Pevisone

Indication
Steroid-responsive inflammatory dermatoses, Tinea pedis, Tinea cruris, Tinea corporis, Pityriasis versicolor, Cutaneous candidiasis, Onychomycoses
Adult Dose
Topical Adults: Apply 2-3 times daily to the affected area and rub on the skin gently with the finger. Continue the applications for 14 days
Contraindication
Not to be used in the treatment of tuberculous lesions and viral diseases of the skin (herpes, vaccinia, varicella).True hypersensitivity.
Mode of Action
Econazole modifies the permeability of cell wall membrane in fungi; may interfere w/ RNA and protein synthesis, and lipid metabolism. Triamcinolone has mainly glucocorticoid activity. It suppresses the migration of polymorphonuclear leukocytes and reduces capillary permeability thereby decreasing inflammation.
Precaution
Hypersensitivity has rarely been recorded. If it occurs, application of the product should be discontinued. The infected area should be kept clean and dry during treatment.
Side Effect
Rarely, transient local mild irritation, itching & redness may occur immediately after application. Econazole has minimal allergenic effect and is well tolerated, even by delicate skin. Adrenal suppression on long term continuous topical steroid therapy may occur, particularly in infants or children, or when occlusive dressings are applied. It should be noted that an infant's napkin may act as an occlusive dressing.
Interaction
Econazole: Theoretical potential for compd metabolized by CYP3A4/2C9, oral anticoagulants eg warfarin & acenocoumarol. Triamcinolone: Lowering of plasma salicylates levels. Increased risk of GI bleeding and ulceration with NSAIDs. Antagonised blood glucose-lowering effects of the antidiabetics. Increased risk of hyperkalaemia with amphotericin B, beta-blockers, potassium-depleting diuretics, theophylline. Increased clearance of the triamcinolone with ciclosporin, carbamazepine, phenytoin, barbiturate, rifampicin. Infections may develop if given with live vaccines.

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