Contents
- 1 Do I need to keep Daktacort in the fridge
- 2 How should Daktacort cream be stored
- 3 Is Daktacort cream being discontinued
- 4 Should hydrocortisone be kept in the fridge
- 5 How long does hydrocortisone last in the fridge
- 6 What are the side effects with Daktacort
- 7 Why do you have to be careful with hydrocortisone cream
- 8 How long does daktarin cream take to work
- 9 Why can you only use Daktacort for 7 days
- 10 Is Daktacort stronger than hydrocortisone
- 11 Is it OK to put medicine in the fridge
- 12 Why are some drugs stored in the fridge
- 13 At what temperature does hydrocortisone degrade
- 14 Why can’t you use hydrocortisone for more than 2 weeks
- 15 What happens if you put hydrocortisone on a fungal infection
- 16 What temperature should hydrocortisone cream be stored at
Do I need to keep Daktacort in the fridge
Daktacort cream and ointment with other medicines – Daktacort cream and ointment are not known to significantly affect other medicines, but if you are using other creams, ointments or lotions then you should leave at least 30 minutes between applying Daktacort and other medicated skin products.
This allows each product time to be absorbed and avoids them mixing or diluting on the skin. If you’re taking warfarin to prevent blood clots, there is a very small risk that miconazole applied to the skin may enhance the effect of the warfarin. Your doctor may want to check your blood-clotting time (INR) while you’re using Daktacort.
Last updated: 18-08-2020
How should Daktacort cream be stored
My Account Area – 1. Name of the medicinal product Daktacort 2% / 1% w/w cream.2. Qualitative and quantitative composition Miconazole nitrate 2% w/w and hydrocortisone 1% w/w. Excipients with known effect Daktacort contains 2 mg/g benzoic acid (E210) 5 g: This medicine contains 10 mg benzoic acid in each tube of 5 g cream which is equivalent to 2 mg/g cream.10 g: This medicine contains 20 mg benzoic acid in each tube of 10 g cream which is equivalent to 2 mg/g cream.15 g: This medicine contains 30 mg benzoic acid in each tube of 15 g cream which is equivalent to 2 mg/g cream.30 g: This medicine contains 60 mg benzoic acid in each tube of 30 g cream which is equivalent to 2 mg/g cream.75 g: This medicine contains 150 mg benzoic acid in each tube of 75 g cream which is equivalent to 2 mg/g cream. Daktacort contains 0.052 mg/g butylated hydroxyanisole (E320). For full list of excipients, see section 6.1.3. Pharmaceutical form White, homogeneous cream.4. Clinical particulars 4.1 Therapeutic indications For the topical treatment of inflamed dermatoses where infection by susceptible organisms and inflammation co-exist, eg intertrigo and infected eczema. Moist or dry eczema or dermatitis including atopic eczema, primary irritant or contact allergic eczema or seborrhoeic eczema including that associated with acne. Intertriginous eczema including inflammatory intertrigo, perianal and genital dermatitis. Organisms which are susceptible to miconazole are dermatophytes and pathogenic yeasts (eg Candida spp.). Also many Gram-positive bacteria including most strains of Streptococcus and Staphylococcus,4.2 Posology and method of administration For topical administration. Apply the cream two or three times a day to the affected area, rubbing in gently until the cream has been absorbed by the skin. The properties of Daktacort indicate it particularly for the initial stages of treatment. Because of its corticosteroid content avoid long-term treatment with Daktacort. Once the inflammatory symptoms have disappeared (after about 7 days), treatment can be continued where necessary with miconazole nitrate 20 mg/g cream or miconazole nitrate 20 mg/g powder. Treatment should be continued without interruption until the lesion has completely disappeared (usually after 2 to 5 weeks). If after about 7 days’ application, no improvement has occurred, cultural isolation of the offending organism should be followed by appropriate local or systemic antimicrobial therapy. The same dosage applies to both adults and children. Elderly Natural thinning of the skin occurs in the elderly, hence corticosteroids should be used sparingly and for short periods of time. Paediatrics In infants and children, caution is advised when Daktacort is applied to extensive surface areas or under occlusive dressings including baby napkins (diapers). In infants, long term continuous topical corticosteroid therapy should be avoided (see Section 4.4).4.3 Contraindications True hypersensitivity to miconazole/miconazole nitrate, other imidazole derivatives, hydrocortisone or to any of the excipients listed in section 6.1. Tubercular or viral infections of the skin or those caused by Gram-negative bacteria.4.4 Special warnings and precautions for use When Daktacort is used by patients taking oral anticoagulants, the anticoagulant effect should be carefully monitored. Severe hypersensitivity reactions, including anaphylaxis and angioedema, have been reported during treatment with Daktacort and with other miconazole topical formulations (see section 4.8). If a reaction suggesting hypersensitivity or irritation should occur, the treatment should be discontinued. Daktacort must not come into contact with the mucosa of the eyes. As with any topical corticosteroid, caution is advised with infants and children when Daktacort is to be applied to extensive surface areas or under occlusive dressings including baby napkins; similarly, application to the face should be avoided. In infants, long term continuous topical corticosteroid therapy should be avoided. Adrenal suppression can occur even without occlusion. Long term continuous or inappropriate use of topical steroids can result in the development of rebound flares after stopping treatment (topical steroid withdrawal syndrome). A severe form of rebound flare can develop which takes the form of a dermatitis with intense redness, stinging and burning that can spread beyond the initial treatment area. It is more likely to occur when delicate skin sites such as the face and flexures are treated. Should there be a recurrence of the condition within days to weeks after successful treatment a withdrawal reaction should be suspected. Reapplication should be with caution and medical advice is recommended in these cases or other treatment options should be considered. Because of its corticosteroid content avoid long-term treatment with Daktacort. Once the inflammatory symptoms have disappeared treatment may be continued with miconazole nitrate 20mg/g cream or powder. (See Section 4.2) Daktacort can damage certain synthetic materials. Therefore, it is recommended to wear cotton underwear if this clothing comes into contact with the affected area. The concurrent use of latex condoms or diaphragms with vaginal anti-infective preparations may decrease the effectiveness of latex contraceptive agents. Therefore Daktacort should not be used concurrently with a latex condom or latex diaphragm. Visual disturbance Visual disturbance may be reported with systemic and topical corticosteroid use. If a patient presents with symptoms such as blurred vision or other visual disturbances, the patient should be considered for referral to an ophthalmologist for evaluation of possible causes which may include cataract, glaucoma or rare diseases such as central serous chorioretinopathy (CSCR) which have been reported after use of systemic and topical corticosteroids. Daktacort cream contains benzoic acid. Benzoic acid may cause local irritation. Benzoic acid may increase jaundice (yellowing of the skin and eyes) in newborn babies (up to 4 weeks old). Daktacort cream contains butylated hydroxanisole, which may cause local skin reactions (e.g. contact dermatitis), or irritation to the eyes and mucous membranes.4.5 Interaction with other medicinal products and other forms of interaction Miconazole administered systemically is known to inhibit CYP3A4/2C9. Due to the limited systemic availability after topical