinued when control is achieved. If no improvement is seen within 2 weeks, contact the physician. Laboratory Tests The following tests may be helpful in evaluating patients for HPA axis suppression: ACTH stimulation test A.M. plasma cortisol test Urinary free cortisol test Carcinogenesis, Mutagenesis, and Impairment of Fertility Long-term animal studies have not been performed to evaluate the carcinogenic potential of hydrocortisone valerate. Westcort Ointment was shown to be non-mutagenic in the Ames-Salmonella/Microsome Plate Test. There are no studies which assess the effects of hydrocortisone valerate on fertility and general reproductive performance. Pregnancy Teratogenic Effects, Pregnancy Category C Corticosteroids have been shown to be teratogenic in laboratory animals when administered systemically at relatively low dosage levels. Some corticosteroids have been shown to be teratogenic after dermal application in laboratory animals. Dermal embryofetal developmental studies were conducted in rabbits and rats with hydrocortisone valerate cream, 0.2%. Hydrocortisone valerate cream, 0.2%, was administered topically for 4 hours/day, rather than the preferred 24 hours/day, during the period of organogenesis in rats (gestational days 5-16) and rabbits (gestational days 6-19). Topical doses of hydrocortisone valerate up to 9 mg/kg/day (54 mg/m 2 /day) were administered to rats and 5 mg/kg/day (60 mg/m 2 /day) were administered to rabbits. In the absence of maternal toxicity, a significant increase in delayed skeletal ossification in fetuses was noted at 9 mg/kg/day [2.5X the Maximum Recommended Human Dose (MRHD) based on body surface area (BSA) comparisons] in the rat study. No malformations in the fetuses were noted at 9 mg/kg/day (2.5X MRHD based on BSA comparisons) in the rat study. Indicators of embryofetal toxicity, significant decrease in fetal weight at 2 mg/kg/day (1X MRHD based on BSA) and a significant increase in post-implantation loss and embryo resorption at 5 mg/kg (3X MRHD based on BSA), were noted in the rabbit study. A significant increase in delayed skeletal ossification in fetuses was noted at 5 mg/kg/day (3X the MRHD based on BSA comparisons) in the rabbit study. Increased numbers of fetal malformations (e.g., cleft palate, omphalocele and clubbed feet) were noted at 5 mg/kg/day (3X MRHD based on BSA comparisons) in the rabbit study. There are no adequate and well-controlled studies in pregnant women. Westcort (hydrocortisone valerate ointment) Ointment, 0.2% should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Nursing Mothers Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk. Because many drugs are excreted in human milk, caution should be exercised when Westcort Ointment is administered to a nursing woman. Pediatric Use Safety of this product in pediatric patients has not been established. There is no data on adrenal suppression and/or growth suppression. Because of a higher ratio of skin surface area to body mass, pediatric patients are at a greater risk than adults of HPA axis suppression and Cushing s syndrome when they are treated with topical corticosteroids. They are therefore also at a greater risk of adrenal insufficiency during and/or after withdrawal of treatment. Adverse effects including striae have been reported with inappropriate use of topical corticosteroids in infants and children. (See PRECAUTIONS .) HPA axis suppression, Cushing s syndrome, linear growth retardation, delayed weight gain, and intracranial hypertension have been reported in children receiving topical corticosteroids. Manifestations of adrenal suppression in children include low plasma cortisol levels, and an absence of response to ACTH stimulation. Manifestations of intracranial hypertension include bulging fontanelles, headaches, and bilateral papilledema. Geriatric Use Clinical studies ofWestcort Ointment, 0.2% did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. Adverse Reactions In controlled clinical trials, the total incidence of adverse reactions associated with the use of Westcort Ointment was approximately 12%. These included worsening of condition (2%), transient itching (2%), irritation (1%) and redness (1%). In controlled