NDC 70518-1997 Nystatin And Triamcinolone Acetonide

Nystatin And Triamcinolone Acetonide

NDC Product Code 70518-1997

NDC Code: 70518-1997

Proprietary Name: Nystatin And Triamcinolone Acetonide Additional informationCallout TooltipWhat is the Proprietary Name?
The proprietary name also known as the trade name is the name of the product chosen by the medication labeler for marketing purposes.

Non-Proprietary Name: Nystatin And Triamcinolone Acetonide Additional informationCallout TooltipWhat is the Non-Proprietary Name?
The non-proprietary name is sometimes called the generic name. The generic name usually includes the active ingredient(s) of the product.


Code Structure
  • 70518 - Remedyrepack Inc.
    • 70518-1997 - Nystatin And Triamcinolone Acetonide

NDC 70518-1997-0

Package Description: 1 TUBE in 1 CARTON > 30 g in 1 TUBE

NDC Product Information

Nystatin And Triamcinolone Acetonide with NDC 70518-1997 is a a human prescription drug product labeled by Remedyrepack Inc.. The generic name of Nystatin And Triamcinolone Acetonide is nystatin and triamcinolone acetonide. The product's dosage form is cream and is administered via topical form.

Labeler Name: Remedyrepack Inc.

Dosage Form: Cream - An emulsion, semisolid3 dosage form, usually containing > 20% water and volatiles5 and/or < 50% hydrocarbons, waxes, or polyols as the vehicle. This dosage form is generally for external application to the skin or mucous membranes.

Product Type: Human Prescription Drug Additional informationCallout TooltipWhat kind of product is this?
Indicates the type of product, such as Human Prescription Drug or Human Over the Counter Drug. This data element matches the “Document Type” field of the Structured Product Listing.


Nystatin And Triamcinolone Acetonide Active Ingredient(s)

Additional informationCallout TooltipWhat is the Active Ingredient(s) List?
This is the active ingredient list. Each ingredient name is the preferred term of the UNII code submitted.

  • NYSTATIN 100000 [USP'U]/g
  • TRIAMCINOLONE ACETONIDE 1 mg/g

Inactive Ingredient(s)

Additional informationCallout TooltipAbout the Inactive Ingredient(s)
The inactive ingredients are all the component of a medicinal product OTHER than the active ingredient(s). The acronym "UNII" stands for “Unique Ingredient Identifier” and is used to identify each inactive ingredient present in a product.

  • ALUMINUM HYDROXIDE (UNII: 5QB0T2IUN0)
  • CETOSTEARYL ALCOHOL (UNII: 2DMT128M1S)
  • POLYOXYL 20 CETOSTEARYL ETHER (UNII: YRC528SWUY)
  • GLYCERYL MONOSTEARATE (UNII: 230OU9XXE4)
  • PROPYLENE GLYCOL (UNII: 6DC9Q167V3)
  • DIMETHICONE (UNII: 92RU3N3Y1O)
  • SORBIC ACID (UNII: X045WJ989B)
  • SORBITOL (UNII: 506T60A25R)
  • TITANIUM DIOXIDE (UNII: 15FIX9V2JP)

Administration Route(s)

Additional informationCallout TooltipWhat are the Administration Route(s)?
The translation of the route code submitted by the firm, indicating route of administration.

  • Topical - Administration to a particular spot on the outer surface of the body. The E2B term TRANSMAMMARY is a subset of the term TOPICAL.

Pharmacological Class(es)

Additional informationCallout TooltipWhat is a Pharmacological Class?
These are the reported pharmacological class categories corresponding to the SubstanceNames listed above.

  • Polyene Antifungal - [EPC] (Established Pharmacologic Class)
  • Polyenes - [CS]
  • Corticosteroid - [EPC] (Established Pharmacologic Class)
  • Corticosteroid Hormone Receptor Agonists - [MoA] (Mechanism of Action)

Product Labeler Information

Additional informationCallout TooltipWhat is the Labeler Name?
Name of Company corresponding to the labeler code segment of the Product NDC.

