Desoximetasone (topical)

As a topically-applied corticosteroid with anti-inflammatory properties, Desoximetasone helps to alleviate redness and irritation of the skin and can be used to treat rashes.

Overview

Desoximetasone, which is often marketed in the US as Topicort or Topisolone, is a topical cream which belongs to a family of medicines known as corticosteroids. It is synthetically produced and has anti-pruritic and anti-inflammatory properties, making it particularly effective as a treatment for psoriasis, skin rashes, eczema, dermatitis, irritation, redness and itching.

It is approved by the FDA and is a relatively inexpensive drug to manufacture, making it a popular choice in the treatment of skin conditions. It is available in a variety of strengths ranging from 0.5mg per gram concentration, which is typically used to treat minor ailments, to 2.5mg per gram concentrations which are prescribed for more serious dermatological conditions.

The precise mechanism of Desoximetasone is unknown, although it is thought to act via the induction of phospholipase inhibitory proteins. This is achieved when the drug binds to the glutocorticoid receptors before translocating to the nucleus and binding to the DNA, causing various repressions of genes, including the inhibition of arachidonic acid, which is a contributor to inflammation and redness.

Desoximetasone is currently prescribed in more than 100 countries worldwide, including the United States, Spain, France and Germany, typically as a cream or ointment. In smaller concentrations it is sometimes sold in gel form, and in its strongest form it is available as a spray.

Type of medicine

  • Corticosteroid

Conditions treated

  • Skin rash
  • Psoriasis
  • Eczema
  • Dermatitis

Side effects

Along with its desired effects, Desoximetasone can also cause some unwanted side effects in certain patients. The most commonly reported side effects by people undergoing treatment with this medicine include the following: unusually warm skin, redness/blistering/peeling or loosening of the skin, flushing of the skin and/or irritation.

As the patient continues to apply Desoximetasone topical cream as prescribed, most (if not all) of the previously mentioned side effects should start to lessen. If side effects persist over a prolonged period or appear to get worse, the patient is advised to contact their doctor immediately. In some instances, a healthcare provider may be able to offer suggestions on how to treat side effects which cause mild discomfort with over the counter remedies or natural medicines.

Generally, most patients will only experience minimal side effects when undergoing treatment with Desoximetasone. Most doctors agree that the benefits of treating painful or irritating dermatological conditions with this medicine for a short period far outweigh the risks of experiencing the mild discomfort caused by side effects.

Other side effects which are experienced rarely, albeit often enough to warrant mentioning, include the following: thinning of the skin, easily bruising skin (particularly on the face or wherever the skin folds together, such as between the fingers), redness or scaling around the mouth, acne, pimples, lightening of normal skin color, lightening of areas of otherwise dark skin, reddish-purple lines on the arms/face/trunk/groin, softer skin, crusting and/or flaking of the skin.

Although general, dermatologic, endocrine, local and metabolic side effects have been reported during Desoximetasone clinical trials, not all side effects of this medication may have been reported as of yet. Patients who feel they may have experienced side effects which are not listed are advised to contact their doctor and to report their findings to the FDA.

Dosage

Like all medicines, it is imperative that the patient takes Desoximetasone only as prescribed by a qualified doctor. This means that patients should avoid applying more of this topical cream than advised, either in dose size or frequency. In addition to this, patients should stop using Desoximetasone if advised to do so by their healthcare provider, even if they still have a supply of the cream remaining.

Although the manufacturer providers general dose instructions in the literature provided with the medicine, it should be reiterated that these guidelines can be altered by the patient’s doctor, who will devise a course of treatment based on various factors including the height, weight, age and condition of the patient.

Usual adult dosage for dermatitis, psoriasis and eczema:

For the treatment of inflammatory and pruritic instances of dermatoses which are responsive to corticosteroids, a thin film of Desoximetasone topical cream, ointment, gel or spray should be applied to the affected areas of the skin twice per day, until the patient responds to the treatment. Use of this medicine for periods exceeding four weeks is not recommended. Desoximetasone should not be used if there are signs of atrophy at the direct site of treatment. Patients are advised not to wrap, bandage or cover the affected area of skin before or after treatment with Desoximetasone unless they have been specifically directed to by a healthcare provider. Use of stronger concentration topical Desoximetasone sprays should be discontinued when control of the condition is obtained, prompting the patient to switch to lower concentration creams or gels.

