Label: FLUOCINONIDE- fluocinonide cream FLUOCINONIDE- fluocinonide ointment FLUOCINONIDE- fluocinonide solution 

  • Category: HUMAN PRESCRIPTION DRUG LABEL
  • DEA Schedule: None
  • Marketing Status: New Drug Application

Drug Label Information

Updated 01/12

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  • SPL UNCLASSIFIED SECTION

    FOR TOPICAL USE ONLY

    NOT FOR OPHTHALMIC USE

    Rx only

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  • DESCRIPTION

    Fluocinonide Cream USP, 0.05%, Fluocinonide Cream USP, 0.05% (Emulsified Base), Fluocinonide Gel USP, 0.05% and Fluocinonide Ointment USP, 0.05% and Flucinonide Topical Solution USP are intended for topical administration. The active component in each is the corticosteroid fluocinonide, which is the 21-acetate ester of fluocinolone acetonide and has the chemical name pregna-1,4-diene-3,20-dione,21-(acetyloxy) -6,9-difluoro-11-hydroxy-16,17-[(1-methylethylidene)bis(oxy)]-,(6a,11b,16a)-. It has the following chemical structure:

    Molecular Weight:
    494.54
    Molecular Formula:
    C26H32F2O7
    Chemical Structure-Fluocinonide

    Fluocinonide Cream USP, 0.05% contains fluocinonide 0.5 mg/g in a specially formulated cream base consisting of citric acid, glycerin, 1,2,6-hexanetriol, polyethylene glycol-3350, polyethylene glycol-8000, propylene glycol and stearyl alcohol. This white cream vehicle is greaseless, non-staining, anhydrous and completely water miscible. The base provides emollient and hydrophylic properties.

    Fluocinonide Cream USP, 0.05% (Emulsified Base) contains fluocinonide 0.5 mg/g in a water-washable aqueous emollient base of cetyl alcohol, citric acid (anhydrous), mineral oil, polysorbate 60, propylene glycol, purified water, sorbitan monostearate, stearyl alcohol and white petrolatum.

    Fluocinonide Gel USP, 0.05% contains fluocinonide 0.5 mg/g in a specially formulated gel base consisting of carbomer 940, edetate disodium, propyl gallate, propylene glycol, sodium hydroxide (to adjust pH) and purified water. This clear, colorless, thixotropic vehicle is greaseless, non-staining and completely water miscible.

    Fluocinonide Ointment USP, 0.05% contains fluocinonide 0.5 mg/g in a specially formulated ointment base consisting of glyceryl monostearate, propylene carbonate, propylene glycol, white petrolatum and white wax. It provides the occlusive and emollient effects desirable in an ointment.

    Flucinonide Topical Solution USP contains fluocinonide 0.5 mg/mL in a solution of alcohol (35%), citric acid, diisopropyl adipate, and propylene glycol.

    In the Fluocinonide Cream USP, 0.05%, Fluocinonide Gel USP, 0.05%, and Fluocinonide Ointment USP, 0.05% formulations, the active ingredient is totally in solution.

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  • CLINICAL PHARMACOLOGY

    Topical corticosteroids share anti-inflammatory, anti-pruritic and vasoconstrictive actions.

    The mechanism of anti-inflammatory activity of the topical corticosteroids is unclear. Various laboratory methods, including vasoconstrictor assays, are used to compare and predict potencies and/or clinical efficacies of the topical corticosteroids. There is some evidence to suggest that a recognizable correlation exists between vasoconstrictor potency and therapeutic efficacy in man.

    Pharmacokinetics

    The extent of percutaneous absorption of topical corticosteroids is determined by many factors including the vehicle, the integrity of the epidermal barrier, and the use of occlusive dressings. A significantly greater amount of fluocinonide is absorbed from the solution than from the cream or gel formulations.

    Topical corticosteroids can be absorbed from normal intact skin. Inflammation and/or other disease processes in the skin increase percutaneous absorption. Occlusive dressings substantially increase the percutaneous absorption of topical corticosteroids. Thus, occlusive dressings may be a valuable therapeutic adjunct for treatment of resistant dermatoses. (See DOSAGE AND ADMINISTRATION.)

    Once absorbed through the skin, topical corticosteroids are handled through pharmacokinetic pathways similar to systemically administered corticosteroids. Corticosteroids are bound to plasma proteins in varying degrees. Corticosteroids are metabolized primarily in the liver and are then excreted by the kidneys. Some of the topical corticosteroids and their metabolites are also excreted into the bile.

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  • INDICATIONS AND USAGE

    Fluocinonide Cream USP, 0.05%, Fluocinonide Cream USP, 0.05% (Emulsified Base), Fluocinonide Gel USP, 0.05% and Fluocinonide Ointment USP, 0.05% and Flucinonide Topical Solution USP are indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid responsive dermatoses.

