C

Calcium Channel Blockers

USES

Treatment of essential hypertension, treatment of and prophylaxis of angina pectoris (including vasospastic, chronic stable, unstable), prevention/control of supraventricular tachyarrhythmias, prevention of neurologic damage due to subarachnoid hemorrhage.

ACTION

Calcium channel blockers inhibit the flow of extracellular Ca²⁺ ions across cell membranes of cardiac cells, vascular tissue. They relax arterial smooth muscle, depress the rate of sinus node pacemaker, slow AV conduction, decrease heart rate, produce negative inotropic effect (rarely seen clinically due to reflex response). Calcium channel blockers decrease coronary vascular resistance, increase coronary blood flow, reduce myocardial oxygen demand. Degree of action varies with individual agent.

CALCIUM CHANNEL BLOCKERS

Name	Availability	Indications	Dosage Range	Side Effects
Amlodipine (Norvasc)	T: 2.5 mg, 5 mg, 10 mg	HTN, angina	HTN: Initially, 2.5–5 mg once daily. May titrate q7–14 days up to 10 mg/day Angina: 5–10 mg once daily	Abdominal pain, flushing, headaches, peripheral edema
Diltiazem (Cardizem)	T: 30 mg, 60 mg, 90 mg, 120 mg (ER): 120 mg, 180 mg, 240 mg, 300 mg, 360 mg, 420 mg C (SR-12HR): 60 mg, 90 mg, 120 mg, (ER-24HR): 120 mg, 180 mg, 240 mg, 300 mg, 360 mg, 420 mg I: 5 mg/ml	PO: HTN, angina IV: Arrhythmias	See monograph HTN: 120–540 mg/day Angina: 120–480 mg/day I: 20–25 mg IV bolus, then 5–15 mg/hr infusion	Dizziness, drowsiness, edema, headache
Felodipine (Plendil)	T: 2.5 mg, 5 mg, 10 mg	HTN	Initially, 5 mg/day. May increase q2wks. Usual dose: 5–10 mg/day	Peripheral edema, headaches
Isradipine	C: 2.5 mg, 5 mg	HTN	Initially, 2.5 mg 2 times/day. May increase at 2–4 wk intervals at 2.5–5 mg increments. Usual dose: 5–10 mg 2 times/day	Headaches
Nicardipine (Cardene)	C (IR): 20 mg, 30 mg C (ER): 30 mg, 45 mg, 60 mg I: 2.5 mg/ml	HTN, angina	Angina/HTN: Initially, 20–30 mg 3 times/day. May increase q3days. Usual dose: 20–40 mg 3 times/day	Flushing, peripheral edema, headache, dizziness
Nifedipine (Adalat, Procardia)	C (IR): 10 mg, 20 mg T (ER): 30 mg, 60 mg, 90 mg	HTN, angina	HTN (ER): Initially, 30–60 mg once daily. Usual dose: 90–120 mg once daily Angina (IR): 10–20 mg tid or (ER): Initially, 30–60 mg once daily. Titrate up to 90 mg daily. Maximum: 120 mg	Peripheral edema, dizziness, flushed face, headaches, nausea
Nimodipine (Nimotop, Nymalize)	C: 30 mg S: 60 mg/20 ml	Prevent neurologic damage following subarachnoid hemorrhage	60 mg q4h for 21 days	Nausea, reduced B/P, headache, rash, diarrhea
Verapamil (Calan, Isoptin)	T (IR): 40 mg, 80 mg, 120 mg T (SR): 120 mg, 180 mg, 240 mg	HTN, angina	Angina (IR): Initially, 40–120 mg 3 times/day. Usual dose: 80–160 mg tid or (SR): Initially, 180 mg at HS. May increase at weekly intervals up to 480 mg/day HTN (IR): Initially, 80 mg 3 times/day. Usual dose: 240–480 mg/day in divided doses (SR): Initially, 120–180 mg/day. May increase at weekly intervals to 240 mg/day, then 180 mg 2 times/day. Maximum: 240 mg 2 times/day	Nausea, gingival hyperplasia, headache, fatigue, dizziness

C, Capsules; CR, controlled-release; ER, extended-release; HTN, hypertension; I, injection; S, solution; SR, sustained-release; T, tablets.

Chemotherapeutic Agents

USES

Treatment of a variety of cancers; may be palliative or curative. Treatment of choice in hematologic cancers. Often used as adjunctive therapy (e.g., with surgery or irradiation); most effective when tumor mass has been removed or reduced by radiation. Often used in combinations to increase therapeutic results, decrease toxic effects. Certain agents may be used in nonmalignant conditions: polycythemia vera, psoriasis, rheumatoid arthritis, or immunosuppression in organ transplantation (used only in select cases that are severe and unresponsive to other forms of therapy). Refer to individual monographs.

ACTION

Most antineoplastics can be divided into alkylating agents, antimetabolites, anthracyclines, plant alkaloids, and topoisomerase inhibitors. These agents affect cell division or DNA synthesis. Newer agents (monoclonal antibodies and tyrosine kinase inhibitors) directly target a molecular abnormality in certain types of cancer. Hormones modulate tumor cell behavior without directly attacking those cells. Some agents are classified as miscellaneous.