application (see Section 5.2 Pharmacokinetic properties), clinically relevant interactions are rare. However, in patients on oral anticoagulants, such as warfarin, caution should be exercised and anticoagulant effect should be monitored. Miconazole is a CYP3A4 inhibitor that can decrease the rate of metabolism of hydrocortisone. Serum concentrations of hydrocortisone may be higher with the use of Daktacort compared with topical preparations containing hydrocortisone alone.4.6 Fertility, pregnancy and lactation Pregnancy Clinical data on the use of Daktacort Cream in pregnancy are limited. In animals, corticosteroids are known to cross the placenta and consequently can affect the foetus (see Section 5.3). Administration of corticosteroids to pregnant animals can cause abnormalities of foetal development. The relevance of these findings to humans has not been established. As a precautionary measure, it is preferable to avoid the use of Daktacort during pregnancy. Treatment of large surfaces and the application under occlusive dressing is not recommended. Breastfeeding There are no adequate and well-controlled studies on the topical administration of Daktacort Cream during breastfeeding. It is not known whether concomitant topical administration of Daktacort Cream to the skin could result in sufficient systemic absorption to produce detectable quantities of hydrocortisone and miconazole in breast milk in humans. A risk to the newborn child cannot be excluded. A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from Daktacort therapy taking into account the benefit of breast feeding for the child and the benefit of therapy for the woman. Treatment of large surfaces and the application under occlusive dressing is not recommended.4.7 Effects on ability to drive and use machines None known.4.8 Undesirable effects The safety of Daktacort Cream was evaluated in 480 patients who participated in 13 clinical trials (six double-blind and seven open-label trials) of Daktacort Cream. These studies examined patients from 1 month to 95 years of age with infections of the skin caused by dermatophytes or Candida species in which inflammatory symptoms were prominent. All Patients No adverse reactions were reported by ≥1% of the 480 Daktacort Cream-treated patients (adult and paediatric patients combined). The frequency categories use the following convention: very common (>1/10); common (>1/100 to 1/1,000 to 1/10,000 to <1/1,000); very rare (<1/10,000); and not known (cannot be estimated from the available clinical trial data). Of the three adverse reactions identified from the 13 clinical trials of Daktacort Cream, skin irritation was reported in one clinical trial that included patients aged 17 to 84 years, skin burning sensation in two clinical trials that included patients aged 13 to 84 years, and irritability in one clinical trial of infants aged 1 to 34 months. Paediatric Population The safety of Daktacort Cream was evaluated in 63 paediatric patients (1 month to 14 years of age) who were treated with Daktacort Cream in 3 of the 13 clinical trials noted above. One adverse reaction term (irritability) was reported in these 3 trials. The frequency of irritability in Daktacort Cream-treated paediatric patients was common (3.2%). All events of irritability occurred in one clinical trial of infants (aged 1 to 34 months) with napkin (diaper) dermatitis. The frequency, type, and severity of other adverse reactions in paediatric patients are expected to be similar to those in adults. Adverse reactions were reported by ≥1% of the 480 Daktacort Cream-treated patients (adult and paediatric patients combined). Adverse Reactions in Adult and Paediatric Patients Treated With Daktacort Cream
System Organ Class | Adverse reactions | |
Frequency Category | ||
Uncommon (≥1/1,000 to <1/100) | Not Known | |
Immune System Disorders | Anaphylactic reaction, Hypersensitivity | |
Skin and Subcutaneous Tissue Disorders | Skin irritation, Skin burning sensation, Urticaria, Pruritus | Angioedema, Rash, Contact dermatitis, Erythema, Skin inflammation, Skin hypopigmentation, Application site reaction, Withdrawal reactions a (see section 4.4) |
General Disorders and Administration Site Conditions | Irritability | |
Eye disorders | Vision, blurred (see also section 4.4) |
a Redness of the skin which may extend to areas beyond the initial affected area, burning or stinging sensation, itch, skin peeling, oozing pustules. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.
- It allows continued monitoring of the benefit/risk balance of the medicinal product.
- Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.4.9 Overdose Prolonged and excessive use can result in skin irritation, which usually disappears after discontinuation of therapy.
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.5. Pharmacological properties 5.1 Pharmacodynamic properties Pharmacotherapeutic group: Imidazole and triazole derivatives, combinations, ATC code: D01AC20.
Miconazole nitrate is active against dermatophytes and pathogenic yeasts, and many Gram-positive bacteria. Hydrocortisone is an anti-inflammatory steroid. Its anti-inflammatory action is due to reduction in the vascular component of the inflammatory response, suppression of migration of polymorphonuclear leukocytes, and reversal of increased capillary permeability.
The vasoconstrictor action of hydrocortisone may also contribute to its anti-inflammatory activity.5.2 Pharmacokinetic properties Absorption Miconazole remains in the skin after topical application for up to 4 days. Systemic absorption of miconazole is limited, with a bioavailability of less than 1% following topical application of miconazole.
Plasma concentrations of miconazole and/or its metabolites were measurable 24 and 48 hours after application. Approximately 3% of the dose of hydrocortisone is absorbed after application on the skin. Distribution Absorbed miconazole is bound to plasma proteins (88.2%) and red blood cells (10.6%). More than 90% of hydrocortisone is bound to plasma proteins.
Metabolism and elimination The small amount of miconazole that is absorbed is eliminated predominantly in faeces as both unchanged drug and metabolites over a four-day post-administration period. Smaller amounts of unchanged drug and metabolites also appear in urine.
The half-life of hydrocortisone is about 100 minutes. Metabolism takes place in the liver and tissues and the metabolites are excreted with the urine, mostly as glucuronides, together with a very small fraction of unchanged hydrocortisone.5.3 Preclinical safety data Preclinical data on the drug product (miconazole nitrate + hydrocortisone) revealed no special hazard for humans based on conventional studies of ocular irritation, dermal sensitization, single dose oral toxicity, primary dermal irritation toxicity, and 21-day repeat dose dermal toxicity.
Additional preclinical data on the individual active ingredients in this drug product reveal no special hazard for humans based on conventional studies of local irritation, single and repeated dose toxicity, genotoxicity, and for miconazole toxicity to reproduction.
- Miconazole has shown no teratogenic effects but is fetotoxic at high oral doses.
- Reproductive effects (fetotoxicty, reduced weight gain) and developmental abnormalities specifically craniofacial effects including cleft palate have been reported with hydrocortisone in various animal models.6.
- Pharmaceutical particulars 6.1 List of excipients PEG-6, PEG-32 and glycol stearate Oleoyl macroglycerides Liquid paraffin Benzoic acid (E210) Disodium edetate Butylated hydroxyanisole (E320) Purified water 6.2 Incompatibilities Contact should be avoided between latex products such as contraceptive diaphragms or condoms and Daktacort since the constituents of Daktacort may damage the latex.6.3 Shelf life 36 months.6.4 Special precautions for storage Store in a refrigerator (2-8°C).6.5 Nature and contents of container Aluminium tube with polypropylene cap.
