Chinese Fluocinonide Ointment: Facts and Warnings

The active constituent fluocinonide is generally available for prescription use. But, while Amfulan and Lidex – two recognized tradenames of floucinonide requires a written order from a physician, the Chinese Fluocinonide can be bought without a prescription. In the Philippines, Chinese Fluocinonide is usually procured in Chinese shops. However, it can also be bought from market places and even from side-walk vendors. Faith healers also promote Chinese Fluocinonide use. Interestingly, these people are citing Chinese Fluocinonide safety for use in new born infants.

Fluocinonide is a recognized topical medication for various skin disorders usually applied 2 to 3 times a day.  It is categorized as a corticosteroid useful for dermatitis, psoriasis, eczema and for other allergic skin inflammation.  Although, popular as an ointment, fluocinonide can also be available in lotion, cream and in gel dosage forms. Fluocinonide strength is generally 0.025 to 0.05 percent. While Lidex (MEDICIS), Dermadex (Tianjin Pharmaceuticals), Amfulan (Everest Pharm) - some tradenames of fluocinonide are to be used in precaution with pregnant women and children, Chinese Fluocinonide is a type of floucinomide that is revealed as safe for babies. True?

Facts about the Chinese Fluocinonide

Chinese Fluocinonide is actually a generic fluocinonide made from China. It is manufactured by Tianjin Pacific Pharmaceutical Technology Group. Chinese Fluocinonide ointment is available in 10 and 20 gram tubes. While 2.5 mg of fluocinonide comprises the 10g tube, 5mg of the active ingredient makes up the 20 gram tube.  However, under the company name Pacific Pharmaceuticals Co Ltd which is also Tianjin Pacific Pharmaceutical Technology Group, Chinese Fluocinonide is only available in 2.5mg per 10 gram only.

  • Precautions

Like other fluocinonide equivalents, it is to be used in precaution with pregnant women and breastfeeding mothers. Although, topically applied and may not affect the fetus and the milk, care should be exercised. Fluocinonide should not be applied on the breasts. It is categorized as C concerning pregnancy which means it has only been found teratogenic in animal fetuses but not in human.  However, there are no sufficient data regarding this matter. Fluocinonide should not be used by pregnant women if possible.

There are incidences of Cushing’s syndrome, HPA axis suppression and intracranial hypertension in children under topical corticosteroid therefore; floucinonide application should be reduced in young people.  Fluocinonide should not be used by both children and adults for a long period of time.

  • Contraindications

As a corticosteroid, fluocinonide is contraindicated with fungal and viral infections. Corticosteroids have been known to weaken the immune system that it won’t be useful for skin problems of fungal or viral origins.

  • Side effects

Some side effects of fluocinonide are allergic skin reactions like burning and itching. Prolonged use of this ointment may cause telangiectasia (dilatation of the small blood vessels).

Image by the author

Health concerns and warnings about Chinese Fluocinonide ointment

In the Philippines, Chinese Fluocinonide is more popular than the brandname Lidex or Dermadex. It is usually recognized as the ‘green tube with the Chinese markings’ not for its actual name. Not only that this generic fluocinonide is cheap and can be bought almost everywhere, Chinese Fluocinonide is highly suggested for its use in many skin problems including psoriasis and eczema.

However, as Chinese Fluocinonide is recognized as a non-prescription medication, its use is taken for granted and misunderstood. Someone who had been successful using this ‘green tube’ will recommend it to a family or friend or to other people. Witch doctors and even faith healers give Chinese Fluocinonide to their patients. These people are confident that this medication can cure any skin problems.

As a corticosteroid, Chinese Fluocinonide can be very effective indeed - but, not for all types of skin conditions. Viral (e.g. chicken pox) and fungal (e.g. ringworm) origins are some exceptions since fluocinonide can make these worse.

Chinese Fluocinonide revealed as safe for newborn infants is also not true. Like other fluocinonide equivalents, it can be indicated for children and babies but with a great precaution because younger people are delicate. Children and infants have small body mass compared to the adults. Thus, they are more at risk for corticosteroid absorption which can be lead to health issues including growth retardation.