CHEMOTHERAPEUTIC AGENTS

Name	Availability	Category	Side Effects
Abiraterone (Zytiga)	T: 250 mg	Antiandrogen	Joint swelling, hypokalemia, edema, muscle discomfort, hot flashes, diarrhea, UTI, cough, hypertension, arrhythmia, dyspepsia, upper respiratory tract infection
Aldesleukin (Proleukin)	I: 22 million units	Biologic response modifier	Hypotension, sinus tachycardia, nausea, vomiting, diarrhea, renal impairment, anemia, rash, fatigue, agitation, pulmonary congestion, dyspnea, fever, chills, oliguria, weight gain, dizziness
Alectinib (Alecensa)	C: 150 mg	Kinase inhibitor	Constipation, fatigue, edema, myalgia
Anastrozole (Arimidex)	T: 1 mg	Aromatase inhibitor	Peripheral edema, chest pain, nausea, vomiting, diarrhea, constipation, abdominal pain, anorexia, pharyngitis, vaginal hemorrhage, anemia, leukopenia, rash, weight gain, diaphoresis, increased appetite, pain, headaches, dizziness, depression, paresthesia, hot flashes, increased cough, dry mouth, asthenia, dyspnea, phlebitis
Arsenic trioxide (Trisenox)	I: 10 mg/ml	Miscellaneous	AV block, GI hemorrhage, hypertension, hypoglycemia, hypokalemia, hypomagnesemia, neutropenia, oliguria, prolonged QT interval, seizures, sepsis, thrombocytopenia
Asparaginase (Elspar)	I: 10,000 units	Miscellaneous	Anorexia, nausea, vomiting, hepatic toxicity, pancreatitis, nephrotoxicity, clotting factor abnormalities, malaise, confusion, lethargy, EEG changes, respiratory distress, fever, hyperglycemia, depression, stomatitis, allergic reactions, drowsiness
Atezolizumab (Tecentriq)	I: 60 mg/ml	Miscellaneous	Fatigue, decreased appetite, nausea, urinary tract infections, constipation, pyrexia
Axitinib (Inlyta)	T: 1 mg, 5 mg	Kinase inhibitor	Diarrhea, hypertension, fatigue, decreased appetite, nausea, dysphoria, vomiting, asthenia, constipation
Azacitidine (Vidaza)	I: 100 mg	DNA methylation inhibitor	Edema, hypokalemia, weight loss, myalgia, cough, dyspnea, upper respiratory tract infection, back pain, pyrexia, weakness
BCG (TheraCys, Tice BCG)	I: 50 mg, 81 mg	Biologic response modulator	Nausea, vomiting, anorexia, diarrhea, dysuria, hematuria, cystitis, urinary urgency, anemia, malaise, fever, chills
Belinostat (Beleodaq)	I: 500 mg	Miscellaneous	Nausea, fatigue, pyrexia, anemia, vomiting
Bendamustine (Treanda)	I: 100 mg	Alkylating agent	Neutropenia, pyrexia, thrombocytopenia, nausea, anemia, leukopenia, vomiting
Bevacizumab (Avastin)	I: 25 mg/ml	Monoclonal antibody	Increased B/P, fatigue, blood clots, diarrhea, decreased WBCs, headaches, decreased appetite, stomatitis
Bexarotene (Targretin)	C: 75 mg Gel: 1%	Miscellaneous	Anemia, dermatitis, fever, hypercholesterolemia, infection, leukopenia, peripheral edema
Bicalutamide (Casodex)	T: 50 mg	Antiandrogen	Gynecomastia, hot flashes, breast pain, nausea, diarrhea, constipation, nocturia, impotence, pain, muscle pain, asthenia, abdominal pain
Bleomycin (Blenoxane)	I: 15 units, 30 units	Antibiotic	Nausea, vomiting, anorexia, stomatitis, hyperpigmentation, alopecia, pruritus, hyperkeratosis, urticaria, pneumonitis progression to fibrosis, weight loss, rash
Blinatumomab (Blincyto)	I: 35 mcg	Miscellaneous	Pyrexia, headache, peripheral edema, febrile neutropenia, nausea, hypokalemia, tremor, rash, constipation
Bortezomib (Velcade)	I: 3.5 mg	Proteasome inhibitor	Anxiety, dizziness, headaches, insomnia, peripheral neuropathy, pruritus, rash, abdominal pain, decreased appetite, constipation, diarrhea, dyspepsia, nausea, vomiting, arthralgia, dyspnea, asthenia, edema, pain
Bosutinib (Bosulif)	T: 100 mg, 500 mg	Kinase inhibitor	Nausea, diarrhea, thrombocytopenia, vomiting, abdominal pain, anemia, fever, fatigue
Brentuximab (Adcetris)	I: 50 mg	Miscellaneous	Neutropenia, peripheral sensory neuropathy, fatigue, nausea, anemia, upper respiratory tract infection, diarrhea, pyrexia, thrombocytopenia, cough, vomiting
Busulfan (Myleran)	T: 2 mg	Alkylating agent	Nausea, vomiting, hyperuricemia, myelosuppression, skin hyperpigmentation, alopecia, anorexia, weight loss, diarrhea, stomatitis
Cabazitaxel (Jevtana)	I: 60 mg/1.5 ml	Microtubule inhibitor	Neutropenia, anemia, leukopenia, thrombocytopenia, diarrhea, fatigue, nausea, vomiting, constipation, asthenia, abdominal pain, hematuria, anorexia, peripheral neuropathy, dyspnea, alopecia
Cabozantinib (Cabometyx)	T: 20 mg, 40 mg, 60 mg	Kinase inhibitor	Diarrhea, fatigue, nausea, decreased appetite, palmar-plantar erythrodysesthesia, hypertension, decreased weight, constipation, vomiting
Capecitabine (Xeloda)	T: 150 mg, 300 mg	Antimetabolite	Nausea, vomiting, diarrhea, stomatitis, myelosuppression, palmar-plantar erythrodysesthesia syndrome, dermatitis, fatigue, anorexia
Carboplatin (Paraplatin)	I: 50 mg, 150 mg, 450 mg	Alkylating agent	Nausea, vomiting, nephrotoxicity, myelosuppression, alopecia, peripheral neuropathy, hypersensitivity, ototoxicity, asthenia, diarrhea, constipation
Carfilzomib (Kyprolis)	I: 60 mg	Proteasome inhibitor	Anemia, fatigue, nausea, thrombocytopenia, dyspnea, diarrhea, pyrexia
Carmustine (BiCNU)	I: 100 mg	Alkylating agent	Anorexia, nausea, vomiting, myelosuppression, pulmonary fibrosis, pain at injection site, diarrhea, skin discoloration
Ceritinib (Zykadia)	C: 150 mg	Kinase inhibitor	Diarrhea, nausea, increased LFTs, vomiting, abdominal pain, fatigue, decreased appetite, constipation
Cetuximab (Erbitux)	I: 2 mg/ml	Monoclonal antibody	Dyspnea, hypotension, acne-like rash, dry skin, weakness, fatigue, fever, constipation, abdominal pain
Chlorambucil (Leukeran)	T: 2 mg	Alkylating agent	Myelosuppression, dermatitis, nausea, vomiting, hepatic toxicity, anorexia, diarrhea, abdominal discomfort, rash
Cisplatin (Platinol-AQ)	I: 50 mg, 100 mg	Alkylating agent	Nausea, vomiting, nephrotoxicity, myelosuppression, neuropathies, ototoxicity, anaphylactic-like reactions, hyperuricemia, hypomagnesemia, hypophosphatemia, hypokalemia, hypocalcemia, pain at injection site
Cladribine (Leustatin)	I: 1 mg/ml	Antimetabolite	Nausea, vomiting, diarrhea, myelosuppression, chills, fatigue, rash, fever, headaches, anorexia, diaphoresis
Cobimetinib (Cotellic)	T: 20 mg	Kinase inhibitor	Diarrhea, photosensitivity reaction, nausea, vomiting, pyrexia, increased ALT, AST, alkaline phosphatase
Crizotinib (Xalkori)	C: 200 mg, 250 mg	Tyrosine kinase inhibitor	Vision disorders, nausea, vomiting, diarrhea, edema, constipation
