Desonide - Uses, Warnings, Side Effects, and Pharmacological Aspects

Overview:

Desonide is a corticosteroid medication that is commonly used for the treatment of atopic dermatitis, also known as eczema. It is available in different formulations, such as creams, ointments, lotions, gels, and foams, which are applied directly to the affected areas of the skin. With its anti-inflammatory properties, Desonide provides relief and aids in enhancing the overall health of the skin affected by inflammatory skin disorders. The United States Food and Drug Administration (FDA) approved the use of Desonide for its indication in 2006. Avoid drug contact with eyes or other mucus membranes, and avoid fire, flame, or smoking during or immediately following the application of the medication.

Drug Group:

Desonide is a topical corticosteroid, which means it is used to alleviate inflammation in the skin. It is in a class of medications called corticosteroids, which are also known as steroids. Desonide is a low-potency corticosteroid, which means it is not as strong as other corticosteroids.

Corticosteroids exert their effects by inducing the production of proteins known as lipocortins, which can inhibit phospholipase A2. This enzyme is essential for the release of arachidonic acid, a precursor involved in the synthesis of potent inflammatory mediators like prostaglandins and leukotrienes. By inhibiting phospholipase A2 and subsequent arachidonic acid release, Desonide and other corticosteroids can effectively control inflammation.

Available Doses and Dosage Forms:

Desonide is available in the following dosage forms and strengths:

• Cream: 0.05 percent.

• Ointment: 0.05 percent.

• Foam: 0.05 percent.

• Gel: 0.05 percent.

• Lotion: 0.05 percent.

For Patients:

What Is Atopic Dermatitis?

Atopic dermatitis, also known as eczema, is a persistent skin problem that impacts millions of individuals globally. It is distinguished by dryness, itchiness, and inflamed skin that can appear red, swollen, and scaly. This condition often starts in early childhood but can continue into adulthood. Although the precise cause of this illness is unknown, a mix of hereditary and environmental factors is thought to be responsible. Triggers such as allergens, irritants, stress, and climate changes can exacerbate the symptoms.

While atopic dermatitis can be a challenging condition to live with, with proper care and management, it is possible to minimize symptoms and maintain healthy skin. Seeking guidance from a dermatologist is crucial to developing an effective treatment plan tailored to individual needs.

How Does Desonide Work?

Desonide inhibits the production and release of certain inflammatory substances, such as prostaglandins and leukotrienes. By doing so, Desonide helps to reduce the redness, itching, and swelling associated with inflammatory skin conditions. Desonide also has vasoconstrictive properties, which means it helps to constrict the skin's blood vessels. This can lessen the amount of fluid that leaks from blood arteries into the tissues around them, further alleviating inflammation and swelling.

What Is the Dosage of Desonide?

The dosage of Desonide will vary depending on the age of the patient, the severity of the skin condition, and the form of Desonide being used. In general, Desonide is applied to the affected area of the skin once or twice a day.

How Effective Is Desonide?

Clinical studies have shown that Desonide can significantly improve symptoms such as itching, redness, and inflammation associated with these skin conditions. Many individuals experience relief from their symptoms after using Desonide as directed by their healthcare provider.

What Are the Things to Inform the Doctor Before Taking the Drug?

Prior to taking Desonide or any medication, it is crucial to inform the doctor about several factors to guarantee safe and appropriate usage. The following are important details to communicate:

• Allergies: Notify the doctor of any known allergies or sensitivities, especially if there has been an allergic reaction to Desonide or any other corticosteroid medication in the past.

• Pregnancy and Breastfeeding: If pregnant, planning to become pregnant, or breastfeeding, inform the doctor. They can assess the potential risks and benefits of using Desonide during these periods and recommend the most suitable course of action.

• Medical History: Share the complete medical history with the doctor, particularly if there are underlying health conditions like diabetes (raised blood sugar level), hypertension (raised blood pressure), or other chronic illnesses. Also, disclose the presence of any skin infections or open wounds in the area that require treatment.

