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Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
Prepared to a prescriber's order for one patient. Not FDA-approved.
Hydrocortisone is a low-potency corticosteroid, commonly compounded in topical creams, ointments and lotions and in rectal and oral preparations.
Hydrocortisone is a glucocorticoid, a synthetic form of the steroid hormone cortisol that the adrenal glands make naturally. Applied to the skin, it narrows small blood vessels, reduces the release of inflammatory chemicals and calms the local immune response, which eases redness, swelling and itching. In the United States seven-class potency system it sits in Class VII, the least potent group. Manufactured products include prescription hydrocortisone 2.5% cream and ointment, FDA-approved for the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses, over-the-counter 1% anti-itch products, and Cortef tablets, FDA-approved for adrenocortical insufficiency and a range of other conditions.
A prescriber may order hydrocortisone compounded when a patient needs a strength, vehicle or dosage form that is not manufactured, a preparation free of a specific preservative or allergen, or a combination with another active ingredient. Compounded hydrocortisone preparations are not FDA-approved and require a prescription.
Hydrocortisone labels carry no boxed warning. The topical label warns that enough can be absorbed through the skin to suppress the body's own cortisol production (HPA axis suppression) and, in some patients, cause Cushing's syndrome, high blood sugar or sugar in the urine, especially with large amounts, large areas, prolonged use or covering the treated area. Children absorb proportionally more and are more susceptible. If the treated skin is infected, the label calls for an appropriate antibacterial or antifungal to be used as well, and for the corticosteroid to be stopped if the infection does not clear promptly. Oral hydrocortisone (Cortef) carries additional warnings about infection, live vaccines, blood pressure, mood changes, cataracts and glaucoma, and adrenal suppression when stopped suddenly, and is contraindicated in systemic fungal infections. Do not use hydrocortisone if you are hypersensitive to it. Phenobarbital, phenytoin, rifampin and ketoconazole change how the body clears corticosteroids. The topical label advises use in pregnancy only if the potential benefit justifies the risk and caution while nursing; LactMed considers short-term topical use unlikely to harm a breastfed infant and advises only water-miscible creams or gels on the breast, cleaned off before nursing. If you notice burning, thinning skin, stretch marks or signs of infection, talk to your prescriber or pharmacist.
Hydrocortisone (cortisol) is a Class VII topical corticosteroid. Mechanisms include vasoconstriction in the upper dermis, lipocortin induction with inhibition of phospholipase A2 and reduced prostaglandin and leukotriene synthesis, suppression of NF-kB driven pro-inflammatory gene expression, and anti-mitotic and immunosuppressive effects. Percutaneous absorption depends on vehicle, skin barrier integrity and occlusion; ointments are the most occlusive and potent vehicle, absorption varies by site by up to 300-fold between eyelid and sole, and penetration rises two- to ten-fold in inflamed skin. Absorbed corticosteroid is protein bound to varying degrees, metabolized in the liver and excreted by the kidneys. Tachyphylaxis of the vasoconstrictor response occurs with continuous use.
Labeled indications: hydrocortisone 2.5% cream and ointment for corticosteroid-responsive dermatoses; Cortef tablets for adrenocortical insufficiency, congenital adrenal hyperplasia and listed rheumatic, dermatologic, allergic, ophthalmic, respiratory, hematologic, neoplastic and gastrointestinal conditions. Prescribers have ordered compounded hydrocortisone in combination topical, rectal and oral liquid preparations where a manufactured strength or vehicle is not available. Strength, vehicle, frequency and duration are per prescriber; StatPearls advises limiting topical courses to 2 to 4 weeks and reducing occlusion. Monitor for local atrophy, striae and infection, and for HPA axis suppression with large-area, prolonged or occluded use, particularly in children. Hepatic enzyme inducers increase clearance; ketoconazole reduces it. Hydrocortisone is not a controlled substance.
Wash your hands. Fill the applicator to the mark on your label, or use a prefilled applicator. Lie on your back with knees bent, insert the applicator gently as far as is comfortable, and push the plunger slowly until it stops. Remove the applicator; wash a reusable one with mild soap and water or discard a single-use one. Bedtime use is common. Wash your hands afterward.
A gel can have a nonaqueous or a water-based base, and USP <795> sets its default beyond-use date by water content, not by the word gel. A nonaqueous gel usually carries a beyond-use date of up to 180 days at room temperature or refrigerated. A water-based gel carries up to 35 days with a preservative, or 14 days refrigerated without one. Your label states which applies. Keep the container closed, keep from freezing, keep out of reach of children, and discard after the beyond-use date on your label.
This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.
Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.
Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.
Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.
Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.
Insert/apply intravaginally
