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Treatment of cutaneous candidiasis
Hypersensitivity to nystatin, triamcinolone, or any component of the formulation
Cutaneous Candida: Topical: Apply sparingly to affected area(s) twice daily. Therapy should be discontinued when control is achieved or if symptoms persist for >25 days of therapy.
Refer to adult dosing.
Refer to adult dosing.
External use only; do not use on open or weeping wounds; do not use with occlusive dressings.
Store at 15 ‚ °C to 30 ‚ °C (59 ‚ °F to 86 ‚ °F). Avoid freezing.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Cream: Nystatin 100,000 units and triamcinolone acetonide 0.1% (15 g, 30 g, 60 g)
Ointment: Nystatin 100,000 units and triamcinolone acetonide 0.1% (15 g, 30 g, 60 g)
Aldesleukin: Corticosteroids may diminish the antineoplastic effect of Aldesleukin. Avoid combination
Ceritinib: Corticosteroids may enhance the hyperglycemic effect of Ceritinib. Monitor therapy
Corticorelin: Corticosteroids may diminish the therapeutic effect of Corticorelin. Specifically, the plasma ACTH response to corticorelin may be blunted by recent or current corticosteroid therapy. Monitor therapy
Deferasirox: Corticosteroids may enhance the adverse/toxic effect of Deferasirox. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased. Monitor therapy
Hyaluronidase: Corticosteroids may diminish the therapeutic effect of Hyaluronidase. Management: Patients receiving corticosteroids (particularly at larger doses) may not experience the desired clinical response to standard doses of hyaluronidase. Larger doses of hyaluronidase may be required. Consider therapy modification
Progesterone: Antifungal Agents (Vaginal) may diminish the therapeutic effect of Progesterone. Avoid combination
Urinary free cortisol test, morning plasma cortisol test, and ACTH stimulation test may be used to evaluate HPA axis suppression; signs of infection
Frequency not defined.
Dermatologic: Acne, allergic dermatitis, dryness, folliculitis, hypertrichosis, hypopigmentation, maceration of the skin, miliaria, perioral dermatitis, skin atrophy, striae
Local: Burning, irritation, itching
Miscellaneous: Increased incidence of secondary infection
Concerns related to adverse effects:
- Adrenal suppression: Systemic absorption of topical corticosteroids may cause hypercorticism 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.
- Dermatitis: Cutaneous hypersensitivity/contact dermatitis to individual ingredients has been reported; instruct patients to seek medical attention.
- Infection: Steroids may mask infection or enhance existing infection; prolonged use may result in secondary infections due to immunosuppression.
- Kaposis sarcoma: Prolonged treatment with corticosteroids has been associated with the development of Kaposi's sarcoma (case reports); if noted, discontinuation of therapy should be considered.
- 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.
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See individual agents.
See individual agents.
- Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
- Patient may experience burning, itching, or dry skin. Have patient report immediately to prescriber signs of high blood sugar (confusion, feeling sleepy, more thirst, hunger, passing urine more often, flushing, fast breathing, or breath that smells like fruit), signs of skin changes (pimples, stretch marks, slow healing, or hair growth), skin discoloration, or severe skin irritation (HCAHPS).
- Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.