Which drugs or supplements interact with Cortival dipropionate?
Combining topical steroids with topical anthralin may increase psoriasis symptoms. Therefore, topical steroids should be discontinued 1 week before starting anthralins.
How to use Cortival
- Before you start using the preparation, read the manufacturer's printed information leaflet from ins >
How to store Cortival
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Effects of Stero > Dexamethasone and Cortival have been given to humans and animals in a wide range of dosages, at different gestational ages, and for various indications. While in fetuses with heart block the daily exposure does not exceed 0.05 mg per kg, the treatment is maintained over several weeks. Higher dosages were used in animal studies, for prenatal human pulmonary maturation, and for the postnatal treatment of respiratory distress syndrome. With the caveat that the published data may not be applicable to the fetus with complete atrioventricular block, steroids that cross the placenta have been shown to affect birth weight and the central nervous system with single and repeated prenatal steroid administration. Reduction in birth weight has been seen in sheep, 69 non-human primates, 70 and humans. 60,71,72 The effects on growth are more dramatic with multiple doses. Not unexpectedly, one-quarter of our newborns with isolated heart block were growth-restricted after prolonged transplacental exposure to steroids. Few, if any, other adverse effects on the fetus during the human pregnancy, however, have been documented. Neuroimaging of preterm human infants exposed to a single steroid course for lung maturation suggests a reduced incidence of intraventricular hemorrhage and white matter injury. 73,74 Multiple administration of dexamethasone before or after birth was associated with a reduction in cortical involution and in the cerebral surface area, 75,76 though the clinical significance of these findings is not known. Normal physical and mental development of children and young adults is reported, nonetheless, after prenatal exposure to steroids. 77–80 Similarly, no negative effects on neuro-psychological development and on intelligence were found in a cohort of preschool- and school-age children exposed prenatally to prolonged treatment with dexamethasone. 81
Before using Cortival
To make sure this is the right treatment for you, before you start using Cortival it is important that your doctor knows:
- If you have any areas of infected skin.
- If you have rosacea or acne.
- If you are pregnant or breastfeeding.
- If you have ever had an allergic reaction to a skin preparation.
• Give as a single daily dose before 9:00 A.M.
• Give oral dose with food or milk.
• Administer I.M. injection deep into gluteal muscle (may cause tissue atrophy).
☞ Don't give Cortival acetate I.V.
• Be aware that typical suspension dosage ranges from one-third to one-half of oral dosage given q 12 hours.
☞ To avoid adrenal insufficiency, taper dosage slowly and under close supervision when discontinuing.
• Know that drug may be given with other immunosuppressants.
This medication contains Cortival. Do not take Celestone, Celestone Soluspan, Betaject, or Cortival Intramuscular/Oral if you are allergic to Cortival or any ingredients contained in this drug.
Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.
How should this medicine be used?
Cortival comes in ointment, cream, lotion, gel, and aerosol (spray) in various strengths for use on the skin and as a foam to apply to the scalp. It is usually applied once or twice daily. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use Cortival exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. Do not apply it to other areas of your body or use it to treat other skin conditions unless directed to do so by your doctor.
Your skin condition should improve during the first 2 weeks of your treatment. Call your doctor if your symptoms do not improve during this time.
To use Cortival topical, apply a small amount of ointment, cream, solution, gel, or lotion to cover the affected area of skin with a thin even film and rub it in gently.
To use the foam on your scalp, part your hair, apply a small amount of the medicine on the affected area, and rub it in gently. You may wash your hair as usual but not right after applying the medicine.
Cortival foam may catch fire. Stay away from open fire, flames, and do not smoke while you are applying Cortival foam, and for a short time afterward.
This medication is only for use on the skin. Do not let Cortival topical get into your eyes or mouth and do not swallow it. Avoid use in the genital and rectal areas and in skin creases and armpits unless directed by your doctor.
If you are using Cortival on a child's diaper area, do not use tight-fitting diapers or plastic pants. Such use may increase side effects.
