Pevisone
Generic Name
econazole nitrate and triamcinolone acetonide
Manufacturer
Janssen-Cilag
Country
Belgium
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Description
Overview of the medicine
Pevisone cream is a topical medication combining an antifungal (econazole nitrate) and a corticosteroid (triamcinolone acetonide) used to treat skin infections that are accompanied by inflammation, such as fungal infections with eczema.
Uses & Indications
Dosage
Adults
Apply a thin layer to the affected skin area once or twice daily. Continue treatment until resolution of fungal infection, typically 2-4 weeks, but no longer than 4 weeks without reassessment due to corticosteroid component.
Elderly
No specific dose adjustment required; use with caution.
Renal_impairment
No specific dose adjustment required as systemic absorption is minimal.
How to Take
Topical use only. Wash and dry the affected area before application. Apply a thin layer and rub gently. Avoid contact with eyes, nose, mouth, and other mucous membranes. Do not use occlusive dressings unless advised by a doctor.
Mechanism of Action
Pevisone combines the antifungal action of econazole nitrate with the anti-inflammatory and antipruritic effects of triamcinolone acetonide. Econazole inhibits fungal cell wall synthesis, while triamcinolone reduces inflammation, redness, and itching associated with skin infections.
Pharmacokinetics
Onset
Relief from itching and inflammation typically occurs within a few days; complete fungal eradication may take several weeks.
Excretion
Econazole metabolites are excreted in urine and feces. Triamcinolone metabolites are primarily excreted in urine.
Half life
Not well established for topical application; systemic half-life of econazole is approximately 5-6 hours, triamcinolone acetonide is about 18-36 hours when given systemically, but topical absorption is minimal.
Absorption
Minimal systemic absorption occurs following topical application, especially on intact skin. Absorption may be increased if applied to large surface areas, damaged skin, or with occlusive dressings.
Metabolism
Econazole is extensively metabolized by the liver into inactive metabolites. Triamcinolone is primarily metabolized in the liver.
Side Effects
Contraindications
- Hypersensitivity to econazole, triamcinolone, or any component of the cream
- Tuberculosis of the skin
- Viral skin infections (e.g., herpes simplex, vaccinia, varicella)
- Acne rosacea, perioral dermatitis
- Primary bacterial skin infections
- Nappy rash
Drug Interactions
Warfarin
Concurrent use with large amounts of econazole may increase the anticoagulant effect of warfarin. Monitor INR.
Other topical corticosteroids
Avoid concurrent use to prevent excessive corticosteroid absorption.
Storage
Store below 30°C. Do not freeze. Keep out of reach of children.
Overdose
Topical overdose is unlikely to cause systemic effects due to minimal absorption. Excessive or prolonged use, especially on large areas or broken skin, may lead to local adverse effects (e.g., skin thinning) or rarely systemic corticosteroid effects. Discontinue use and manage symptoms.
Pregnancy & Lactation
Use with caution during pregnancy only if the potential benefit outweighs the potential risk. Avoid large areas or prolonged use. Consult a doctor. Use with caution during lactation; it is unknown if components are excreted in breast milk. Avoid applying to breasts.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date.
Availability
Pharmacies
Approval Status
Approved
Patent Status
Expired
Clinical Trials
Clinical trials have demonstrated the efficacy of econazole nitrate and triamcinolone acetonide in treating inflammatory fungal dermatoses.
Lab Monitoring
- Not typically required for topical use. For extensive or prolonged use, monitoring for systemic corticosteroid effects (e.g., blood glucose, adrenal function) might be considered, especially in children.
Doctor Notes
- Emphasize not to exceed the recommended duration of treatment due to the steroid component.
- Advise patients on proper application technique and hygiene to prevent recurrence.
- Be aware of potential for systemic absorption in infants and young children, or with extensive use.
Patient Guidelines
- Use exactly as directed by your doctor.
- Do not use for longer than prescribed, especially on the face or in skin folds.
- Avoid contact with eyes and mucous membranes.
- Wash hands before and after application.
- Report any worsening or new skin irritation to your doctor.
Missed Dose Advice
If a dose is missed, apply it as soon as remembered. Do not apply a double dose to make up for a missed one. Continue with the regular schedule.
Driving Precautions
Pevisone cream is for topical use and is not expected to affect the ability to drive or operate machinery.
Lifestyle Advice
- Keep the affected area clean and dry.
- Wear loose-fitting clothing to allow air circulation.
- Avoid sharing towels or clothing to prevent spread of infection.
- Complete the full course of treatment even if symptoms improve.
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