Not recommended in patients who are hypersensitive to other corticosteroids; patients w/ acne vulgaris, rosacea or perioral dermatitis. Do not apply on intertriginous areas (axillae & genitoanal regions) & on other erosive skin surfaces. Contains alcohol (ethanol) that may cause burning sensation on damaged skin. May potentially induce post treatment rebound, relapses, development of tolerance (tachyphylaxis) & development of local or systemic toxicity eg, skin atrophy, infection (including isolated cases of systemic infections), telangiectasia of the skin or hypothalamic-pituitary-adrenal axis suppression. May provoke generalized pustular psoriasis in case of intensive & prolonged topical use in treatment of psoriasis w/ corticosteroids (or its w/drawal). Large surface areas, long-term continuous therapy, or use of occlusive dressings can enhance absorption & lead to higher risk of systemic effects (evaluate periodically for evidence of hypothalamic-pituitary-adrenal axis suppression). Reversible adrenal suppression w/ potential for glucocorticosteroid insufficiency, manifestations of Cushing's syndrome, hyperglycemia, & glycosuria. The face, more than other areas of the body, may exhibit atrophic changes after prolonged treatment. Osteonecrosis, serious infections (including necrotizing fasciitis), & systemic immunosuppression (sometimes resulting in reversible Kaposi's sarcoma lesions) in long-term use beyond recommended doses. Visual disturbance. Abrupt discontinuation can lead to acute adrenal insufficiency, especially in childn. Renal impairment. Severe liver dysfunction & DM (monitor side-effects). Pregnancy & lactation. Elderly ≥65 yr. Not recommended in patients between 2-18 yr.
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