prednicarbate

Action and Spectrum

Actions and Spectrum: 

prednicarbate is a topical corticosteroid used to treat various skin conditions. Its mechanism of action is believed to involve several different pathways: 

• Anti-inflammatory: prednicarbate works by suppressing the inflammatory response in the skin. It inhibits the production of cytokines and chemokines, which are responsible for inflammation and immune response. 
• Immunomodulatory: prednicarbate has immunomodulatory properties, meaning that it can modify the immune response in the skin. It reduces the number of immune cells in the skin, such as T and mast cells, which play a role in inflammation. 
• Antipruritic: prednicarbate also has antipruritic properties, which can reduce itching and discomfort associated with skin conditions.

prednicarbate has a broad spectrum of activity and is effective in treating a variety of skin conditions, including: 

• Contact dermatitis: prednicarbate can also be used to treat contact dermatitis, which occurs when the skin comes into contact with an irritant or allergen. It can help to reduce inflammation and itching associated with the condition. 
• Psoriasis: prednicarbate can treat mild to moderate psoriasis, a chronic autoimmune condition that causes skin scaling and inflammation. 
• Other skin conditions: prednicarbate can also be used to treat other skin conditions, such as seborrheic dermatitis, lichen planus, and discoid lupus erythematosus. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Skin atrophy 

Acneform lesions 

HPA suppression (with higher potency used >2 wk) 

Allergic contact dermatitis 

Pustulation 

Urticaria 

Leukoderma 

Striae 

Pigmentation changes 

Intracranial hypertension 

Pruritus 

Perioral dermatitis 

Hypertrichosis 

Black Box Warning

Contraindication / Caution

Contraindications/caution: 

Contraindications: 

• Hypersensitivity: Individuals with known hypersensitivity or allergy to prednicarbate or its components should not use this medication. 

• Infections: Topical corticosteroids such as prednicarbate can increase the risk of developing or worsening infections in the affected area. The medication should not be used in areas of the skin with active viral, fungal, or bacterial infections, such as herpes simplex, chickenpox, or tuberculosis. 

• Rosacea: prednicarbate may exacerbate rosacea or other skin conditions that cause facial redness, flushing, and inflammation. 

• Acne: prednicarbate may worsen acne or cause acne-like eruptions. 

• Pregnancy and breastfeeding: The safety of prednicarbate during pregnancy and breastfeeding is not established, and the medication should be used only if the benefits outweigh the potential risks. 

• Children: prednicarbate should be used cautiously, as their skin is more sensitive and may absorb more medication. It should not be used for prolonged periods or in large amounts. 

Caution: 

• Long-term use: Prolonged use of prednicarbate can lead to skin thinning, stretch marks, and increased susceptibility to infections. It is essential to use the medication as directed and not exceed the recommended duration of use. 
• Use on the face and intertriginous areas: prednicarbate should be used with caution on the face and in areas where skin rubs against skin, such as the groin or underarms. These areas are more susceptible to skin thinning and other side effects. 
• Use with occlusive dressings: Occlusive dressings, such as bandages or plastic wraps, can increase the absorption of prednicarbate and the risk of side effects.  
• Interactions with other medications: prednicarbate may interact with other medications, such as antifungals, antibiotics, and other corticosteroids. It is essential to inform your healthcare provider of all medications, supplements, and herbal products you are using before starting prednicarbate. 
• Systemic effects: While prednicarbate is a topical medication, some absorption into the bloodstream can occur. This can lead to systemic effects, such as adrenal suppression, exceedingly prolonged use, or use on large body areas. 
• Discontinuation: Abrupt discontinuation of prednicarbate can lead to rebound inflammation and other withdrawal symptoms. Following the healthcare provider’s instructions for discontinuing the medication is essential. 

Pregnancy / Lactation

Pregnancy consideration: The safety of prednicarbate during pregnancy and breast-feeding is not established, and the medication should be used only if the benefits outweigh the potential risks 

Pregnancy Category: C 

Lactation: Excretion of the drug in human breast milk is unknown 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.   

