Aristocort Plus 1%+0.1% Cream 5g Tube

✔️ Pharmacology

Econazole Nitrate is a broad-spectrum imidazole antifungal. It acts primarily by interfering with fungal cell-membrane synthesis, resulting in damage to the fungal cell membrane and inhibition of fungal growth. It is active against a variety of dermatophytes, yeasts, and other susceptible fungi, including organisms responsible for tinea and candidal infections.

Econazole also has activity against certain Gram-positive bacteria that may be present in mixed skin infections.

Triamcinolone Acetonide is a synthetic corticosteroid. It suppresses inflammatory responses in the skin and helps reduce redness, swelling, itching, and other symptoms associated with inflammation.

Following topical application, systemic absorption of econazole is minimal, whereas triamcinolone can be absorbed through the skin. Absorption of the corticosteroid may increase when applied to large areas, damaged skin, under occlusion, or for prolonged periods.

✔️ Side Effects:

Possible side effects include:

• Mild irritation
• Burning or itching
• Redness
• Local hypersensitivity or allergic reactions

Prolonged or excessive use of topical triamcinolone may cause:

• Skin thinning and atrophy
• Stretch marks (striae)
• Telangiectasia
• Purpura
• Delayed wound healing
• Increased risk of secondary or opportunistic infections
• Systemic corticosteroid effects, including adrenal suppression

✔️ Aristocort Plus Cream should not be used in patients with:

• Known hypersensitivity to econazole, triamcinolone, or any component of the formulation
• Cutaneous tuberculosis
• Untreated viral skin infections, including herpes simplex, herpes zoster, or chickenpox
• Skin infections associated with certain viral, bacterial or fungal conditions where corticosteroid use is inappropriate
• Rosacea
• Rosacea-like dermatitis
• Application to fresh vaccination sites
• Decubitus ulcers unless specifically directed by a physician

✔️ Dosage and Administration

Adults

• Apply a thin layer of Aristocort Plus Cream to the affected area up to twice daily, preferably once in the morning and once in the evening.
• Gently spread the cream over the affected area and surrounding skin as directed.
• Do not apply under an occlusive dressing unless specifically instructed by a doctor.
• Avoid applying it to large areas of the body.
• Treatment with the combination should generally be limited to no more than 2 weeks.
• Once the inflammatory symptoms have subsided, continued antifungal treatment may be given with an econazole-containing preparation without the corticosteroid, if required.

Children

Children may be more susceptible to corticosteroid-related adverse effects, including suppression of the hypothalamic-pituitary-adrenal (HPA) axis and Cushing's syndrome.

Use in children should therefore be:

• For short periods only
• On small affected areas
• Under medical supervision

Avoid prolonged use or application over large areas. In particular, a child's diaper may act as an occlusive dressing and increase corticosteroid absorption.

✔️ Safety Information:

• For external use only. Do not use in the eyes or mouth.
• Do not apply to large areas or damaged skin unless directed by a doctor.
• Avoid prolonged or continuous use because triamcinolone may cause skin atrophy and systemic corticosteroid effects.
• Do not use occlusive dressings unless specifically prescribed.
• If irritation, hypersensitivity, or worsening of the infection occurs, discontinue use and seek medical advice.
• Corticosteroids can mask or worsen certain infections and may increase the risk of secondary infection.
• If the condition does not improve within the expected treatment period, reassessment of the diagnosis and treatment may be necessary.
• Children require particular caution because they can absorb proportionally larger amounts of topical corticosteroids.
• If blurred vision or other visual disturbances occur during corticosteroid treatment, consult a healthcare professional for evaluation.

✔️ Drug Interactions

Econazole

Topical econazole has limited systemic absorption, but caution is advised in patients taking oral anticoagulants such as:

• Warfarin
• Acenocoumarol

Appropriate monitoring may be required.

Triamcinolone

Systemic absorption of topical corticosteroids may potentially affect or interact with:

• Antidiabetic medicines
• NSAIDs
• Salicylates
• Potassium-depleting medicines
• Amphotericin B
• Theophylline
• Certain enzyme-inducing medicines such as rifampicin, phenytoin, carbamazepine and barbiturates
• Ciclosporin

Clinically significant interactions are more likely with extensive or prolonged topical corticosteroid use.

✔️ Pregnancy and Breastfeeding

Pregnancy

Topical corticosteroids should be used during pregnancy only when clearly indicated and under medical supervision. Large amounts, prolonged treatment, or application over extensive areas should be avoided.

Breastfeeding

Use during breastfeeding should be discussed with a doctor. If treatment is necessary, avoid applying the cream to the breast or nipple immediately before breastfeeding to prevent direct exposure of the infant.

✔️ Storage:

• Store below 30°C in a cool, dry place.
• Protect from excessive heat and light.
• Keep out of reach of children.
• Do not use after the expiry date