Very potent corticosteroid with added antimicrobial agents (Formulary)

Do not use in preference to topical corticosteroids alone, unless there is overt infection, see guidance.  Refer to antimicrobial guidance.  They should only be on repeat prescription when recommended by a specialist.

Please consider if a steroid emergency card needs to be given to the patient alongside the traditional steroid treatment card.  This is to support the timely recognition and treatment of potential adrenal crisis and is suitable for some patients on oral, inhaled, topical or rectal steroids.  For more information, including which patients should receive the card, see HIS for details.  Steroid emergency cards have been distributed to, hospitals, GP surgeries and community pharmacies. Primary care can order replacement cards from 01463 706886.

MHRA advice: Topical corticosteroids: introduction  of new labelling and reminder of the possibility of severe side effects, including Topical Steroid Withdrawal Reactions (May 2024) (www.gov.uk).
MHRA advice: Topical corticosteroids: information on the risk of topical steroid withdrawal reactions (September 2021) (www.gov.uk).

See Peri-operative guidelines for patients with or at risk of adrenal insufficiency