Home Drug Guide Fluocinolone Acetonide

Drug Guide

Generic Name

Fluocinolone Acetonide

Brand Names Synalar, Synalar-hp, Derma-smoothe/fs, Dermotic, Capex, Retisert, Fluonid, Fluotrex, Fluocet, Iluvien, Yutiq, Fluocinonide Acetonide, Flucinolone Acetonide, Flac

Classification

Therapeutic: Anti-inflammatory, corticosteroid

Pharmacological: Glucocorticoid

FDA Approved Indications

Inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses
Uveitis (Retisert, Yutiq, Iluvien)

Mechanism of Action

Fluocinolone Acetonide binds to intracellular glucocorticoid receptors, modulating gene expression to suppress inflammation and immune response.

Dosage and Administration

Adult: Apply topically as directed; intraocular injections as per ophthalmic instructions for Retisert, Yutiq, Iluvien

Pediatric: Use with caution; dosing depends on condition

Geriatric: Adjustments not typically needed but monitor for systemic effects

Renal Impairment: No specific dose adjustment required

Hepatic Impairment: No specific data, caution advised.

Pharmacokinetics

Absorption: Limited absorption through skin; systemic absorption can occur with extensive application

Distribution: Wide tissue distribution, including ocular tissues in ophthalmic forms

Metabolism: Metabolized hepatically

Excretion: Metabolites excreted via urine

Half Life: Approx. 0.8 hours systemically, varies with formulation and route

Contraindications

Hypersensitivity to fluocinolone or other corticosteroids

Precautions

Use with caution in infections (fungal, bacterial, viral), eyes with infections, and in systemic infections; avoid in live vaccines; monitor for signs of adrenal suppression

Adverse Reactions - Common

Skin irritation, dryness, dermatitis (Common)
Elevated intraocular pressure, cataracts (ophthalmic forms) (Common)

Adverse Reactions - Serious

Perioral dermatitis, secondary infection, adrenocortical suppression (Less common)
Glaucoma, increased intraocular pressure (ophthalmic forms) (Less common)

Drug-Drug Interactions

Potent CYP3A4 inhibitors may increase corticosteroid levels

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess skin or ocular condition before and during therapy; monitor for signs of infection or increased intraocular pressure

Diagnoses:

Risk for infection
Risk for impaired skin integrity

Implementation: Use as directed; monitor response and side effects; educate patient about proper application

Evaluation: Evaluate effectiveness in reducing inflammation and monitor for adverse effects

Patient/Family Teaching

Apply medication as prescribed; do not discontinue abruptly
Report signs of infection, vision changes, or skin reactions
Use ocular formulations with caution to avoid increased IOP or cataracts

Special Considerations

Black Box Warnings:

Potential for systemic absorption leading to HPA axis suppression, especially with ocular implant forms

Genetic Factors: Genetic variations may influence metabolism (CYP3A4 involvement)

Lab Test Interference: May suppress adrenal function tests

Overdose Management

Signs/Symptoms: Signs of systemic corticosteroid excess: weight gain, edema, hypertension, hyperglycemia

Treatment: Discontinue corticosteroid; provide supportive care; in cases of severe overdose, provide cortisol replacement therapy if needed

Storage and Handling

Storage: Store at room temperature, 15-30°C, away from light and moisture

Stability: Stable under recommended storage conditions for the duration of use