LOCOID LIPOCREAM

Indications

Approved Uses

Relief of inflammatory and pruritic manifestations of corticosteroid‑responsive dermatoses (e.g., eczema/atopic dermatitis, contact dermatitis, seborrheic dermatitis).

Dosage & Administration

Dosing by Condition

Corticosteroid‑responsive dermatoses (including atopic dermatitis): apply a thin layer to affected areas 1-2 times daily; reduce frequency once controlled and stop when resolved; seek reassessment if no improvement within ~2 weeks.

Initial Dose

Apply a thin layer to the affected area twice daily.

Maximum Dose

Apply a thin layer 1-2 times daily; reassess if not controlled within 2-4 weeks (earlier for face/intertriginous areas and in children), and avoid prolonged continuous use without medical review.

Children's Dosage

Children 3 months and older: Apply twice daily for up to 4 weeks; use with caution due to risk of HPA axis suppression.

Dose Adjustment Notes

No renal/hepatic dose adjustment is typically required for topical use; use the minimum effective amount and taper frequency as control is achieved; avoid occlusion unless directed; reassess if inadequate response after ~2 weeks or if worsening occurs.

How to Take

For topical use only: apply a thin layer to the affected skin and rub in gently; wash hands before and after use (unless treating the hands); avoid eyes, mouth, and other mucous membranes; do not use on broken/infected skin unless advised; avoid occlusive dressings/bandaging unless directed; use the smallest amount for the shortest duration needed.

Side Effects

Common Side Effects

Common: application-site burning/stinging, itching, irritation, redness, and dryness; with prolonged/excessive use: skin atrophy, striae, telangiectasia, folliculitis/acneiform eruptions, and hypopigmentation.

Side Effect Frequency

Common: application-site burning/stinging, pruritus, irritation, and dryness. Uncommon/rare: folliculitis, acneiform eruptions, allergic contact dermatitis, hypopigmentation, perioral dermatitis, hypertrichosis, skin atrophy, striae, telangiectasia, and secondary infection; very rare/systemic (with prolonged, extensive, or occlusive use-especially in children): HPA-axis suppression/Cushingoid effects.

Safety & Warnings

Contraindications

Hypersensitivity to hydrocortisone butyrate/excipients; untreated cutaneous infections (bacterial, fungal, viral-including herpes/varicella-or parasitic) unless appropriately treated; rosacea; acne vulgaris; perioral dermatitis.

Warnings & Precautions

Avoid eyes/mucosa; avoid occlusion unless directed; do not apply to infected lesions without appropriate antimicrobial therapy; use extra caution on face/groin/axillae and in children; limit duration/area to reduce atrophy and systemic absorption; advise to report visual symptoms and avoid prolonged periocular use.

Age Restriction

Safe and effective in pediatric patients 3 months of age and older when used as directed.

Driving Warning

Safe

Drug Interactions

Drug Interactions

No clinically significant drug interactions are expected with appropriate topical use; interaction concerns mainly relate to increased systemic corticosteroid exposure when used extensively/under occlusion (additive HPA-axis suppression with other corticosteroids).

Interaction Severity

No clinically significant drug-drug interactions expected with normal topical use; potential additive systemic corticosteroid effects (e.g., HPA axis suppression) if used extensively/under occlusion or combined with other corticosteroids.

Food Interaction

No clinically relevant food interactions (topical product).

Special Populations

Pregnancy

Caution

Breastfeeding

Caution

Children

Children 3 months and older: Apply twice daily for up to 4 weeks; use with caution due to risk of HPA axis suppression.

Elderly

Standard adult dosing; use with caution as elderly patients may have thinner, more fragile skin increasing risk of atrophy and systemic absorption

Kidney Impairment

No adjustment needed

Liver Impairment

No adjustment needed

Storage & Patient Advice

Stopping the Medicine

Stop when control is achieved; if used for prolonged periods or on large areas/under occlusion, taper by reducing frequency/potency to minimize rebound.

Overdose

Acute topical overdose is unlikely; chronic excessive use (large area, prolonged, occlusion) can cause local atrophy/striae and systemic effects (HPA-axis suppression/Cushingoid features); management is to stop or taper and provide supportive care; accidental ingestion warrants medical assessment.

Patient Counseling

Apply a thin layer to the affected skin once or twice daily (or as directed) and rub in gently; use the smallest amount for the shortest time needed. Avoid contact with eyes, mouth, and mucous membranes; do not apply to broken/infected skin unless advised. Do not use under occlusive dressings/diapers or on large areas unless instructed. Wash hands after application (unless treating hands). Stop and seek medical advice if irritation, signs of infection, or skin thinning/striae occur, or if no improvement within 1-2 weeks (or if needing use beyond ~2 weeks, especially on face/flexures/children).

Monitoring Requirements

Monitor clinical response and local adverse effects (atrophy, striae, telangiectasia, irritation, secondary infection); consider HPA axis suppression monitoring only if high-risk use (large surface area, prolonged duration, occlusion, pediatric use).

Pharmacology

Mechanism of Action

Topical glucocorticoid: binds intracellular glucocorticoid receptors to alter gene transcription, inducing lipocortins that inhibit phospholipase A2 and downstream prostaglandins/leukotrienes, producing anti‑inflammatory, antipruritic, and vasoconstrictive effects.

Onset of Action

Symptom improvement often begins within 1-3 days, with more noticeable benefit over several days; reassess if no improvement by ~2 weeks.

Duration of Effect

Not precisely defined; clinical benefit is maintained with regular use, and dosing is typically once or twice daily rather than based on a known hour-by-hour duration.

Bioavailability

Percutaneous absorption is generally low but variable; it increases with impaired/inflamed skin, application to thin-skin areas (e.g., face/flexures), large surface area use, prolonged use, and occlusion.

Excretion

Any systemically absorbed fraction is eliminated mainly via renal excretion of inactive metabolites (conjugated glucuronide/sulfate); minor biliary/fecal excretion may occur.

Product Information

Available Dosage Forms

For this SFDA-registered product: Cream (Lipocream) 0.1% in a 30 g tube.

Composition per Dose

Each gram of cream: 1 mg hydrocortisone butyrate (0.1%) in a lipocream base

Generic Availability

Yes

Skin Condition

Eczema/atopic dermatitis

Steroid Potency

Moderate

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