Hydrocortisone/ Diiodohydroxyquinoline/ Chlorobutanol

Registered South African indications:

• Atopic skin conditions 
• Neurodermatitis 
• Seborrhoeic dermatitis 
• Contact dermatitis 
• Ano-genital pruritus 

Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients

Contraindications

• Hypersensitivity to the active ingredient or any of the excipients in this combination product
• Infections caused by herpes simplex, cowpox, and varicella
• Pregnancy

Cautions

• Breastfeeding
• Renal impairment
• Hepatic impairment
• Elderly
• Occlusive dressings 
• Plaque psoriasis 
• Paediatrics
• Prolonged use
• High doses
• Thyroid disease

Forms avail. in SA and covered in this monograph: cre

Atopic skin conditions 
Eczema
Neurodermatitis 
Seborrhoeic dermatitis 
Contact dermatitis 
Ano-genital pruritus

Hydrocortisone/ Diiodohydroxyquinoline/ Chlorobutanol
12.5/150/50 (mg/5g)

• Topical (cre): Apply to affected area with a protective dressing, 8-12hrly 

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Cream is for external use only

Not established for use in children

Recommendations for this combination product as per highest risk category when comparing individual active ingredients

Pregnancy

• Contraindicated

Breastfeeding

• Caution; not recommended (Hydrocortisone)

Renal Impairment

• Caution; no dose adjustment recommended (Hydrocortisone)

Hepatic Impairment

• Contraindicated (Diiodohydroxyquinoline)

Elderly

• Caution; dose adjustment recommended (Hydrocortisone)

Drugs in Sport

• Permitted - No warning

Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients

Hydrocortisone
Central Nervous System Disorders 

• Euphoria
• Psychological dependence
• Depression
• Insomnia
• Aggravation of schizophrenia 
• Increased intra-cranial pressure with papilloedema in children
• Aggravation of epilepsy

Cardiovascular Disorders 

• Bradycardia
• Cardiac arrest
• Cardiac arrhythmias
• Cardiac enlargement
• Congestive heart failure
• Fat embolism
• Hypertension
• Hypertrophic cardiomyopathy in premature infants
• Myocardial rupture following recent myocardial infarction 
• Pulmonary oedema
• Syncope
• Tachycardia
• Thromboembolism
• Thrombophlebitis
• Vasculitis

Gastrointestinal Disorders 

• Dyspepsia
• Peptic ulceration with perforation and haemorrhage
• Acute pancreatitis
• Candidiasis

Endocrine and Metabolic Disorders 

• Suppression of the hypothalamic-pituitary-adrenal axis
• Growth suppression (children)
• Menstrual irregularity and amenorrhoea
• Cushingoid faces
• Hirsutism
• Increased weight 
• Impaired carbohydrate tolerance
• Negative protein balance 
• Negative calcium balance
• Increased appetite
• Sodium and water retention
• Hypokalaemic alkalosis

Musculoskeletal Disorders

• Osteoporosis
• Vertebral and long bone fractures
• Avascular osteonecrosis
• Tendon rupture
• Proximal myopathy

Skin and Subcutaneous Tissue Disorders 

• Impaired healing
• Pruritis
• Skin atrophy
• Striae 
• Telangectasia
• Pustular acne
• Peri-oral dermatitis
• Skin depigmentation
• Dermatitis
• Eczema
• Ecchymoses

Immune, Blood and Lympathic system disorders 

• Increased susceptibility and severity of infections
• Opportunistic infections
• Recurrence of dormant tuberculosis 
• Hypersensitivity
• Leucocytosis

Sensory Disorders 

• Increased intraocular pressure
• Glaucoma
• Papilloedema
• Posterior subcapsular cataracts
• Corneal or scleral thinning
• Exacerbation of ophthalmic viral or fungal diseases

Others 

• Flushing

Diiodohydroxyquinoline
Central Nervous System Disorders 

• Chills
• Headache
• Peripheral neuropathy
• Vertigo
• Fever

Gastrointestinal Disorders

• Abdominal cramps
• Diarrhoea
• Nausea and vomiting
• Pruritus ani

Endocrine and Metabolic Disorders

• Goitre

Skin and Subcutaneous Tissue Disorders

• Pruritus
• Skin rash
• Urticaria

Sensory Disorders

• Optic atrophy
• Optic neuritis

No information available 

None routine. Specific cases may require

• Blood glucose
• Electrolytes
• Ophthalmic examination

Hydrocortisone
Hydrocortisone inhibits the release of arachadonic acid from the cell membrane and thus interferes with the initiation of the inflammatory response. It may depress the formation, release and activity of endogenous chemical mediators of inflammation. It has anti-inflammatory, antipruritic, antiallergic and vasoconstrictive effects.

Diiodohydroxyquinoline
Diiodohydroxyquinoline is a quinoline derivative that can be used to treat amoebiasis; the exact mechanism of action is unknown.

Chlorobutanol
This ingredient has no pharmacological effect.

COMBINATION PREPARATIONS

Hydrocortisone/ Diiodohydroxyquinoline/ Chlorobutanol

Cream 12.5mg/150mg/50mg

• Viocort (Pharmacare)