Amcinonide is a potent synthetic corticosteroid used primarily to treat various skin conditions such as eczema, psoriasis, dermatitis, and allergic reactions. It belongs to a class of drugs known as topical steroids. Topical steroids help reduce inflammation, itching, and redness associated with these conditions.

Amcinonide is a high potency steroid used as a topical steroid that is used to relieve the inflammatory and pruritic symptoms of corticosteroid-responsive dermatoses.

Amcinonide Dose in Adults

Amcinonide use in Steroid-responsive dermatoses:

• How to use: Gently rub a thin layer on the affected skin 2-3 times a day.
• Duration: Stop using the cream when the skin condition improves. If there's no improvement, you might need to check again with your doctor to make sure the diagnosis is correct.

Amcinonide Dose in Children

• Apply in a thin film of topical amcinonide twice or thrice daily.
• Discontinue therapy when symptoms resolve or there is no improvement.
• Re-evaluation may be necessary in patients non-responsive to the therapy.

Pregnancy Risk Factor C

• Amcinonide falls under Pregnancy Risk Factor C, which means it could be harmful to an unborn baby, as shown by animal studies with potent topical corticosteroids.
• Pregnant women should avoid using this medication extensively, in large amounts, or for a long period to reduce potential risks.

Use during breastfeeding:

• It's unclear whether using amcinonide on the skin results in detectable levels of the medication in breast milk.

Amcinonide Dose in Renal Disease:

• No dosage adjustment required in renal disease.

Amcinonide Dose in Liver Disease:

• No dosage adjustment required in liver disease.

Side Effects of Amcinonide Include:

• Central nervous system: burning sensation at the site
• Dermatologic: Acne vulgaris, allergic dermatitis, atrophic striae, hypertrichosis, folliculitis, , hypopigmentation, local dryness & maceration of the skin, miliaria, pruritus, skin atrophy, and telangiectasia
• Endocrine & metabolic: Cushing's syndrome, growth suppression, secondary diabetes, and suppression of the hypothalamic pituitary axis.
• Infection: Secondary infection
• Local: Local irritation

Contraindications to Amcinonide include:

• Amcinonide should not be used by anyone who is allergic to it or any of its ingredients, and it should not be applied to the face, groin, or underarms.

Warnings and Precautions

Suppression of the adrenals:

• Using amcinonide, especially in high doses or for a long time, can interfere with the body's stress hormone system, known as the hypothalamic-pituitary-adrenal (HPA) axis.
• This can lead to conditions like hypercortisolism (excess cortisol levels) or adrenal suppression.
• The risk is higher in young children and can potentially lead to an adrenal crisis, a serious condition that occurs when the adrenal glands don’t produce enough hormones.

Contact dermatitis:

• Allergic contact dermatitis can occur with the use of amcinonide.
• This type of skin reaction is often identified not by a worsening of symptoms but by a lack of improvement or healing when using the medication.
• If the condition doesn't get better with treatment, it could indicate an allergic reaction to the product.

Kaposi's Sarcoma

• In some cases, prolonged corticosteroids use has been linked to Kaposi's Sarcoma.
• Prolonged use of corticosteroids like amcinonide has been linked to the development of Kaposi's sarcoma, a type of cancer, according to some case reports.
• If Kaposi's sarcoma is observed, it may be necessary to consider discontinuing the treatment.

Systemic effects

• Topical corticosteroids like amcinonide can be absorbed through the skin, potentially leading to systemic effects.
• This absorption may result in symptoms similar to Cushing's syndrome, such as increased levels of cortisol, as well as high blood sugar levels (hyperglycemia) or sugar in the urine (glycosuria).
• Factors such as using occlusive dressings, applying the medication to damaged skin, or covering large areas of the body can increase absorption.

Infected/ weeping lesions:

• Occlusive dressings, which create a barrier to keep medications on the skin, should not be used if the skin has an infection or if there are open, weeping lesions.
• Using occlusive dressings in these situations can trap moisture and bacteria, worsening the infection or delaying healing.

Amcinonide: Drug Interaction

Note: Drug Interaction Categories:

• Risk Factor C: Monitor When Using Combination
• Risk Factor D: Consider Treatment Modification
• Risk Factor X: Avoid Concomitant Use

Monitoring Parameters:

•  Monitor for response to therapy, blood sugars, growth velocity in children, and features of cushings syndrome.

How to Administer Amcinonide?

• Twice or three times each day, apply a thin coating over the afflicted region.

Mechanism of Action of Amcinonide:

• Amcinonide is a strong topical corticosteroid that helps reduce inflammation, itching, and blood vessel widening.
• It works by stopping the body from making certain chemicals that cause swelling and irritation.
• This medication is potent, meaning it's very effective at calming skin problems.

Absorption:

• Amcinonide can be absorbed well through normal skin.
• Absorption increases when the skin is inflamed or when the medication is covered with a bandage.

Metabolism:

• The liver processes amcinonide after it's absorbed into the body.

Excretion:

• The body eliminates amcinonide through urine and feces after it has been metabolized in the liver.

International Brands of Amcinonide:

• Amciderm
• Amcinide
• Amcinil
• Amicla
• Narsin
• Penticort
• Visderm
• Cyclocort
• RATIO-Amcinonide
• TARO-Amcinonide

Amcinonide Brands in Pakistan: