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System Formulary Update
Topical Corticosteroids Formulary Update
Situation
The topical corticosteroids class review and formulary standardization was approved at the <month> 2021 System Pharmacy and Therapeutics Committee meeting.
Background
The following medications were reviewed: alclometasone dipropionate, amcinonide, betamethasone dipropionate, betamethasone valerate, betamethasone and clomitrazole, clobetasol propionate, clocortolone pivalate, desonide, desoximetasone, diflorasone diacetate, fluocinolone acetonide, fluocinonide, fluticasone propionate, flurandrenolide, halobetasol propionate, halocinonide, hydrocortisone (base, > 2%), hydrocortisone (base, < 2%), hydrocortisone acetate, hydrocortisone butyrate, hydrocortisone probutate, hydrocortisone valerate, hydrocortisone and pramoxine, mometasone furoate, nystatin and triamcinolone, prednicarbate, triamcinolone acetonide
Assessment/Recommendation
Changes effective: Tuesday, May 24, 2022
System P&T voted to include the following products on the UNC Health Medication Formulary:
- Betamethasone and clotrimazole 0.05%-1% cream (15 g, 45 g)
- Clobetasol propionate 0.05% ointment (15 g, 30 g, 60 g)
- Clobetasol propionate 0.05% cream (15 g, 30 g, 60 g)
- Fluocinonide 0.05% cream (15 g, 30 g)
- Fluocinonide 0.05% ointment (15 g, 30 g)
- Fluocinonide 0.05% solution (60 mL)
- Hydrocortisone 2.5% cream (20 g, 28 g, 30 g, 454 g)
- Hydrocortisone 2.5% ointment (28 g, 454 g)
- Hydrocortisone 1% cream (30 g)
- Hydrocortisone 1% ointment (28 g, 454 g)
- Hydrocortisone and pramoxine 1%-1% rectal foam (10 g)
- Triamcinolone acetonide 0.025% cream (15 g, 80 g)
- Triamcinolone acetonide 0.025% ointment (15 g, 80 g, 454 g)
- Triamcinolone acetonide 0.05% emollient cream (extemporaneous compound, 454 g)
- Triamcinolone acetonide 0.1% cream (15 g, 80 g, 454 g)
- Triamcinolone acetonide 0.1% ointment (15 g, 454 g)
- Triamcinolone acetonide 0.1% dental paste (5 g)
- Triamcinolone acetonide 0.5% cream (15 g)
- Triamcinolone and nystatin 100,000 unit/g (0.1%) cream (15 g)
Note: Stock of these formulary products may vary at individual entities
As a result, the following products will be removed from the UNC Health Medication Formulary
- Alclometasone dipropionate 0.05% cream (all sizes)
- Alclometasone dipropionate 0.05% ointment (all sizes)
- Amcinonide 0.1% cream (all sizes)
- Amcinonide 0.1% lotion (all sizes)
- Betamethasone dipropionate 0.05% cream, augmented (all sizes)
- Betamethasone dipropionate 0.05% lotion, augmented (all sizes)
- Betamethasone dipropionate 0.05% gel, augmented (all sizes)
- Betamethasone dipropionate 0.05% ointment, augmented (all sizes)
- Betamethasone dipropionate 0.05% cream (all sizes)
- Betamethasone dipropionate 0.05% ointment (all sizes)
- Betamethasone dipropionate 0.05% spray (all sizes)
- Betamethasone valerate 0.1% cream (all sizes)
- Betamethasone valerate 0.1% lotion (all sizes)
- Betamethasone valerate 0.1% ointment (all sizes)
- Betamethasone valerate 0.12% foam (all sizes)
- Betamethasone and clotrimazole 0.05%-1% lotion (all sizes)
- Clobetasol propionate 0.025% cream (all sizes)
- Clobetasol propionate 0.05% cream, emollient (all sizes)
- Clobetasol propionate 0.05% gel (all sizes)
- Clobetasol propionate 0.05% foam (all sizes)
- Clobetasol propionate 0.05% lotion (all sizes)
- Clobetasol propionate 0.05% ointment (45 g)
- Clobetasol propionate 0.05% spray (all sizes)
- Clobetasol propionate 0.05% shampoo (all sizes)
- Clobetasol propionate 0.05% solution (all sizes)
- Clocortolone pivalate 0.1% cream (all sizes)
- Desonide 0.05% cream (all sizes)
- Desonide 0.05% foam (all sizes)
- Desonide 0.05% gel (all sizes)
- Desonide 0.05% lotion (all sizes)
- Desonide 0.05% ointment (all sizes)
- Desoximetasone 0.05% cream (all sizes)
- Desoximetasone 0.05% gel (all sizes)
- Desoximetasone 0.05% ointment (all sizes)
- Desoximetasone 0.25% spray (all sizes)
- Desoximetasone 0.25% cream (all sizes)
- Desoximetasone 0.25% ointment (all sizes)
- Desoximetasone 0.25% spray (all sizes)
- Diflorasone diacetate 0.05% ointment (all sizes)
- Diflorasone diacetate 0.05% cream, emollient (all sizes)
- Diflorasone diacetate 0.05% ointment (all sizes)
- Diflorasone diacetate 0.05% cream (all sizes)
- Fluocinolone acetonide 0.01% cream (all sizes)
- Fluocinolone acetonide 0.01% oil (all sizes)
- Fluocinolone acetonide 0.01% shampoo (all sizes)
- Fluocinolone acetonide 0.01% solution (all sizes)
- Fluocinolone acetonide 0.025% cream (all sizes)
- Fluocinolone acetonide 0.025% ointment (all sizes)
