Flurandrenolide (Drenison) is an intermediate potency corticosteroid that is used topically for the treatment of eczema and other skin-related steroid-responsive conditions.

Flurandrenolide Uses:

• Corticosteroid-responsive dermatoses:

  • Use for the alleviation of inflammatory and itchy dermatoses that respond to corticosteroids.

Read: Topical Hydrocortisone Cream, Ointment, Lotion

Flurandrenolide (Drenison) Dose in Adutls

Flurandrenolide (Drenison) Dose in the treatment of Corticosteroid-responsive dermatoses: Topical:

Note: When control is attained, therapy should be stopped; if no improvement is noticed in 2 weeks, re-evaluation of the diagnosis may be necessary.

• Tape:
  • Apply 1 to 2 times per day
• Cream, lotion, ointment:
  • Every two to three hours, apply a thin coating to the affected region.

Flurandrenolide (Drenison) Dose in Children

Note:

• Use the least amount of the treatment for the shortest time possible to prevent HPA axis suppression; dosage should be depending on the severity of the disease and the patient's reaction.
• Reassessing the diagnosis may be essential if there isn't any change after the first two weeks of therapy. When control is attained, therapy should be stopped.

Flurandrenolide (Drenison) Dose in the treatment of Dermatoses that is steroid-responsive, including contact/atopic dermatitis:

• Infants, young children, and teenagers

• Topical:

  • Tape:
    • Apply 1 to 2 times daily
  • Cream, lotion, ointment:
    • Apply a small quantity or thin film 2 to 3 times daily.

Pregnancy Risk Factor C

• Corticosteroids have been linked to adverse events in animal reproduction studies.
• For pregnant women, it is not recommended to use topical products for prolonged periods of time or in large quantities.
• Topical corticosteroids should not be administered during pregnancy if they are required.
• Low- to mid-potency preparations work best. Higher potency preparations should only be used for a short time and should be closely monitored for fetal growth.

Flurandrenolide use during breastfeeding:

• Flurandrenolide should not be administered to nursing mothers.
• Human milk contains corticosteroids, but no information about flurandrenolide. 
• If systemic absorption occurs after topical application, it is unknown if measurable levels will appear in human milk.
• Avoid applying topical corticosteroids on the nipples. Hypertension has been reported in nursing infants who were given a topical corticosteroid during nursing.

Dose in Kidney Disease:

No recommendations regarding dosage adjustments have been provided in the manufacturer's labeling.

Dose in Liver disease:

No dosage adjustment has been provided in the manufacturer's labeling in patients with liver disease.

Side effects of Flurandrenolide (Drenison):

• Central Nervous System:

  • Burning Sensation

• Dermatologic:

  • Miliaria
  • Allergic Contact Dermatitis
  • Atrophic Striae
  • Folliculitis
  • Hypopigmentation
  • Skin Atrophy
  • Perioral Dermatitis
  • Pruritus
  • Acneiform Eruptions
  • Xeroderma
  • Acne Vulgaris
  • Hypertrichosis
  • Maceration Of The Skin

• Local:

  • Local Irritation

• Infection:

  • Secondary Infection

Contraindications to Flurandrenolide (Drenison):

• Hypersensitivity to any ingredient in the mixture, including flurandrenolide
• Lesions that leak serum or are in the intertriginous region (tape).
• There is not much evidence of cross-reactivity between corticosteroids and allergens. 
• Cross-sensitivity is possible due to similarities in chemical structure or pharmacologic effects.

Warnings and precautions

• Kaposi's Sarcoma:

  • Kaposi's Sarcoma can be caused by prolonged treatment with corticosteroids (case reports). If this is the case, it should be discontinued.
•  

• Suppression of the adrenals:

  • Especially in younger children or individuals getting large doses for extended periods of time, may result in hypercortisolism or suppression of the hypothalamic-pituitary-adrenal (HPA) axis.
  • Adrenal crisis may result from suppression of the HPA axis.
  • Patients who are taking large amounts of topical steroids should be evaluated periodically for HPA suppression with ACTH stimulation and urinary-free cortisol.
  • Stop taking a corticosteroid and withdraw from it. Alternately, take less frequently and switch to a stronger steroid.
  • Most people recover quickly and completely after stopping taking steroid drugs.
  • However, if withdrawal symptoms occur, you may need to take supplemental systemic steroids.

• Contact dermatitis:

  • It's possible to get allergy contact dermatitis. Instead of clinical aggravation, the failure of healing is frequently used to diagnose it.
  • Stop using if the dermatological infection continues despite antibiotic therapy.

• Systemic effects

  • Absorption can be boosted by applying to skin that is dehydrated or using occlusive dressings.
  • Percutaneous absorption of topical corticosteroids is possible. 
  • The skin may absorb topical corticosteroids, which can lead to hyperglycemia, glycosuria and Cushing's syndrome.

• Skin infections

  • If concomitant skin infection persists, discontinue flurandrenolide therapy.

Flurandrenolide: Drug Interaction

Monitoring parameters:

Use the following tests to evaluate the patient if HPA axis suppression is suspected:

Growth in youngsters; ACTH stimulation test; urine-free cortisol test

How to administer Flurandrenolide (Drenison)?

Lotion, ointment, cream:

• For external use only.
• To clean, dry skin, apply a thin coating, and then gently rub it in.
• Avoid getting it in your eyes, and typically don't use it on your face, underarms, or crotch.
• It is not advised to use occlusive dressings unless instructed to do so by a healthcare professional.
• Shake the lotion well before use.

Tape:

• Apply to dry, clean skin (allow the skin to dry for 1 hour before applying new tape).
• To prevent the growth of odour under the tape, clean the regions to be covered with crusts, dried exudates, scales, and previously applied ointments or creams.
• To encourage adhesion and facilitate removal, trim or shave the hair in the treatment region.
• Keep your skin smooth and firmly tuck it in.
• Always cut the tape, and never rip it.
• It is not advised to use occlusive dressings, such as plastic pants or tight-fitting diapers unless they are being used to treat resistant disorders like psoriasis.
• The ideal tolerance is for the tape to be changed every 12 hours, yet if tolerated well, it can be left in place for 24 hours.
• If necessary, it may only be used at night and taken off during the day.

Mechanism of action of Flurandrenolide (Drenison):

• Topical corticosteroids are vasoconstrictive, anti-inflammatory, and anti-pruritic.
• By stimulating phospholipase A2 inhibitory protein (lipocortins), it prevents the generation, release, or activity of endogenous chemical mediators (kinins and prostaglandins), and does so by first inhibiting the release of arachidonic acids. It has a medium level of potency.

Absorption:

• • With intact skin, absorption is sufficient.
  • Repeated application can lead to depot effects, which could result in increased percutaneous absorption.
  • Absorption can be accelerated by using occlusive dressings and inflamed skin.

Excretion:

• Urine;
• feces (small amounts)

Metabolism:

• Hepatic

International Brand Names of Flurandrenolide:

• Cordran
• Haelan
• Nolix
• Drenison

Flurandrenolide Brand Names in Pakistan:

There is no brand available in Pakistan.

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