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  • CONTRAINDICATIONS

    Topical corticosteroids are contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation.

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  • PRECAUTIONS

    General

    Systemic absorption of topical corticosteroids has produced reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, manifestation of Cushing's syndrome, hyperglycemia, and glucosuria in some patients.

    Conditions which augment systemic absorption include the application of the more potent steroids, use over large surface areas, prolonged use, the addition of occlusive dressings.

    Therefore, patients receiving a large dose of a potent topical steroid applied to a large surface area or under an occlusive dressing should be evaluated periodically for evidence of HPA axis suppression by using the urinary free cortisol and ACTH stimulation tests. 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 steroid.

    Recovery of HPA axis function is generally prompt and complete upon discontinuation of the drug. Infrequently, signs and symptoms of steroid withdrawal may occur, requiring supplemental systemic corticosteroids.

    Children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity. (See PRECAUTIONS - Pediatric Use).

    This preparation is not for ophthalmic use. Severe irritation is possible if fluocinonide solution contacts the eye. If that should occur, immediate flushing of the eye with a large volume of water is recommended.

    If irritation develops, topical corticosteroids should be discontinued and appropriate therapy instituted.

    As with any topical corticosteroid product, prolonged use may produce atrophy of the skin and subcutaneous tissues. When used on intertriginous or flexor areas, or on the face, this may occur even with short-term use.

    In the presence of dermatological infections, the use of an appropriate antifungal or antibacterial agent should be instituted. If a favorable response does not occur promptly, the corticosteroid should be discontinued until the infection has been adequately controlled.

    Information for the Patient

    Patients using topical corticosteroids should receive the following information and instructions:

    1. This medication is to be used as directed by the physician. It is for external use only. Avoid contact with the eyes. If there is contact with the eyes and severe irritation occurs, immediately flush with a large volume of water.
    2. Patients should be advised not to use this medication for any disorder other than for which it was prescribed.
    3. The treated skin area should not be bandaged or otherwise covered or wrapped as to be occlusive unless directed by the physician.
    4. Patients should report any signs of local adverse reactions especially under occlusive dressing.
    5. Parents of pediatric patients should be advised not to use tightfitting diapers or plastic pants on a child being treated in the diaper area, as these garments may constitute occlusive dressings.

    Laboratory Tests

    The following tests may be helpful in evaluating HPA axis suppression:

    Urinary free cortisol test
    ACTH stimulation test

    Carcinogenesis, Mutagenesis, and Impairment of Fertility

    Long-term animal studies have not been performed to evaluate the carcinogenic potential or the effect on fertility of topical corticosteroids.

    Studies to determine mutagenicity with prednisolone and hydrocortisone have revealed negative results.

    Pregnancy Category C

    Corticosteroids are generally teratogenic in laboratory animals when administered systemically at relatively low dosage levels. The more potent corticosteroids have been shown to be teratogenic after dermal application in laboratory animals. There are no adequate and well-controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids. Therefore, topical corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Drugs of this class should not be used extensively on pregnant patients, in large amounts, or for prolonged periods of time.

    Nursing Mothers

    It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk. Systemically administered corticosteroids are secreted into breast milk in quantities not likely to have a deleterious effect on the infant. Nevertheless, caution should be exercised when topical corticosteroids are administered to a nursing woman.

    Pediatric Use

    Pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced HPA axis suppression and Cushing's syndrome than mature patients because of the larger skin surface area to body weight ratio.

    Hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome, and intracranial hypertension have been reported in children receiving topical corticosteroids. Manifestations of adrenal suppression in children include linear growth retardation, delayed weight gain, low plasma cortisol levels, and absence of response to ACTH stimulation. Manifestations of intracranial hypertension include bulging fontanelles, headaches, and bilateral papilledema.

    Administration of topical corticosteroids to children should be limited to the least amount compatible with an effective therapeutic regimen. Chronic corticosteroid therapy may interfere with the growth and development of children.

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  • ADVERSE REACTIONS

    The following local adverse reactions are reported infrequently with topical corticosteroids, but may occur more frequently with the use of occlusive dressings. These reactions are listed in an approximate decreasing order of occurrence.

    Burning
    Itching
    Irritation
    Dryness
    Folliculitis
    Hypertrichosis
    Acneiform eruptions
    Hypopigmentation
    Perioral dermatitis
    Allergic contact dermatitis
    Maceration of the skin
    Secondary infection
    Skin atrophy
    Striae
    Miliaria

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  • OVERDOSAGE

    Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects. (See PRECAUTIONS.)

