Table 4. Some Topical Drugs for Atopic Dermatitis Table 4. Some Topical Drugs for Atopic Dermatitis (cont.

)
Drug Vehicle Drug Vehicle
CALCINEURIN INHIBITORS Medium-High Potency
Pimecrolimus 1% Amcinonide 0.1%
a d e l (Novartis) cream generic cream. lotion
Tacrolimus 0.03% Betamethasone dipropionate 0.05c.%
Protopic (Astellas) oint generic cream
Tacrolimus 0.1% Betamethasone
Protopic (Astellas) oint valerate 0.19 oint
CORTICOSTEROIDS Desoximetasone
1 0.05%
Super-High Potency generic cream
0 —
Diflorasone
Betamethasone dipropionate g e n e 0.05%
r
diacetate
augmented 0.05% — generic °int. lotion, gel i generic
c cream
Diprolene (Schering-Plough) oint. gel
Fluocinonide
Clobetasol propionate 0_059'0 emollient 0.05%
generic cream. oint, gel,
foam. soln generic cream
Cormax (Watson) oint, soln Fluticasone propionate 0_005%
generic oint
C i a o ( (Gaiderma) lotion, spray.
Cutivate (PharmDerm)
shampoo
foam Triamcinolone
Olux (Connetics Corp) acetonide 0.19/0
Temovate (GSK) cream, soin, oint,
generic oint
gel
Fluocinonide 0.1% Triamcinolone acetonide 0.5%
cream generic cream
Vance (Megicis)
Halobetasol propionate 0.05% Medium Potency
generic cream, oint Betamethasone valerate 0.12%
Uttravate (Ranbaxy) cream, oint timid (Stiefel Labs) foam
Flu ocinolone
High Potency
oint acetonide 0.0259'0
Amcinonide 0.1% — generic
generic oint
Betamethasone
Hydrocortisone
dipropionate 0.05% valerate 0.2%
augmented — generic cream oint
generic
aprolene AF cream Westcort (Ranbaxy) Dint
(Schering-Plough) Mometasone furoate 0.1%
Beta methasone generic cream, lotion
dipropionate 0.05• Elocon (Schering-Plough) cream, lotion
generic oint Triamcinolone acetonide 0.19'0
Desoximetasone 0.25% generic cream
generic cream, gel, oint Medium-Low Potency
Topicort (Taro) cream, gel, oint Betamethasone dipropionate 0.05%
Desoximetasone 0.05% lotion
generic
generic gel Betamethasone valerate 0.1%
Topicort 0.05% (Taro) gel generic cream
Diflorasone diacetate 0.05% Desonide 0.059'0
generic oint oint
Fluocinonide 0_05% generic
Desowen (Galderma)
generic gel, oint, soln Fluocinolone acetonide 0_025%
cream cream
generic
Halcinonide 0.1% Flurandrenolide 0_05%
Ha log (Ranbaxy) cream. oint lotion
Cordran (Aqua)
Mometasone furo ate a l % cream
Cordran SP (Aqua)
generic oint
oint Fluticasone propionate 0_05%
Docon (Schering-Plough) cream
generic
Triamcinolone acelonide 0.5%
Cutivate (PharmaDerm)
generic oint
 BRAND NAME GENERIC NAME BRAND NAME GENERIC NAME

CLASS 2 - Potent (cont.) CLASS 5 - Lower Mid-Strength (cont.)

Halog Ointment/Cream, 0.1% Halcinonide DesOwen Lotion, 0.05% Desonide

Lidex Cream/Gel/Ointment, 0.05% Fluocinonide Locoid Cream/Lotion/Ointment/ Hydrocortisone

Solution, 0.1%
Psorcon Cream, 0.05% Diflorasone
diacetate Pandel Cream, 0.1% Hydrocortisone

Topicort Cream/Ointment, 0.25% Desoximetasone Synalar Cream, 0.03/0.01% Fluocinolone acetonide