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

prednicarbate is a synthetic topical corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictive properties. It treats various skin conditions such as eczema, psoriasis, dermatitis, and allergic reactions. The medication works by binding to intracellular glucocorticoid receptors and activating anti-inflammatory genes while suppressing pro-inflammatory genes. This reduces the production and release of inflammatory cytokines and chemokines, decreasing inflammation, swelling, and itching. 

Pharmacodynamics: 

• Anti-inflammatory effect: prednicarbate reduces inflammation by inhibiting the release of inflammatory mediators such as prostaglandins, leukotrienes, and cytokines. It also decreases the migration of immune cells to the site of inflammation. 
• Immunosuppressive effect: prednicarbate suppresses the immune system by inhibiting the activation and proliferation of T-lymphocytes, B-lymphocytes, and macrophages. This helps to prevent an overactive immune response, which can contribute to various skin conditions. 
• Antipruritic effect: prednicarbate reduces itching by inhibiting the release of histamine, a central mediator. 
• Vasoconstrictive effect: prednicarbate constricts blood vessels in the skin, which can reduce redness and swelling. 
• Epidermal barrier restoration: prednicarbate promotes the formation of tight junctions between the epidermis cells, which helps restore the skin’s barrier function. 

Pharmacokinetics: 

Absorption 

prednicarbate is a topical medication that is absorbed through the skin. Its absorption depends on various factors, such as the formulation, strength, and application site. The medication is well-absorbed and can penetrate deep into the skin layers.  

Distribution 

Once absorbed, prednicarbate binds to plasma proteins and is distributed throughout the body. The medication has a high affinity for corticosteroid-binding globulin (CBG) and albumin, two major plasma proteins. 

Metabolism 

prednicarbate is metabolized primarily in the liver through various metabolic pathways, including oxidation, reduction, and conjugation. The primary metabolite of prednicarbate is 6-hydroxyprednicarbate, which is inactive. 

Elimination and Excretion 

prednicarbate and its metabolites are excreted primarily in the urine and feces. The elimination half-life of prednicarbate is approximately 4 hours, meaning that half of the medication is eliminated from the body within 4 hours. 

Adminstartion

Administration: 

prednicarbate is a topical medication that is applied to the skin. It is available in different formulations, including creams, ointments, gels, and different strengths, ranging from 0.1% to 0.5%. The choice of formulation and strength depends on the severity and location of the skin condition being treated.  

Here are some general guidelines for the administration of prednicarbate: 

• Wash and dry the affected area: Before applying prednicarbate, make sure the affected area is clean and dry. Use mild soap and water to wash the area, then pat it dry with a towel. 
• Apply a thin layer: Apply a thin layer of prednicarbate to the affected area and rub it in gently until it is absorbed. Avoid applying the medication to open wounds or areas of the skin that are broken or infected. 
• Do not cover: In most cases, covering the area with a bandage or dressing is unnecessary. However, if directed by a healthcare provider, cover the area with a sterile dressing or gauze. 
• Wash your hands: After applying prednicarbate, wash your hands thoroughly to avoid accidentally getting the medication in your eyes or mouth. 
• Follow the directions: Use prednicarbate as directed by a healthcare provider. Do not exceed the recommended dose, frequency, or duration of use. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: prednicarbate 

Why do we use prednicarbate? 

prednicarbate is a topical corticosteroid medication that is primarily used to treat various skin conditions, such as: 

• Eczema: prednicarbate can help reduce the inflammation, itching, and redness associated with eczema, a chronic skin condition characterized by dry, itchy skin. 
• Psoriasis: prednicarbate can help relieve the symptoms of psoriasis, a chronic autoimmune condition that causes thick, scaly patches on the skin. 
• Contact dermatitis: prednicarbate can help reduce the inflammation and itching caused by contact dermatitis, an allergic reaction to certain substances that come into contact with the skin. 
• Seborrheic dermatitis: prednicarbate can help reduce the inflammation and scaling associated with seborrheic dermatitis, a chronic skin condition that affects the scalp, face, and other parts of the body. 
• Lichen planus: prednicarbate can help reduce the itching and inflammation caused by lichen planus, an inflammatory skin condition affecting various body parts. 
• Pruritus: prednicarbate can help relieve the itching associated with various skin conditions, including eczema, psoriasis, and contact dermatitis.