Desoximetasone 0.25% Ointment 100gm
It is used to treat skin irritation.It is used to treat skin rashes.
Drug Class
Topical Corticosteroid
Pharmacologic Class
Synthetic Glucocorticoid; Anti-inflammatory Agent
Pregnancy Category
Category C
FDA Approved
Jun 1977
DEA Schedule
Not Controlled
Overview
What is this medicine?
Desoximetasone ointment is a strong medicine applied to the skin to reduce redness, swelling, and itching caused by skin conditions like eczema or psoriasis. It belongs to a group of medicines called corticosteroids.
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
Apply this medication only to your skin, as directed by your doctor. Do not take it by mouth.
Avoid getting the medication in your mouth, nose, or eyes, as it may cause burning.
Do not apply the medication to the vagina.
Wash your hands before and after applying the medication, unless your hand is the treated area. In that case, do not wash your hand after application.
Clean the affected area before applying the medication and dry it thoroughly.
Apply a thin layer of the medication to the affected skin and gently rub it in.
Using Dressings or Bandages
Do not cover the treated area with bandages or dressings unless your doctor instructs you to do so.
Storage and Disposal
Store the medication at room temperature.
Keep all medications in a safe place, 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 by your pharmacist. Check with your pharmacist for guidance on the best way to dispose of medications, and consider participating in a drug take-back program in your area.
Missing a Dose
If you miss a dose, apply it as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and resume your regular schedule.
* Do not apply two doses at the same time or use extra doses.
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
Apply this medication only to your skin, as directed by your doctor. Do not take it by mouth.
Avoid getting the medication in your mouth, nose, or eyes, as it may cause burning.
Do not apply the medication to the vagina.
Wash your hands before and after applying the medication, unless your hand is the treated area. In that case, do not wash your hand after application.
Clean the affected area before applying the medication and dry it thoroughly.
Apply a thin layer of the medication to the affected skin and gently rub it in.
Using Dressings or Bandages
Do not cover the treated area with bandages or dressings unless your doctor instructs you to do so.
Storage and Disposal
Store the medication at room temperature.
Keep all medications in a safe place, 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 by your pharmacist. Check with your pharmacist for guidance on the best way to dispose of medications, and consider participating in a drug take-back program in your area.
Missing a Dose
If you miss a dose, apply it as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and resume your regular schedule.
* Do not apply two doses at the same time or use extra doses.
Lifestyle & Tips
- Apply a thin layer of ointment to the affected skin area as directed by your doctor, usually twice a day.
- Rub it in gently and completely.
- Wash your hands before and after applying the ointment, unless your hands are the treated area.
- Do not cover the treated area with bandages or other dressings unless specifically instructed by your doctor, as this can increase absorption and side effects.
- Avoid applying the ointment to the face, groin, or armpits unless directed by your doctor.
- Do not use this medicine for longer than prescribed, as prolonged use can lead to skin thinning or other side effects.
- Avoid contact with eyes. If contact occurs, rinse thoroughly with water.
- Do not use on open wounds or broken skin.
Available Forms & Alternatives
Available Strengths:
- Desoximetasone 0.25% Crm 15gm
- Desoximetasone 0.25% Crm 60gm
- Desoximetasone 0.05% Cream 60gm
- Desoximetasone 0.05% Gel 60gm
- Desoximetasone 0.05% Gel 15gm
- Desoximetasone 0.05% Cream 15gm
- Desoximetasone 0.25% Cream 100gm
- Desoximetasone 0.25% Crm 60gm
- Desoximetasone 0.05% Cream 100gm
- Desoximetasone 0.05% Ointment 60gm
- Desoximetasone 0.25% Crm 15gm
- Desoximetasone 0.05% Ointment 100gm
- Desoximetasone 0.25% Ointment 15gm
- Desoximetasone 0.25% Ointment 60gm
- Desoximetasone 0.05% Cream 60gm
- Desoximetasone 0.25% Spray 100ml
- Desoximetasone 0.25% Ointment 100gm
Dosing & Administration
Adult Dosing
Standard Dose:
Apply a thin film to the affected skin areas two times daily.
Condition-Specific Dosing:
psoriasis:
Apply a thin film to the affected skin areas two times daily.
eczema:
Apply a thin film to the affected skin areas two times daily.
Pediatric Dosing
Neonatal:
Not established (increased risk of systemic absorption and HPA axis suppression)
Infant:
Not established (increased risk of systemic absorption and HPA axis suppression)
Child:
Apply a thin film to the affected skin areas two times daily. Use with caution and for the shortest duration possible due to increased risk of systemic absorption and HPA axis suppression.
Adolescent:
Apply a thin film to the affected skin areas two times daily.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment needed due to minimal systemic absorption.
Moderate:
No specific adjustment needed due to minimal systemic absorption.