Cyclophosphamide (Cytoxan)	I: 100 mg, 200 mg, 500 mg, 1 g, 2 g T: 25 mg, 50 mg	Alkylating agent	Nausea, vomiting, hemorrhagic cystitis, myelosuppression, alopecia, interstitial pulmonary fibrosis, amenorrhea, azoospermia, diarrhea, darkening skin/fingernails, headaches, diaphoresis
Cytarabine (Ara-C, Cytosar)	I: 100 mg, 500 mg, 1 g, 2 g	Antimetabolite	Anorexia, nausea, vomiting, stomatitis, esophagitis, diarrhea, myelosuppression, alopecia, rash, fever, neuropathies, abdominal pain
Dacarbazine (DTIC)	I: 200 mg	Alkylating agent	Nausea, vomiting, anorexia, hepatic necrosis, myelosuppression, alopecia, rash, facial flushing, photosensitivity, flu-like symptoms, confusion, blurred vision
Daratumumab (Darzalex)	I: 20 mg/ml	Monoclonal antibody	Fatigue, nausea, infusion reactions, back pain, pyrexia, nausea, upper respiratory tract infections
Dasatinib (Sprycel)	T: 20 mg, 50 mg, 70 mg	Tyrosine kinase inhibitor	Pyrexia, pleural effusion, febrile neutropenia, GI bleeding, pneumonia, thrombocytopenia, dyspnea, anemia, cardiac failure, diarrhea
Daunorubicin (Cerubidine)	I: 20 mg	Anthracycline	HF, nausea, vomiting, stomatitis, mucositis, diarrhea, hematuria, myelosuppression, alopecia, fever, chills, abdominal pain
Daunorubicin liposomal (DaunoXome)	I: 50 mg	Anthracycline	Nausea, diarrhea, abdominal pain, anorexia, vomiting, stomatitis, myelosuppression, rigors, back pain, headaches, neuropathy, depression, dyspnea, fatigue, fever, cough, allergic reactions, diaphoresis
Denileukin (Ontak)	I: 300 mcg/2 ml	Miscellaneous	Hypersensitivity reaction, back pain, dyspnea, rash, chest pain, tachycardia, asthenia, flu-like symptoms, chills, nausea, vomiting, infection
Dinutuximab (Unituxin)	I: 3.5 mg/ml	Monoclonal antibody	Pain, arthralgia, myalgia, neuralgia, pyrexia, hypotension, vomiting, diarrhea, urticaria, hypoxia
Docetaxel (Taxotere)	I: 20 mg, 80 mg	Antimicrotubular	Hypotension, nausea, vomiting, diarrhea, mucositis, myelosuppression, rash, paresthesia, hypersensitivity, fluid retention, alopecia, asthenia, stomatitis, fever
Doxorubicin (Adriamycin)	I: 10 mg, 20 mg, 50 mg, 75 mg, 150 mg, 200 mg	Anthracycline	Cardiotoxicity, including HF; arrhythmias, nausea, vomiting, stomatitis, esophagitis, GI ulceration, diarrhea, anorexia, hematuria, myelosuppression, alopecia, hyperpigmentation of nail beds and skin, local inflammation at injection site, rash, fever, chills, urticaria, lacrimation, conjunctivitis
Doxorubicin liposomal (Doxil)	I: 20 mg, 50 mg	Anthracycline	Neutropenia, palmar-plantar erythrodysesthesia syndrome, cardiomyopathy, HF
Elotuzumab (Empliciti)	I: 300 mg, 400 mg	Immunostimulatory antibody	Fatigue, diarrhea, pyrexia, constipation, cough, peripheral neuropathy, nasopharyngitis, decreased appetite, upper respiratory tract infections, pneumonia
Enzalutamide (Xtandi)	C: 40 mg	Antiandrogen	Fatigue, weakness, back pain, diarrhea, tissue swelling, musculoskeletal pain, headache, upper respiratory tract infections, blood in urine, spinal cord compression
Epirubicin (Ellence)	I: 2 mg/ml	Anthracycline	Anemia, leukopenia, neutropenia, infection, mucositis
Erlotinib (Tarceva)	T: 25 mg, 100 mg, 150 mg	Tyrosine kinase inhibitor	Diarrhea, rash, nausea, vomiting
Estramustine (Emcyt)	C: 140 mg	Alkylating agent	Increased risk of thrombosis, gynecomastia, nausea, vomiting, diarrhea, thrombocytopenia, peripheral edema
Etoposide (VePesid)	I: 20 mg/ml C: 50 mg	Podophyllotoxin derivative	Nausea, vomiting, anorexia, myelosuppression, alopecia, diarrhea, drowsiness, peripheral neuropathies
Everolimus (Afinitor, Zortress)	T (Afinitor): 5 mg, 10 mg T (Zortress): 0.25 mg, 0.5 mg, 0.75 mg	mTOR kinase inhibitor	Stomatitis, infections, asthenia, fatigue, cough, diarrhea
Exemestane (Aromasin)	T: 25 mg	Aromatase inactivator	Dyspnea, edema, hypertension, mental depression
Fludarabine (Fludara)	I: 50 mg	Antimetabolite	Nausea, diarrhea, stomatitis, bleeding, anemia, myelosuppression, skin rash, weakness, confusion, visual disturbances, peripheral neuropathy, coma, pneumonia, peripheral edema, anorexia
Fluorouracil (Adrucil, Efudex)	I: 50 mg/ml Cream: 1%, 5% Solution: 1%, 2%, 5%	Antimetabolite	Nausea, vomiting, stomatitis, GI ulceration, diarrhea, anorexia, myelosuppression, alopecia, skin hyperpigmentation, nail changes, headaches, drowsiness, blurred vision, fever
Flutamide (Eulexin)	C: 125 mg	Antiandrogen	Hot flashes, nausea, vomiting, diarrhea, hepatitis, impotence, decreased libido, rash, anorexia
Fulvestrant (Faslodex)	I: 125 mg/2.5 ml, 250 mg/5 ml syringes	Estrogen receptor antagonist	Asthenia, pain, headaches, injection site pain, flu-like symptoms, fever, nausea, vomiting, constipation, anorexia, diarrhea, peripheral edema, dizziness, depression, anxiety, rash, increased cough, UTI
Gefitinib (Iressa)	T: 250 mg	Tyrosine kinase inhibitor	Diarrhea, rash, acne, nausea, dry skin, vomiting, pruritus, anorexia
Gemcitabine (Gemzar)	I: 200 mg, 1 g	Antimetabolite	Increased LFT, nausea, vomiting, diarrhea, stomatitis, hematuria, myelosuppression, rash, mild paresthesia, dyspnea, fever, edema, flu-like symptoms, constipation
Goserelin (Zoladex)	I: 3.6 mg, 10.8 mg	Hormone agonist	Hot flashes, sexual dysfunction, erectile dysfunction, gynecomastia, lethargy, pain, lower urinary tract symptoms, headaches, nausea, depression, diaphoresis
Hydroxyurea (Hydrea)	C: 500 mg	Antimetabolite	Anorexia, nausea, vomiting, stomatitis, diarrhea, constipation, myelosuppression, fever, chills, malaise
Ibritumomab (Zevalin)	Injection kit	Monoclonal antibody	Neutropenia, thrombocytopenia, anemia, infection, asthenia, abdominal pain, fever, pain, headaches, nausea, peripheral edema, allergic reaction, GI hemorrhage, apnea
Idarubicin (Idamycin PFS)	I: 5 mg, 10 mg, 20 mg	Anthracycline	HF, arrhythmias, nausea, vomiting, stomatitis, myelosuppression, alopecia, rash, urticaria, hyperuricemia, abdominal pain, diarrhea, esophagitis, anorexia
Idelalisib (Zydelig)	T: 100 mg, 150 mg	Kinase inhibitor	Diarrhea, pyrexia, fatigue, nausea, cough, abdominal pain, pneumonia, increased ALT/AST
Ifosfamide (Ifex)	I: 1 g, 3 g	Alkylating agent	Nausea, vomiting, hemorrhagic cystitis, myelosuppression, alopecia, lethargy, drowsiness, confusion, hallucinations, hematuria
Imatinib (Gleevec)	C: 100 mg	Tyrosine kinase inhibitor	Nausea, fluid retention, hemorrhage, musculoskeletal pain, arthralgia, weight gain, pyrexia, abdominal pain, dyspnea, pneumonia
