Desowen 0.05% Ointment 15gm
It is used to treat skin rashes and other skin irritation.
Drug Class
Corticosteroid, Topical
Pharmacologic Class
Topical anti-inflammatory, vasoconstrictor
Pregnancy Category
Category C
FDA Approved
Aug 1978
DEA Schedule
Not Controlled
Overview
What is this medicine?
Desonide is a mild corticosteroid medicine applied to the skin to reduce redness, swelling, and itching caused by various skin conditions like eczema or dermatitis.
How to Use This Medicine
Proper Use of This Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. Continue using the medication as directed, even if your symptoms improve.
Application Instructions
This medication is for topical use only, meaning it should be applied directly to the affected area of your skin. Avoid ingesting the medication or applying it to your mouth, nose, or eyes, as it may cause irritation.
Before applying the medication, wash your hands thoroughly. If the affected area is on your hand, you do not need to wash that hand after application. Clean the affected area before applying the medication and make sure it is completely dry.
Apply a thin layer of the medication to the affected skin and gently rub it in. Unless instructed by your doctor, do not cover the treated area with bandages or dressings. Also, avoid applying the medication to your face, underarms, or groin area unless specifically directed to do so by your doctor.
Storage and Disposal
Store this medication at room temperature, avoiding freezing. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about the disposal of your medication, consult your pharmacist. You may also want to check if there are drug take-back programs available in your area.
Missed Dose
If you miss a dose, apply it as soon as you remember. However, if it is close to the time for your next scheduled dose, skip the missed dose and continue with your regular application schedule. Do not apply two doses at the same time or use extra doses to make up for a missed one.
To use this medication correctly, follow your doctor's instructions and read all the information provided. Continue using the medication as directed, even if your symptoms improve.
Application Instructions
This medication is for topical use only, meaning it should be applied directly to the affected area of your skin. Avoid ingesting the medication or applying it to your mouth, nose, or eyes, as it may cause irritation.
Before applying the medication, wash your hands thoroughly. If the affected area is on your hand, you do not need to wash that hand after application. Clean the affected area before applying the medication and make sure it is completely dry.
Apply a thin layer of the medication to the affected skin and gently rub it in. Unless instructed by your doctor, do not cover the treated area with bandages or dressings. Also, avoid applying the medication to your face, underarms, or groin area unless specifically directed to do so by your doctor.
Storage and Disposal
Store this medication at room temperature, avoiding freezing. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about the disposal of your medication, consult your pharmacist. You may also want to check if there are drug take-back programs available in your area.
Missed Dose
If you miss a dose, apply it as soon as you remember. However, if it is close to the time for your next scheduled dose, skip the missed dose and continue with your regular application schedule. Do not apply two doses at the same time or use extra doses to make up for a missed one.
Lifestyle & Tips
- Wash your hands before and after applying the ointment.
- Apply a thin layer to the affected area and rub in gently.
- Do not cover the treated area with bandages or other dressings unless directed by your doctor, as this can increase absorption and side effects.
- Avoid contact with eyes, mouth, and other mucous membranes. If contact occurs, rinse thoroughly with water.
- Do not use on the face, groin, or armpits unless specifically instructed by your doctor, as these areas are more prone to side effects.
- Do not use for longer than prescribed, especially in children.
- Inform your doctor if your condition does not improve or worsens after a few days of treatment.
Available Forms & Alternatives
Available Strengths:
Generic Alternatives:
Dosing & Administration
Adult Dosing
Standard Dose:
Apply a thin film to the affected skin areas two to three times daily.
Condition-Specific Dosing:
eczema:
Apply a thin film to the affected skin areas two to three times daily.
dermatitis:
Apply a thin film to the affected skin areas two to three times daily.
Pediatric Dosing
Neonatal:
Not established (use with extreme caution due to increased systemic absorption)
Infant:
Apply a thin film to the affected skin areas two to three times daily, for short periods, under strict medical supervision. Avoid occlusive dressings.
Child:
Apply a thin film to the affected skin areas two to three times daily, for short periods. Avoid occlusive dressings.
Adolescent:
Apply a thin film to the affected skin areas two to three times daily.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment typically needed due to minimal systemic absorption.
Moderate:
No adjustment typically needed due to minimal systemic absorption.
Severe:
No adjustment typically needed due to minimal systemic absorption.
Dialysis:
No specific considerations due to minimal systemic absorption.
Hepatic Impairment:
Mild:
No adjustment typically needed due to minimal systemic absorption.
Moderate:
No adjustment typically needed due to minimal systemic absorption.
Severe:
No adjustment typically needed due to minimal systemic absorption.