• Current Medications: Provide a comprehensive list of all current medications, including prescription drugs, over-the-counter medications, herbal supplements, and vitamins. Certain medications may interact with Desonide, potentially impacting its effectiveness or increasing the risk of side effects.

• Corticosteroid Use: Notify the doctor if there has been recent use or current usage of any other corticosteroid medications, either topically or systemically. This information is vital in preventing potential interactions or cumulative effects.

• Other Topical Treatments: Inform the doctor if using any other topical medications or treatments on the same area of the skin. This includes creams, ointments, lotions, or cosmetics, as they may interact with Desonide.

How Is Desonide Administered?

Desonide should be applied topically on the skin as a thin film, and it should be rubbed gently. Desonide should not be used for longer than two weeks without talking to the doctor. The following are the dosage recommendations for Desonide:

• Adults: Apply a thin film of Desonide cream, ointment, or lotion to the affected area once or twice a day.

• Children: The dosage of Desonide for children will vary depending on the child's age and weight. It is important to follow the directions on the Desonide label or talk to the child's doctor about the correct dosage.

• Babies: Desonide should not be used on babies younger than three months old.

What Are the Side Effects of Desonide?

The common side effects include

• Burning.

• Itching.

• Irritation.

• Scaling or dryness of the skin at the application site.

• Acne.

• Excessive hair growth.

• Rashes around the mouth.

• Allergic contact dermatitis.

• Maceration of the skin (softening and breaking down of the skin as a result of repeated contact with moisture).

• Secondary skin infection (an infection that occurs on top of a pre-existing skin condition).

These side effects are usually mild and go away on their own within a few days or weeks. If they are severe or do not go away, discuss them with the concerned doctor.

Less common side effects:

• Skin thinning or change in skin color (usually occurs with prolonged or excessive use).

• Hypopigmentation (loss of skin color).

• Allergic reaction (rash, hives, itching, swelling).

Dietary Considerations:

There are no specific dietary alterations recommended for people administering Desonide. However, if there any particular considerations are advised by the doctor, adhere to the given instructions.

Missed Dose:

If a dose of Desonide is missed, apply it as soon as possible. Skip the missed dosage if the following dose is soon due and apply the next dose at the regular time. Do not apply twice the dose to make up for the missed dose.

Overdose:

Overdosing is unlikely for topical application. However, if ingestion of the drug occurs, contact the nearest poison control center or hospital immediately.

Storage:

Store Desonide at room temperature, away from heat and direct light. Do not store in the bathroom. Keep the medication out of reach of children.

For Doctors:

Indication:

The FDA-labeled indications of Desonid include

• Mild to moderate atopic dermatitis.

• Inflammatory hyperkeratotic dermatosis.

Dose:

Atopic Dermatitis: Apply a thin layer of the foam or gel topically to the affected area. The duration of therapy should not exceed four consecutive weeks.

Dosing Considerations: In pediatrics aged three months and older, apply a thin layer of the foam or gel topically to the affected area. The duration of therapy should not exceed four consecutive weeks.

What Are the Pharmacological Aspects of Desonide?

1. Mechanism of Action:

Desonide has several beneficial properties, such as anti-inflammatory, antipruritic, and vasoconstrictive effects. The drug acts by binding to glucocorticoid receptors located in the cytosol. This receptor-drug complex then moves to the nucleus and attaches to specific genetic elements in the DNA (deoxyribonucleic acid). Through this mechanism, Desonide can activate or suppress various genes involved in the inflammatory response.

2. Pharmacodynamics:

Desonide is a synthetic corticosteroid that is specifically designed for topical use in dermatology. It belongs to a class of steroids known as corticosteroids, which are primarily synthetic in nature. These corticosteroids are widely used topically due to their anti-inflammatory and antipruritic properties, making them effective in treating various skin conditions.

3. Pharmacokinetics:

• The absorption of topical corticosteroids can occur through intact skin, and the presence of inflammation or other skin conditions can potentially enhance this percutaneous absorption process.

• Data regarding other pharmacokinetic parameters of the drug are not yet available.