Labeler Name: Remedyrepack Inc.
Labeler Code: 70518
FDA Application Number: ANDA062367 Additional informationCallout TooltipWhat is the FDA Application Number?
This corresponds to the NDA, ANDA, or BLA number reported by the labeler for products which have the corresponding Marketing Category designated. If the designated Marketing Category is OTC Monograph Final or OTC Monograph Not Final, then the Application number will be the CFR citation corresponding to the appropriate Monograph (e.g. “part 341”). For unapproved drugs, this field will be null.

Marketing Category: ANDA - A product marketed under an approved Abbreviated New Drug Application. Additional informationCallout TooltipWhat is the Marketing Category?
Product types are broken down into several potential Marketing Categories, such as NDA/ANDA/BLA, OTC Monograph, or Unapproved Drug. One and only one Marketing Category may be chosen for a product, not all marketing categories are available to all product types. Currently, only final marketed product categories are included. The complete list of codes and translations can be found at www.fda.gov/edrls under Structured Product Labeling Resources.

Start Marketing Date: 04-01-2019 Additional informationCallout TooltipWhat is the Start Marketing Date?
This is the date that the labeler indicates was the start of its marketing of the drug product.

Listing Expiration Date: 12-31-2020 Additional informationCallout TooltipWhat is the Listing Expiration Date?
This is the date when the listing record will expire if not updated or certified by the product labeler.

Exclude Flag: N Additional informationCallout TooltipWhat is the NDC Exclude Flag?
This field indicates whether the product has been removed/excluded from the NDC Directory for failure to respond to FDA’s requests for correction to deficient or non-compliant submissions. Values = ‘Y’ or ‘N’.

* Please review the disclaimer below.

Nystatin And Triamcinolone Acetonide Product Label Images

Nystatin And Triamcinolone Acetonide Product Labeling Information

The product labeling information includes all published material associated to a drug. Product labeling documents include information like generic names, active ingredients, ingredient strength dosage, routes of administration, appearance, usage, warnings, inactive ingredients, etc.

Product Labeling Index

Description

Nystatin and Triamcinolone Acetonide Cream, USP for dermatologic use contains the antifungal agent nystatin and the synthetic corticosteroid triamcinolone acetonide.

Nystatin is a polyene antimycotic obtained from
Streptomyces noursei. It is a yellow to light tan powder with a cereal-like odor, very slightly soluble in water, and slightly to sparingly soluble in alcohol. It has a structural formula of C
47H
75NO
17 and a molecular weight of 926.13.

Triamcinolone acetonide is designated chemically as 9-fluoro-11β, 16α, 17, 21-tetrahydroxypregna-1,4-diene-3,20-dione cyclic 16, 17-acetal with acetone. The white to cream crystalline powder has a slight odor, is practically insoluble in water, and very soluble in alcohol. It has a structural formula of C
24H
31FO
6 and a molecular weight of 434.50.

Nystatin and Triamcinolone Acetonide Cream, USP is a soft, smooth cream having a light yellow color. Each gram provides 100,000 Nystatin units and 1 mg Triamcinolone Acetonide in an aqueous perfumed vanishing cream base containing aluminum hydroxide rehydragel, barcroft aluminum hydroxide gel, cetearyl alcohol (and) ceteareth-20, glyceryl monostearate, polyethylene glycol monostearate, propylene glycol, simethicone emulsion, sorbic acid, sorbitol solution, titanium dioxide, and white petrolatum.

Clinical Pharmacology

NystatinNystatin exerts its antifungal activity against a variety of pathogenic and nonpathogenic yeasts and fungi by binding to sterols in the cell membrane. The binding process renders the cell membrane incapable of functioning as a selective barrier. Nystatin provides specific anticandidal activity to


Candida (Monilia)


albicans and other


Candida species, but it is not active against bacteria, protozoa, trichomonads, or viruses.


