Hydrocortisone 2.5% Ointment 20gm
It is used to treat skin irritation.It is used to treat skin rashes.
Drug Class
Topical corticosteroid
Pharmacologic Class
Glucocorticoid receptor agonist
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Hydrocortisone ointment is a type of medicine called a corticosteroid. It works by reducing inflammation, redness, and itching caused by various skin conditions like eczema, dermatitis, and rashes. It helps calm down your skin's immune response.
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. Use this medication only as directed and follow all instructions carefully.
Application Instructions
Do not take this medication by mouth. It is for use on your skin only.
Avoid getting the medication in your mouth, nose, or eyes, as it may cause burning.
Do not apply the medication to the vagina.
Continue using the medication as directed, even if your symptoms improve.
Wash your hands before and after applying the medication, unless your hand is the treated area.
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.
Special Precautions
Do not cover the treated area with bandages or dressings unless your doctor instructs you to do so.
Avoid applying the medication to your face, underarms, or groin area unless your doctor tells you to do so.
If you are treating a area in the diaper region, do not use tight-fitting diapers or plastic pants, as this may increase the amount of medication absorbed into the body.
Storage and Disposal
Store the medication at room temperature and do not freeze it.
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.
Missed Dose Instructions
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. Use this medication only as directed and follow all instructions carefully.
Application Instructions
Do not take this medication by mouth. It is for use on your skin only.
Avoid getting the medication in your mouth, nose, or eyes, as it may cause burning.
Do not apply the medication to the vagina.
Continue using the medication as directed, even if your symptoms improve.
Wash your hands before and after applying the medication, unless your hand is the treated area.
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.
Special Precautions
Do not cover the treated area with bandages or dressings unless your doctor instructs you to do so.
Avoid applying the medication to your face, underarms, or groin area unless your doctor tells you to do so.
If you are treating a area in the diaper region, do not use tight-fitting diapers or plastic pants, as this may increase the amount of medication absorbed into the body.
Storage and Disposal
Store the medication at room temperature and do not freeze it.
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.
Missed Dose Instructions
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
- Wash your hands before and after applying the ointment.
- Apply a thin layer of the ointment to the affected skin area, gently rubbing it in until it disappears.
- Do not cover the treated area with bandages or dressings unless directed by your doctor, as this can increase absorption.
- Avoid applying the ointment to your eyes, mouth, or inside your nose.
- Do not use on broken skin, open wounds, or infected areas unless specifically instructed by your doctor.
- Use only for the prescribed duration; prolonged use can lead to skin thinning or other side effects.
- Keep out of reach of children.
Available Forms & Alternatives
Available Strengths:
- Hydrocortisone 1% Ointment 28.35gm
- Hydrocortisone 2.5% Cream 30gm
- Hydrocortisone 1% Cream 28.35gm
- Hydrocortisone 2.5% Oint 28.35gm
- Hydrocortisone Val 0.2% Cream 15gm
- Hydrocortisone Val 0.2% Cream 45gm
- Hydrocortisone Val 0.2% Cream 60gm
- Hydrocortisone Val 0.2% Oint 15gm
- Hydrocortisone Val 0.2% Ont 45gm
- Hydrocortisone Val 0.2% Ont 60gm
- Hydrocortisone 2.5% Oint 453.6gm
- Hydrocortisone 1% Ointment 453.6gm
- Hydrocortisone 2.5% Ointment 20gm
- Hydrocortisone 2.5% Cream
- Hydrocortisone AC 25mg Rectal Supp
- Hydrocortisone 1% Cream
- Hydrocort Butyrate 0.1% Soln 60ml
- Hydrocortisone Ace 30mg Suppository
- Hydrocortisone Val 0.2% Cream 45gm
- Hydrocortisone But 0.1% Oint 15gm
- Hydrocortisone But 0.1% Oint 45gm
- Hydrocortisone Val 0.2% Cream 60gm
- Hydrocortisone Val 0.2% Cream 15gm
- Hydrocortisone But 0.1% Cream 15gm
- Hydrocortisone But 0.1% Cream 45gm
- Hydrocortisone 2.5% Ointment 454gm
- Hydrocortisone 2.5% Cream 20gm
- Hydrocort Butyrate 0.1% Soln 20ml
- Hydrocortisone 2.5% Lotion 59ml
- Hydrocortisone 2.5% Lotion 118ml
- Hydrocortisone 2.5% Cream 28.35gm
- Hydrocortisone 100mg Enema 7 X 60ml
- Hydrocortisone 10mg Tablets
- Hydrocortisone 20mg Tablets
- Hydrocortisone 5mg Tablets
- Hydrocortisone Butyr 0.1% Crm 60gm
- Hydrocortisone Butyr 0.1% Crm 45gm
- Hydrocortisone 1% Cream 454gm
