| VYTONE® Cream 1% |
Prescribing Information |
|
| (hydrocortisone-iodoquinol) |
DESCRIPTION |
CLINICAL PHARMACOLOGY
INDICATIONS AND USAGE |
CONTRAINDICATIONS
WARNINGS AND PRECAUTIONS
ADVERSE REACTIONS
DOSAGE AND ADMINISTRATION |
HOW SUPPLIED
DESCRIPTION
Each gram of Vytone® Cream 1% contains 10 mg of hydrocortisone
and 10 mg of iodoquinol in a greaseless base of purified water, propylene glycol, glyceryl monostearate
SE, cholesterol and related sterols, isopropyl myristate, polysorbate 60, cetyl alcohol, sorbitan
monostearate, polyoxyl 40 stearate, sorbic acid, and polysorbate 20.
Chemically, hydrocortisone is [Pregn-4-ene-3,20-dione, 11, 17, 21- trihydroxy-, (11ß)-] with the
molecular formula (C21H30O5) and is represented by the following
structural formula:

and iodoquinol, 5,7-diiodo-8-quinolinol (C9H5I2NO)
is represented by the following structure:
Hydrocortisone is an anti-inflammatory and antipruritic agent,
while iodoquinol is an antifungal and antibacterial agent.
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CLINICAL
PHARMACOLOGY
Hydrocortisone has anti-inflammatory, antipruritic and
vasoconstrictor properties. The mechanism of anti-inflammatory activity is unclear. There is some
evidence to suggest that a recognizable correlation exists between vasoconstrictor potency and
therapeutic efficacy in man.
Iodoquinol has both antifungal and antibacterial properties.
Pharmacokinetics: The extent of percutaneous absorption of topical corticosteroids is determined
by many factors including vehicle, the integrity of the epidermal barrier, and the use of occlusive dressings.
Hydrocortisone can be absorbed from normal intact skin. Inflammation and/or other inflammatory disease
processes in the skin increase percutaneous absorption. Occlusive dressings substantially increase the
percutaneous absorption of topical corticosteroids.
Once absorbed through the skin, hydrocortisone is metabolized in the liver and most body tissues to
hydrogenated and degraded forms such as tetrahydrocortisone and tetrahydrocortisol. These are excreted
in the urine, mainly conjugated as glucuronides, together with a very small proportion of unchanged
hydrocortisone.
There are no data available regarding the percutaneous absorption of iodoquinol; however, following oral
administration, 3-5% of the dose was recovered in the urine as a glucuronide.
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INDICATIONS
AND USAGE
Based on a review of a related drug by the National
Research Council and subsequent FDA classification for that drug, the indications are as follows: “Possibly” Effective: Contact or atopic dermatitis; impetiginized eczema; nummular eczema; infantile
eczema; endogenous chronic infectious dermatitis; stasis dermatitis; pyoderma; nuchal eczema and
chronic eczematoid otitis externa; acne urticata; localized or disseminated neurodermatitis; lichen
simplex chronicus; anogenital pruritus (vulvae, scroti, ani); folliculitis, bacterial dermatoses;
mycotic dermatoses such as tinea (capitis, cruris, corporis, pedis); moniliasis, intertrigo. Final
classification of the less-than-effective indications requires further investigation. |
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CONTRAINDICATIONS
Vytone Cream is contraindicated in those patients with a history
of hypersensitivity to hydrocortisone, iodoquinol or any other components of the preparation.
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WARNINGS AND PRECAUTIONS
For external use only. Keep away from eyes. If irritation develops,
the use of Vytone Cream should be discontinued and appropriate therapy instituted. Staining of the skin and
fabrics may occur. If extensive areas are treated or if the occlusive technique is used, the possibility exists
of increased systemic absorption of the corticosteroid, and suitable precautions should be taken. Children may
absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity.
Parents of pediatric patients should be advised not to use tight-fitting diapers or plastic pants on a child being
treated in the diaper area, as these garments may constitute occlusive dressings. Iodoquinol may be absorbed through
the skin and interfere with thyroid function tests. If such tests are contemplated, wait at least one month after
discontinuance of therapy to perform these tests. The ferric chloride test for phenylketonuria (PKU) can yield a
false positive result if iodoquinol is present in the diaper or urine.
Prolonged use may result in overgrowth of non-susceptible organisms requiring appropriate therapy. Keep out of
reach of children.
Carcinogenesis, Mutagenesis and Impairment of Fertility: Long term animal studies have not been performed to
evaluate the carcinogenic potential or the effect on fertility of hydrocortisone or iodoquinol.
In vitro studies to determine mutagenicity with hydrocortisone have revealed negative results. Mutagenicity
studies have not been conducted with iodoquinol.
Pregnancy Category C: Animal reproductive studies have not been conducted with Vytone Cream.
It is not known whether Vytone Cream can cause fetal harm when administered to a pregnant woman or
can affect reproductive capacity. Vytone Cream should be given to a pregnant woman only if clearly needed.
Nursing Mothers: It is not known whether this drug is excreted in human milk. Because many drugs
are excreted in human milk, caution should be exercised when Vytone Cream is administered to a nursing woman.
Pediatric Use: Safety and effectiveness in pediatric patients under the age of 12 have not been established.
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ADVERSE
REACTIONS
The following local adverse reactions are reported infrequently
with topical corticosteroids. These reactions are listed in an approximate decreasing order of occurrence:
| |
Burning
Itching
Irritation
Dryness
Folliculitis
Hypertrichosis
Acneiform eruptions
Hypopigmentation
Perioral dermatitis |
Allergic contact dermatitis
Maceration of the skin
Secondary infection
Skin atrophy
Striae
Miliaria |
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DOSAGE
AND ADMINISTRATION
Apply to affected area 3 to 4 times daily in accordance with physician's directions.
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HOW
SUPPLIED
1% –Tube 1 oz NDC 0066-0051-01
Store at room temperature. Keep tightly closed.
Prescribing Information as of September 2006.
Rx ONLY
Manufuactured for:
Dermik Laboratories
a business of sanofi-aventis U.S. LLC
Bridgewater, NJ 08807
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DESCRIPTION |
CLINICAL PHARMACOLOGY
INDICATIONS AND USAGE |
CONTRAINDICATIONS
WARNINGS AND PRECAUTIONS
ADVERSE REACTIONS
DOSAGE AND ADMINISTRATION |
HOW SUPPLIED
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