Finally, Chinese Fluocinonide ointment may have a legitimate drug company. However, since this medication is not really available for the Philippines, most Chinese Fluocinonide can be counterfeit drugs. Medicines nowadays are often tampered especially those types with foreign and unfamilliar markings. It is best to procure these products from a genuine distributor or wiser, to see a registered physician prior using a Chinese Fluocinonide ointment.

© Phoenix Montoya @ September 5, 2012

References:

  1. http://mims.com/China/drug/info/Fluocinonide-Pacific%20Pharm/Fluocinonide%20oint-Pacific%20Pharm?q=fluocinonide&type=brief
  2. http://www.pacificphar.com/en/company2.asp

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Quadriderm Cream

What is Quadriderm cream used for? Quadriderm ointment or cream is a topical dermatological preparation highly effective in treating many skin disorders. Quadriderm cream or ointment should be stored in a cool place and protected from light and moisture. The validity of Quadriderm ointment or cream is 36 months, and is recorded on the outer packaging, in case of expiration render the product unusable.

Quadriderm cream

Quadriderm cream or ointment contains betamethasone as 17 - valerate (0.05%), gentamicin sulfate (0.1%), Tolnaftate (1%) and clioquinol (1%).

Quadriderm cream or ointment - Tubes with 20 grams.

What is Quadriderm cream used for?

Quadriderm ointment or cream is a topical dermatological preparation highly effective in treating many skin disorders.

Quadriderm cream or ointment should be stored in a cool place and protected from light and moisture.

The validity of Quadriderm ointment or cream is 36 months, and is recorded on the outer packaging, in case of expiration render the product unusable.

Tell your doctor the occurrence of pregnancy during treatment or after its termination. Inform your doctor if you are breastfeeding. Follow the advice of your doctor, always respecting the schedules, doses and duration of treatment. Do not stop treatment without the knowledge of your doctor. Tell your doctor the appearance of unpleasant reactions such as burning, itching, irritation and dry skin. Tell your doctor about any medication you are using before the start or during treatment.

Quadriderm ointment or cream is not suitable for ophthalmic use.

TECHNICAL INFORMATION - Quadriderm

Quadriderm cream or ointment is a topical dermatological preparation highly effective in treating many skin disorders. Quadriderm ensures greater safety of therapeutic success, especially when the causative agent cannot be readily identified.

Because it is a composition of four agents with different pharmacological effects, Quadriderm provides anti-inflammatory, antibacterial and antifungal in the treatment of inflammatory and allergic skin disorders complicated by some types of bacteria or fungi, including Candida.

Quadriderm cream uses

Quadriderm is indicated for topical use in dermatoses caused, complicated or threatened by some types dde bacterial or fungal infection, including candidiasis. It is indicated for the prevention and treatment of infections caused by bacteria or fungi in a variety of eczema and other allergic and inflammatory dermatoses. It has been used successfully to treat acne inguinal, chronic dermatoses of the extremities, erythrasma the external ear otitis, balanoposthitis, herpes zoster, dermatitis, eczema, contact dermatitis, dermatitis microbial follicular dermatitis, dyshidrosis, paronychia (candida) anal pruritus, intertrigo, seborrheic eczema, parakeratosis, pustular acne, impetigo of the scalp, neurodermatitis, angular stomatitis, seborrheic dermatitis, occipital area, photosensitivity dermatitis, lichenified and groin ringworm ringworm infections, like tinea cruris, tinea pedis, and tinea corporis.

CONTRAINDICATIONS - Quadriderm

Quadriderm cream or ointment is contraindicated in patients with a history of hypersensitivity to any of its components. It is also contraindicated in cases of tuberculous lesions of the skin, acute herpes simplex, vaccinia and varicella.

WARNINGS - Quadriderm

any adverse effects reported to the systemic application of corticosteroids, which include adrenal suppression, may also take place with topical corticosteroids, especially in children and newborns.

The absorption of Quadriderm cream or ointment will be larger if wide body surface are treated or if the occlusive method is used. Possible safety measures ought to be taken in advance in these situations or when it is prolonged use of the product, particularly in young children.