Pharmacology
Mechanism of Action
Desonide is a low-potency topical corticosteroid. Corticosteroids diffuse across cell membranes and bind to specific cytoplasmic receptors. These complexes then enter the nucleus, bind to DNA (chromatin), and stimulate the transcription of messenger RNA (mRNA) and subsequent protein synthesis of various enzymes, which are responsible for the anti-inflammatory effects. They inhibit the release of arachidonic acid, thereby inhibiting the formation of prostaglandins and leukotrienes. They also suppress the migration of polymorphonuclear leukocytes and reverse increased capillary permeability, leading to vasoconstriction and reduced edema.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption; varies with vehicle, skin integrity, and use of occlusive dressings. Increased absorption in areas with thin skin (e.g., face, groin, axillae) or damaged skin.
Tmax:
Not applicable for topical application to achieve systemic peak; local effect is primary.
FoodEffect:
Not applicable
Distribution:
Vd:
Not available (minimal systemic distribution)
ProteinBinding:
Not available (minimal systemic distribution)
CnssPenetration:
Limited (minimal systemic absorption)
Elimination:
HalfLife:
Not available (minimal systemic absorption)
Clearance:
Not available (minimal systemic absorption)
ExcretionRoute:
Primarily renal excretion of inactive metabolites if systemically absorbed.
Unchanged:
Not available
Pharmacodynamics
OnsetOfAction:
Within hours to days for symptomatic relief.
PeakEffect:
Days to weeks of consistent application.
DurationOfAction:
Varies; effects persist as long as applied, with residual effects for a short period after discontinuation.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood sugar, including:
+ Confusion
+ Feeling sleepy
+ Unusual thirst or hunger
+ Passing urine more often
+ Flushing
+ Fast breathing
+ Breath that smells like fruit
Signs of a weak adrenal gland, such as:
+ Severe upset stomach or vomiting
+ Severe dizziness or passing out
+ Muscle weakness
+ Feeling very tired
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, including:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Skin irritation
Skin changes, such as:
+ Pimples
+ Stretch marks
+ Slow healing
+ Hair growth
Change in skin color
Changes in eyesight, eye pain, or severe eye irritation
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Burning or stinging
Dry skin
* Signs of a common cold
This is not an exhaustive list of possible side effects. If you have questions or concerns, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood sugar, including:
+ Confusion
+ Feeling sleepy
+ Unusual thirst or hunger
+ Passing urine more often
+ Flushing
+ Fast breathing
+ Breath that smells like fruit
Signs of a weak adrenal gland, such as:
+ Severe upset stomach or vomiting
+ Severe dizziness or passing out
+ Muscle weakness
+ Feeling very tired
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, including:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Skin irritation
Skin changes, such as:
+ Pimples
+ Stretch marks
+ Slow healing
+ Hair growth
Change in skin color
Changes in eyesight, eye pain, or severe eye irritation
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Burning or stinging
Dry skin
* Signs of a common cold
This is not an exhaustive list of possible side effects. If you have questions or concerns, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe burning, itching, or irritation at the application site.
- Signs of skin infection (e.g., pus, spreading redness, fever).
- Thinning of the skin, easy bruising, or stretch marks.
- Acne-like rash or increased hair growth in the treated area.
- Any signs of systemic side effects, such as unusual weight gain, swelling in the face, or muscle weakness (rare with proper use).
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
The presence of an infection at the site where this medication will be applied.
* Any areas of thinning skin where you plan to apply this medication.
This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. They will help you determine if it is safe to take this medication in combination with your other medications and health conditions.
Remember, do not start, stop, or change the dosage of any medication without first consulting your doctor to ensure your safety.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
The presence of an infection at the site where this medication will be applied.
* Any areas of thinning skin where you plan to apply this medication.
This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. They will help you determine if it is safe to take this medication in combination with your other medications and health conditions.
Remember, do not start, stop, or change the dosage of any medication without first consulting your doctor to ensure your safety.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Before using any other medications or products on your skin, including soaps, consult with your doctor.
When using this medication, avoid using tight-fitting diapers or plastic pants if the treated area is in the diaper region, as this can increase the amount of medication absorbed into the body. Do not apply this medication to cuts, scrapes, or damaged skin. Exercise caution when using this medication on a large area of skin and discuss this with your doctor.
Use this medication only for the duration prescribed by your doctor. Do not exceed the recommended treatment period. Be aware that this medication may increase the risk of developing cataracts or glaucoma, and consult with your doctor about this potential risk.
When using this medication in children, exercise caution, as the risk of certain side effects may be higher in this population. In some cases, this medication may affect growth in children and teenagers, and regular growth checks may be necessary. Discuss this with your doctor.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor, as you will need to discuss the benefits and risks of using this medication to both you and your baby. If you are breastfeeding and apply this medication to your breast or nipple, be sure to wash the area before breastfeeding your child.
When using this medication, avoid using tight-fitting diapers or plastic pants if the treated area is in the diaper region, as this can increase the amount of medication absorbed into the body. Do not apply this medication to cuts, scrapes, or damaged skin. Exercise caution when using this medication on a large area of skin and discuss this with your doctor.
Use this medication only for the duration prescribed by your doctor. Do not exceed the recommended treatment period. Be aware that this medication may increase the risk of developing cataracts or glaucoma, and consult with your doctor about this potential risk.