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  • DOSAGE AND ADMINISTRATION

    Fluocinonide Cream USP, 0.05%, Fluocinonide Cream USP, 0.05% (Emulsified Base), Fluocinonide Gel USP, 0.05% and Fluocinonide Ointment USP, 0.05% and Flucinonide Topical Solution USP should be applied to the affected area as a thin film from two to four times daily depending on the severity of the condition.

    Occlusive dressings may be used for the management of psoriasis or recalcitrant conditions.

    If an infection develops, the use of occlusive dressings should be discontinued and appropriate antimicrobial therapy instituted.

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  • HOW SUPPLIED

    Fluocinonide Cream USP, 0.05% is supplied as follows:

    15 gm tube (NDC 60429-904-15)

    30 gm tube (NDC 60429-904-30)

    60 gm tube (NDC 60429-904-60)

    Store at 20°-25°C (68°-77°F)[see USP Controlled Room Temperature].

    Fluocinonide Ointment USP, 0.05% is supplied as follows:

    15 gm tube (NDC 60429-907-15)

    30 gm tube (NDC 60429-907-30)

    60 gm tube (NDC 60429-907-60)

    Store at 20°-25°C (68°- 77°F) [see USP Controlled Room Temperature]. Avoid temperature above 30°C (86°F).

    Floucinonide Topical Solution USP, 0.05%.
    Plastic squeeze bottles of 60 mL. (NDC 60429-908-60)

    Store at 20°-25°C (68°- 77°F) [see USP Controlled Room Temperature]. Avoid excessive heat, above 40°C (104°F).

    Rx Only

    Mfd. by: Taro Pharmaceuticals Inc., Brampton, Ontario, Canada L6T 1C1

    Marketed/Packaged by: GSMS Inc. Camarillo, CA 93012

    Issued: April, 2010

    PK-4964-2 1040

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  • Principal Display Panel - Cream
  • Principal Display Panel - Ointment
  • Principal Display Panel - Solution
  • INGREDIENTS AND APPEARANCE
    FLUOCINONIDE 
    fluocinonide cream
    Product Information
    Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:60429-904(NDC:51672-1253)
    Route of Administration TOPICAL DEA Schedule     
    Active Ingredient/Active Moiety
    Ingredient Name Basis of Strength Strength
    Fluocinonide (Fluocinonide) Fluocinonide 0.5 mg  in 1 mL
    Inactive Ingredients
    Ingredient Name Strength
    alcohol  
    CITRIC ACID MONOHYDRATE  
    diisopropyl adipate  
    propylene glycol  
    Packaging
    # Item Code Package Description Marketing Start Date Marketing End Date
    1 NDC:60429-904-15 15 mL in 1 TUBE
    2 NDC:60429-904-30 30 mL in 1 TUBE
    3 NDC:60429-904-60 60 mL in 1 TUBE
    Marketing Information
    Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
    NDA NDA019117 06/26/1984
    FLUOCINONIDE 
    fluocinonide ointment
    Product Information
    Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:60429-907(NDC:51672-1264)
    Route of Administration TOPICAL DEA Schedule     
    Active Ingredient/Active Moiety
    Ingredient Name Basis of Strength Strength
    Fluocinonide (Fluocinonide) Fluocinonide 0.5 mg  in 1 mL
    Inactive Ingredients
    Ingredient Name Strength
    alcohol  
    CITRIC ACID MONOHYDRATE  
    diisopropyl adipate  
    propylene glycol  
    Packaging
    # Item Code Package Description Marketing Start Date Marketing End Date
    1 NDC:60429-907-15 15 mL in 1 TUBE
    2 NDC:60429-907-30 30 mL in 1 TUBE
    3 NDC:60429-907-60 60 mL in 1 TUBE
    Marketing Information
    Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
    ANDA ANDA074935 07/29/1997
    FLUOCINONIDE 
    fluocinonide solution
    Product Information
    Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:60429-908(NDC:51672-1273)
    Route of Administration TOPICAL DEA Schedule     
    Active Ingredient/Active Moiety
    Ingredient Name Basis of Strength Strength
    Fluocinonide (Fluocinonide) Fluocinonide 0.5 mg  in 1 mL
    Inactive Ingredients
    Ingredient Name Strength
    alcohol  
    CITRIC ACID MONOHYDRATE  
    diisopropyl adipate  
    propylene glycol  
    Packaging
    # Item Code Package Description Marketing Start Date Marketing End Date
    1 NDC:60429-908-60 60 mL in 1 BOTTLE
    Marketing Information
    Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
    ANDA ANDA074799 12/31/1996
    Labeler - Golden State Medical Supply, Inc. (603184490)
    Establishment
    Name Address ID/FEI Business Operations
    Golden State Medical Supply, Inc. 603184490 RELABEL(60429-904, 60429-907, 60429-908)
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