Esperson Special Precautions

Visual disturbance may be associated with systemic and topical corticosteroid use. If a patient presents with symptoms such as blurred vision or other visual disturbances, the patient should be considered for referral to an ophthalmologist for evaluation of possible causes which may include cataract, glaucoma or rare diseases such as central serous chorioretinopathy (CSCR).
Esperson Ointment must only be used in infants or children under six years of age if there are compelling medical reasons, since in these age groups the risk of systemic effects due to corticosteroid absorption (for example growth retardation) is increased. If use is unavoidable, application must be limited to the minimum dose required for successful treatment.
In adult, it may in exceptional circumstances be necessary to apply Esperson Ointment over large areas of skin. In such cases, particularly in prolonged use, the possibility of adrenal suppression must be taken into account. Therefore patients should be evaluated periodically for evidence of HPA (hypothalamic-pituitary-adrenal) axis suppression by using the urinary free cortisol and ACTH stimulation test. If this occurs, it may be necessary to discontinue Esperson Ointment gradually or to substitute a less potent steroid.
Over the course of time, increased intra-ocular pressure can develop if small doses of topical corticosteroids (to include Esperson Ointment) come into repeated contact with the conjunctival sac. For this reason, prolonged application of Esperson Ointment in the immediate vicinity of the eyes. If irritation develops, topical corticosteroid should be discontinued and appropriate therapy instituted.
Topical corticosteroids such as Esperson Ointment must only be used for symptomatic therapy of bacterial and/or mycotic skin infections in combination with concomitant antibacterial or antimycotic treatment.
If a favorable response does not occur promptly, the corticosteroid should be discontinued until the infection has been adequately controlled.