The safety and efficacy of Desoximetasone has not been established in children. While this medication may be prescribed to patients under the age of 18, the dosage size will be decided at the discretion of the doctor who is overseeing the treatment, as the manufacturer does not specify a recommended pediatric dose.

When applying Desoximetasone, the patient should take great care to rub the topical medicine in gently. This medicine is not designed for oral, intravaginal or ophthalmic use, and its application on the face, groin or axilla should be avoided.

Patients are warned against applying too much of this medicine. If the patient misses a dose, they should simply take the missed dose as soon as they realize – unless it is closer to the time when they would have taken the next dose. In this case, the patient should simply omit the missed dose and carry on with the dosing schedule as normal from the next scheduled dose onwards.

Although the propensity for overdose on Desoximetasone is virtually non-existent, patients who experience symptoms of overdose after using this or any other drug should contact their local poison control center on 1800-222-1222 or emergency services on 911 immediately. Symptoms of overdose can vary from medicine to medicine, but as a rule, patients should make their way to their local ER if they experience an extremely fast or slow heartbeat, seizures, loss of co-ordination, flushed skin or difficulty breathing.

Interactions

All drugs have the potential to interact with other medicines or chemicals within the human body. These interactions have the propensity to cause one or more medicines to become ineffective in the treatment of the symptoms they were prescribed to combat. In some instances, interactions can even cause potentially dangerous or fatal side effects. Because of this risk, patients are advised to keep a full, detailed list of all medicines they are currently undergoing treatment with. This extends to over the counter remedies, herbal supplements, complimentary medicines and vitamin pills as well as prescribed medications.

Below is a partial list of some of the medicines known to have interacted negatively with Desoximetasone. Patients who are already taking one or more of these drugs should notify their doctor before applying a first dose of Desoximetasone topical ointment:

  • Acarbose
  • Acetohexamide
  • Albiglutide
  • Dapagliflozin/Metformin
  • Dapagliflozin/Saxagliptin
  • Dulaglutide
  • Empagliflozin
  • Empagliflozin/Linagliptin
  • Empagliflozin/Metformin
  • Exenatide
  • Glimepiride
  • Glimepiride/Pioglitazone
  • Glimepiride/Rosiglitazone
  • Glipizide
  • Metformin/Glipizide
  • Glyburide
  • Metformin/Glyburide
  • Insulin
  • Insulin Aspart Protamine
  • Insulin Aspart Protamine & Insulin Apart
  • Insulin Aspart/Insulin Degludec
  • Alogliptin
  • Alogliptin/Metformin
  • Alogliptin/Pioglitazone
  • Canagliflozin
  • Insulin Degludec
  • Insulin Degludec/Liraglutide
  • Detemir/Insulin
  • Insulin Glulisine
  • Insulin Isophane
  • Insulin Regular
  • Metformin/Pioglitazone
  • Metformin/Repaglinide
  • Metformin/Rosiglitazone
  • Insulin Lispro/Insulin Regular
  • Insulin Zinc
  • Insulin Zinc (Extended)
  • Linagliptin
  • Linagliptin/Metformin
  • Liraglutide
  • Lixisenatide
  • Metformin
  • Metformin/Saxagliptin
  • Insulin Lispro/Insulin Lispro Protamine
  • Metformin/Sitagliptin
  • Insulin Inhalation (Rapid Working)
  • Miglitol
  • Nateglinide
  • Pioglitazone
  • Insulin Glargine
  • Pramlintide
  • Repaglinide
  • Rosiglitazone
  • Saxagliptin
  • Simvastatin/Sitagliptin
  • Sitagliptin
  • Tolazamide
  • Insulin Lispro
  • Tolbutamide
  • Troglitazone

Warnings

Desoximetasone should be used only as prescribed by a doctor. Care should be taken to avoid applying too much of the topical medication, as corticosteroids can be absorbed through the skin, and can potentially cause steroid side effects throughout the rest of the body.