Prolonged use of topical antibiotics may occasionally result in growth of non-susceptible organisms. If this occurs, or if irritation, sensitization or super infections are present, treatment with Quadriderm cream or ointment should be discontinued and appropriate therapy should be instituted.

The ferric chloride test for phenylketonuria may yield false positive if clioquinol is present in the urine.

Light stains on clothing may occur due to clioquinol.

Quadriderm cream or ointment is not suitable for ophthalmic use.

Ascof and Solmux: A Comparison of Two Cough Remedies

A comparison between the herbal medicine Ascof and the synthetic cough cure Solmux – two popular cough remedy the Philippines. Is Ascof better than Solmux?

In the Philippines, most cough remedies are considered as OTC or Over-The- Counter medications. Customers usually choose a product based on  drug popularity. The more they see or hear about it from the media, the more they feel secure in purchasing the product for their loved ones or for themselves.

 Ascof and Solmux are two common cough cures. While Ascof is known as a herbal remedy, Solmux as a carbocisteine is also notorious for being in the market for 50 years as a mucoregulator in respiratory diseases  since the 1960s. Both claim efficacy and safety, but which of the two is really better?

Ascof

 

Image by the author

Manufactured by Pascual/ Altermed, Ascof (Lagundi) is from a herbal source. It is indicated for bronchospasm in acute bronchial asthma, chronic bronchitis and other bronco pulmonary disorder.

Contraindication: No known contraindication.

Precaution: Pregnancy and lactation.

Side-effect: Itchiness, nausea and vomiting, tachycardia, diarrhea, drowsiness and body malaise.

Solmux 

Image by the author

Solmux (Carbocisteine) is a derivative of cysteine which is an amino acid. It is manufactured by Westmont/ Unilab Consumer Health and its primary use is to reduce the viscosity of pulmonary secretions in patients. It is for wet productive coughs, to help eliminate phlegm.

Contraindication: Peptic ulcer.

Side-effect: GI disturbance, GI bleeding, headache, skin rash.

Ascof and Solmux comparison

  • Formulation

Ascof and Solmux have different formulations. Ascof is available in 300mg tablet, 600mg caplet and in 300mg syrup drug form. It contains powdered Lagundi leaves (Vitex negundo linne family Verbenaceae). Ascof is for mild to moderate cough usually associated with common colds.

Solmux is available in 500mg capsule and in suspension forms. It has a mucolytic property. It is more beneficial in eliminating excessive mucous in the lungs.

  • Relief

Solmux in its encapsulated form has faster effect than Ascof tablet. Capsule forms of medications have greater dissolution compared to tablets thus they have faster relief. On the other hand, syrup has faster effect than suspension types. This means, Ascof syrup has a much faster effect than Solmux suspension.

  • Safety

Ascof reveals some mild side effects on few patients like itchiness, vomiting etc. These adverse reactions as they claim were reported without prevailing complaint with similar frequency on the placebo control. Solmux’s adverse effect involves gastric upsets. This drug is also used in precaution with old people with severe respiratory insufficiency or asthmatic patients.

Ascof VS Solmux

Considering the formulation, Ascof is more attractive for most consumers because of its herbal origin.  As for relief, liquid forms of medication have faster action and both Solmux and Lagundi have these dosage forms. Although, in terms of solid preparations, Solmux capsule is better than Ascof tablet.

Regarding safety, Ascof has no known contraindications and has mild adverse reactions that are reported rarely. However like most drugs, it is used in precaution with pregnant women and in lactation. Solmux on the other hand, causes stomach upsets, thus strictly contraindicated to people with peptic ulcer. More to this, it is also to be used in precaution with old people with weak lungs or asthmatic patients.

So which is better?

Summing it up, Ascof may have all the advantages over Solmux. But, these drugs possess dissimilar modes of action. Solmux is a mucolytic while Ascof is a simple cough formula with an anti-asthma effect. Ascof won’t be effective enough if the cough will be involving too much phlegm in the lungs. On the contrary, Solmux will not be also suitable for a simple cough with asthma involved.