Toxicity:

On prolonged use, corticosteroids can decrease the absorption of calcium and increase the excretion of calcium. However, acute toxicity by overdosing is rare. Management measures include the following:

• Airway monitoring and administering antihistamines with or without inhaled beta-agonists, corticosteroids, or Epinephrine for mild to moderate cases.

• For severe effects, oxygen, aggressive airway management, antihistamines, Epinephrine, corticosteroids, ECG (electrocardiogram) monitoring, and IV (intravenous) fluids.

Monitoring of Patient: Routine laboratory studies are not likely to be necessary after an acute overdose. Serum electrolytes and glucose are useful to assess for adverse effects from chronic therapy. Monitor vital signs, fluid, and electrolyte status as indicated. Monitor neurologic status as indicated in symptomatic patients.

Clinical Studies:

• A randomized, double-blind, placebo-controlled trial was conducted to assess the efficacy of Desonide cream in patients with atopic dermatitis. The study found that Desonide significantly reduced itching, erythema, and overall disease severity compared to the placebo group.

• A comparative study was conducted to evaluate the efficacy and safety of Desonide compared to other topical corticosteroids in the treatment of psoriasis. The results demonstrated that Desonide exhibited similar efficacy to other corticosteroids while having a more favorable safety profile.

What Are the Contraindications of Desonide?

Desonide is contraindicated if the patient has a previous history of allergy or hypersensitivity to the active or inactive components of the drug.

Warnings and Precautions:

1. Administration:

• Advise patients to refrain from exposing the treated area to fire, flames, or smoking during and immediately after application.

• Prolonged use (more than two weeks at a time) may heighten the risk of hypothalamic-pituitary-adrenal axis suppression, symptoms of Cushing's syndrome, hyperglycemia, and glucosuria.

• When applying the medication to a large body surface area, there is an increased risk of hypothalamic-pituitary-adrenal axis suppression, manifestations of Cushing's syndrome, hyperglycemia, and glucosuria.

• Application of the medication under occlusive dressings can increase the risk of hypothalamic-pituitary-adrenal axis suppression, symptoms of Cushing's syndrome, hyperglycemia, and glucosuria.

2. Immunological:

• Cease use until concurrent skin infections resolve, even if they do not improve with antifungal, antibacterial, or antiviral treatment.

3. Ophthalmic:

• Reports of cataracts and glaucoma exist; avoid contact with the eyes; consider referral to an ophthalmologist if necessary.

4. Specific Populations:

• Pediatric patients are at a heightened risk of toxicity from equivalent adult doses due to their greater skin surface area compared to body mass.

What Are the Drug Interactions of Desonide?

The drug interactions of Desonide are as listed:

• Desmopressin (contraindicated).

• Aspirin.

• Bemiparin.

• Bupropion.

• Macimorelin.

• Nadroparin.

• Sargramostim.

• Auranofin.

Specific Considerations:

Desonide in Pediatrics: Desonide should be used with caution in pediatric patients. Children have a larger skin surface area in proportion to their body mass, which can increase the risk of systemic absorption and potential adverse effects. Prolonged use or excessive application of Desonide in children may result in hypothalamic-pituitary-adrenal (HPA) axis suppression, growth retardation, and other systemic effects. Consequently, it is crucial to utilize the lowest effective dose for the shortest duration possible in pediatric patients and closely monitor for any signs of HPA axis suppression or systemic effects.

Desonide in Geriatrics: Desonide can be used in geriatric patients, but caution should be exercised. Elderly people may have a higher risk of skin thinning and increased susceptibility to skin damage.

Desonide in Preganant and Lactating Women: The use of Desonide during pregnancy and lactation should be approached with caution. There is limited data available on the safety of Desonide in pregnant and breastfeeding women. The decision to use Desonide in pregnant or lactating women should be made after considering the potential benefits and risks.

Desonide in Patients With Hepatic Impairment: Caution should be exercised when using Desonide in patients with hepatic impairment. Close monitoring for adverse effects is important in these patients.

Desonide in Patients With Renal Impairment:There is limited information available regarding the use of Desonide in patients with renal impairment. Caution should still be exercised when using Desonide in patients with renal impairment, and close monitoring for any adverse effects is recommended.