Each tube contains 5 g, 10 g, 15 g, 30 g or 75 g cream.6.6 Special precautions for disposal and other handling None.7. Marketing authorisation holder Janssen-Cilag Ltd 50-100 Holmers Farm Way High Wycombe Buckinghamshire HP12 4 EG UK 8. Marketing authorisation number(s) PL 00242/0042 9.
Is Daktacort cream being discontinued
Janssen has taken the decision to discontinue Daktacort 2% / 1% w/w ointment in December 2022.
Should hydrocortisone be kept in the fridge
You can use hydrocortisone for more than 7 days but no longer than 4 weeks. STOP using hydrocortisone when your symptoms stop. Can be stored in the fridge.
Can you use Daktacort longer than 7 days?
My Account Area – 1. Name of the medicinal product Daktacort Hydrocortisone Cream 2. Qualitative and quantitative composition Miconazole nitrate 2% w/w; Hydrocortisone acetate equivalent to hydrocortisone 1% w/w. Excipients with known effect: 2 mg/g of benzoic acid (E210) 0.052 mg/g of butylhydroxyanisole (E320). For the full list of excipients see section 6.1 3. Pharmaceutical form Cream. White, homogeneous, odourless cream 4. Clinical particulars 4.1 Therapeutic indications Athlete’s foot and candidal intertrigo where there are co-existing symptoms of inflammation. Organisms which are susceptible to miconazole are dermatophytes and pathogenic yeasts (e.g., Candida spp.). Also many Gram-positive bacteria including most strains of Streptococcus and Staphylococcus, The properties of Daktacort Hydrocortisone Cream indicate it particularly for the initial stages of treatment. Once the inflammatory symptoms have disappeared, treatment can be continued with Daktarin cream or Daktarin powder.4.2 Posology and method of administration For topical administration Apply the cream twice a day to the affected area, rubbing in gently until the cream has been absorbed by the skin. The maximum period of treatment is 7 days. Elderly Natural thinning of the skin occurs in the elderly, hence corticosteroids should be used sparingly and for short periods of time.4.3 Contraindications Known hypersensitivity to miconazole or other imidazole derivatives, hydrocortisone or to any of the excipients listed in section 6.1. Tubercular or viral infections of the skin or those caused by Gram-negative bacteria. Daktacort Hydrocortisone Cream should not be used in the following conditions: • If the skin is broken • On large areas of skin • Used for longer than 7 days • To treat cold sores and acne • Use on the face, eyes and mucous membranes • Children under 10 years of age, unless prescribed by a doctor • On the ano-genital region unless prescribed by a doctor • To treat ringworm unless prescribed by a doctor • To treat secondary infected conditions unless prescribed by a doctor 4.4 Special warnings and precautions for use When Daktacort Hydrocortisone Cream is used by patients taking oral anticoagulants, the anticoagulant effect should be carefully monitored. Severe hypersensitivity reactions, including anaphylaxis and angioedema, have been reported during treatment with Daktacort Hydrocortisone Cream and other miconazole topical formulations (See Adverse reactions). If a reaction suggesting hypersensitivity or irritation should occur, the treatment should be discontinued. Daktacort Hydrocortisone Cream must not come into contact with the mucosa of the eyes. Visual disturbance may be reported with systemic and topical corticosteroid use. If a patient presents with symptoms such as blurred vision or other visual disturbances, the patient should be considered for referral to an ophthalmologist for evaluation of possible causes which may include cataract, glaucoma or rare diseases such as central serous chorioretinopathy (CSCR) which have been reported after use of systemic and topical corticosteroids. As with any topical corticosteroid, caution is advised when Daktacort Hydrocortisone Cream is to be applied to extensive surface areas or under occlusive dressings including baby napkins; similarly application to the face should be avoided. Long term continuous topical corticosteroid therapy should be avoided. Adrenal suppression can occur even without occlusion. Once the inflammatory conditions have disappeared treatment may be continued with Daktarin Cream or Daktarin powder (see section 4.1). Contact should be avoided between latex products such as contraceptive diaphragms or condoms and Daktacort Hydrocortisone Cream since the constituents of Daktacort Hydrocortisone Cream may damage the latex. Daktacort Hydrocortisone Cream can damage certain synthetic materials. Therefore, it is recommended to wear cotton underwear if this clothing comes into contact with the affected area. This medicine contains 2 mg/g of Benzoic acid (E210) which may cause local irritation. This medicine also contains 0.052 mg/g of Butylhydroxyanisole (E320) which may cause local skin reactions (e.g., contact dermatitis), or irritation to the eyes and mucous membranes.4.5 Interaction with other medicinal products and other forms of interaction Miconazole administered systemically is known to inhibit CYP3A4/2C9. Due to the limited systemic availability after topical application, clinically relevant interactions are rare. However, in patients on oral anticoagulants, such as warfarin, caution should be exercised and anticoagulant effect should be monitored. Miconazole is a CYP3A4 inhibitor that can decrease the rate of metabolism of hydrocortisone. Serum concentrations of hydrocortisone may be higher with the use of Daktacort Hydrocortisone Cream compared with topical preparations containing hydrocortisone alone.4.6 Fertility, pregnancy and lactation Pregnancy Clinical data on the use of Daktacort Hydrocortisone Cream in pregnancy are limited. Corticosteroids are known to cross the placenta and consequently can affect the foetus (See Section 5.3). Administration of corticosteroids to pregnant animals can cause abnormalities of foetal development. The relevance of these findings to humans has not been established. As a precautionary measure, it is preferable to avoid the use of Daktacort Hydrocortisone during pregnancy. Treatment of large surfaces and the application under occlusive dressing should be avoided during that time. Breastfeeding There are no adequate and well-controlled studies on the topical administration of Daktacort Hydrocortisone Cream during lactation. It is not known whether concomitant topical administration of Daktacort Hydrocortisone Cream to the skin could result in sufficient systemic absorption to produce detectable quantities of hydrocortisone and miconazole in breast milk in humans. Caution is recommended during breast-feeding. Treatment of large surfaces and the application under occlusive dressing should be avoided during that time. A risk to the newborn child cannot be excluded.4.7 Effects on ability to drive and use machines This medicine has no influence on the ability to drive and use machines.4.8 Undesirable effects The safety of Daktacort Hydrocortisone Cream was evaluated in 480 patients who participated in 13 clinical trials (six double-blind and seven open-label trials) of Daktacort Hydrocortisone Cream. These studies examined patients from 1 month to 95 years of age with infections of the skin caused by dermatophytes or Candida species in which inflammatory symptoms were prominent. All patients No adverse drug reactions (ADRs) were reported by ≥ 1% of the 480 Daktacort Hydrocortisone Cream-treated patients (adult and paediatric patients combined). The frequency categories use the following convention: very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to < 1/1,000); very rare (<1/10,000) and not known (cannot be estimated from the available clinical trial data). Of the three ADR's identified from the 13 clinical trials of Daktacort Hydrocortisone Cream, skin irritation was reported in one clinical trial that included patients aged 17 to 84 years, skin burning sensation in two clinical trials that included patients aged 13 to 84 years, and irritability in one clinical trial of infants aged 1 to 34 months. Paediatric population The safety of Daktacort Hydrocortisone Cream was evaluated in 63 paediatric patients (1 month to 14 years of age) who were treated with Daktacort Hydrocortisone Cream in 3 of the 13 clinical trials noted above. One ADR term (irritability) was reported in these 3 trials. The frequency of irritability in Daktacort Hydrocortisone Cream-treated paediatric patients was common (3.2%). All events of irritability occurred in one clinical trial of infants (aged 1 to 34 months) with napkin dermatitis. The frequency, type and severity of other ADRs in paediatric patients are expected to be similar to those in adults. Table 1: Adverse Drug Reactions in Adult and Paediatric Patients Treated with Daktacort Hydrocortisone Cream
System Organ Class | Adverse Drug Reactions | |
Frequency Category | ||
Uncommon (≥1/1,000 to <1/100) | Not known | |
Immune System Disorders | Anaphylactic reaction, Hypersensitivity | |
Eye disorders | Vision, blurred (see also section 4.4) | |
Skin and Subcutaneous Tissue Disorders | Skin irritation, Skin burning sensation. Urticaria, Pruritis | Angioedema, Rash, Contact dermatitis, Erythema, Skin inflammation, Skin hypopigmentation, Application site reaction |
General Disorders and Administration Site Conditions | Irritability |
Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store 4.9 Overdose Prolonged and excessive use can result in skin irritation, which usually disappears after discontinuation of therapy.