- Hydrocortisone 1% Ointment 28gm
- Hydrocortisone 0.5% W/aloe Cream
- Hydrocortisone 2.5% Rectal Cream
- Hydrocortisone 1% Cream 14.2gm
- Hydrocortisone 1% Rectal Crm 28.4gm
- Hydrocortisone 1%/iodoquinol 1% Crm
- Hydrocortisone 1% Cream 28gm
- Hydrocortisone 10mg Tablets
- Hydrocortisone 20mg Tablets
- Hydrocortisone 5mg Tablets
- Hydrocortisone Val 0.2% Oint 45gm
- Hydrocortisone Val 0.2% Oint 60gm
- Hydrocortisone 1% Cream 28.4gm
- Hydrocortisone 1% Cream 454gm
- Hydrocortisone 2.5% Cream 454gm
- Hydrocortisone 100mg Enema 60ml
- Hydrocortisone But 0.1% Lotion 59ml
- Hydrocortisone 1% W/aloe Cream 28gm
- Hydrocortisone 1% Plus Cream 28.4gm
Dosing & Administration
Adult Dosing
Standard Dose:
Apply a thin film to the affected area 2 to 4 times daily
Dose Range:
2 - 4 mg
Condition-Specific Dosing:
eczema:
Apply a thin film to the affected area 2 to 4 times daily
dermatitis:
Apply a thin film to the affected area 2 to 4 times daily
pruritus:
Apply a thin film to the affected area 2 to 4 times daily
Pediatric Dosing
Neonatal:
Not established
Infant:
Apply a thin film to the affected area 2 to 4 times daily; use with caution, especially on large surface areas or under occlusion, due to increased risk of systemic absorption.
Child:
Apply a thin film to the affected area 2 to 4 times daily; use with caution, especially on large surface areas or under occlusion, due to increased risk of systemic absorption.
Adolescent:
Apply a thin film to the affected area 2 to 4 times daily
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed for topical use
Moderate:
No adjustment needed for topical use
Severe:
No adjustment needed for topical use
Dialysis:
No specific considerations for topical use
Hepatic Impairment:
Mild:
No adjustment needed for topical use
Moderate:
No adjustment needed for topical use
Severe:
No adjustment needed for topical use
Pharmacology
Mechanism of Action
Hydrocortisone is a corticosteroid that acts by binding to glucocorticoid receptors in the cytoplasm, forming a complex that translocates to the nucleus. This complex then modulates gene expression, leading to the synthesis of anti-inflammatory proteins (e.g., lipocortins) and inhibition of pro-inflammatory mediators (e.g., prostaglandins, leukotrienes, cytokines). This results in anti-inflammatory, antipruritic, and vasoconstrictive actions.
Pharmacokinetics
Absorption:
Bioavailability:
Variable (low systemic absorption, typically <5% but can be higher with damaged skin, occlusion, or large surface areas)
Tmax:
Not precisely quantifiable for topical local effect; systemic absorption peak varies
FoodEffect:
Not applicable for topical administration
Distribution:
Vd:
Not precisely quantifiable for topical local effect; systemically absorbed drug distributes widely
ProteinBinding:
Approximately 90% (to albumin and corticosteroid-binding globulin) for systemically absorbed drug
CnssPenetration:
Limited (for systemically absorbed drug)
Elimination:
HalfLife:
Approximately 1.5-2 hours (systemic)
Clearance:
Not precisely quantifiable for topical local effect
ExcretionRoute:
Renal (metabolites)
Unchanged:
<1% (systemic)
Pharmacodynamics
OnsetOfAction:
Within hours to days for symptomatic relief
PeakEffect:
Days to weeks of consistent use for maximal effect
DurationOfAction:
Varies with frequency of application and severity of condition
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction: 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, or swelling of the mouth, face, lips, tongue, or throat
Signs of high blood sugar: confusion, drowsiness, unusual thirst or hunger, frequent urination, flushing, rapid breathing, or fruity-smelling breath
Signs of a weak adrenal gland: severe nausea or vomiting, severe dizziness or fainting, muscle weakness, extreme fatigue, mood changes, decreased appetite, or weight loss
Signs of Cushing's syndrome: weight gain in the upper back or abdomen, moon face, severe headache, or slow wound healing
Changes in vision
Severe headache
Irritation at the site of application
Signs of skin infection: oozing, heat, swelling, redness, or pain
Skin changes (acne, stretch marks, slow healing, hair growth)
Thinning of the skin
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or only minor ones. If you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Burning or stinging sensation
Dryness
* Tingling
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, 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.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction: 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, or swelling of the mouth, face, lips, tongue, or throat
Signs of high blood sugar: confusion, drowsiness, unusual thirst or hunger, frequent urination, flushing, rapid breathing, or fruity-smelling breath