Severe:
No specific adjustment needed due to minimal systemic absorption.
Dialysis:
No specific adjustment needed due to minimal systemic absorption.
Hepatic Impairment:
Mild:
No specific adjustment needed due to minimal systemic absorption.
Moderate:
No specific adjustment needed due to minimal systemic absorption.
Severe:
No specific adjustment needed due to minimal systemic absorption.
Pharmacology
Mechanism of Action
Desoximetasone is a synthetic corticosteroid that possesses anti-inflammatory, antipruritic, and vasoconstrictive properties. Its anti-inflammatory effects are thought to involve the induction of phospholipase A2 inhibitory proteins, lipocortins. These proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
Pharmacokinetics
Absorption:
Bioavailability:
Varies (systemic absorption is generally low but can increase with inflamed skin, occlusive dressings, or in pediatric patients)
Tmax:
Not well-defined for topical application
FoodEffect:
Not applicable (topical)
Distribution:
Vd:
Not well-defined for topical application
ProteinBinding:
Not well-defined for topical application (systemically absorbed corticosteroids are highly protein bound)
CnssPenetration:
Limited (systemic absorption is minimal)
Elimination:
HalfLife:
Not well-defined for topical application
Clearance:
Not well-defined for topical application
ExcretionRoute:
Renal (if systemically absorbed)
Unchanged:
Not available
Pharmacodynamics
OnsetOfAction:
Within hours to days (for symptomatic relief)
PeakEffect:
Within days to weeks (for maximal therapeutic effect)
DurationOfAction:
Varies (depends on application frequency and severity of condition)
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Attention Immediately
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 medical help right away:
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 a weak adrenal gland, including:
+ Severe upset stomach or vomiting
+ Severe dizziness or fainting
+ Muscle weakness
+ Feeling extremely tired
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, such as:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Signs of high blood sugar, including:
+ Confusion
+ Feeling sleepy
+ Unusual thirst or hunger
+ Frequent urination
+ Flushing
+ Fast breathing
+ Breath that smells like fruit
Skin changes, such as:
+ Pimples
+ Stretch marks
+ Slow healing
+ Hair growth
Thinning of the skin
Changes in eyesight
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 unusual symptoms, contact your doctor or seek medical help:
Burning, itching, dryness, or other irritation at the application site
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact 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 medical help right away:
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 a weak adrenal gland, including:
+ Severe upset stomach or vomiting
+ Severe dizziness or fainting
+ Muscle weakness
+ Feeling extremely tired
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, such as:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Signs of high blood sugar, including:
+ Confusion
+ Feeling sleepy
+ Unusual thirst or hunger
+ Frequent urination
+ Flushing
+ Fast breathing
+ Breath that smells like fruit
Skin changes, such as:
+ Pimples
+ Stretch marks
+ Slow healing
+ Hair growth
Thinning of the skin
Changes in eyesight
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 unusual symptoms, contact your doctor or seek medical help:
Burning, itching, dryness, or other irritation at the application site
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact 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:
- Increased redness, swelling, or pus at the application site (signs of infection)
- Severe burning, itching, or irritation that was not present before
- Skin thinning, easy bruising, or stretch marks (striae) in the treated area
- Acne-like breakouts or increased hair growth in the treated area
- Signs of systemic absorption, especially in children, such as weight gain, rounding of the face (moon face), or slowed growth.
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 symptoms you experienced as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor and pharmacist assess potential interactions between this medication and other substances you are taking.
* Any existing health problems, as this medication may interact with certain conditions.
To ensure your safety, it is crucial to verify that it is safe to take this medication with all your current medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting 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 symptoms you experienced as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor and pharmacist assess potential interactions between this medication and other substances you are taking.
* Any existing health problems, as this medication may interact with certain conditions.
To ensure your safety, it is crucial to verify that it is safe to take this medication with all your current medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
When applying this medication to the diaper area, avoid using tight-fitting diapers or plastic pants, as this can increase the amount of medication absorbed into the body.
Before using any other medications or products on your skin, including soaps, consult with your doctor to ensure safe use.
Do not apply this medication to cuts, scrapes, or damaged skin. Exercise caution when applying it to large areas of skin or near open wounds, and discuss any concerns 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. Discuss this potential risk with your doctor.
In children and teenagers, this medication may affect growth in some cases. Regular growth checks may be necessary, so consult with your doctor to monitor growth and development.
When using this medication in children, exercise caution, as the risk of certain side effects may be higher in this age group.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor to discuss the potential benefits and risks to you and your baby.
If you are breastfeeding, avoid applying this medication to your chest, and consult with your doctor for guidance on safe use.
When applying this medication to the diaper area, avoid using tight-fitting diapers or plastic pants, as this can increase the amount of medication absorbed into the body.