Interferon alfa-2b (Intron-A)	I: 3 million units, 5 million units, 10 million units, 18 million units, 25 million units, 50 million units	Miscellaneous	Mild hypotension, hypertension, tachycardia with high fever, nausea, diarrhea, altered taste, weight loss, thrombocytopenia, myelosuppression, rash, pruritus, myalgia, arthralgia associated with flu-like symptoms
Ipilimumab (Yervoy)	I: 5 mg/ml	Miscellaneous	Fatigue, diarrhea, pruritus, rash, colitis
Irinotecan (Camptosar)	I: 40 mg, 100 mg	Camptothecin	Diarrhea, nausea, vomiting, abdominal cramps, anorexia, stomatitis, increased AST, severe myelosuppression, alopecia, diaphoresis, rash, weight loss, dehydration, increased serum alkaline phosphatase, headaches, insomnia, dizziness, dyspnea, cough, asthenia, rhinitis, fever, back pain, chills
Ixabepilone (Ixempra)	I: 15 mg, 45 mg	Antimicrotubular	Peripheral sensory neuropathy, fatigue, myalgia, alopecia, nausea, vomiting, stomatitis, diarrhea, anorexia, abdominal pain
Ixazomib (Ninlaro)	C: 2.3 mg, 3 mg, 4 mg	Proteasome inhibitor	Diarrhea, constipation, thrombocytopenia, peripheral neuropathy, nausea, peripheral edema, back pain, vomiting
Lapatinib (Tykerb)	T: 250 mg	Tyrosine kinase inhibitor	Diarrhea, palmar-plantar erythrodysesthesia, nausea, rash, vomiting, fatigue
Lenvatinib (Lenvima)	C: 4 mg, 10 mg	Kinase inhibitor	Hypertension, fatigue, diarrhea, arthralgia, decreased weight, nausea, stomatitis, headache, vomiting, proteinuria, abdominal pain
Letrozole (Femara)	T: 2.5 mg	Aromatase inhibitor	Hypertension, nausea, vomiting, constipation, diarrhea, abdominal pain, anorexia, rash, pruritus, musculoskeletal pain, arthralgia, fatigue, headaches, dyspnea, coughing, hot flashes
Leuprolide (Lupron)	I: 3.75 mg, 5 mg, 7.5 mg, 11.25 mg, 15 mg, 22.5 mg, 30 mg	Hormone agonist	Hot flashes, gynecomastia, nausea, vomiting, constipation, anorexia, dizziness, headaches, insomnia, paresthesia, bone pain
Lomustine (CeeNU)	C: 10 mg, 40 mg, 100 mg	Alkylating agent	Anorexia, nausea, vomiting, stomatitis, hepatotoxicity, nephrotoxicity, myelosuppression, alopecia, confusion, slurred speech
Mechlorethamine (Mustargen)	I: 10 mg/ml	Alkylating agent	Severe nausea and vomiting, metallic taste, diarrhea, myelosuppression, alopecia, phlebitis, vertigo, tinnitus, hyperuricemia, infertility, azoospermia, anorexia, headaches, drowsiness, fever
Megestrol (Megace)	T: 20 mg, 40 mg Suspension: 40 mg/ml	Hormone	Deep vein thrombosis, Cushing-like syndrome, alopecia, carpal tunnel syndrome, weight gain, nausea
Melphalan (Alkeran)	T: 2 mg	Alkylating agent	Anorexia, nausea, vomiting, myelosuppression, diarrhea, stomatitis
Mercaptopurine (Purinethol)	T: 50 mg	Antimetabolite	Anorexia, nausea, vomiting, stomatitis, hepatic toxicity, myelosuppression, hyperuricemia, diarrhea, rash
Methotrexate (Rheumatrex)	T: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg I: 5 mg, 50 mg, 100 mg, 200 mg, 250 mg	Antimetabolite	Nausea, vomiting, stomatitis, GI ulceration, diarrhea, hepatic toxicity, renal failure, cystitis, myelosuppression, alopecia, urticaria, acne, photosensitivity, interstitial pneumonitis, fever, malaise, chills, anorexia
Mitomycin (Mutamycin)	I: 20 mg, 40 mg	Antibiotic	Anorexia, nausea, vomiting, stomatitis, diarrhea, renal toxicity, myelosuppression, alopecia, pruritus, fever, hemolytic uremic syndrome, weakness
Mitotane (Lysodren)	T: 500 mg	Miscellaneous	Anorexia, nausea, vomiting, diarrhea, skin rashes, depression, lethargy, drowsiness, dizziness, adrenal insufficiency, blurred vision, impaired hearing
Mitoxantrone (Novantrone)	I: 20 mg, 25 mg, 30 mg	Anthracenedione	HF, tachycardia, EKG changes, chest pain, nausea, vomiting, stomatitis, mucositis, myelosuppression, rash, alopecia, urine discoloration (bluish green), phlebitis, diarrhea, cough, headaches, fever
Necitumumab (Portrazza)	I: 16 mg/ml	Epidermal growth factor receptor (EGFR) antagonist	Rash, hypomagnesemia
Nelarabine (Arranon)	I: 5 mg/ml	Antimetabolite	Anemia, neutropenia, thrombocytopenia, nausea, vomiting, diarrhea, fatigue, fever, dyspnea, severe neurologic events (convulsions, peripheral neuropathy)
Nilotinib (Tasigna)	C: 200 mg	Tyrosine kinase inhibitor	Rash, pruritus, nausea, fatigue, headache, constipation, diarrhea, vomiting, thrombocytopenia, neutropenia
Nilutamide (Nilandron)	T: 50 mg	Antiandrogen	Hypertension, angina, hot flashes, nausea, anorexia, increased hepatic enzymes, dizziness, dyspnea, visual disturbances, impaired adaptation to dark, constipation, decreased libido
Nivolumab (Opdivo)	I: 10 mg/ml	Miscellaneous	Fatigue, dyspnea, musculoskeletal pain, decreased appetite, cough, nausea, constipation
Olaparib (Lynparza)	C: 50 mg	Miscellaneous	Anemia, fatigue, nausea, vomiting, diarrhea, dysgeusia, dyspepsia, headache, decreased appetite
Osimertinib (Tagrisso)	T: 40 mg, 80 mg	Kinase inhibitor	Diarrhea, rash, dry skin, nail toxicity
Oxaliplatin (Eloxatin)	I: 50 mg, 100 mg	Alkylating agent	Fatigue, neuropathy, abdominal pain, dyspnea, diarrhea, nausea, vomiting, anorexia, fever, edema, chest pain, anemia, thrombocytopenia, thromboembolism, altered hepatic function tests
Paclitaxel (Taxol)	I: 30 mg, 100 mg	Antimicrotubular	Hypertension, bradycardia, EKG changes, nausea, vomiting, diarrhea, mucositis, myelosuppression, alopecia, peripheral neuropathies, hypersensitivity reaction, arthralgia, myalgia
Palbociclib (Ibrance)	C: 75 mg, 100 mg, 125 mg	Kinase inhibitor	Neutropenia, leukopenia, fatigue, anemia, upper respiratory tract infection, nausea, stomatitis, alopecia, diarrhea, thrombocytopenia, decreased appetite, vomiting, asthenia, peripheral neuropathy, epistaxis
Panitumumab (Vectibix)	I: 20 mg/ml	Monoclonal antibody	Pulmonary fibrosis, severe dermatologic toxicity, infusion reactions, abdominal pain, nausea, vomiting, constipation, skin rash, fatigue
Panobinostat (Farydak)	C: 10 mg, 15 mg, 20 mg	Miscellaneous	Diarrhea, fatigue, nausea, peripheral edema, decreased appetite, pyrexia, vomiting
Pegaspargase (Oncaspar)	I: 750 international units/ml	Miscellaneous	Hypotension, anorexia, nausea, vomiting, hepatotoxicity, pancreatitis, depression of clotting factors, malaise, confusion, lethargy, EEG changes, respiratory distress, hypersensitivity reaction, fever, hyperglycemia, stomatitis