Signs of a weak adrenal gland: severe nausea or vomiting, severe dizziness or fainting, muscle weakness, extreme fatigue, mood changes, decreased appetite, or weight loss
Signs of Cushing's syndrome: weight gain in the upper back or abdomen, moon face, severe headache, or slow wound healing
Changes in vision
Severe headache
Irritation at the site of application
Signs of skin infection: oozing, heat, swelling, redness, or pain
Skin changes (acne, stretch marks, slow healing, hair growth)
Thinning of the skin
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or only minor ones. If you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Burning or stinging sensation
Dryness
* Tingling
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, 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:
- Worsening of skin condition
- Signs of skin infection (pus, fever, increased pain, spreading redness)
- Severe burning, itching, or irritation after application
- Skin thinning, easy bruising, or stretch marks in the treated area
- Unusual hair growth in the treated area
- Changes in skin color
- Any signs of systemic side effects like unusual weight gain, swelling in the face, or muscle weakness (rare with topical use, but possible with extensive or prolonged 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 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. Do not initiate, discontinue, or modify the dosage 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. Do not initiate, discontinue, or modify the dosage 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. Before using any other medications or skin products, including soaps, consult with your doctor to ensure safe use.
When applying this medication, avoid putting it on cuts, scrapes, or damaged skin. If you need to use it on a large area of skin, discuss this with your doctor to minimize potential risks.
In case of accidental ingestion, immediately contact a doctor or poison control center, as this medication can be harmful if swallowed. Adhere to your doctor's prescribed treatment duration and do not use this medication for an extended period.
Prolonged use of this medication may increase the risk of developing cataracts or glaucoma; therefore, consult with your doctor to discuss this potential risk. Additionally, some products may not be suitable for use in the diaper area, so it is crucial to consult with your doctor before application.
When using this medication on children, exercise caution, as they may be more susceptible to certain side effects. In some cases, this medication may affect growth in children and teenagers, and regular growth checks may be necessary. Consult with your doctor to discuss this potential risk.
If you are breast-feeding and apply this medication to your breast or nipple, ensure you wash the area thoroughly before breast-feeding your child. Note that some formulations of this medication may not be suitable for all age groups of children, so it is essential to consult with your doctor if you have any questions.
If you are pregnant, plan to become pregnant, or are breast-feeding, inform your doctor, as they will need to discuss the benefits and risks of using this medication with you to ensure the best possible outcome for you and your baby.
When applying this medication, avoid putting it on cuts, scrapes, or damaged skin. If you need to use it on a large area of skin, discuss this with your doctor to minimize potential risks.
In case of accidental ingestion, immediately contact a doctor or poison control center, as this medication can be harmful if swallowed. Adhere to your doctor's prescribed treatment duration and do not use this medication for an extended period.
Prolonged use of this medication may increase the risk of developing cataracts or glaucoma; therefore, consult with your doctor to discuss this potential risk. Additionally, some products may not be suitable for use in the diaper area, so it is crucial to consult with your doctor before application.
When using this medication on children, exercise caution, as they may be more susceptible to certain side effects. In some cases, this medication may affect growth in children and teenagers, and regular growth checks may be necessary. Consult with your doctor to discuss this potential risk.
If you are breast-feeding and apply this medication to your breast or nipple, ensure you wash the area thoroughly before breast-feeding your child. Note that some formulations of this medication may not be suitable for all age groups of children, so it is essential to consult with your doctor if you have any questions.
If you are pregnant, plan to become pregnant, or are breast-feeding, inform your doctor, as they will need to discuss the benefits and risks of using this medication with you to ensure the best possible outcome for you and your baby.