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.5. Pharmacological properties 5.1 Pharmacodynamic properties Pharmacotherapeutic group: Imidazole and triazole derivatives, combinations, ATC code: D01AC20. Miconazole nitrate is active against dermatophytes and pathogenic yeasts and many Gram-positive bacteria.
The clinical efficacy of miconazole has been demonstrated against dermatophytes, Candida spp., Aspergillus spp., dimorphous fungi, Cryptococcus neoformans, Malassezia spp. and Torulopsis glab rata. Miconazole also has an antibacterial activity against some gram-positive bacilli and cocci.
- Hydrocortisone is an anti-inflammatory steroid.
- Its anti-inflammatory action is due to reduction in the vascular component of the inflammatory response, suppression of migration of polymorphonuclear leukocytes, and reversal of increased capillary permeability.
- The vasoconstrictor action of hydrocortisone may also contribute to its anti-inflammatory activity.5.2 Pharmacokinetic properties Absorption Miconazole remains in the skin after topical application for up to 4 days.
Systemic absorption of miconazole is limited, with a bioavailability of less than 1% following topical application of miconazole. Plasma concentrations of miconazole and/or its metabolites were measurable 24 and 48 hours after application. Approximately 3% of the dose of hydrocortisone is absorbed after application on the skin.
- Distribution Absorbed miconazole is bound to plasma proteins (88.2%) and red blood cells (10.6%).
- More than 90% of hydrocortisone is bound to plasma proteins.
- Metabolism and elimination The small amount of miconazole that is absorbed is eliminated predominantly in faeces as both unchanged drug and metabolites over a four-day post-administration period.
Smaller amounts of unchanged drug and metabolites also appear in urine. The half-life of hydrocortisone is about 100 minutes. Metabolism takes place in the liver and tissues and the metabolites are excreted with the urine, mostly as glucuronides, together with a very small fraction of unchanged hydrocortisone.5.3 Preclinical safety data Preclinical data on the drug product (miconazole nitrate + hydrocortisone) revealed no special hazard for humans based on conventional studies of ocular irritation, dermal sensitisation, single dose oral toxicity, primary dermal irritation toxicity, and 21-day repeat dose dermal toxicity.
Additional preclinical data on the individual active ingredients in this drug product reveal no special hazard for humans based on conventional studies of local irritation, single and repeated dose toxicity, genotoxicity, and for miconazole toxicity to reproduction. Miconazole has shown no teratogenic effects but is foetotoxic at high oral doses.
Reproductive effects (foetotoxicity, reduced weight gain) and developmental abnormalities, specifically craniofacial effects including cleft palate have been reported with hydrocortisone in various animal models.6. Pharmaceutical particulars 6.1 List of excipients Macrogol 6-32 stearate and glycol stearate Oleoyl macrogolglycerides Liquid paraffin Butylhydroxyanisole (E320) Benzoic acid (E210) Disodium edetate Sodium hydroxide solution Purified water 6.2 Incompatibilities Contact should be avoided between latex products such as contraceptive diaphragms or condoms and Daktacort Hydrocortisone cream since the constituents of Daktacort may damage the latex.6.3 Shelf life 2 years 6.4 Special precautions for storage None 6.5 Nature and contents of container Tube formed from aluminium/PE laminate with a polypropylene screw cap.
Each tube contains 15g cream.6.6 Special precautions for disposal and other handling No special requirements for disposal. Any unused medicinal product or waste material should be disposed of in accordance with local requirements.7. Marketing authorisation holder McNeil Products Limited 50 -100 Holmers Farm Way High Wycombe Buckinghamshire HP12 4EG UK 8.
Marketing authorisation number(s) PL 15513/0303 9. Date of first authorisation/renewal of the authorisation 24 August 2001/27 February 2009 10. Date of revision of the text 13 November 2020.
What temperature should hydrocortisone cream be stored at?
Store at 20°-25°C (68°-77°F).
Which is better daktarin or Daktacort?
Are Daktarin and Daktacort the same? – Daktacort is different to Daktarin. Though they both contain the active ingredient ‘miconazole’, Daktacort also contains ‘hydrocortisone’, a mild, topical steroid. The addition of this ingredient allows Daktacort to also treat more severe skin irritation and swelling.
How long does hydrocortisone last in the fridge
CONCLUSIONS: The hydrocortisone succinate preservative-free oral solutions at pH 5.5, 6.5, or 7.4 are chemically stable when stored under refrigeration for at least 14 days. They provide flexible and convenient dosage forms without any preservatives for pediatric patients.
What are the side effects with Daktacort
Daktacort Side Effects – The use of Daktacort can affect people in different ways and like any medication, it can bring with it a number of side effects. These include skin irritation, itching, rashes, burning and stinging. Other possible side effect includes thinning of the skin, acne, increased hair growth, stretch marks and a decrease in skin pigmentation.
Why do you have to be careful with hydrocortisone cream
8. Common questions about hydrocortisone skin treatments – How does hydrocortisone work? Hydrocortisone is a steroid (also called a corticosteroid). Steroids help to reduce swelling (inflammation) in the skin (and other parts of the body). Skin gets inflamed when an allergic reaction or irritation causes chemicals to be released in the skin.