Pemetrexed (Alimta)	I: 500 mg	Antimetabolite	Anorexia, constipation, diarrhea, neuropathy, anemia, chest pain, dyspnea, rash, fatigue
Pentostatin (Nipent)	I: 10 mg	Antibiotic	Nausea, vomiting, hepatic disorders, elevated hepatic function tests, leukopenia, anemia, thrombocytopenia, rash, fever, upper respiratory infection, fatigue, hematuria, headaches, myalgia, arthralgia, diarrhea, anorexia
Pertuzumab (Perjeta)	I: 420 mg/14 ml	HERZ/neu receptor antagonist	Alopecia, diarrhea, nausea, neutropenia, rash, fatigue, peripheral neuropathy
Procarbazine (Matulane)	C: 50 mg	Alkylating agent	Nausea, vomiting, stomatitis, diarrhea, constipation, myelosuppression, pruritus, hyperpigmentation, alopecia, myalgia, paresthesia, confusion, lethargy, mental depression, fever, hepatic toxicity, arthralgia, respiratory disorders
Ramucirumab (Cyramza)	I: 100 mg, 500 mg	Miscellaneous	Diarrhea, hypertension
Rituximab (Rituxan)	I: 100 mg, 500 mg	Monoclonal antibody	Hypotension, arrhythmias, peripheral edema, nausea, vomiting, abdominal pain, leukopenia, thrombocytopenia, neutropenia, rash, pruritus, urticaria, angioedema, myalgia, headaches, dizziness, throat irritation, rhinitis, bronchospasm, hypersensitivity reaction
Sipuleucel-T (Provenge)	I: Minimum of 50 million autologous CD54+ cells in lactated Ringer’s	Miscellaneous	Chills, fatigue, fever, back pain, nausea, headache, joint ache
Sonidegib (Odomzo)	C: 200 mg	Hedgehog pathway inhibitor	Muscle spasms, alopecia, dysgeusia, fatigue, nausea, diarrhea, decreased weight, musculoskeletal pain, myalgia, headache, abdominal pain, vomiting, pruritus
Sorafenib (Nexavar)	T: 200 mg	Tyrosine kinase inhibitor	Fatigue, alopecia, nausea, vomiting, anorexia, constipation, diarrhea, neuropathy, dyspnea, cough, asthenia, pain
Sunitinib (Sutent)	C: 12.5 mg, 25 mg, 50 mg	Tyrosine kinase inhibitor	Hypotension, edema, fatigue, headache, fever, dizziness, rash, hyperpigmentation, diarrhea, nausea, dyspepsia, altered taste, vomiting, neutropenia, thrombocytopenia, increased ALT/AST
Tamoxifen (Nolvadex-D)	T: 10 mg, 20 mg	Estrogen receptor antagonist	Skin rash, nausea, vomiting, anorexia, menstrual irregularities, hot flashes, pruritus, vaginal discharge or bleeding, myelosuppression, headaches, tumor or bone pain, ophthalmic changes, weight gain, confusion
Temozolomide (Temodar)	C: 5 mg, 20 mg, 100 mg, 250 mg	Alkylating agent	Amnesia, fever, infection, leukopenia, neutropenia, peripheral edema, seizures, thrombocytopenia
Temsirolimus (Torisel)	I: 25 mg/ml	mTOR kinase inhibitor	Rash, asthenia, mucositis, nausea, edema, anorexia, thrombocytopenia, leukopenia
Thioguanine (Tabloid)	T: 40 mg	Antimetabolite	Anorexia, stomatitis, myelosuppression, hyperuricemia, nausea, vomiting, diarrhea
Thiotepa (Thioplex)	I: 15 mg	Alkylating agent	Anorexia, nausea, vomiting, mucositis, myelosuppression, amenorrhea, reduced spermatogenesis, fever, hypersensitivity reactions, pain at injection site, headaches, dizziness, alopecia
Tipiracil/trifluridine (Lonsurf)	T: 6.14 mg/15 mg; 8.19 mg/20 mg	Miscellaneous	Asthenia, fatigue, nausea, diarrhea, vomiting, decreased appetite, pyrexia, abdominal pain
Topotecan (Hycamtin)	I: 4 mg	Camptothecin	Nausea, vomiting, diarrhea, constipation, abdominal pain, stomatitis, anorexia, neutropenia, leukopenia, thrombocytopenia, anemia, alopecia, headaches, dyspnea, paresthesia
Toremifene (Fareston)	T: 60 mg	Estrogen receptor antagonist	Elevated hepatic function tests, nausea, vomiting, constipation, skin discoloration, dermatitis, dizziness, hot flashes, diaphoresis, vaginal discharge or bleeding, ocular changes, cataracts, anxiety
Trabectedin (Yondelis)	I: 1 mg	Alkylating agent	Nausea, vomiting, fatigue, diarrhea, decreased appetite, peripheral edema, dyspnea, headache; increased ALT, AST, alkaline phosphatase; neutropenia, thrombocytopenia, anemia
Trastuzumab (Herceptin)	I: 440 mg	Monoclonal antibody	HF, heart murmur (S3 gallop), nausea, vomiting, diarrhea, abdominal pain, anorexia, rash, peripheral edema, back or bone pain, asthenia (loss of strength, energy), headaches, insomnia, dizziness, cough, dyspnea, rhinitis, pharyngitis
Tretinoin (Vesanoid)	C: 10 mg	Miscellaneous	Flushing, nausea, vomiting, diarrhea, constipation, dyspepsia, mucositis, leukocytosis, dry skin/mucous membranes, rash, pruritus, alopecia, dizziness, anxiety, insomnia, headaches, depression, confusion, intracranial hypertension, agitation, dyspnea, shivering, fever, visual changes, earaches, hearing loss, bone pain, myalgia, arthralgia
Valrubicin (Valstar)	I: 200 mg/5 ml	Anthracycline	Dysuria, hematuria, urinary frequency/incontinence/urgency
Vandetanib (Caprelsa)	T: 100 mg, 300 mg	Tyrosine kinase inhibitor	Diarrhea, rash, acne, nausea, hypertension, headache, fatigue, decreased appetite, abdominal pain
Venetoclax (Vencelexta)	T: 10 mg, 50 mg, 100 mg	BCL-2 inhibitor	Diarrhea, neutropenia, anemia, nausea, upper respiratory tract infections, thrombocytopenia, fatigue
Vinblastine (Velban)	I: 10 mg	Vinca alkaloid	Nausea, vomiting, stomatitis, constipation, myelosuppression, alopecia, peripheral neuropathy, loss of deep tendon reflexes, paresthesia, diarrhea
Vincristine (Oncovin)	I: 1 mg, 2 mg, 3 mg	Vinca alkaloid	Nausea, vomiting, stomatitis, constipation, pharyngitis, polyuria, myelosuppression, alopecia, numbness, paresthesia, peripheral neuropathy, loss of deep tendon reflexes, headaches, abdominal pain
Vincristine liposomal (Marqibo)	I: 5 mg/31 ml	Vinca alkaloid	Constipation, nausea, pyrexia, fatigue, peripheral neuropathy, febrile neutropenia, diarrhea, anemia, reduced appetite, insomnia
Vinorelbine (Navelbine)	I: 10 mg, 50 mg	Vinca alkaloid	Elevated LFT, nausea, vomiting, constipation, ileus, anorexia, stomatitis, myelosuppression, alopecia, vein discoloration, venous pain, phlebitis, interstitial pulmonary changes, asthenia, fatigue, diarrhea, peripheral neuropathy, loss of deep tendon reflexes
Vismodegib (Erivedge)	C: 150 mg	Hedgehog pathway inhibitor	Alopecia, muscle spasms, dysgensia, weight loss, fatigue, nausea, diarrhea, reduced appetite, vomiting, arthralgia
Vorinostat (Zolinza)	C: 100 mg	Histone deacetylase inhibitor	Diarrhea, fatigue, nausea, thrombocytopenia, anorexia, dysgeusia
ziv-aflibercept (Zaltrap)	I: 25 mg/ml	Miscellaneous	Leukopenia, neutropenia, diarrhea, proteinuria, increased ALT/AST, stomatitis, thrombocytopenia, hypertension, epistaxis, headache, abdominal pain

