The Pharmaceutical Journal
Vol 273 No 7315 p306
4 September 2004

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Use topical steroids only once or twice a day

Topical steroids should be used only once or twice a day in the treatment of atopic eczema, says the National Institute for Clinical Excellence. It also recommends that where more than one steroid within a potency class is clinically appropriate, the drug with the lowest cost should be prescribed.

In new guidance on frequency of application, NICE says that there is no compelling evidence of a clinically significant difference between once-daily application and more frequent application in terms of effectiveness, patient satisfaction or adverse effects.

The British National Formulary already notes that it is not necessary to apply topical steroids more than once or twice a day. Some products are licensed for more frequent use and two of the newer products — fluticasone propionate cream and mometasone furoate cream and ointment— are licensed for use only once a day. NICE comments that use of these “once daily only” products costs more than twice-daily use of one of the older steroids of equivalent potency.

The guidance is available via PJ Online (www.pjonline.com/links/pj).