Before using any other medications or products on your skin, including soaps, consult with your doctor to ensure safe use.
Do not apply this medication to cuts, scrapes, or damaged skin. Exercise caution when applying it to large areas of skin or near open wounds, and discuss any concerns 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. Discuss this potential risk with your doctor.
In children and teenagers, this medication may affect growth in some cases. Regular growth checks may be necessary, so consult with your doctor to monitor growth and development.
When using this medication in children, exercise caution, as the risk of certain side effects may be higher in this age group.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor to discuss the potential benefits and risks to you and your baby.
If you are breastfeeding, avoid applying this medication to your chest, and consult with your doctor for guidance on safe use.
Overdose Information
Overdose Symptoms:
- Prolonged or excessive use can lead to systemic effects due to absorption, including Cushing's syndrome (e.g., moon face, central obesity, hypertension, hyperglycemia)
- Adrenal suppression (fatigue, weakness, nausea, vomiting, low blood pressure)
What to Do:
Discontinue the medication gradually under medical supervision. Symptomatic and supportive treatment. Call 1-800-222-1222 for Poison Control.
Drug Interactions
Monitoring
Baseline Monitoring
Skin condition assessment
Rationale: To establish baseline severity of dermatosis and identify areas for treatment.
Timing: Prior to initiation of therapy.
Routine Monitoring
Clinical response (e.g., reduction in inflammation, pruritus)
Frequency: Regularly during treatment, typically weekly or bi-weekly initially.
Target: Improvement in symptoms and skin appearance.
Action Threshold: Lack of improvement or worsening of condition may require re-evaluation of diagnosis or treatment.
Local skin adverse reactions (e.g., atrophy, striae, telangiectasias, folliculitis)
Frequency: At each follow-up visit.
Target: Absence of or minimal adverse effects.
Action Threshold: Presence of significant adverse effects may require reduction in frequency, change in potency, or discontinuation.
Signs of HPA axis suppression (e.g., fatigue, weakness, weight loss, hypotension)
Frequency: Periodically, especially with extensive use, prolonged use, occlusive dressings, or in pediatric patients.
Target: Normal HPA axis function.
Action Threshold: Symptoms or laboratory evidence (e.g., morning plasma cortisol, ACTH stimulation test) of suppression require discontinuation or gradual withdrawal.
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 Cushing's syndrome (e.g., moon face, buffalo hump, central obesity)
- Growth retardation (in children)
Special Patient Groups
Pregnancy
Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Systemic absorption of topical corticosteroids can occur.
Trimester-Specific Risks:
First Trimester:
Potential for fetal harm, though data are limited for topical corticosteroids. Use with caution.
Second Trimester:
Use with caution; systemic absorption can occur.
Third Trimester:
Use with caution; systemic absorption can occur. Consider potential for HPA axis suppression in the neonate if used extensively.
Lactation
Use with caution. 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 limited, short-term use. Potential for adverse effects if significant systemic absorption occurs in the mother and is transferred to the infant.
Pediatric Use
Pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced HPA axis suppression and Cushing's syndrome than mature patients because of a larger skin surface area to body weight ratio. Use the least potent corticosteroid that is effective, for the shortest duration possible. Monitor for growth retardation and signs of systemic toxicity.
Geriatric Use
No specific dosage adjustments are required. However, geriatric patients may have thinner skin, which could increase the risk of local adverse effects like skin atrophy or purpura. Monitor for skin integrity.
Clinical Information
Clinical Pearls
- Desoximetasone 0.25% ointment is a high-potency topical corticosteroid. Use it judiciously, especially on sensitive areas like the face, intertriginous areas, or in children.
- The ointment formulation is generally preferred for dry, scaly, or lichenified lesions due to its occlusive properties.
- Educate patients on the 'less is more' principle for topical corticosteroids to minimize side effects.
- Avoid abrupt discontinuation after prolonged use on large areas, as this can lead to rebound flares of the dermatosis.
- Consider pulse therapy (e.g., 2-3 days/week) for maintenance in chronic conditions to reduce cumulative exposure and side effects.
Alternative Therapies
- Other high-potency topical corticosteroids (e.g., Clobetasol propionate, Halobetasol propionate)
- Medium-potency topical corticosteroids (e.g., Triamcinolone acetonide, Mometasone furoate)
- Low-potency topical corticosteroids (e.g., Hydrocortisone)
- Calcineurin inhibitors (e.g., Tacrolimus, Pimecrolimus) for steroid-sparing therapy
- Systemic therapies (e.g., Methotrexate, Cyclosporine, Biologics) for severe, widespread conditions
- Phototherapy
Cost & Coverage
Average Cost:
Varies, typically $50 - $200 per 100gm tube
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 2 (for generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, 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 for more information. 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 details about the medication taken, the amount, and the time it happened.