AV, Atrioventricular; C, capsules; EEG, electroencephalogram; EKG, electrocardiogram; GI, gastrointestinal; HF, heart failure; I, injection; LFT, liver function test; T, tablets; UTI, urinary tract infection.

Contraception

ACTION

Combination oral contraceptives decrease fertility primarily by inhibition of ovulation. In addition, they can promote thickening of the cervical mucus, thereby creating a physical barrier for the passage of sperm. Also, they can modify the endometrium, making it less favorable for nidation.

CLASSIFICATION

Oral contraceptives either contain both an estrogen and a progestin (combination oral contraceptives) or contain only a progestin (progestin-only oral contraceptives). The combination oral contraceptives have three subgroups:

Monophasic: Daily estrogen and progestin dosage remains constant.

Biphasic: Estrogen remains constant, but the progestin dosage increases during the second half of the cycle.

Triphasic: Progestin changes for each phase of the cycle.

Four-phasic: Contains four progestin/estrogen dosing combinations during the 20-day cycle.

Over the past several years, options have expanded to include a combined hormonal patch (Ortho Evra), vaginal ring (NuvaRing), and extended cycle contraceptives (e.g., Loestrin-24 FE, Seasonale, Seasonique, Yaz). The latest oral contraceptive, Natazia, is a four-phase dosing regimen (estradiol steps down and dienogest, a progestin, steps up during the cycle to help avoid breakthrough bleeding).

COMMON COMPLAINTS WITH ORAL CONTRACEPTIVES

Too much estrogen	Nausea, bloating, breast tenderness, increased B/P, melasma, headache
Too little estrogen	Early or midcycle breakthrough bleeding, increased spotting, hypomenorrhea
Too much progestin	Breast tenderness, headache, fatigue, changes in mood
Too little progestin	Late breakthrough bleeding
Too much androgen	Increased appetite, weight gain, acne, oily skin, hirsutism, decreased libido, increased breast size, breast tenderness, increased LDL cholesterol, decreased HDL cholesterol

B/P, Blood pressure; HDL, high-density lipoprotein; LDL, low-density lipoprotein.