These make blood vessels widen and the irritated skin becomes red, swollen, itchy and painful. Hydrocortisone skin treatments work on your skin’s cells to stop these chemicals being released. This reduces symptoms like swelling, redness and itching. When will my skin get better? Your skin should start to get better after using hydrocortisone for a few days.
If you’re using a treatment you’ve bought from a pharmacy or shop, speak to your doctor if you still have symptoms after 1 week, or if your skin gets worse at any time. How long will I use hydrocortisone skin treatments for? How long you use it for depends on why you’re using it.
- For insect bites and stings, nappy rash or contact dermatitis you’ll probably only need to use hydrocortisone for up to 1 week.
- For long-term skin problems such as eczema and psoriasis you may need to use hydrocortisone for longer.
- To reduce the risk of side effects your doctor may recommend that you only use hydrocortisone for a few weeks at a time.
Once your skin is better, use moisturisers to keep it from becoming inflamed again. Can I use hydrocortisone skin treatments on my face? Do not use a hydrocortisone on your face unless a doctor has told you to and given you a prescription for it. The skin on your face is delicate, so if hydrocortisone damages it, it’s particularly noticeable.
- Some common skin problems that affect the face, such as impetigo, rosacea and acne, can be made worse by hydrocortisone.
- If your doctor has prescribed hydrocortisone for your face, follow their instructions carefully.
- Do not put hydrocortisone near your eyes or on your eyelids.
- Is it safe to use for a long time? Using hydrocortisone for a long time without stopping can mean some of the medicine gets into your blood.
If this happens, there’s a very small chance it can cause serious side effects, such as adrenal gland problems, high blood sugar (hyperglycaemia), or problems with your eyesight. If you have been using hydrocortisone for a long time, your doctor may tell you to gradually reduce the amount you use before stopping completely.
- Can I drink alcohol with it? Yes, you can drink alcohol while using hydrocortisone.
- Is there any food or drink I need to avoid? No, you can eat and drink normally while using hydrocortisone.
- Can I still have vaccinations? Using hydrocortisone cream does not stop you or your child having vaccinations.
- But tell the doctor or nurse that you’re using hydrocortisone cream so they can give the vaccine in an untreated area of skin.
Will it affect my fertility? There’s no clear evidence that hydrocortisone skin treatments affect male or female fertility. Can I drive or ride a bike? Hydrocortisone does not make you sleepy, so it’s safe to drive, ride a bike, or use tools and machinery when using this medicine.
How long does daktarin cream take to work
How long does Daktarin Cream take to work? – The length of treatment when using Daktarin cream can vary and depends on the type and severity of the infection. Some patients experience an improvement within a few days of starting treatment, while for others, it can take up to 6 weeks.
Why can you only use Daktacort for 7 days
Side effects of Daktacort Hydrocortisone – Side effects are rare when Daktacort Hydrocortisone cream is used as directed for short-term. Some people using Daktacort Hydrocortisone cream may experience some irritation where the cream is applied, for example burning, stinging, itching, redness, rash, blistering or peeling.
Stop using the cream and consult your doctor or pharmacist if you have a severe reaction to it. If Daktacort Hydrocortisone cream is applied excessively, for long periods of time, underneath dressings, to broken or raw skin, large areas of skin, or areas of skin that rub together, it has the potential to cause some of the side effects associated with topical steroids, such as skin thinning, stretch marks or hair growth, although these are still very rare with this mild steroid.
If you experience any changes in your vision while using Daktacort Hydrocortisone cream, such as blurred vision, you should tell your doctor.
Is Daktacort stronger than hydrocortisone
A double-blind study comparing Daktacort, miconazole and hydrocortisone in inflammatory skin infections – PubMed Clipboard, Search History, and several other advanced features are temporarily unavailable. The,gov means it’s official. Federal government websites often end in,gov or,mil. Before sharing sensitive information, make sure you’re on a federal government site. The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Display options Format Abstract PubMed PMID In a 4-week double-blind trial, Daktacort cream was compared with each of its constituents (i.e.
- Miconazole 2% and hydrocortisone 1%) in a total of 63 patients (aged 12-60 years) with inflamed skin infections of bacterial or mycotic origin.
- Daktacort treatment induced a significant improvement of all symptoms within 1 week and was superior to both miconazole and hydrocortisone in suppressing the inflammation.
This tendency persisted throughout the trial but at the end miconazole treatment proved also superior to hydrocortisone.
White I, Blatchford N. White I, et al. Br J Clin Pract.1983 Jun;37(6):215-6, 222. Br J Clin Pract.1983. PMID: 6882651 No abstract available. McVie DH, Cartwright KA, Milne LJ. McVie DH, et al. Br J Clin Pract.1978 Dec;32(12):353-7. Br J Clin Pract.1978. PMID: 737114 No abstract available. Fischman O, Levites J, Grinblat M. Fischman O, et al. Mykosen.1977 Dec;20(12):471-5. Mykosen.1977. PMID: 600303 No abstract available. Havlickova B, Friedrich M. Havlickova B, et al. Mycoses.2008 Sep;51 Suppl 4:16-26. doi: 10.1111/j.1439-0507.2008.01615.x. Mycoses.2008. PMID: 18783560 Review. Williams A, Venables J. Williams A, et al. J Wound Care.1996 May;5(5):223-6. doi: 10.12968/jowc.1996.5.5.223. J Wound Care.1996. PMID: 8850905 Review. No abstract available.
Is Daktacort cream good for yeast infections?
Consultant Gynaecologist Mr Narendra Pisal outlines the common causes of vulval/vaginal itching and irritation:
Vaginal candidiasis (thrush or yeast infection)
The most common cause of vaginal itching, if it is short term, is vaginal candidiasis. This is a common infection and is associated with whitish curd-like discharge and symptoms of itching. This can be easily treated by taking an oral Fluconazole, a 150mg tablet which can be obtained over the counter without a prescription.
Other infections such as Bacterial vaginosis
Bacterial vaginosis is a common infection of the vagina that can occur when the natural balance of the bacteria in the vagina changes, t his can cause intense vaginal irritation and itching. Making a diagnosis isn’t always straightforward and a visit to the GP or gynaecologist may be needed.
Menopausal changes
Lack of oestrogen after menopause can make the vaginal mucosa and vulval skin more prone to breaking and irritation. Local oestrogen cream or pessary can help.
Breastfeeding
Many women aren’t aware that breastfeeding can cause the vaginal mucosa to become more atrophic and prone to dryness and irritation. Using additional lube may help.
Skin conditions
Another common cause of vulval itching is a condition called Lichen Sclerosus, particularly if your symptoms are of longer duration. This is a condition that can be sometimes difficult to control and cure. You will need to see a specialist for an expert opinion and diagnosis. They are likely to prescribe a mild steroid cream, which will control the symptoms.
