urea and hydrocortisone

Action and Spectrum

Actions and Spectrum: 

• urea/hydrocortisone is a combination medication used topically for treating certain skin conditions, such as eczema, psoriasis, and other forms of dermatitis. The mechanism of action of urea/hydrocortisone is a combination of the effects of the two active ingredients. 
• urea is a naturally occurring substance in the skin that helps retain moisture. When applied topically, urea acts as a moisturizer and helps to hydrate dry and itchy skin. It also has a mild exfoliating effect, which helps to remove dead skin cells and promote skin renewal. 
• hydrocortisone is a synthetic corticosteroid that has anti-inflammatory and immunosuppressive properties. When applied topically, hydrocortisone helps to reduce inflammation and itching by inhibiting the release of inflammatory mediators such as histamine and prostaglandins. This can relieve symptoms of skin conditions such as eczema and psoriasis. 
• The spectrum of urea/hydrocortisone activity primarily focuses on treating inflammatory skin conditions, such as eczema, psoriasis, and dermatitis. The combination of urea and hydrocortisone provides both moisturizing and anti-inflammatory effects, effectively managing symptoms such as dryness, itching, and inflammation. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Itching 

Dryness 

Hypertrichosis 

Hypopigmentation 

Allergic contact dermatitis 

Secondary infection 

Striae 

Burning 

Irritation 

Folliculitis 

Acneiform eruptions 

Perioral dermatitis 

Maceration of the skin 

Skin atrophy 

Miliaria 

Black Box Warning

Contraindication / Caution

Contraindications/caution: 

Contraindications: 

• Allergy or hypersensitivity: Individuals allergic or hypersensitive to urea, hydrocortisone, or other ingredients in the medication should not use urea/hydrocortisone. 
• Skin infections: urea/hydrocortisone should not be used on infected skin, as it may worsen the infection or mask the symptoms of the infection. 
• Rosacea, acne, and perioral dermatitis: urea/hydrocortisone should not be used on skin affected by rosacea, acne, or perioral dermatitis, as it may worsen these conditions. 
• Viral skin infections: urea/hydrocortisone should not be used on skin affected by viral infections such as herpes simplex, varicella zoster, or vaccinia, as it may worsen these conditions. 
• Pregnancy and breast-feeding: urea/hydrocortisone should be used with caution in pregnant or breastfeeding women, as the safety of this medication in these populations has not been fully established. 
• Children: urea/hydrocortisone should not be used in children under two years, as the safety and efficacy of this medication in this age group have not been established. 

Caution: 

• Diabetes: urea/hydrocortisone should be used cautiously in individuals with diabetes, as the medication may affect blood sugar levels. 
• Hypertension: urea/hydrocortisone should be used cautiously in individuals with hypertension, as the medication may affect blood pressure. 
• Immunocompromised individuals: urea/hydrocortisone should be used cautiously in individuals with weakened immune systems, as the medication may increase the risk of infections. 
• Skin atrophy: urea/hydrocortisone may cause skin thinning or atrophy with prolonged use, especially in areas with thin skin, such as the face or groin. 
• Contact dermatitis: urea/hydrocortisone may cause contact dermatitis in some individuals, especially those with sensitive skin. 
• Glaucoma: urea/hydrocortisone should be used cautiously in individuals with glaucoma, as the medication may increase intraocular pressure. 

Pregnancy / Lactation

Pregnancy consideration: C 

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

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: 

• urea is a naturally occurring compound found in mammals’ urine and produced in the liver as a waste product of protein metabolism. In pharmacology, urea is used topically to treat various skin conditions such as dry skin, psoriasis, and eczema.  
• urea works as a keratolytic agent, which helps soften and break down dead skin cells, allowing for their removal. It also helps increase the skin’s water content, improving its overall hydration.  
• urea may also have antimicrobial properties, although its exact mechanism of action has yet to be fully understood. 
• hydrocortisone, on the other hand, is a synthetic form of cortisol, a hormone the adrenal gland produces.  
• hydrocortisone is a corticosteroid and is used primarily as an anti-inflammatory agent. It reduces inflammation and swelling by suppressing the immune system’s response.  
• It is used topically to treat various skin conditions, such as eczema, psoriasis, and allergic reactions, to reduce redness, itching, and inflammation. hydrocortisone is also used in systemic forms to treat various medical conditions, including adrenal insufficiency, inflammatory bowel disease, and asthma. 
• In summary, while both urea and hydrocortisone may be used topically for treating skin conditions, they have different pharmacological properties and mechanisms of action. urea works as a keratolytic agent and helps to improve skin hydration, while hydrocortisone is a corticosteroid that works as an anti-inflammatory agent.

Pharmacodynamics: 

The pharmacodynamics of urea and hydrocortisone differ due to their distinct mechanisms of action. 

• urea, when applied topically, works as a keratolytic agent by breaking down the intercellular matrix that holds dead skin cells together. This action helps to exfoliate and soften the skin, making it smoother and more hydrated. Additionally, urea is hygroscopic, meaning it attracts water to itself, which helps increase the skin’s moisture content. urea can also have an antimicrobial effect by disrupting the cell wall of certain bacteria, although this effect is not fully understood. 
• hydrocortisone is a synthetic corticosteroid that binds to glucocorticoid receptors in the cytoplasm of cells. Once bound to these receptors, it enters the nucleus and binds to DNA, altering the transcription of specific genes. The anti-inflammatory effects of hydrocortisone are due to its ability to reduce the production and release of pro-inflammatory cytokines and chemokines, as well as decrease the infiltration of immune cells into the inflamed area. hydrocortisone can also suppress the immune system’s response, including the production of antibodies and lymphocyte proliferation. 
• Overall, the pharmacodynamics of urea and hydrocortisone are different, with urea working as a keratolytic agent and moisturizer and hydrocortisone working as an anti-inflammatory agent and immune system suppressant. 

Pharmacokinetics: 

Absorption 

urea/hydrocortisone is absorbed through the skin when applied topically.  

Distribution 

Once absorbed, urea/hydrocortisone is distributed throughout the bloodstream.  

Metabolism 

the liver metabolizes urea/hydrocortisone into carbon dioxide and ammonia, which are excreted by the lungs and kidneys.  

Elimination and Excretion 

urea/hydrocortisone is excreted by the kidneys in the urine, with a small amount being eliminated in the feces. 

Adminstartion

Administration: 

urea and hydrocortisone can be administered topically as a cream or lotion. The application method and frequency of use may depend on the condition being treated and the product formulation 

Patient Information Leaflet

Patient information leaflet 

Generic Name: urea/hydrocortisone topical 

Why do we use urea/hydrocortisone topical? 

The topical formulations of urea and hydrocortisone have different uses due to their distinct pharmacological effects: 

urea topical: 

• Moisturizing and softening dry, scaly, or rough skin 
• Treating hyperkeratotic conditions such as psoriasis, eczema, and calluses 
• Reducing itching and irritation associated with dry skin 
• Helping to improve the penetration of other topical medications 

hydrocortisone topical: 

• Reducing inflammation and itching associated with skin conditions such as eczema, dermatitis, and psoriasis 
• Relieving itching, redness, and swelling caused by insect bites, poison ivy, and other skin irritations