CONTRACEPTIVES

Name	Estrogen Content	Progestin Content
Low-Dose Monophasic Pills
Aubra Aviane Falmina Lessina Lutera Orsythia Sronyx	EE 20 mcg	Levonorgestrel 0.1 mg
Gildess 1/20 Junel 1/20 Junel Fe 1/20 Loestrin Fe 1/20 Microgestin Fe 1/20 Tarina Fe 1/20	EE 20 mcg	Norethindrone 1 mg
Altavera Levora Marlissa Portia-28	EE 30 mcg	Levonorgestrel 0.15 mg
Cryselle-28 Lo/Ovral-28 Low-Ogestrel, -28	EE 30 mcg	Norgestrel 0.3 mg
Gildess 1.5/30 Junel 1.5/30 Junel Fe 1.5/30 Larin 1.5/30 Loestrin Fe 1.5/30 Microgestin 1.5/30 Microgestin Fe 1.5/30	EE 30 mcg	Norethindrone acetate 1.5 mg
Apri Desogen Ortho-Cept Reclipsen	EE 30 mcg	Desogestrel 0.15 mg
Yasmin Ocella Syeda	EE 30 mcg	Drospirenone 3 mg
Kelnor 1/35 Zovia 1/35	EE 35 mcg	Ethynodiol diacetate 1 mg
Ortho-Cyclen Mononessa Previfem Sprintec	EE 35 mcg	Norgestimate 0.25 mg
Necon 1/50 Norinyl 1+50	Mestranol 50 mcg	Norethindrone 1 mg
Balziva Femcon Fe Gildagia Zenchent	EE 35 mcg	Norethindrone 0.4 mg
Brevicon-28 Modicon Necon 0.5/35 Nortrel 0.5/35	EE 35 mcg	Norethindrone 0.5 mg (total of 10.5 mg/cycle)
Necon 1/35–28 Norinyl 1+35 Nortrel 1/35 Ortho-Novum 1/35–28	EE 35 mcg	Norethindrone 1 mg (total of 21 mg/cycle)
High-Dose Monophasic Pills
Zovia 1/50–28	EE 50 mcg	Ethynodiol diacetate 1 mg
Ogestrel 0.5/50–28	EE 50 mcg	Norgestrel 0.5 mg
Biphasic Pills
Azurette Kariva Mircette	EE 20 mcg × 21 days, placebo × 2 days, 10 mcg × 5 days	Desogestrel 0.15 mg × 21 days
Necon 10/11	EE 35 mcg	Norethindrone 0.5 mg × 10 days, 1 mg × 11 days
Triphasic Pills
Tilia Tri-Legest Fe	EE 20 mcg × 5 days, 30 mcg × 7 days, 35 mcg × 9 days	Norethindrone 1 mg × 21 days
Ortho Tri-Cyclen Lo	EE 25 mcg × 21 days	Norgestimate 0.18 mg × 7 days, 0.215 mg × 7 days, 0.25 mg × 7 days
Caziant Cyclessa Velivet	EE 25 mcg × 21 days	Desogestrel 0.1 mg × 7 days, 0.125 mg × 7 days, 0.15 mg × 7 days
Enpresse Trivora	EE 30 mcg × 6 days, 40 mcg × 5 days, 30 mcg × 10 days	Levonorgestrel 0.05 mg × 6 days, 0.075 mg × 5 days, 0.125 mg × 10 days
Ortho Tri-Cyclen Trinessa Tri-Previfem Tri-Sprintec	EE 35 mcg × 21 days	Norgestimate 0.18 mg × 7 days, 0.215 mg × 7 days, 0.25 mg × 7 days
Aranelle Leena Tri-Norinyl	EE 35 mcg × 21 days	Norethindrone 0.5 mg × 7 days, 1 mg × 9 days, 0.5 mg × 5 days
Ortho-Novum 7/7/7 Nortrel 7/7/7 Necon 7/7/7	EE 35 mcg × 21 days	Norethindrone 0.5 mg × 7 days, 0.75 mg × 7 days, 1 mg × 7 days
Four Phasic
Natazia	Estradiol 3 mg × 2 days, then 2 mg × 22 days, then 1 mg × 2 days, then 2-day pill-free interval	Dienogest none × 2 days, then 2 mg × 5 days, then 3 mg × 17 days, then none for 4 days
Extended-Cycle Pills
Loestrin FE	EE 20 mcg × 24 days	Norethindrone 1 mg × 24 days
Jolessa	EE 30 mcg × 84 days	Levonorgestrel 0.15 mg × 84 days
Quartette Quasense	EE 20 mcg × 42 days, 25 mcg × 21 days, 30 mcg × 21 days, then 10 mcg × 7 days	Levonorgestrel 0.15 mg × 84 days
Seasonique	EE 30 mcg × 84 days, 10 mcg × 7 days	Levonorgestrel 0.15 mg × 84 days
Yaz Gianvi	EE 20 mcg × 24 days	Drospirenone 3 mg × 24 days
Continuous Cycle Pill
Amethyst	EE 20 mcg	Levonorgestrel 90 mcg
Progestin-Only Pills
Camilia Errin Jolivette Nor-QD Nora-BE	N/A	Norethindrone 0.35 mg
Emergency Contraception
Plan B Next Choice	N/A	Levonorgestrel 0.75-mg tablets taken 12 hrs apart
Ella	N/A	Ulipristal 30 mg one time within 5 days after unprotected intercourse
Hormonal Alternative to Oral Contraception
Depo-Provera Cl Medroxyprogesterone Acetate	None	Medroxyprogesterone 150 mg
Depo-SubQ Provera 104	None	Medroxyprogesterone 104 mg
Implanon	None	Etonogestrel (release rate varies over time)
Mirena	None	Levonorgestrel 20 mcg/day for 5 yrs
NuvaRing	Ethinyl estradiol 15 mcg/day	Etonogestrel 0.12 mg/day
Ortho Evra	Ethinyl estradiol 20 mcg/day	Norelgestromin 200 mcg/day

EE, ethinyl estradiol.

Corticosteroids

USES

Replacement therapy in adrenal insufficiency, including Addison’s disease. Symptomatic treatment of multiorgan disease/conditions. Rheumatoid arthritis (RA), osteoarthritis, severe psoriasis, ulcerative colitis, lupus erythematosus, anaphylactic shock, acute exacerbation of asthma, status asthmaticus, organ transplant.

