Version May 2024
Atopic dermatitis: Topical: Apply 3 times daily to affected area(s) for ≤14 days
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
Refer to adult dosing.
Atopic dermatitis: Topical: Children ≥3 years and Adolescents: Refer to adult dosing.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
Frequency not always defined.
Dermatologic: Dermatitis (exacerbation: 2%), acne rosacea, atrophic striae, burning sensation of skin, dyschromia, hypertrichosis, pruritus, secondary skin infection, skin atrophy, subcutaneous atrophy, telangiectasia, xeroderma
Hypersensitivity: Hypersensitivity reaction
Local: Local irritation (2%)
Hypersensitivity to fusidic acid, hydrocortisone acetate, or any component of the formulation; skin infections (fungal, viral, or bacterial) that are untreated or uncontrolled; untreated or uncontrolled tuberculosis of the skin; eruptions following vaccinations; perioral dermatitis; rosacea.
Concerns related to adverse effects:
• Adrenal suppression: Systemic absorption of topical corticosteroids 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.
• 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:
• Pediatric: Children may absorb proportionally larger amounts of corticosteroids 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:
• Appropriate use: Avoid use with occlusive dressings. Do not use in or near the eye; conjunctival irritation may occur. Do not use for >14 days without clinical improvement.
Not available in the United States.
No
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Cream, External:
Fucidin H: Fusidic acid 2% and hydrocortisone acetate 1% (30 g)
Topical: For external use only; not for use in or near the eye.
Topical: For external use only; apply sparingly to affected areas; not for use in or near the eye. Use only as directed and for the duration prescribed.
Note: Not approved in the United States.
Atopic dermatitis: Treatment of mild to moderately severe atopic dermatitis caused by susceptible organisms (eg, Staphylococcus aureus).
KIDs List: Medium, high, and very high potency topical corticosteroids, when used in neonates and infants <1 year of age for diaper dermatitis, are identified on the Key Potentially Inappropriate Drugs in Pediatrics (KIDs) list; use should be avoided due to risk of adrenal suppression; systemic absorption is higher in pediatric patients than adults (strong recommendation; low quality of evidence) (PPA [Meyers 2020]).
Refer to individual components.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Calcipotriene: Hydrocortisone (Topical) may diminish the therapeutic effect of Calcipotriene. Management: Monitor for reduced calcipotriene efficacy if combined with hydrocortisone valerate. Consider separating the administration of these agents by 10 to 12 hours to minimize the risk of this potential interaction. Risk C: Monitor therapy
See individual agents.
See individual agents.
See individual agents.
Absorption: Fusidic acid: ~2%; hydrocortisone acetate: 1% to 5% (may be higher if integrity of skin is compromised).
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