| 4.2 Posology and Method of administration
For topical application.
The following instruction has been deleted -
Dosage: To be applied evenly and sparingly two or three times daily
and has been replaced with -
Dosage: To be applied evenly and sparingly no more than twice daily
4.4 Special warnings and precautions for use
The following paragraph has been added:
The cetostearyl alcohol may cause local skin reactions (e.g. contact dermatitis) and the propyl parahydroxybenzoate may cause allergic reactions which can be delayed.
4.8 Undesirable effects
The following paragraphs has been deleted -
Local atrophic changes may occur in intertriginous areas or in nappy areas in young children where moist conditions favour hydrocortisone absorption. Systemic absorption from such sites may be sufficient to produce hypercorticism and suppression of the pituitary adrenal axis after prolonged treatment. This effect is more likely to occur in infants and children and if occlusive dressings are used or large areas of skin treated.
The cetostearyl alcohol may cause local skin reactions (e.g. contact dermatitis) and the propyl parahydroxybenzoate may cause allergic reactions which can be delayed.
and replaced with the following table –
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System Organ Class
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Rare
>/10,000,<1/1000
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Very rare
</10,000
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Not known
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Immune system disorders
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Hypersensitivity
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Endocrine disorders
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Adrenal suppression
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Skin and subcutaneous tissue disorders
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Skin atropy, often irreversible, with thinning of the epidermis
Telangiectasia
Skin striae
Pustular acne
Perioral dermatitis
Rebound effect
Skin depigmentation
Dermatitis and eczema, including contact dermatitis
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