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Medihoney barrier cream contains only natural products with the addition of 30% active 100% Pure Medical Grade Manuka Honey. In adults and children, Elocon Ointment is used to reduce redness and itchiness caused by certain skin problems called psoriasis or dermatitis. Excessive, prolonged use of topical corticosteroids can suppress hypothalamic-pituitary-adrenal function resulting in secondary adrenal insufficiency which is usually reversible. Paediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced hypothalamic-pituitary-adrenal axis suppression and Cushing's syndrome than mature patients because of a larger skin surface area to body weight ratio. It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk.
Patients may prefer creams for application to the face and hands and can be more suitable for moist or weeping lesions. Ointments are preferable to creams as they have a deeper, more prolonged emollient effect. They are also less likely to cause irritation and/or sensitisation to the product, as they do not contain preservatives. Barrier preparations are useful on the skin around stomas, bedsores, and pressure areas in the elderly where the skin is intact. Please contact the Medicines Management Team for additional information regarding prescribing of alternative preparations other than 'specials' & also see the link below.
Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. Unlicensed indication 13.13 Topical circulatory preparations No products have been included in this formulary as they are of little value and are considered as being less suitable for prescribing. Neither systemic nor topical vasodilator therapy has been established as being effective. Moderate to severe plaque psoriasis in children and young people aged 6 to 17 years.
These are drugs for use in Secondary Care ONLY, Consultant Prescribing ONLY or by Tertiary Centres ONLY where indicated in the text. The other ingredients are hexylene glycol; purified water; phosphoric acid; propylene glycol stearate; white bees wax; white soft paraffin. If you have been using Elocon for a long time and your skin problem seems to have got better, you should not suddenly stop using the ointment. If you do, you may find that your skin becomes red and you may notice stinging or burning.
If used on the face, courses should be limited to 5 days and occlusion should not be used. Long term continuous therapy should be avoided in all patients irrespective of age. Outside of ACBS approved indications, and in common with the rest of the population, when a sunscreen is indicated patients should purchase their own supply. Zlatal® syringes are available for patients who prefer to use a pre-filled syringe. Methofill® pre-filled injectors and pre-filled syringes are available for patients unable to use Metoject due to dexterity issues. Not routinely commissioned in paediatrics - IFR approval must be sought before treatment initiation.
Visual disturbance may be reported with systemic and topical corticosteroid use. As with all potent topical glucocorticoids, avoid sudden discontinuation of treatment. When long term topical treatment with potent glucocorticoids is stopped, a rebound phenomenon can develop which takes the form of a dermatitis with intense redness, stinging and burning. This can be prevented by slow reduction of the treatment, for instance continue treatment on an intermittent basis before discontinuing treatment. Paediatric patients may be more susceptible to systemic toxicity from equivalent doses due to their larger skin surface to body mass ratios. As the safety and efficacy of Elocon in paediatric patients below 2 years of age have not been established, its use in this age group is not recommended.
Nizoral 2% cream for other skin conditions is formulary see above. Available via EAMS in specialist paediatric dermatology centres for children 6 to 11 years of age with severe atopic dermatitis who are candidates for systemic therapy and where existing systemic therapies are not advisable. An emollient for the relief of dry skin in eczema, psoriasis and other dry skin conditions and for use as a soap substitute for skin washing. A highly moisturising gel for regular and frequent use in eczema, psoriasis and other dry skin conditions. Other side effects that may occur with topical corticosteroids are dry skin, skin irritation, dermatitis, dermatitis around the mouth, and small dilated blood vessels.
The hospital specialist should also provide the GP with enough information and support to allow the safe transfer and ongoing management of prescribing into primary care. Drugs designated RED are considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs are not expected to be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy. This may include arranging for supply via a home-care company. Unlicensed medicines, indications and intravenous preparations are automatically classified as RED unless designated otherwise within the formulary.
Reserved for patients with severe eczema and infants under the age of 1 year. Do not put the ointment under your child’s nappy, as this makes it easier for the active drug to pass through the skin and possibly cause some unwanted effects. Side effects that may happen with inhaled or oral corticosteroids may also occur with corticosteroids used on the skin, especially in infants and children. Medicines which are not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety.
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