clinical studies involving pediatric atopic dermatitis patients 2 through 12 years of age (n=64), the incidence of adverse experiences was approximately 28.1%, which is higher than that seen in adult patients. Reported reactions included eczema (12.5%), pruritis (6%), stinging (2%), and dry skin (2%). Patients were not specifically evaluated for signs of atrophy (thinning, telangiectasia, erythema). No studies were performed to assess adrenal suppression and/or growth suppression. The following additional local adverse reactions have been reported with topical corticosteroids, and they may occur more frequently with the use of occlusive dressings. These reactions are listed in an approximate decreasing order of occurrence: burning, dryness, folliculitis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, secondary infection, skin atrophy, striae, and miliaria. Overdosage Topically applied Westcort Ointment can be absorbed in sufficient amounts to produce systemic effects (see PRECAUTIONS ). Westcort Dosage and Administration Westcort Ointment should be applied to the affected area as a thin film two or three times daily depending on the severity of the condition. As with other corticosteroids, therapy should be discontinued when control is achieved. If no improvement is seen within 2 weeks, reassessment of the diagnosis may be necessary. Westcort Ointment should not be used with occlusive dressings unless directed by a physician. Westcort Ointment should not be applied in the diaper area if the patient requires diapers or plastic pants as these garments may constitute occlusive dressing. How is Westcort Supplied Westcort (hydrocortisone valerate ointment) Ointment, 0.2% is supplied in the following tube sizes: 15 g NDC 10631-105-15 45 g NDC 10631-105-45 60 g NDC 10631-105-60 STORAGE Store between 59 F-78 F (15 C-26 C) RANBAXY Jacksonville, FL 32257 USA July 2009 PACKAGE LABEL PRINCIPAL DISPLAY PENAL 15 g Tube label 15 g Carton label Westcort hydrocortisone valerate ointment Product Information Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:10631-105 Route of Administration TOPICAL DEA Schedule Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength HYDROCORTISONE VALERATE (HYDROCORTISONE) HYDROCORTISONE VALERATE 2 mg in 1 g Inactive Ingredients Ingredient Name Strength SODIUM PHOSPHATE, DIBASIC ANHYDROUS MINERAL OIL PROPYLENE GLYCOL SODIUM LAURYL SULFATE SORBIC ACID STEARYL ALCOHOL WATER PETROLATUM STEARETH-2 STEARETH-100 CARBOMER HOMOPOLYMER TYPE B (ALLYL SUCROSE CROSSLINKED) Packaging # Item Code Package Description 1 NDC:10631-105-15 15 g in 1 TUBE 2 NDC:10631-105-45 45 g in 1 TUBE 3 NDC:10631-105-60 60 g in 1 TUBE Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date NDA NDA018726 10/06/2008 Labeler - Ranbaxy Laboratories Inc. (169932519) Registrant - Ranbaxy Laboratories Inc. (169932519) Establishment Name Address ID/FEI Operations Contract Pharmaceuticals Limited 248761249 manufacture(10631-105), pack(10631-105) Establishment Name Address ID/FEI Operations Sanofi Chimie 291538267 api manufacture(10631-105) Revised: 09/2009 Ranbaxy Laboratories Inc. Next Interactions Print this page Add to My Med List More about Westcort (hydrocortisone topical) Side Effects During Pregnancy or Breastfeeding Dosage Information Drug Interactions Support Group Pricing & Coupons En Español 1 Review Add your own review/rating Drug class: topical steroids Consumer resources Westcort Westcort Topical application (Advanced Reading) Professional resources Hydrocortisone topical (AHFS Monograph) Hydrocortisone in Absorbase (FDA) Other brands: Proctozone HC , Anucort-HC , Proctocort , Locoid , ... +18 more Related treatment guides Atopic Dermatitis Dermatitis Eczema Intertrigo ... +4 more} FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx OTC Availability Rx and/or OTC C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Drug Class Topical steroids Related Drugs topical steroids fluticasone topical , triamcinolone topical , hydrocortisone topical , clobetasol topical Eczema prednisone , fluticasone topical , triamcinolone topical , hydrocortisone topical , dexamethasone , clobetasol topical , More... 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