Allergic reaction
Itching can also be a result of an allergic reaction to either fabric softener, sanitary products or soap products used for washing. You can see if your symptoms are relieved by changing these products or using antihistaminic medication such as Piriton, which again can be obtained without a prescription.
Vulval warts/condylomas
Genital warts can cause itching. These are single or multiple projections with irregular surface caused by low risk strains of human papilloma virus (HPV). Since the HPV vaccination programme started, the incidence of warts has gone down. Warts will often resolve spontaneously but can sometimes need treatment with local cream or cryocauterisation.
Cancerous or precancerous patch
Fortunately this is not common, but it is still possible. If your symptoms are persistent, you should always see a gynaecologist so that an appropriate diagnosis can be made and treatment can be started. Treatment is usually by removing the affected area.
Hygiene
Simple precautions should be followed, such as changing out of gym clothes as soon as possible, using simple moisturising soaps for washing and getting out of the itch-scratch-itch vicious cycle.
Is it OK to put medicine in the fridge
Q: I bought three months’ worth of medicines. Is it advisable to store them in the refrigerator? – A: Proper storage of medicines is crucial to ensure their effectiveness and potency. All medicines must be stored in a cool, dry place, away from sunlight and moisture.
Some medicines require special storage conditions such as in the refrigerator, or even the freezer. Such medicines can expire quickly if they are improperly stored at room temperature, becoming toxic or less effective. Some examples of medicines that require refrigeration are hormone injections used during IVF (in vitro fertilisation), and unopened vials of insulin.
Very few medicines require freezing, but an example would be vaccine injections. Not all medicines need to be refrigerated though. In fact, they may be adversely affected by the fluctuating temperatures of home refrigerators. Another problem is that the medicines may freeze inadvertently, becoming damaged by the solid water crystals that form.
Patients are advised to read the pharmacy labels carefully before storing their medicines at home. Only medicines that carry the instruction “Refrigerate, do not freeze” should be stored in the refrigerator, preferably in the main compartment away from the door or the cooling vent area. If you’re in doubt, speak to your pharmacist.
Ref: R14
Why are some drugs stored in the fridge
Storing medications in the refrigerator: Keep up Introduction Each medicinal product should be stored as recommended by the manufacturer, following stability tests done to the product at different temperatures for certain periods of time. There are medications that have to be kept frozen; others can be stored at room temperature while some need to be stored in the refrigerator.
- This article explains tips on proper storage of medications in the refrigerator, handling of refrigerated medications while travelling, and the importance of complying to temperature requirements during medication storage.
- Tips on Knowing Medications’ Storage Conditions
- How to know the right storage conditions of medications? You can follow these tips:
- Medications’ storage instructions are usually stated on the box or on the original packaging of the medication.
- Medications’ storage instructions can be found in the package insert under the heading “storage”.
- The pharmacist may paste a sticker with storage instructions on the medication container.
- You can ask directly to the pharmacist who dispense the medication.
- Example of storage instructions on a medication packaging
- Medications to be Kept Refrigerated
- If the instructions on the medication packaging says “keep refrigerated” or “store at 2 – 8°C”, it means you have to keep the medication in the refrigerator.
Refrigerators in the pharmacy are equipped with devices that can display the current temperature inside the refrigerator. However, most domestic refrigerators do not display the current temperature. Therefore, the following steps are recommended for storage of medications in a domestic refrigerator:
- Keep medications in the middle of the refrigerator shelves and space them away from other stuffs in the refrigerator.
- Keep medications away from the freezer compartment and away from the air vents to avoid formation of ice crystals that can damage the medications.
- Do not store medications at the refrigerator door because they will be exposed to uneven temperature every time the refrigerator door is opened.
- Please ensure that medications are not easily accessible to children.
These are some examples of refrigerated medications in the pharmacy that need to be kept refrigerated at home:
- Insulin injections (unused)
- Erythropoietin injections (for example: Eprex® and Recormon®)
- Some interferon injections (for example: Pegasys®)
- Filgrastim injections (for example: Neupogen®)
- Eye drops (for example: latanoprost (Xalatan®) and chloramphenicol)
- Ear drops (for example: chloramphenicol)
- Synthetic salmon calcitonin nasal sprays (for example: Miacalcic®)
- Alfacalcidol oral drops (for example: One-Alpha®)
- Ritonavir capsules (for example: Norvir®)
In addition, some medicinal preparations that are compounded or diluted in the healthcare facility also need to be stored in the refrigerator. These preparations usually have shorter expiry dates. Examples are:
- Mixtures such as omeprazole suspension and spironolactone syrup
- Eye drops such as cyclosporin dan sodium chloride 3%
- Ear drops such as sodium bicarbonate 5%
- Antibiotic syrups / suspensions which are compounded from powder such as amoxycillin supension
Medications to be Kept Frozen Medications to be kept frozen means medications that should be stored below freezing temperature of -10 to -20°C. Certain types of vaccines and pessaries should be kept frozen in the healthcare facility and only be placed at room temperature just before use.
- To maintain the medication’s effectiveness. Medications that need to be kept cold will lose their effectiveness when placed outside the recommended temperature range after a certain period of time. The period of stability is dependent on the type of medication and is usually specified in the package insert.
- To maintain the medication’s sterility. Sterile means medications are free from microorganisms such as bacteria. Some medications especially eye drops or ear drops that are compounded at healthcare facilities aseptically (free from germ) and without preservatives should always be kept in cold conditions to slow the growth of bacteria.
- To maintain the physical form of medication. Some medications in suppository form need to be stored in the refrigerator so that they do not melt before use.
Example of insulin in use Not all medications that are stored in the refrigerator in a pharmacy should be kept in the same condition by patients at home. For example, insulin currently in use can be placed at room temperature with stability of up to one month, depending on the type of insulin.
Example of medication that should be stored in the refrigerator after being mixed with water. Tips for Travelling Travelling could take a long time. If you have to travel with refrigerated medications, make sure you have a cool bag and ice packs with you. This is to ensure that the quality of medications are not compromised due to exposure to warm temperatures.
Example of a cool bag used to carry refrigerated medications while travelling A cool bag and ice packs can be purchased at the supermarket or a baby store. You can also make your own ice pack by putting ice cubes in a leak-proof plastic envelop then wrap it with a cloth. Following are tips for travelling with refrigerated medications:
- Keep the medication in a cool bag with ice packs.
- Make sure that the medication does not directly touch the surface of the ice packs so that it does not freeze.
- Put the cool bag in the cabin area of the vehicle.
- If you need to stop and leave your vehicle, bring the cool bag together.
- Store the medication in a refrigerator as soon as you arrive at your destination.
Cold Chain Refrigerated medications are sensitive towards temperature changes and will be damaged if exposed to temperatures beyond the recommended range for a certain period of time. Therefore, the ideal temperature range must be maintained throughout the process of transporting the medications from the factory to the hands of patients.