Overdose Information
Overdose Symptoms:
- Skin thinning
- Stretch marks
- Acne
- Increased hair growth
- Easy bruising
- Moon face
- Weight gain (especially in trunk)
- High blood pressure
- High blood sugar
- Muscle weakness
- Fatigue
What to Do:
Discontinue use and consult a healthcare professional. For accidental ingestion or significant systemic symptoms, call a poison control center (1-800-222-1222) or seek emergency medical attention.
Drug Interactions
Monitoring
Baseline Monitoring
Skin condition assessment
Rationale: To establish baseline severity of dermatosis and identify any contraindications (e.g., active infection).
Timing: Prior to initiation of therapy
Routine Monitoring
Efficacy (reduction in inflammation, pruritus)
Frequency: Regularly during treatment, typically weekly to bi-weekly initially
Target: Improvement in symptoms
Action Threshold: Lack of improvement or worsening of symptoms may require re-evaluation of diagnosis or treatment plan.
Local adverse effects (skin atrophy, striae, telangiectasias, folliculitis, perioral dermatitis, hypopigmentation)
Frequency: Regularly during treatment, especially with prolonged use
Target: Absence of or minimal adverse effects
Action Threshold: Development of significant local adverse effects may require reduction in strength, frequency, or discontinuation.
Signs of systemic absorption (e.g., Cushing's syndrome, adrenal suppression)
Frequency: Periodically, especially with extensive use, occlusion, or in pediatric patients
Target: Absence of systemic effects
Action Threshold: Suspicion of systemic effects warrants immediate medical evaluation and discontinuation.
Symptom Monitoring
- Redness
- Itching
- Swelling
- Pain
- Skin thinning
- Stretch marks (striae)
- Spider veins (telangiectasias)
- Acne-like eruptions
- Increased hair growth
- Changes in skin color
- Signs of infection (pus, fever, worsening pain)
- Unusual fatigue
- Weight gain (especially in face/trunk)
- Muscle weakness
Special Patient Groups
Pregnancy
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Topical corticosteroids are generally considered low risk, but extensive use, especially of high-potency agents, should be avoided.
Trimester-Specific Risks:
First Trimester:
Limited data, but systemic absorption is low. Use with caution.
Second Trimester:
Generally considered low risk with appropriate use.
Third Trimester:
Generally considered low risk with appropriate use.
Lactation
Considered compatible with breastfeeding when used topically in usual doses. Systemic absorption is minimal, making infant exposure unlikely to be significant.
Infant Risk:
Low risk. Advise mothers to avoid applying to the breast or nipple area to prevent direct infant ingestion.
Pediatric Use
Children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity (e.g., HPA axis suppression, Cushing's syndrome, growth retardation). Use the least potent effective dose for the shortest duration possible. Avoid prolonged use, especially on large surface areas or under occlusion.
Geriatric Use
No specific dosage adjustments are typically needed. However, elderly patients may have thinner skin, which could potentially increase systemic absorption. Monitor for local and systemic adverse effects.
Clinical Information
Clinical Pearls
- Hydrocortisone 2.5% is a low-potency topical corticosteroid, suitable for mild to moderate inflammatory dermatoses.
- Ointment formulations are generally more potent and occlusive than creams or lotions, making them suitable for dry, scaly lesions.
- Advise patients to apply a very thin layer; 'less is more' with topical steroids to minimize side effects.
- Educate patients on the signs of skin atrophy (thinning, bruising, striae) and to report them to their healthcare provider.
- Avoid use on the face, groin, or axillae for prolonged periods unless specifically directed by a dermatologist, due to increased risk of local side effects.
- If no improvement is seen after 1-2 weeks, re-evaluate the diagnosis or consider a different treatment.
Alternative Therapies
- Other topical corticosteroids (e.g., triamcinolone, fluocinolone, clobetasol - varying potencies)
- Topical calcineurin inhibitors (e.g., tacrolimus, pimecrolimus) for eczema, especially on sensitive areas
- Topical phosphodiesterase-4 (PDE4) inhibitors (e.g., crisaborole) for eczema
- Emollients and moisturizers for dry skin conditions
- Antihistamines (oral) for pruritus
- Systemic therapies for severe or widespread conditions
Cost & Coverage
Average Cost:
$15 - $50 per 20gm tube
Generic Available:
Yes
Insurance Coverage:
Tier 1 or 2 (Generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it's 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 be sure to check with your pharmacist for more details. If you have any questions or concerns about this medication, don't hesitate to reach out to 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 information about the medication taken, the amount, and the time it happened.