Creobic Double Action Special Precautions

Creobic DA Cream should not be used with adhesive dressing as well as occlusive dressings. Treatment should be discontinued and appropriate therapy instituted, if irritation or sensitization develops with the use of this cream. An appropriate antibacterial agent should be administered concomitantly, in the presence of a bacterial infection. Creobic DA Cream therapy should be discontinued if a favourable response does not occur promptly, until the infection has been controlled adequately. If there is a lack of response to Creobic DA Cream, appropriate microbiological studies should be repeated to confirm the diagnosis and rule out other pathogens before instituting another course of antimycotic therapy. Any of the side effects that are reported following systemic use of corticosteroids may also occur with topical corticosteroids, including adrenal suppression, manifestations of Cushing's syndrome, hyperglycemia and glycosuria. The use of more potent corticosteroid agents will increase the systemic absorption of topical corticosteroids, with prolonged usage or if extensive body surface areas are treated. Therefore, patients receiving large doses of potent topical corticosteroids, applied to a large surface area should be evaluated periodically for evidence of hypothalamic-pituitary- adrenal (HPA) axis suppression. If hypothalamic- pituitary-adrenal (HPA) axis suppression occurs, an attempt should be made to withdraw the drug to reduce the frequency of application, or to substitute with a less potent corticosteroid agent. Upon discontinuation of the drug, the recovery of hypothalamic-pituitary-adrenal (HPA) axis function is generally prompt and complete. Infrequently signs and symptoms of corticosteroids withdrawal may occur, requiring supplemental systemic corticotherapy. Not for ophthalmic use.
Use in Pregnancy & Lactation: The safety of topical corticosteroid use in pregnant women has not been established. Hence, drugs of this class should not be used during pregnancy, unless the potential benefit justifies the potential risk to the fetus and such use should not be extensive i.e. in large amounts or for prolonged periods of time. As it is not known whether topical administration of corticosteroids can result in sufficient systemic absorption to produce detectable quantities in breast milk, a decision should be made to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Use in Children: Compared to mature patients, pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced hypothalamic-pituitary-adrenal (HPA) axis suppression and to exogenous corticosteroid effects because of greater absorption due to a large skin surface area to body weight ratio. Hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome, linear growth retardation, delayed weight gain, and intracranial hypertension have been reported in children receiving topical corticosteroids. Manifestations of adrenal suppression in children include low plasma cortisol levels and absence of response to ACTH stimulation. Manifestations of intracranial hypertension include a bulging fontanelle, headaches and bilateral papilledema. The use of Creobic DA Cream in diaper dermatitis is not recommended.