‘Cold chain’ refers to maintaining the recommended cold temperature of a medication throughout its transportation process. Refrigerated medications that have been exposed to room temperature are different from each other in terms of stability. For example, insulin can last up to one month at room temperature but filgrastim and erythropoietin lose their effectiveness after a few hours.
Therefore, patients are advised to bring a cool bag and ice packs to the pharmacy if they are supplied with refrigerated medications that could not last long. Conclusion Some medications need to be kept in the refrigerator to maintain their effectiveness, sterility or physical form.
- Coleiro, D. (2012). Storage of Medicines and Medical Devices. Diambil daripada http://www.um.edu.mt/_data/assets/pdf_file/0016/153160/Storage_of_Medicines_and_Medical_devices.pdf
- PL Technician Tutorial, Stay Cool: Storing Meds in the Fridge or Freezer. Pharmacist’s Letter/Pharmacy Technician’s Letter. Disember 2012.
- Bahagian Perkhidmatan Farmasi, Kementerian Kesihatan Malaysia. (14 Oktober 2015). Perjalanan Jauh Bersama Ubat Ubatan. Youtube diambil daripada https://youtube.com/watch?v=q-DpJlsc-eI
Last Reviewed | : | 27 October 2017 |
Writer/Translator | : | Zuhailah bt. Mohd Shafawi |
Accreditor | : | Kamariah Shamsinar bt. Kamarul Baharin |
Storing medications in the refrigerator: Keep up
At what temperature does hydrocortisone degrade
Abstract – Background Hydrocortisone in high doses is given to haemodynamicly unstable patients as a vasopressor. Frequently the same patients have volume restriction, and high concentrations of hydrocortisone are necessary. Although there is no certain evidence of the benefits of continuous infusion over bolus injection, continuous infusion is a well-established practice in our hospital.
Manufacturers state that the solution after reconstitution and dilution should be used immediately, however it is not defined how long this infusion can be used after application. There are limited data on the stability of hydrocortisone in concentrations greater than 1 mg/ml. Purpose The aim of our study was to determine the physical and chemical stability of hydrocortisone sodium succinate in two concentrations (1 mg/ml and 4 mg/ml) at room temperature up to 24 hours after reconstitution and dilution.
These are the most frequent circumstances in the wards in our hospital. Material and methods We used duplicate samples of hydrocortisone sodium succinate diluted in 0.9% sodium chloride and 5% glucose to concentrations 1 mg/ml and 4 mg/ml. Samples were stored at room temperature (25°C) and at elevated temperature (30°C).
- Another set of reconstituted and diluted solutions stored at room temperature was protected from light.
- Concentrations were measured by a validated high-performance liquid chromatography (HPLC) method to determine the percentage of degradation after 3, 5, 7, 9, 12, 24 and 48 hours.
- Results Our study demonstrates that hydrocortisone is equally stable at concentrations 1 mg/ml and 4 mg/ml, in both 0.9% sodium chloride and 5% glucose, regardless whether it is protected from light or not.
At room temperature, degradation of hydrocortisone after 12, 24 and 48 hours was 3%, 5% and 10%, respectively. Declines from the initial hydrocortisone concentration in samples stored at 30°C after 3, 5, 12 and 24 hours were 3%, 5%, 9% and 14% respectively.
Why can’t you use hydrocortisone for more than 2 weeks
Applying hydrocortisone cream too often or for a long time (more than 4 weeks) can cause excess absorption into the body. This may lead to more substantial side effects.
What happens if you put hydrocortisone on a fungal infection
An emerging international problem – In the United States, over-the-counter steroid creams are not very powerful, which is why they’re called “low potency.” But in some other countries, people can buy creams containing strong steroids without a prescription.
Many of these steroid creams also contain antifungal and antibacterial medicines, and the labels say that the cream can be used to treat fungal infections. However, healthcare providers in India report seeing more cases of severe ringworm in people who have used these combination medications. These infections have been reported to cover large parts of the body, last for months or longer, and spread to family members.
If you travel internationally, develop a rash, and think it might be ringworm, be aware that strong over-the-counter steroid creams containing combinations of antifungal and antibacterial medicines can make ringworm worse and can cause other health problems.
Is it bad to use steroid cream too long?
Learn the potential side effects of topical corticosteroids used for psoriasis. Question: What are the potential side effects of topical corticosteroids? Answer: Most of the time, topical corticosteroids are used without side effects. They come in a variety of strengths.
Choosing the right strength for the right problem and location on the body helps avoid problems. Side effects can occur, however, usually with overuse. These ordinarily take weeks to months to appear and include skin thinning, stretch marks, easy bruising, dilated blood vessels and, less commonly, increased hair growth.
Using topical steroids on the face may cause a red rash around the mouth or an acne-like rash. Care must be taken when steroids are used around the eyes because glaucoma or cataracts may result. If large doses of stronger steroids are used continuously for long periods, the body can absorb enough of the drug to cause body-wide side effects, including stunted growth, elevated blood sugar levels and osteoporosis.
What temperature should hydrocortisone cream be stored at
Store at 20°-25°C (68°-77°F).
How do you store hydrocortisone cream?
Store in the original package and keep the tube in the outer carton. Do not use Hydrocortisone Cream after the expiry date which is stated on the tube/carton. Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required.
How long can refrigerated medicine be left out?