When using this medication in children, exercise caution, as the risk of certain side effects may be higher in this population. In some cases, this medication may affect growth in children and teenagers, and regular growth checks may be necessary. Discuss this with your doctor.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor, as you will need to discuss the benefits and risks of using this medication to both you and your baby. If you are breastfeeding and apply this medication to your breast or nipple, be sure to wash the area before breastfeeding your child.
Overdose Information
Overdose Symptoms:
- Prolonged or excessive use, especially over large surface areas or under occlusive dressings, can lead to systemic absorption and symptoms of hypercorticism (e.g., Cushing's syndrome, hyperglycemia, glucosuria).
- Symptoms may include moon face, central obesity, thinning skin, easy bruising, muscle weakness, and high blood sugar.
What to Do:
Discontinue the medication gradually under medical supervision. Symptomatic and supportive treatment. Call 1-800-222-1222 (Poison Control Center) for advice.
Drug Interactions
Monitoring
Baseline Monitoring
Skin condition assessment
Rationale: To establish baseline severity of dermatosis and identify any signs of infection or skin breakdown.
Timing: Prior to initiation of therapy.
Routine Monitoring
Efficacy (reduction in inflammation, pruritus)
Frequency: Regularly during treatment (e.g., weekly or bi-weekly)
Target: Improvement in symptoms and appearance of affected skin.
Action Threshold: Lack of improvement or worsening symptoms may indicate need for re-evaluation or alternative therapy.
Local adverse effects (e.g., atrophy, striae, telangiectasias, folliculitis, burning, itching)
Frequency: Regularly during treatment
Target: Absence of new or worsening local adverse effects.
Action Threshold: Development of significant local adverse effects may require dose reduction, discontinuation, or change in therapy.
Signs of HPA axis suppression (with extensive or prolonged use, especially in children or with occlusive dressings)
Frequency: Consider if large body surface area treated, prolonged use, or in pediatric patients.
Target: Normal cortisol levels (e.g., morning cortisol).
Action Threshold: Abnormal cortisol levels may require gradual withdrawal of therapy and/or systemic corticosteroid replacement.
Symptom Monitoring
- Burning
- Itching
- Irritation
- Dryness
- Folliculitis
- Hypertrichosis
- Acneiform eruptions
- Hypopigmentation
- Perioral dermatitis
- Allergic contact dermatitis
- Skin maceration
- Secondary infection
- Skin atrophy
- Striae
- Miliaria
- Signs of systemic absorption (e.g., Cushing's syndrome symptoms, hyperglycemia, glucosuria, growth retardation in children)
Special Patient Groups
Pregnancy
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Topical corticosteroids should not be used extensively on pregnant patients, in large amounts, or for prolonged periods.
Trimester-Specific Risks:
First Trimester:
Limited data; theoretical risk of teratogenicity with high systemic exposure, but unlikely with appropriate topical use.
Second Trimester:
Limited data; theoretical risk of teratogenicity with high systemic exposure, but unlikely with appropriate topical use.
Third Trimester:
Limited data; theoretical risk of teratogenicity with high systemic exposure, but unlikely with appropriate topical use.
Lactation
Caution should be exercised when desonide is administered to a nursing woman. It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk. Avoid applying to the breast area to prevent infant ingestion.
Infant Risk:
Low risk with appropriate use due to minimal systemic absorption, but monitor infant for potential adverse effects.
Pediatric Use
Pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced HPA axis suppression and Cushing's syndrome than mature patients due to a larger skin surface area to body weight ratio. Use the least amount necessary for the shortest duration. Avoid occlusive dressings.
Geriatric Use
No specific dosage adjustments are typically needed. However, elderly patients may have thinner skin, which could potentially increase systemic absorption. Monitor for skin atrophy and other local side effects.
Clinical Information
Clinical Pearls
- Desonide is a low-potency topical corticosteroid, making it suitable for sensitive areas like the face, groin, and axillae, but still requires caution.
- It's often preferred for pediatric patients due to its lower potency compared to stronger corticosteroids.
- Educate patients on the 'less is more' principle: a thin layer is sufficient. Over-application does not increase efficacy but increases risk of side effects.
- Advise patients to moisturize regularly, even when using corticosteroids, to help maintain skin barrier function.
- If no improvement is seen after 2-4 weeks, re-evaluate the diagnosis or treatment plan.
Alternative Therapies
- Hydrocortisone (lower potency topical corticosteroid)
- Triamcinolone acetonide (medium potency topical corticosteroid)
- Fluocinolone acetonide (medium potency topical corticosteroid)
- Pimecrolimus cream (non-steroidal calcineurin inhibitor)
- Tacrolimus ointment (non-steroidal calcineurin inhibitor)
- Crisaborole ointment (PDE4 inhibitor)
Cost & Coverage
Average Cost:
$20 - $60 per 15gm ointment
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 2 (preferred generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.