Home' Australian Pharmacist : Australian Pharmacist August 2016 Contents Australian Pharmacist August 2016 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
Aggravating factors that should be
avoided include: overheating (e.g.
avoid electric blankets and hot water,
turn down heaters in winter, and use
fans and air conditioners in summer),
dryness (central ducted heating causes
drying), contact with irritants (e.g.
soap, shampoo, bubble baths, heavily
chlorinated pools or spas), infections
and allergies (e.g. house dust mites,
grasses, pollens, animal dander).
Patients should also avoid scratching
(relieve itching by applying a cold
compress to the skin, and using a
Directions for use2,4
Wash your hands well with soap and
water before opening any packaging,
and shake the lotion well before use.
Apply the topical product to the
affected area as directed by the
prescriber or pharmacist.
Avoid contact with eyes, nose, mouth
and other sensitive areas.
Allow sufficient time for absorption
between application of a topical
corticosteroid and a moisturiser; it is
not clear which to apply first.
Consult your doctor or pharmacist, if
the condition gets worse.
• Wash your hands after application
(unless your hands are the affected
• The preparation should be stored
protected from light in a cool place
(below 25 °C) and kept away from
children and pets.
KEY LEARNING POINTS
• Hydrocortisone topical products may
be compounded by pharmacists to
meet specific patient needs where
commercial products do not meet
• Pharmacists are able to select a
suitable vehicle in order to prepare
a topical application to ensure
• Pharmacists are able to advise
patients/carers on the appropriate
storage and safety during use of
a topical application containing
1. Sansom LN, ed. Australian pharmaceutical formulary and
handbook. 23rd edn. Canberra: Pharmaceutical Society of
2. Rossi S, ed. Australian medicines handbook. Adelaide:
Australian Medicines Handbook; 2015.
3. Dermatology Expert Group. Therapeutic guidelines:
dermatology. Version 4. Melbourne: Therapeutic Guidelines;
2015. p. 214.
4. Therapeutic Goods Administration. PI & CMI trade names
and active ingredients containing hydrocortisone acetate.
In: TGA product and consumer medicine information.
5. Allen LV. The basics of compounding: compounding creams
and lotions. Int J Pharm Compd 1999;3(2):111–15.
6. Allen LV, Popovich NG, Ansel HC. Chapter 14 Disperse systems.
In: Ansel’s pharmaceutical dosage forms and drug delivery
systems. 9th edn. Baltimore: Lippincott Williams & Wilkins; 2011.
7. Aquanil HC. At: www.dermstore.com/product_HC_588.htm
8. DailyMed. Fougera hydrocortisone lotion USP, 2.5%.
2011. At: www.dailymed.nlm.nih.gov/dailymed/fda/
9. Mericon Industries. Hydrocortisone lotion 1%. 2016. At: www.
10. Drugs.com. Hydrocortisone lotion. 2016. At: www.drugs.com/
11. Sarkar AB, Dudley R, Melethil S, et al. Chemical stability of
hydrocortisone in topical preparation in proprietary VersaPro
cream base. Innovations in Pharmacy 2011;2(3):1–3 .
12. Martindale: The complete drug reference. London:
Pharmaceutical Press; 2015. At: www.medicinescomplete.com
13. Allen LV. Hydrocortisone 0.5% ethanolic gel. Int J Pharm Compd
14. Allen LV. Hydrocortisone acetate 1% gel, alcohol-free. Int J
Pharm Compd 2011;15(1):65.
15. Rowe RC, Sheskey PJ, Fenton ME. Handbook of pharmaceutical
excipients. 7th edn. London: Pharmaceutical Press; 2012.
16. Gupta VD. Effect of vehicles and other active ingredients on
stability of hydrocortisone. J Pharm Sci 1978;67(3):299–302.
17. Pharmaceutical Society of Australia. Standard 10: Compounding
(also known as Extemporaneous Dispensing). In: Professional
practice standards. Version 4. Canberra: PSA; 2010. At: www.psa.
18. Bewley A, Dermatology Working Group. Expert consensus: time
for a change in the way we advise our patients to use topical
corticosteroids. Br J Dermatol 2008;158(5):917–20.
19. DermNet NZ. Emollients and moisturisers. 2016. At: www.
20. Greenlaw E. Eczema in adults: dealing with itching. In: WebMD.
2012. At: www.webmd.com/skin-problems-and-treatments/
1. Lotions are an appropriate dosage
form in the management of a
number of dermatological conditions
a) Are thicker in consistency than creams
b) Are most appropriate for application to
small areas of the body.
c) Are appropriate for application between
the thighs, due to their non-lubricating
d) Are easy to spread over large areas, due
to a thinner consistency.
2. What is the role of methyl
hydroxybenzoate in Formula 2 and
what is its concentration (% w/v)?
a) Cosolvent; 0.1% w/v.
b) Vehicle; 0.1% w/v.
c) Preservative; 0.2% w/v.
d) Cosolvent; 0.2% w/v.
3. Which of the following is
INCORRECT with regards to labelling
requirements for compounded
topical hydrocortisone products?
a) Label K (FOR EXTERNAL USE ONLY)
should be included on the labelling of
b) All active ingredients and their
amounts/proportions should be
included if a standard pharmacopoeial
formulation is not used.
c) Labelling of products should include
details of storage conditions.
d) Labelling instructions should not
include specific usage conditions.
4. What is the MOST appropriate advice
to give to patients to appropriately
use topical hydrocortisone products?
a) Apply the product sparingly to the
affected area to minimise the risk of side
b) Protect the product from light, and store
in a cool place below 25 °C.
c) Continue to use the product even after
the condition has improved as it will act
as a preventive treatment.
d) If using a topical corticosteroid, do not
use a moisturiser or emollient.
SOLUTIONS THROUGH COMPOUNDING
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