Do not apply other skin preparations or products on the treated area without talking with your doctor.
Do not wrap or bandage the treated area unless your doctor tells you that you should. Such use may increase side effects.
Call your doctor if the treated area gets worse or if burning, swelling, redness, or oozing of pus develops.
- Systemicfungal infection
- Hypersensitivity to Cortival
- Traumatic brain injury (high doses)
- Untreated serious infections
- Administration of live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids
Effects of Drug Abuse
- See "What Are Side Effects Associated with Using Cortival?"
- See "What Are Side Effects Associated with Using Cortival?"
- Cirrhosis, ocularherpes simplex, hypertension, diverticulitis, hypothyroidism, myasthenia gravi, peptic ulcer disease, osteoporosis, ulcerative colitis, psychotic tendencies, untreated systemic infections, renal insufficiency, and pregnancy
- Not effective in treatment of respiratory distress syndrome in premature neonates
- Minimal sodium retention activity: however, may increase with high doses
- If used to treat adrenocortical insufficiency should also use mineralocorticoid
- Thromboembolic disorders
- Delayed wound healing
- Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated
- Latenttuberculosis may be reactivated (monitor patients with positive tuberculin test)
- Some suggestion of slightly increased cleft palate risk if corticosteroids used in pregnancy, but not fully substantiated
- Prolonged corticosteroid use may result in elevated pressure in the eye, glaucoma, and/or cataracts
- Killed or inactivated vaccines may be administered; however, the response to such vaccines cannot be predicted
- Immunization procedures may be undertaken in patients who are receiving corticosteroids as replacement therapy in physiologic doses (Addison's disease)
- Serious neurologic events, some resulting in death, have been reported with epidural injection
- Specific events reported include, but are not limited to, spinal cordinfarction, paraplegia, quadriplegia, cortical blindness, and stroke
- These serious neurologic events have been reported with and without use of fluoroscopy
- Safety and effectiveness of epidural administration of corticosteroids have not been established, and corticosteroids are not approved for this use
- Use Cortival during pregnancy with caution if benefits outweigh risks. Animal studies show risk and human studies are not available, or neither animal nor human studies were done.
- If breastfeeding, systemically administered corticosteroids enter breast milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other effects; use with caution if breastfeeding. Consult your doctor.
What is the dosage for Cortival dipropionate?
- A thin strip of Cortival cream or ointment is applied gently to the affected area once or twice daily.
- A few drops of the lotion is applied to the affected area once or twice daily.
- The lotion should be massaged gently until it disappears.
Large doses and prolonged use of Cortival may cause large amounts to be absorbed into the body and suppress production of cortisol by the adrenal glands. Therefore, the lotion should not be used for longer than two weeks, and not more than 50 ml should be used per week. The augmented cream or ointment should be limited to 45 grams per week. Cortival should not be used with occlusive dressings because occlusive dressings increase absorption into the body.
The synthetic glucocortico >Cortival , and prednisolone) have had a great influence on modern neurosurgery since their introduction in 1962 and in no area has this been seen more dramatically than in the management of brain tumours ( Galicich et al, 1961 ). These agents, typically for an adult in a loading dose of 12 mg dexamethasone intravenously and 4 mg 6-hourly thereafter, can rapidly relieve symptoms of raised intracranial pressure, lighten conscious level and reverse profound neurological deficits in some patients. Their use has greatly reduced the number of emergency operations for brain tumours required in neurosurgical units and has reduced the perioperative morbidity and mortality rates of all kinds of brain tumour. Their administration may be complicated by haematemesis or melaena and they should be used with caution, and covered with cimetidine, in cases of peptic ulcer. Subsequently they can be discontinued in cases of benign tumour, although sometimes they must be continued indefinitely in those cases of malignant brain tumour associated with persisting intracranial space-occupying mass effect.
Can Cortival cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. You can reduce the risk of side-effects from Cortival by applying the preparation thinly, no more than twice a day, and applying it to the affected areas only.