Topicort Gel, 0.05% Desoximetasone Westcort Cream, 0.2% Hydrocortisone valerate

CLASS 3 - Upper Mid-Strength CLASS 6 - Mild

Cutivate Ointment, 0.005% Fluticasone propionate Aclovate Cream/Ointment, 0.05% Alclometasone

dipropionate
Lidex-E Cream, 0.05% Fluocinonide
Derma-Smoothe/FS Oil, 0.01% Fluocinolone acetonide
Luxiq Foam, 0.12% Betamethasone valerate
Desonate Gel, 0.05% Desonide
Topicort LP Cream, 0.05% Desoximetasone
Synalar Cream/Solution, 0.01% Fluocinolone acetonide
CLASS 4 - Mid-Strength
Verdeso Foam, 0.05% Desonide
Cordran Ointment, 0.05% Flurandrenolide
CLASS 7 - Least Potent
Elocon Cream/Lotion, 0.1% Mometasone furoate
Cetacort Lotion, 0.5%/1% Hydrocortisone
Kenalog Cream/Spray, 0.1% Triamcinolone acetonide
Cortaid Cream/Spray/Ointment, 1% Hydrocortisone
Synalar Ointment, 0.03% Fluocinolone acetonide
Hytone Cream/Lotion, 1%/2.5% Hydrocortisone
Westcort Ointment, 0.2% Hydrocortisone valerate
Micort-HC Cream, 2%/2.5% Hydrocortisone
CLASS 5 - Lower Mid-Strength
Nutracort Lotion, 1%/2.5% Hydrocortisone
Capex Shampoo, 0.01% Fluocinolone acetonide
Synacort Cream, 1%/2.5% Hydrocortisone
Cordran Cream/Lotion/Tape, 0.05% Flurandrenolide

Cutivate Cream/Lotion, 0.05% Fluticasone propionate

DermAtop Cream, 0.1% Prednicarbate

12 National Psoriasis Foundation topical treatments 13

 THE SECTION Dermatologic Disorders

MERCK MANUALS SUBJECT Principles of Topical Dermatologic

FOR HEALTHCARE Therapy
TOPIC Principles of Topical Dermatologic
ONLINE MEDICAL LIBRARY P R O F E S S I O N A L S Therapy

RELATIVE POTENCY OF SELECTED

TOPICAL CORTICOSTEROIDS

CLASS* DRUG

I Betamethasone dipropionate 0.05% ointment

Clobetasol propionate 0.05% cream or ointment
Diflorasone diacetate 0.05% ointment
Halobetasol propionate 0.05% cream or ointment

II Amcinonide 0.1% ointment

Betamethasone dipropionate 0.05% cream
Betamethasone dipropionate 0.05% ointment
Desoximetasone 0.25% cream, 0.05% gel, or 0.25% ointment
Diflorasone diacetate 0.05% ointment
Fluocinonide 0.05% cream, gel, ointment, or solution
Halcinonide 0.1% cream
Mometasone furoate 0.1% ointment

III Amcinonide 0.1% cream or lotion

Betamethasone dipropionate 0.05% cream
Betamethasone dipropionate 0.05% lotion
Betamethasone valerate 0.1% ointment
Desoximetasone 0.05% cream
Diflorasone diacetate 0.05% cream
Fluocinonide 0.05% cream
Fluticasone propionate 0.005% ointment
Halcinonide 0.1% ointment or solution
Triamcinolone acetonide 0.1% ointment

IV Fluocinolone acetonide 0.025% ointment

Flurandrenolide 0.05% ointment
Mometasone furoate 0.1% cream or lotion
Triamcinolone acetonide 0.1% ointment
Triamcinolone acetonide 0.1% cream

V Betamethasone valerate 0.1% cream

Desonide 0.05% ointment
Fluocinolone acetonide 0.025% cream
Flurandrenolide 0.05% cream
Fluticasone propionate 0.05% cream
Hydrocortisone butyrate 0.1% cream, ointment, or solution
Hydrocortisone valerate 0.2% cream or ointment
Triamcinolone acetonide 0.1% lotion or 0.025% ointment

VI Alclometasone dipropionate 0.05% cream or ointment

Betamethasone valerate 0.1% lotion
Desonide 0.05% cream
Fluocinolone acetonide 0.01% cream or solution
Flumethasone pivalate 0.03% cream
Triamcinolone acetonide 0.1% cream
Triamcinolone acetonide 0.025% cream or lotion

