Vasoconstrictor activities and bio-availabilities of seven proprietary corticosteroid creams assessed using a non-occluded multiple dosage regimen;clinical implications

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Abstract
The bio-availabilities and activities of commercial creams [Metosyn (fluocinonide), Synalar (fluocinolone acetonide), Betnouate (betamethasone], Locoid, Alphaderm, Dioderm and Efcortelan 1%) were assessed using a multiple dosage regimen vasoconstrictor assay in 10 volunteers. The blanching response 1st increased but then diminished with continued application over a 5 day period: following a 2 day resting period, when no steroid was applied, the application sites recovered considerably but tachyphylaxis again resulted from subsequent repeated applications. Acute tolerance occurred with the hydrocortisone formulations (Alphaderm, Dioderm and Efcortelan 1%) in a manner similar to that observed with the potent preparations. Metosyn was significantly more active (P < 0.05), and Efcortelan 1% was significantly less active (P < 0.05), than the other formulations. Apart from the reversal of Dioderm and Alphaderm the rank order of preparations was similar to that previously noted in the 6 h occluded single-application vasoconstrictor test. The results may have significance in dosage form design and application for topical corticosteroid formulations.