Nystatin is not absorbed from intact skin or mucous membranes.


Triamcinolone AcetonideTriamcinolone acetonide is primarily effective because of its anti-inflammatory, anti-pruritic and vasoconstrictive actions, characteristic of the topical corticosteroid class of drugs. The pharmacological effects of the topical corticosteroids are well known; however, the mechanisms of their dermatologic actions are unclear. Various laboratory methods, including vasoconstrictor assays, are used to compare and predict potencies and/or clinical efficacies of the topical corticosteroids. There is some evidence to suggest that a recognizable correlation exists between vasoconstrictor potency and therapeutic efficacy in man.


PharmacokineticsThe extent of percutaneous absorption of topical corticosteroids is determined by many factors including the vehicle, the integrity of the epidermal barrier, and the use of occlusive dressings (see


DOSAGE AND ADMINISTRATION).


Topical corticosteroids can be absorbed from normal intact skin. Inflammation and/or other disease processes in the skin increase percutaneous absorption. Occlusive dressings substantially increase the percutaneous absorption of topical corticosteroids (see


DOSAGE AND ADMINISTRATION).


Once absorbed through the skin, topical corticosteroids are handled through pharmacokinetic pathways similar to systemically administered corticosteroids. Corticosteroids are bound to plasma proteins in varying degrees. Corticosteroids are metabolized primarily in the liver and are then excreted by the kidneys. Some of the topical corticosteroids and their metabolites are also excreted into the bile.


Nystatin and Triamcinolone Acetonide


During clinical studies of mild to severe manifestations of cutaneous candidiasis, patients treated with nystatin and triamcinolone acetonide showed a faster and more pronounced clearing of erythema and pruritis than patients treated with nystatin or triamcinolone acetonide alone.

Indications And Usage

Nystatin and Triamcinolone Acetonide Cream, USP is indicated for the treatment of cutaneous candidiasis; it has been demonstrated that the nystatin-steroid combination provides greater benefit than the nystatin component alone during the first few days of treatment.

Contraindications

This preparation is contraindicated in those patients with a history of hypersensitivity to any of its components.

Precautions

GeneralSystemic absorption of topical corticosteroids has produced reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, manifestations of Cushing's syndrome, hyperglycemia, and glucosuria in some patients. Conditions that augment systemic absorption include application of the more potent steroids, use over large surface areas, prolonged use, and the addition of occlusive dressings (see


DOSAGE AND ADMINISTRATION).


Therefore, patients receiving a large dose of any potent topical steroid applied to a large surface area should be evaluated periodically for evidence of HPA axis suppression by using the urinary free cortisol and ACTH stimulation tests, and for impairment of internal homeostasis. If HPA axis suppression or elevation of the body temperature occurs, an attempt should be made to withdraw the drug, to reduce the frequency of application, or substitute a less potent steroid.


Recovery of HPA axis function and thermal homeostasis are generally prompt and complete upon discontinuation of the drug. Infrequently, signs and symptoms of steroid withdrawal may occur, requiring supplemental systemic corticosteroids.


Children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity (see


PRECAUTIONS, Pediatric Use).


If irritation or hypersensitivity develops with the combination nystatin and triamcinolone acetonide, treatment should be discontinued and appropriate therapy instituted.


Information for the Patient


Patients using this medicine should receive the following information and instructions.


1.  This medication is to be used as directed by the physician. It is for external use only. Avoid contact with the eyes.


2.  Patients should be advised not to use this medication for any disorder other than for which it was prescribed.


3.  The treated skin area should not be bandaged or otherwise covered or wrapped as to be occluded (see


DOSAGE AND ADMINISTRATION).


4.  Patients should report any signs of local adverse reactions.


5.  When using this medication in the inguinal area, patients should be advised to apply cream sparingly and to wear loose fitting clothing.


