Generic Name

Hydrocortisone Valerate

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Classification

FDA Approved Indications

• Inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses

Mechanism of Action

Hydrocortisone valerate reduces inflammation and immune responses by modulating gene expression which leads to decreased production of inflammatory mediators and suppression of immune cell activity.

Dosage and Administration

Adult: Apply a thin film to affected skin areas 2-4 times daily as directed by physician.

Pediatric: Usage should be limited and prescribed with caution; follow specific pediatric dosing instructions provided by a healthcare provider.

Geriatric: Use with caution; monitor for systemic effects due to increased absorption in compromised skin.

Renal Impairment: No specific dosage adjustment is typically necessary for renal impairment.

Hepatic Impairment: No specific dosage adjustment is typically necessary; however, systemic absorption may be increased in extensive skin damage.

Pharmacokinetics

Absorption: Minimal systemic absorption when used topically, but absorption increases with occlusion or widespread application.

Distribution: Widely distributed; specific data not available.

Metabolism: Metabolized in the liver via ester hydrolysis.

Excretion: Excreted primarily in urine as metabolites.

Half Life: Approximately 8-12 hours, variable based on tissue and site of application.

Contraindications

• Hypersensitivity to hydrocortisone valerate or any component of the formulation.
• Viral, fungal, or bacterial skin infections.
• Vaccine-site reactions.

Precautions

• Use with caution in areas of broken skin, periorbital areas, and in children due to higher risks of systemic absorption.
• Prolonged use may lead to skin atrophy, striae, secondary infections, or HPA suppression.

Adverse Reactions - Common

• Transient burning, stinging, or itching at application site. (Common)

Adverse Reactions - Serious

• Skin atrophy, striae, secondary infection, HPA suppression. (Rare)
• Allergic contact dermatitis. (Rare)

Drug-Drug Interactions

• Potent topical or systemic corticosteroids

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Use exactly as prescribed. Do not cover treated area with occlusive bandages unless directed.
• Report signs of skin irritation, infection, or systemic effects such as weight gain or mood changes.
• Avoid covering large areas or prolonged use to minimize systemic absorption.

Special Considerations

Black Box Warnings:

• Prolonged topical use can lead to HPA axis suppression and corticosteroid side effects.
• Use with caution in children; they are more susceptible to systemic absorption and adverse effects.

Genetic Factors: None specific.

Lab Test Interference: May alter serum cortisol levels in systemic absorption cases.

Overdose Management

Signs/Symptoms: Signs of systemic corticosteroid excess include hyperglycemia, hypertension, and Cushingoid features if absorbed in significant amounts.

Treatment: Discontinue use and provide supportive care; corticosteroid antagonist or tapering may be necessary under medical supervision.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable for the duration of the labeled shelf life.