VII Hydrocortisone 1% or 2.5% cream, 1% or 2.5% lotion, or 1% or

2.5% ointment
Hydrocortisone acetate (1% or 2.5% cream, 1% or 2.5% lotion, or
1% or 2.5% ointment) and pramoxine hydrochloride 1%

*Class I is the most potent, and class VII is the least potent. Potency depends on many factors,
including the drug’s characteristics and concentration and the base in which it is used.
 TOPICAL STEROIDS
Classification of topical steroid preparations by potency
LOW POTENCY
Alclometasone Hydrocortisone base or Hydrocortisone base or
dipropionate 0.05% acetate 1% acetate 2.5%
Aclovate (crm, oint) Cortisporin* (oint) Anusol-HC (crm)
Hytone (crm, oint) Hytone (crm, oint)
Fluocinolone acetonide 0.01% U-cort (crm)
Synalar (soln) Vytone* (crm) Triamcinolone
acetonide 0.025%!
Hydrocortisone base or Kenalog (crm, lotion, oint)
acetate 0.5%
Cortisporin* (crm)

INTERMEDIATE POTENCY
Betamethasone valerate 0.12% Fluocinolone acetonide 0.025% Hydrocortisone butyrate 0.1%
Luxiq (foam) Synalar (crm, oint) Locoid (crm, oint, soln)
Locoid Lipocream (crm)
Clocortolone pivalate 0.1% Flurandrenolide 0.025%
Cloderm (crm) Cordran-SP (crm) Hydrocortisone valerate 0.2%
Cordran (oint) Westcort (crm, oint)
Desonide 0.05%
Desonate (gel) Flurandrenolide 0.05% Mometasone furoate 0.1%
DesOwen (crm, lotion, oint) Cordran-SP (crm) Elocon (crm, lotion, oint)
Verdeso (foam) Cordran (lotion, oint)
Prednicarbate 0.1%
Desoximetasone 0.05% Fluticasone propionate 0.005% Dermatop (emollient crm, oint)
Topicort-LP (emollient crm) Cutivate (oint)
Triamcinolone acetonide 0.1%!
Fluocinolone acetonide 0.01% Fluticasone propionate 0.05% Kenalog (crm, lotion)
Derma-Smoothe/FS (oil) Cutivate (crm, lotion)
Capex (shampoo) Triamcinolone acetonide 0.2%
Hydrocortisone probutate 0.1% Kenalog (aerosol)
Pandel (crm)

HIGH POTENCY
Amcinonide 0.1%◊ Desoximetasone 0.25% Halcinonide 0.1%
Topicort (emollient crm, oint) Halog (crm, oint, soln)
Betamethasone dipropionate,
augmented 0.05% Diflorasone diacetate 0.05% Triamcinolone acetonide 0.5%†
Diprolene AF (emollient crm) Psorcon e (emollient crm, Kenalog (crm)
Diprolene (lotion) emollient oint)
Desoximetasone 0.05% Fluocinonide 0.05%
Topicort (gel) Lidex (crm, gel, oint, soln)
Lidex-E (emollient crm)

SUPER HIGH POTENCY

Betamethasone dipropionate, Clobetasol propionate 0.05% Fluocinonide 0.1%
augmented 0.05% Clobex (lotion, shampoo, spray) Vanos (crm)
Diprolene (oint, gel) Cormax (oint, scalp application)
Olux (foam) Flurandrenolide 4mcg/sq cm
Olux-E (foam) Cordran (tape)
Temovate (crm, gel, oint, scalp Halobetasol propionate 0.05%
application) Ultravate (crm, oint)
Temovate-E (emollient crm)
NOTES
*Indicates that the product has more than one active ingredient.
†Also available as a cream generically.
!Also available as a cream or ointment generically.
◊Also available as a cream, ointment, or lotion generically.

The classification is based on vasoconstrictor assays and clinical studies. Potency varies according to the
corticosteroid, its concentration, and the vehicle. In general, corticosteroids in lotions, creams, gels, and
ointments are increasingly more potent due to increased absorption from these vehicles.
Absorption is increased by prolonged therapy, large areas of skin damage, and the use of occlusive
dressings which may cause an increase in the incidence of side effects. (Rev. 8/2009)