References:

MIMS online

Dovepress

Wilson and Gisvold’s Textbook of Organic Medicinal and Pharmaceutical Chemistry 9th edition

LS BL: Antifungal Corticosteroid Cream

LS BL cream seems to be an improved form of Chinese BL - a popular antifungal agent more recognized for its whitening effect. Contrary to this, LS BL has the same content as Chinese BL cream. With the recent research of the author, it has been found out that Chinese BL not only possesses ketoconazole but clobetasole as well. In the Philippines, LS BL cream is a registered form of Chinese BL cream. Interestingly, similar to Chinese BL, LS BL cream can also be bought anywhere. This is a review about LS BL cream and some warnings.

In the Philippines, LS BL cream is imported and distributed by Manxing Enterprise Corporation from Shanghai Baolong Pharmaceutical Co. Ltd in China. LS BL cream is legal as it is registered in the Food and Drug Authority (FDA).  Unfortunately, like the unregistered Chinese BL, there are also counterfeit LS BL creams.

LS BL cream facts

Similar to the Chinese BL cream, LS BL has ketoconazole with the corticosteroid clobetasol. LS BL is a combination of a 10mg/g ketoconazole and a 500mcg/g clobetasol. Like the Chinese BL, LS BL is a 7g cream contained in a maroon jar.

LS BL is a prescription topical preparation indicated for fungal infections including tinea cruris (jock itch), tinea corporis (ringworm), tinea pedis (athlete’s foot) etc. Because it also contains clobetasol, LS BL can be a lot helpful when the itching and inflammation are severe.

More to this, LS BL is cited to be effective for dermatitis like seborrhoeic dermatitis, atopic dermatitis or eczema and psoriasis.

LS BL is applied one to two times daily.

Dangers

LS BL cream is contraindicated to individuals who have allergies to its components. Although, it is only applied over the skin, LS BL cream can also reach the systemic circulation. It should not be used for a long period of time or applied in the large area of the body. LS BL is to be used in precaution in pregnant and breastfeeding mothers.

Infants and children are apt to have LS BL cream into the bloodstream because they have larger skin area to body weight ratio in comparison to the adults. Newborns or premature babies can also absorb high quantities of clobetasole because of the incomplete development of the stratus corneum – the outermost layer of the skin.

With ketoconazole alone, any topical agent with this active constituent is an OTC or over-the-counter product. But, because LS BL cream contains clobetasole it is categorized as a prescription medicine.

Clobetasole is a corticosteroid and as a steroid it can cause cushing syndrome, intracranial hypertension and growth retardation in children.  More to this, prolonged use of a potent topical corticosteroid like clobetasole or a preparation containing this active constituent can cause cataract, diabetes mellitus, glaucoma and tuberculosis.

Whitening effect?

Similar to the Chinese BL, LS BL cream is not indicated for skin lightening or whitening effect. LS BL is primarily indicated for fungal infections.

Image by the author

Recommendations and warnings

As mentioned LS BL cream is more legal than the Chinese BL cream in the Philippines. LS BL cream was registered in the FDA (Food and Drug Authority) Philippines since December 2012 under the DR number DR-XY40466.

However, because LS BL is also popular like the Chinese BL, it is usually imitated. The photo of LS BL cream above was a purchase of the author from a grocery store. Interestingly, the clerk was selling it for its whitening benefits, unmindful that LS BL cream is a prescription drug.

LS BL cream, similar to the Chinese BL has clobetasole. A topical preparation containing corticosteroid should not be used for over two weeks. It is frightening that some women use LS BL cream as a beauty lotion. LS BL like Chinese BL is primarily for fungal infections. As LS BL cream contains clobetasole propionate, an advice from a registered physician is essential.

Finally, since LS BL cream is FDA approved. Consumers should only buy this product in registered drug outlets to avoid a counterfeit or fake LS BL cream.

© Phoenix Montoya @ January 28, 2013

References:

  1. LS BL cream leaflet
  2. Clobetasole leaflet
  3. http://www.fda.gov.ph/database/k.pdf
  4. http://www.mayoclinic.com/health/seborrheic-dermatitis/DS00984/DSECTION=causes

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