Children should not use corticosteroids such as Desoximetasone for prolonged periods, as they may be more susceptible to unwanted side effects such as growth delays.

Patients are advised to inform their healthcare provider if they are allergic to any medications or substances. This is because Desoximetasone topical treatment may contain active or inactive ingredients which are known to cause allergic reactions in small swathes of the population.

Use of Desoximetasone may increase the level of glucose within the blood or urine. Patients who have been diagnosed with diabetes are therefore advised to inform their doctor or healthcare provider of their condition prior to undergoing treatment with Desoximetasone. In some instances, a doctor may decide to prescribe an alternative treatment, or to advise that Desoximetasone is administered with caution, or under observation until it has been ascertained that it is safe for the patient to use it. If a patient experiences confusion, feels sleepy, passes urine more often, feels hungrier than usual or has a fruit-like breath odor, they are advised to contact their doctor as soon as possible, as these are all signs of an increase in blood sugar levels which can lead to diabetes or other serious conditions if left untreated for a prolonged period.

This topical cream should not be applied to cuts, wounds or broken skin. This is because it is a corticosteroid and the drug may enter the bloodstream at higher concentrations via open wounds.

Desoximetasone should be used as prescribed by a doctor, until the patient is advised to discontinue use. It should still be applied even if signs and symptoms of the dermatological condition it is being used to treat have subsided. However, prolonged use of this medication could lead to the depression of the ability of the adrenal glands to produce corticosteroids. Patients in this situation who abruptly withdraw use of Desoximetasone may experience nausea, vomiting and shock. It is therefore advised that use of this medication is tapered-down when the patient no longer requires treatment with it.

Patients are advised to wash their hands before and after the application of topical Desoximetasone. This helps to avoid the spread of infection, or to avoid the medication coming into contact with other parts of the body. If Desoximetasone comes into contact with the eyes, it can potentially make glaucoma worse or cause intraocular pressure.

This medication may not be suitable for patients with certain immune system diseases or disorders, including acquired immunodeficiency syndrome (AIDS) or severe combined immunodeficiency syndrome (SCID).

Storage

Desoximetasone should be stored at room temperature in the packaging it was supplied in, with the lid tightly closed. The manufacturer recommends that it should be stored away from excess moisture and heat – it is therefore unsuitable for storage in a bathroom.

Patients who need to dispose of unwanted or unused Desoximetasone should do so in a safe and hygenic manner, in accordance with local and state laws. Desoximetasone should not be flushed down the toilet or poured down a drain. The best way to dispose of unwanted medicines is through a medicine take-back program. Most pharmacies operate take-back schemes for the disposal and recycling of unwanted or unused drugs.

It is imperative that Desoximetasone is stored out of the sight and reach of children and pets, as the cap on the tube is not child-resistant and could potentially be opened or tampered with by inquisitive children.

Summary

Although Desoximetasone is a greatly beneficial medicine, it can also pose a risk to patients who do not communicate effectively with their healthcare providers. As a treatment designed to alleviate symptoms of various dermatological conditions, Desoximetasone treats itching, irritation, redness and flaky skin. However, it can also affect breathing and cause blistering or peeling of the epidermis. By affecting blood sugar levels, it can impair the day-to-day functioning of the patient and even give rise to potentially perilous situations if the correct precautions are not taken.

For these reasons, it is imperative that the patient tells their doctors as much as possible about their personal medical history, including any allergies or other medications they are currently taking which could potentially interact with Desoximetasone.

When taken correctly, Desoximetasone provides relief to a myriad of dermatological conditions like psoriasis, eczema and acne. Treatment with this medicine causes skin to become more attractive and alleviates painful and irritating symptoms, thereby improving the patient’s quality of life. In order to achieve this, however, patient and doctor must work together in order to find out the optimum dosing schedule.

Resources
Last Reviewed:
January 30, 2018
Last Updated:
January 27, 2018