Drug Product Brand Name (Manufacturer) Acceptable Duration of Storage at Room Temperature Source of Information Abciximab 2-mg/mL injection Reopro (Centocor B.V.) 8 days Manufacturer Allergen extract concentrate NA a (Greer) 28 days Manufacturer Alprostadil injection Prostin VR Pediatric (Silcor) 34 days at 20 °C 26 days at 30 °C Manufacturer Alteplase Cathflo Activase (Genentech) 4 mo Manufacturer Atracurium injection Tracrium (Catalytica Pharmaceuticals) 14 days Prescribing information Becaplermin 0.01% Regranex topical gel (Ortho-McNeil-Janssen) 6 days Manufacturer Botulinum toxin type-A 100 units Botox (Allergan) 5 days Manufacturer Calcitonin injection Miacalcin (Novartis) 14 days Manufacturer Calcitonin nasal spray Miacalcin (Novartis) 35 days Prescribing information Calcitonin salmon intranasal Fortical (Upsher-Smith) 7 days Manufacturer Candida albicans skin test Candin (Allermed Laboratories) 7 days Manufacturer Cisatracurium injection Nimbex (Abbott) 21 days Prescribing information Conjugated estrogens injection Premarin IV (Wyeth) 7 days Manufacturer Dacarbazine for injection DTIC-Dome (Ben Venue Laboratories) 3 mo Manufacturer Daptomycin for injection Cubicin (Cubist Pharmaceuticals) 12 mo Manufacturer Darbepoetin alfa Aranesp (Amgen) 7 days Manufacturer Digoxin immune fab (ovine) Digibind (GlaxoSmithKline) 30 days Prescribing information Diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B (recombinant) and inactivated poliovirus vaccine combined Pediarix (GlaxoSmithKline) 24 hr Manufacturer Diphtheria and tetanus toxoids and acellular pertussis vaccine adsorbed Infanrix (GlaxoSmithKline) 72 hr Manufacturer Dornase alfa Pulmozyme (Genentech) 24 hr Prescribing information Epoetin alfa multidose Procrit (Ortho Biotech) 7 days Manufacturer Epoetin alfa single dose Procrit (Ortho Biotech) 14 days Manufacturer Eptifibatide 2 mg/mL Integrilin (Schering) 60 days Prescribing information Erythromycin ethylsuccinate oral suspension EES (Abbott) 14 days Prescribing information Etanercept powder Enbrel (Immunex Corporation ) 7 days Manufacturer Etanercept prefilled syringe Enbrel (Immunex Corporation ) 4 days Manufacturer Etoposide injection Vepesid (Gensia/Sicor) 24 mo Prescribing information Exenatide Byetta (Amylin Pharmaceuticals ) Repeated periods of exposure for a combined maximal duration of 6 days Manufacturer Famotidine Pepcid (Bedford) 3 mo Manufacturer Filgrastim vials and Singleject prefilled syringes Neupogen (Amgen) 7 days Manufacturer Fosphenytoin sodium injection Cerebyx (Pfizer) 48 hr Prescribing information Glatiramer acetate injection Copaxone (Teva Neuroscience) 7 days Prescribing information Hepatitis A vaccine, inactivated Havrix (GlaxoSmithKline) 72 hr Manufacturer Hepatitis A vaccine, inactivated Vaqta (Merck) 12 mo at 37 °C Manufacturer Hepatitis B immune globulin (human) Hyperhep B S/D (Bayer) Cumulative exposure for 7 days Manufacturer Hepatitis B vaccine (recombinant) Engerix-B (GlaxoSmithKline) 72 hr Manufacturer Immune globulin (human) Gamastan S/D (Bayer) Cumulative exposure for 7 days Manufacturer Influenza virus vaccine Fluarix (GlaxoSmithKline) 72 hr Manufacturer Insulin as part (rDNA origin) injection Novolog (Novo Nordisk) 28 days Prescribing information Insulin glargine (rDNA origin) vial or cartridge Lantus vial or cartridge (Sanofi-Aventis) 28 days Prescribing information 70% insulin aspart protamine suspension and 30% insulin as part injection (rDNA origin) pen fill cartridge Novolog Mix 70/30 pen fill cartridge (Novo Nordisk) 14 days Prescribing information 70% insulin aspart protamine suspension and 30% insulin as part injection (rDNA origin) vial Novolog Mix 70/30 vial (Novo Nordisk) 28 days Prescribing information Lente human insulin (rDNA origin) zinc suspension Humulin L (Lilly) 28 days Prescribing information Insulin lispro (rDNA origin) vial Humalog vial (Lilly) 28 days Prescribing information NPH, human insulin isophane suspension (rDNA origin) Novolin N vial (Novo Nordisk) 30 days Prescribing information Regular human insulin injection (rDNA origin) Novolin R vial (Novo Nordisk) 30 days Prescribing information Humulin Ultralente human insulin (rDNA origin) extended zinc suspension Humulin U (Lilly) 28 days Prescribing information Hyaluronic acid Healon (AMO Advanced Medical Optics) 14 days Manufacturer Interferon beta-1a i.m.
Injection Avonex (Biogen Idec) 30 days Prescribing information Interferon beta-1a s.c. injection Rebif (Serono) 30 days Prescribing information Latanoprost 0.005% ophthalmic solution Xalatan (Pharmacia and Upjohn) 6 wk Prescribing information Lopinavir/ritonavir capsules Kaletra capsules (Abbott) 60 days Prescribing information Lopinavir/ritonavir oral solution Kaletra solution (Abbott) 60 days Prescribing information Melphalan 2-mg tablets Alkeran (GlaxoSmithKline) 7 days Prescribing information Methylergonovine maleate injection Methergine (Novartis) 14 days Manufacturer Neomycin sulfate-polymixin B sulfate solution for irrigation Neosporin G.U.
Irrigant Sterile (Monarch Pharmaceuticals) 6 mo if undiluted Manufacturer Octreotide acetate injectable suspension Sandostatin (Novartis) 14 days Prescribing information Palivizumab powder and solution Synagis (MedImmune) Lifetime cumulative exposure for 14 days Manufacturer Pancuronium bromide injection Pavulon (Gensia/Sicor) 6 mo Prescribing information Peg-interferon alfa-2a vial Pegasys vial (Roche) 14 days Manufacturer Peg-interferon alfa-2a vial prefilled syringe Pegasys prefilled syringe (Roche) 6 days Manufacturer Penicillin G benzathine injection suspension Bicillin LA (Monarch Pharmaceuticals) 7 days at 77 °F 1 day at 104 °F Manufacturer Penicillin G benzathine and penicillin G procaine injection suspension Bicillin CR (Wyeth) 7 days at 77 °F 1 day at 104 °F Manufacturer Pneumococcal 7-valent conjugate vaccine (diphtheria CRM 197 protein) Prevnar (Wyeth) 7 days Manufacturer Proparacaine hydrochloride ophthalmic solution Alcaine (Alcon Research Ltd.) 30 days Manufacturer Quinupristin-dalfopristin for injection Synercid (DSM Pharmaceuticals) 7 days Manufacturer Rabies immune globulin (human) solvent/detergent treated Hyperab S/D (Talecris) Cumulative exposure for 7 days Manufacturer Rabies vaccine Rabavert (Chiron) 6.2% loss after 12 mo Manufacturer Ritonovir capsules Norvir (Abbott) 30 days Prescribing information Rh o D immune globulin (human) Hyperrho SD (Bayer) Cumulative exposure for 7 days Manufacturer Rocuronium bromide Zemuron (Organon USA) 60 days Prescribing information Saquinavir soft gelatin capsules Fortovase (Roche) 90 days Prescribing information Succinylcholine chloride multidose Anectine (GlaxoSmithKline) 14 days Prescribing information Tetanus immune globulin human solvent/detergent treated Hypertet S/D (Talecris) Cumulative exposure for 7 days Manufacturer Tipranavir capsules Aptivus capsules (Boehringer-Ingelheim) 60 days if opened Prescribing information Tobramycin inhalation solution Tobi (Chiron) 28 days Prescribing information Trifluridine ophthalmic solution Viroptic (Monarch Pharmaceuticals) 14 days Manufacturer Vinorelbine tartrate injection Navelbine (Pierre Fabre Pharmaceuticals) 72 hr Prescribing information Vitamin A Aquasol-A parenteral (Aai Pharma/Mayne) 4 wk Manufacturer
How long does hydrocortisone last in the fridge?
CONCLUSIONS: The hydrocortisone succinate preservative-free oral solutions at pH 5.5, 6.5, or 7.4 are chemically stable when stored under refrigeration for at least 14 days. They provide flexible and convenient dosage forms without any preservatives for pediatric patients.