6.  Parents of pediatric patients should be advised not to use tight-fitting diapers or plastic pants on a child being treated in the diaper area, as these garments may constitute occlusive dressings.


7.  Patients should be advised on preventative measures to avoid reinfection.


Laboratory TestsIf there is a lack of therapeutic response, appropriate microbiological studies (e.g., KOH smears and/or cultures) should be repeated to confirm the diagnosis and rule out other pathogens, before instituting another course of therapy.


A urinary free cortisol test and ACTH stimulation test may be helpful in evaluating hypothalamic-pituitary-adrenal (HPA) axis suppression due to corticosteroids.


Carcinogenesis, Mutagenesis, and Impairment of Fertility


Long-term animal studies have not been performed to evaluate the carcinogenic or mutagenic potential or possible impairment of fertility in males or females.


Pregnancy:


Teratogenic Effects—


Pregnancy Category CThere are no teratogenic studies with combined nystatin and triamcinolone acetonide. Corticosteroids are generally teratogenic in laboratory animals when administered systemically at relatively low dosage levels. The more potent corticosteroids have been shown to be teratogenic after dermal application in laboratory animals. Therefore, any topical corticosteroid preparation should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.


Topical preparations containing corticosteroids should not be used extensively on pregnant patients, in large amounts, or for prolonged periods of time.


Nursing Mothers


It is not known whether any component of this preparation is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised during use of this preparation by a nursing woman.


Pediatric Use


In clinical studies of a limited number of pediatric patients ranging in age from two months through 12 years, nystatin and triamcinolone acetonide cream formulation cleared or significantly ameliorated the disease state in most patients.


Pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced hypothalamic-pituitary-adrenal (HPA) axis suppression and Cushing's syndrome than mature patients because of a larger skin surface area to body weight ratio.


HPA axis suppression, Cushing's syndrome, and intracranial hypertension have been reported in children receiving topical corticosteroids. Manifestations of adrenal suppression in children include linear growth retardation, delayed weight gain, low plasma cortisol levels, and absence of response to ACTH stimulation. Manifestations of intracranial hypertension include bulging fontanelles, headaches and bilateral papilledema.


Administration of topical corticosteroids to children should be limited to the least amount compatible with an effective therapeutic regimen. Chronic corticosteroid therapy may interfere with the growth and development of children.

Adverse Reactions

A single case (approximately one percent of patients studied) of acneiform eruption occurred with use of combined nystatin and triamcinolone acetonide in clinical studies.


Nystatin is virtually nontoxic and nonsensitizing and is well tolerated by all age groups, even during prolonged use. Rarely, irritation may occur.


The following local adverse reactions are reported infrequently with topical corticosteroids (reactions are listed in an approximate decreasing order of occurrence): burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, perioral secondary infection, skin atrophy, striae and miliaria.


To report SUSPECTED ADVERSE REACTIONS, contact G&W Laboratories, Inc. at 1-800-922-1038 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Overdosage

Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects (see


PRECAUTIONS, General); however, acute overdosage and serious adverse effects with dermatologic use are unlikely.

Dosage And Administration

Nystatin and Triamcinolone Acetonide Cream is usually applied to the affected areas twice daily in the morning and the evening by gently and thoroughly massaging the preparation into the skin. The cream should be discontinued if symptoms persist after 25 days of therapy (see


PRECAUTIONS, Laboratory Tests).


Nystatin and Triamcinolone Acetonide Cream should


not be used with occlusive dressings.

How Supplied

Nystatin and Triamcinolone Acetonide Cream, USP is supplied in 15 g, 30 g, and 60 g tubes.

Storage

Store at 20-25°C (68-77°F) [See USP Controlled Room Temperature]. Avoid freezing.


Manufactured by:G&W Laboratories, Inc.


111 Coolidge Street


South Plainfield, NJ 07080


Distributed by:Actavis


Pharma, Inc.


Parsippany, NJ 07054 USA


Rev. 05/2015


8-0677ACT2

* Please review the disclaimer below.

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