- Fluocinonide 0.05% cream (60 g, 120 g)
- Fluocinonide 0.05% emollient cream (all sizes)
- Fluocinonide 0.05% gel (all sizes)
- Fluocinonide 0.05% ointment (60 g)
- Fluocinonide 0.05% solution (20 mL)
- Fluocinolone 0.05% cream (all sizes)
- Fluocinonide 0.05% cream, emollient (all sizes)
- Fluocinonide 0.1% cream (all sizes)
- Fluticasone propionate 0.005% ointment (all sizes)
- Fluticasone propionate 0.05% cream (all sizes)
- Fluticasone propionate 0.05% lotion (all sizes)
- Flurandrenolide 0.05% cream (all sizes)
- Flurandrenolide 0.05% lotion (all sizes)
- Flurandrenolide 0.05% ointment (all sizes)
- Flurandrenolide 4mcg/m2 tape
- Halcinonide 0.1% cream (all sizes)
- Halcinonide 0.1% ointment (all sizes)
- Halcinonide 0.1% solution (all sizes)
- Halobetasol propionate 0.05% cream (all sizes)
- Halobetasol propionate 0.05% foam (all sizes)
- Halobetasol propionate 0.05% lotion (all sizes)
- Halobetasol propionate 0.05% ointment (all sizes)
- Halobetasol propionate 0.1% lotion (all sizes)
- Hydrocortisone 0.5% cream (all sizes)
- Hydrocortisone 0.5% ointment (all sizes)
- Hydrocortisone 2% lotion (all sizes)
- Hydrocortisone 2.5% rectal cream (28.35 g, 30 g)
- Hydrocortisone 2.5% lotion (all sizes)
- Hydrocortisone 2.5% ointment (20 g)
- Hydrocortisone 2.5% solution (all sizes)
- Hydrocortisone 1% cream (14 g, 28 g, 57 g, 99 g, 283 g, 454 g)
- Hydrocortisone 1% gel (all sizes)
- Hydrocortisone 1% lotion (all sizes)
- Hydrocortisone 1% solution (all sizes)
- Hydrocortisone acetate 0.5% cream (all sizes)
- Hydrocortisone acetate 1% cream (all sizes)
- Hydrocortisone acetate 2% lotion (all sizes)
- Hydrocortisone butyrate 0.1% cream (all sizes)
- Hydrocortisone butyrate 0.1% lotion (all sizes)
- Hydrocortisone butyrate 0.1% ointment (all sizes)
- Hydrocortisone butyrate 0.1% solution (all sizes)
- Hydrocortisone probutate 0.1% cream (all sizes)
- Hydrocortisone valerate 0.2% cream (all sizes)
- Hydrocortisone valerate 0.2% ointment (all sizes)
- Hydrocortisone and glycerin 10% cream (extemporaneous compound)
- Hydrocortisone 10% in white petrolatum (extemporaneous compound)
- Hydrocortisone and pramoxine 1%-1% aerosol topical foam (all sizes)
- Hydrocortisone and pramoxine 1%-1% cream (all sizes)
- Hydrocortisone and pramoxine 1%-1% ointment (all sizes)
- Hydrocortisone and pramoxine 2.5%-1% cream (all sizes)
- Hydrocortisone and pramoxine 2.5%-1% lotion (all sizes)
- Hydrocortisone and pramoxine 2.5%-1% ointment (all sizes)
- Mometasone furoate 0.1% cream (all sizes)
- Mometasone furoate 0.1% lotion (all sizes)
- Mometasone furoate 0.1% ointment (all sizes)
- Mometasone furoate 0.1% solution (all sizes)
- Prednicarbate 0.1% ointment (all sizes)
- Triamcinolone acetonide 0.025% cream (454 g)
- Triamcinolone acetonide 0.025% emollient cream (extemporaneous compound)
- Triamcinolone acetonide 0.025% lotion (all sizes)
- Triamcinolone acetonide 0.05% in absorbase cream (extemporaneous compound)
- Triamcinolone acetonide 0.05% ointment (all sizes)
- Triamcinolone acetonide 0.5% ointment (all sizes)
- Triamcinolone acetonide 0.1% cream (30 g)
- Triamcinolone acetonide 0.1% lotion (all sizes)
- Triamcinolone acetonide 0.1% ointment (30 g, 80 g)
- Triamcinolone acetonide 0.2 mg/2 sec aerosol spray (all sizes)
- Triamcinolone in absorbase 0.05%
- Triamcinolone and nystatin 100,000 unit/g (0.1%) cream (30 g, 60 g)
- Triamcinolone and nystatin 100,000 unit/g (0.1%) ointment (all sizes)
- Triamcinolone-menthol-camphor lotion
Non-formulary orders will be converted according to the following therapeutic interchange:
Corticosteroids, Topical |
|
|
Non-Formulary Order |
Formulary Equivalent Order |
|
Hydrocortisone 2.5% rectal cream Apply to the affected area once daily Apply to the affected area twice daily |
Dibucaine 1% ointment Apply to the affected area once daily Apply to the affected area twice daily |
|
Alclometasone dipropionate 0.05% cream Apply to the affected area twice daily Apply to the affected area three times daily |
Hydrocortisone 1% cream Apply to the affected area twice daily Apply to the affected area three times daily |
|
Alclometasone dipropionate 0.05% ointment Apply to the affected area twice daily Apply to the affected area three times daily |
Hydrocortisone 1% ointment Apply to the affected area twice daily Apply to the affected area three times daily |
|
Betamethasone dipropionate 0.05% cream Apply to the affected area once daily Apply to the affected area twice daily |
Triamcinolone acetonide 0.5% cream Apply to the affected area once daily Apply to the affected area twice daily |
|
