PEITEL CREAM

Indications

• Atopic dermatitis
• Contact dermatitis
• Psoriasis
• Seborrheic dermatitis
• Eczematous dermatitis

Dosage

Children: Refer to the BNF for Children for appropriate dosing guidance based on age and condition.

Adults: Apply a thin layer to the affected area once or twice daily, depending on the severity of the condition. Refer to the BNF for further details.

Mechanism of action

Prednicarbate acts by inducing phospholipase A2 inhibitory proteins, collectively known as lipocortins. These proteins inhibit the release of arachidonic acid from membrane phospholipids, thereby controlling the biosynthesis of potent inflammatory mediators such as prostaglandins and leukotrienes. The anti-inflammatory effect is achieved through the suppression of the inflammatory response at the cellular level.

Pharmacodynamics

Corticosteroids like prednicarbate diffuse across cell membranes and bind to specific cytoplasmic receptors. The resulting complexes translocate to the nucleus, where they bind to DNA and stimulate the transcription of mRNA. This leads to the synthesis of various inhibitory proteins that mediate the anti-inflammatory effects. These effects include the inhibition of edema, fibrin deposition, capillary dilation, and the movement and activity of phagocytes, as well as suppression of later inflammatory processes such as capillary production and collagen deposition.

Pharmacokinetics

The pharmacokinetics of prednicarbate when applied topically involves absorption through the skin, where its systemic bioavailability is generally low. The onset of action can vary based on the condition being treated and the formulation used. Prednicarbate's effects are localized primarily to the area of application, minimizing systemic exposure and potential side effects.

Adverse effects

• Skin atrophy
• Striae
• Telangiectasia
• Folliculitis
• Allergic contact dermatitis
• Systemic absorption leading to adrenal suppression

Precautions

• Use with caution in patients with a history of skin infections.
• Avoid prolonged use to minimize risk of skin atrophy.
• Monitor for signs of systemic absorption, especially in children.

Pregnancy

Prednicarbate should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. Limited data is available on its use during pregnancy.

Breast-feeding

Prednicarbate is excreted in breast milk but is unlikely to pose a risk to a breastfeeding infant when applied topically. Consult with a healthcare provider for specific guidance.

Storage

Store at room temperature, away from direct sunlight and moisture. Keep out of reach of children.

Formulations

• Topical cream
• Topical ointment

Mechanism of action

In common with other topical corticosteroids, prednicarbate has anti-inflammatory, antipruritic, and vasoconstrictive properties. In general, the mechanism of the anti-inflammatory activity of topical steroids is unclear. However, corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.

Pharmacodynamics

Corticosteroids diffuse across cell membranes and complex with specific cytoplasmic receptors. These complexes then enter the cell nucleus, bind to DNA (chromatin), and stimulate transcription of messenger RNA (mRNA) and subsequent protein synthesis of various inhibitory enzymes responsible for the anti-inflammatory effects of topical corticosteroids. These anti-inflammatory effects include inhibition of early processes such as edema, fibrin deposition, capillary dilatation, movement of phagocytes into the area, and phagocytic activities. Later processes, such as capillary production, collagen deposition, and keloid formation also are inhibited by corticosteroids.