ACTION

Suppress migration of polymorphonuclear leukocytes (PML) and reverse increased capillary permeability by their anti-inflammatory effect. Suppress immune system by decreasing activity of lymphatic system.

CORTICOSTEROIDS

Name	Availability	Route of Administration	Side Effects
Beclomethasone (Beconase, Qnasl, QVAR)	Aerosol (oral inhalation), QVAR: 40 mcg/inhalation, 80 mcg/inhalation Aerosol (spray, intranasal), Qnasl: 80 mcg/inhalation Suspension (intranasal), Beconase: 42 mcg/inhalation	Inhalation, intranasal	I: Cough, dry mouth/throat, headaches, throat irritation, increased blood glucose Nasal: Headaches, sore throat, intranasal ulceration, increased blood glucose
Betamethasone (Celestone)	I: 6 mg/ml	IV, intralesional, intra-articular	Nausea, vomiting, increased appetite, weight gain, insomnia, increased blood glucose
Budesonide (Pulmicort, Rhinocort)	Nasal: 32 mcg/spray Suspension for nebulization: 250 mcg, 500 mcg	Intranasal	Headaches, sore throat, intranasal ulceration, increased blood glucose
Cortisone (Cortone)	T: 5 mg, 10 mg, 25 mg	PO	Insomnia, nervousness, increased appetite, indigestion, increased blood glucose
Dexamethasone (Decadron)	T: 0.5 mg, 1 mg, 4 mg, 6 mg OS: 0.5 mg/5 ml I: 4 mg/ml, 10 mg/ml	PO, parenteral	Insomnia, weight gain, increased appetite, increased blood glucose
Fludrocortisone (Florinef)	T: 0.1 mg	PO	Edema, headache, peptic ulcer, increased blood glucose
Flunisolide (Nasalide)	Nasal: 25 mcg/spray	Inhalation, intranasal	Headache, nasal congestion, pharyngitis, upper respiratory infections, altered taste/smell, increased blood glucose
Fluticasone (Flonase, Flovent)	Inhalation: 44 mcg, 110 mg, 220 mcg Nasal: 50 mg, 100 mcg	Inhalation, intranasal	Headache, burning/stinging, nasal congestion, upper respiratory infections, increased blood glucose
Hydrocortisone (Solu-Cortef)	T: 5 mg, 10 mg, 25 mg I: 100 mg, 250 mg, 500 mg, 1 g	PO, parenteral	Insomnia, headache, nausea, vomiting, increased blood glucose
Methylprednisolone (Solu-Medrol)	T: 4 mg I: 40 mg, 125 mg, 500 mg, 1 g, 2 g	PO, parenteral	Headache, insomnia, nervousness, increased appetite, nausea, vomiting, increased blood glucose
Prednisolone (Prelone)	T: 5 mg OS: 5 mg/5 ml, 15 mg/5 ml	PO	Headache, insomnia, weight gain, nausea, vomiting, increased blood glucose
Prednisone	T: 1 mg, 2.5 mg, 5 mg, 10 mg, 20 mg, 50 mg	PO	Headache, insomnia, weight gain, nausea, vomiting, increased blood glucose
Triamcinolone (Kenalog, Nasacort AQ)	Injection, suspension: 10 mg/ml, 40 mg/ml Intranasal, suspension: 55 mcg/inhalation	IM, inhalation (nasal)	PO: Insomnia, increased appetite, nausea, vomiting, increased blood glucose I: Cough, dry mouth/throat, headaches, throat irritation, increased blood glucose

I, Injection; OS, oral suspension; T, tablets.

Corticosteroids: Topical

USES

Provide relief of inflammation/pruritus associated with corticosteroid-responsive disorders (e.g., contact dermatitis, eczema, insect bite reactions, first- and second-degree localized burns/sunburn).

ACTION

Diffuse across cell membranes, form complexes with cytoplasm. Complexes stimulate protein synthesis of inhibitory enzymes responsible for anti-inflammatory effects (e.g., inhibit edema, erythema, pruritus, capillary dilation, phagocytic activity).

Topical corticosteroids can be classified based on potency:

May use for facial and intertriginous application for only limited time.

High potency: For more severe inflammatory conditions (e.g., lichen simplex chronicus, psoriasis). May use for facial and intertriginous application for short time only. Used in areas of thickened skin due to chronic conditions.

Low potency: Modest anti-inflammatory effect, safest for chronic application, facial and intertriginous application, with occlusion, for infants/young children.

Medium potency: For moderate inflammatory conditions (e.g., chronic eczematous dermatoses).

Very high potency: Alternative to systemic therapy for local effect (e.g., chronic lesions caused by psoriasis). Increased risk of skin atrophy. Used for short periods on small areas. Avoid occlusive dressings.

CORTICOSTEROIDS: TOPICAL

Name	Availability	Potency	Side Effects
Alclometasone (Aclovate)	C, O: 0.05%	Low	Skin atrophy, contact dermatitis, stretch marks on skin, enlarged blood vessels in the skin, hair loss, pigment changes, secondary infections
Amcinonide (Cyclocort)	C, O, L: 0.1%	High	Same as alclometasone
Betamethasone dipropionate	C, O, G, L: 0.05%	High	Same as alclometasone
Betamethasone valerate	C: 0.01%, 0.05%, 0.1% O: 0.1% L: 0.1%	High	Same as alclometasone
Clobetasol (Temovate)	C, O: 0.05%	High	Same as alclometasone
Desonide (Tridesilon)	C, O, L: 0.05%	Low	Same as alclometasone
Desoximetasone (Topicort)	C: 0.25%, 0.5% O: 0.25% G: 0.05%	High	Same as alclometasone
Fluocinolone (Synalar)	C: 0.01%, 0.025%, 0.2% O: 0.025%	High	Same as alclometasone
Fluocinonide (Lidex)	C, O, G: 0.05%	High	Same as alclometasone
Flurandrenolide (Cordran)	C, O, L: 0.025%, 0.05%	Medium	Same as alclometasone
Fluticasone (Cutivate)	C: 0.05% O: 0.005%	Medium	Same as alclometasone
Halobetasol (Ultravate)	C, O: 0.05%	High	Same as alclometasone
Hydrocortisone (Hytone)	C, O: 0.5%, 1%, 2.5%	Medium	Same as alclometasone
Mometasone (Elocon)	C, O, L: 0.1%	Medium	Same as alclometasone
Prednicarbate (Dermatop)	C: 0.1%	Medium	Same as alclometasone
Triamcinolone (Aristocort, Kenalog)	C, O, L: 0.025%, 0.1%, 0.5%	Medium	Same as alclometasone

C, Cream; G, gel; L, lotion; O, ointment.