Betamethasone valerate 0.1% cream Apply to the affected area once daily Apply to the affected area twice daily |
Triamcinolone acetonide 0.1% cream Apply to the affected area once daily Apply to the affected area twice daily |
|
Betamethasone valerate 0.1% lotion Apply to the affected area once daily Apply to the affected area twice daily |
Triamcinolone acetonide 0.025% cream Apply to the affected area once daily Apply to the affected area twice daily |
|
Betamethasone valerate 0.1% ointment Apply to the affected area once daily Apply to the affected area twice daily |
Triamcinolone acetonide 0.1% ointment Apply to the affected area once daily Apply to the affected area twice daily |
|
Clobetasol propionate 0.05% foam Apply to the affected area twice daily |
Clobetasol propionate 0.05% ointment Apply to the affected area twice daily |
|
Clobetasol propionate 0.05% gel Apply to the affected area twice daily |
Clobetasol propionate 0.05% ointment Apply to the affected area twice daily |
|
Clobetasol propionate 0.05% solution (scalp) Apply to the affected area twice daily |
Fluocinonide 0.05% solution (scalp) Apply to the affected area twice daily |
|
Clobetasol propionate 0.05% emollient cream Apply to the affected area twice daily |
Clobetasol propionate 0.05% ointment Apply to the affected area twice daily |
|
Clocortolone pivalate 0.1% cream Apply to the affected area three times daily |
Triamcinolone acetonide 0.1% cream Apply to the affected area twice daily |
|
Desonide 0.05% cream Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
Triamcinolone acetonide 0.025% cream Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
|
Desonide 0.05% ointment Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
Triamcinolone acetonide 0.025% ointment Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
|
Desoximetasone 0.25% cream Apply to the affected area twice daily |
Fluocinonide 0.05% cream Apply to the affected area twice daily |
|
Desoximetasone 0.25% ointment Apply to the affected area twice daily |
Fluocinonide 0.05% ointment Apply to the affected area twice daily |
|
Desoximetasone 0.05% cream Apply to the affected area twice daily |
Triamcinolone acetonide 0.5% cream Apply to the affected area twice daily |
|
Fluocinolone acetonide 0.01% cream Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
Triamcinolone acetonide 0.025% cream Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
|
Fluocinolone acetonide 0.025% ointment Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
Triamcinolone acetonide 0.1% ointment Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
|
Fluocinonide 0.05% gel Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
Fluocinonide 0.05% cream Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
|
Fluocinonide 0.05% emollient cream Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
Triamcinolone acetonide 0.5% cream Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
|
Hydrocortisone 0.5% cream Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
Hydrocortisone 1% cream Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
|
Hydrocortisone 1% lotion Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
Hydrocortisone 1% cream Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
|
Hydrocortisone 2.5% lotion Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
Hydrocortisone 2.5% cream Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
|
Hydrocortisone acetate 0.5% cream Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
Hydrocortisone 1% cream Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
|
Hydrocortisone acetate 1% cream Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
Hydrocortisone 1% cream Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
|
Hydrocortisone butyrate 0.1% ointment Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily |
Triamcinolone 0.025% ointment Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily |
|
Mometasone furoate 0.1% cream Apply to the affected area once daily |
Triamcinolone acetonide 0.1% cream Apply to the affected area once daily |
|
Nystatin and triamcinolone 100,000 unit/g (0.1%) ointment Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
Nystatin and triamcinolone 100,000 unit/g (0.1%) cream Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
|
Triamcinolone acetonide 0.05% ointment Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |
Triamcinolone acetonide 0.1% ointment Apply to the affected area once daily Apply to the affected area twice daily Apply to the affected area three times daily Apply to the affected area four times daily |