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Hydrocortisone/pramoxine is used to treat swelling, itchiness, and redness caused by various skin conditions. The two medicines, hydrocortisone and pramoxine, work in different ways to reduce symptoms such as inflammation and itching. The most common side effects are skin reactions, such as burning, itching, irritation, dryness, and inflamed hair follicles. There are several forms of hydrocortisone/pramoxine available, including a cream, foam, lotion, and ointment that are applied to the skin. 

Uses

What is hydrocortisone/pramoxine used for?

Hydrocortisone/pramoxine is commonly used to treat swelling (inflammation), redness, and itchiness caused by various skin conditions.

Hydrocortisone/pramoxine may also be used for other conditions as determined by your health care provider.

Note: The FDA has not found some forms of this medicine to be safe and effective, and the labels for the ointment and 2.5%/1% topical cream are not approved by the FDA. Learn more about unapproved drugs here.

How does hydrocortisone/pramoxine work (mechanism of action)?

Hydrocortisone/pramoxine contains two medicines, hydrocortisone and pramoxine. Hydrocortisone is a corticosteroid that works by reducing inflammation and itching. It also causes the blood vessels under the skin to shrink, which may help reduce swelling. Pramoxine is a numbing agent (anesthetic) that works by temporarily blocking nerve signals that cause you to feel pain and itching.

How is hydrocortisone/pramoxine supplied (dosage forms)?

Brands and other names

  • Analpram HC
  • Epifoam
  • Pramosone
  • Proctofoam HC

Example dosage forms and strengths

  • 1%/1%, 2.5%/1% topical ointment
  • 1%/1%, 2.5%/1% topical lotion
  • 1%/1%, 2.5%/1% topical cream
  • 1%/1% topical foam

How should I store hydrocortisone/pramoxine?

Topical Ointment, Lotion, or Cream. Hydrocortisone/pramoxine ointment, lotion, or cream should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Topical Foam. Hydrocortisone/pramoxine topical foam should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). Do not refrigerate or store at temperatures above 120 F (49 C). Store upright.

Side Effects

What are the most common side effects of hydrocortisone/pramoxine?

The most common side effects of hydrocortisone/pramoxine are skin reactions, including burning, itching, irritation, dryness, and inflamed hair follicles (see below). Tell your health care provider if you have any of these side effects that bother you.

There may be other side effects of hydrocortisone/pramoxine that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of hydrocortisone/pramoxine?

While less common, the most serious side effects of hydrocortisone/pramoxine are described below, along with what to do if they happen.

Severe Allergic Reactions. Hydrocortisone/pramoxine may cause allergic reactions, which can be serious. Stop using hydrocortisone/pramoxine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Reduced Adrenal Function. Hydrocortisone/pramoxine can pass through your skin and cause your body’s adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. This is especially a concern if you use the medicine for a long time or over large skin areas, wrap or cover the skin after applying it, or use it on damaged skin. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your health care provider if you have any of the following symptoms of adrenal insufficiency.

  • Nausea and vomiting
  • Weakness, tiredness, or lack of energy
  • Low blood pressure

Cushing’s Syndrome. Hydrocortisone/pramoxine can cause Cushing’s syndrome, a condition that happens when your body is exposed to too much cortisol (the stress hormone). This is especially a concern if you use medicine for a long time or over large skin areas, wrap or cover the skin after applying it, or use it on damaged skin. Tell your health care provider if you notice any of the following symptoms.

  • Rounded, rosy face
  • Weight gain, especially in the upper body
  • Thinning of skin
  • Acnes
  • Unusual tiredness or weakness
  • Depressed mood or anxiety
  • Kidney stones
  • Sleep problems
  • Unusual hair growth

High Blood Sugar. Hydrocortisone/pramoxine may increase your blood sugar levels, especially if you use it over large skin areas, wrap or cover the skin after applying it, or use it on damaged skin. It may also cause your body to leak sugar into your urine (pee). Talk to your health care provider about how to maintain healthy blood sugar levels. Keep all appointments with your health care provider to check your blood work. Call your health care provider if you have the following symptoms of high blood sugar.

  • Thirsty more than usual
  • Peeing more than usual
  • Increase in hunger
  • Tiredness
  • Feeling sick to your stomach
  • Confusion
  • Your breath smelling fruity

Skin Reactions. Hydrocortisone/pramoxine can cause skin-related side effects, which can rarely be serious. Stop using hydrocortisone/pramoxine and tell your health care provider if you have any of the following side effects.

  • Inflamed hair follicles or skin swelling or burning
  • Bumps or blisters on the skin that may look like acne
  • Rash around your mouth
  • Lightening of skin color
  • Skin infections at the site of application
  • Skin thinning
  • Skin itching, dryness, cracking, or scaly skin
  • Stretch marks
  • Heat rash or sweat rash caused by blocked sweat glands

Warnings & Precautions

Who should not use hydrocortisone/pramoxine?

Allergies to Ingredients. People who are allergic to any of the following should not use hydrocortisone/pramoxine.

  • Analpram HC
  • Epifoam
  • Hydrocortisone
  • Pramosone
  • Pramoxine
  • Proctofoam HC
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific hydrocortisone/pramoxine products they stock.

What should I know about hydrocortisone/pramoxine before using it?

Do not use hydrocortisone/pramoxine unless it has been prescribed to you by a health care provider. Use it as prescribed. Tell your health care provider if your symptoms do not get better after using this medicine.

Do not share hydrocortisone/pramoxine with other people, even if they have the same condition as you. It may harm them.

Keep hydrocortisone/pramoxine out of the reach of children.

Hydrocortisone/pramoxine is for use on the skin only. Keep the medicine away from your eyes.

There are multiple forms of hydrocortisone/pramoxine available. Read and follow the instructions for the product you have and make sure you understand how to use it properly. If you have any questions, talk to your health care provider.

Use the smallest amount needed to cover the affected area. Do not bandage, wrap, or otherwise cover the area where hydrocortisone/pramoxine is applied unless your health care provider told you to do so. This includes not using tight-fitting diapers or plastic pants if hydrocortisone/pramoxine is used in the diaper area. These steps will help reduce your risk of serious side effects. 

If you are prescribed hydrocortisone/pramoxine topical foam, shake the container for five to 10 seconds before each use. Rinse the cap and the container with warm water after use.

People who are under 18 can be at greater risk for some side effects from hydrocortisone/pramoxine. Talk to your health care provider about the risks if you are under 18 or if you are treating someone under 18.

What should I tell my health care provider before using hydrocortisone/pramoxine?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if hydrocortisone/pramoxine is right for you.

In particular, make sure that you discuss any of the following.

Adrenal Gland Problems. Hydrocortisone/pramoxine can cause reduced adrenal function, also known as adrenal insufficiency. Tell your health care provider if you have any adrenal gland problems.

Diabetes. Hydrocortisone/pramoxine can increase your blood sugar. Tell your health care provider if you have high blood sugar or diabetes.

Skin Infections. Tell your health care provider if you currently have a skin infection. The infection may need to be treated before you can use hydrocortisone/pramoxine.

Pregnancy. It is not known if or how hydrocortisone/pramoxine could affect pregnancy or harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if hydrocortisone/pramoxine passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should use hydrocortisone/pramoxine while breastfeeding.

Interactions

Does hydrocortisone/pramoxine interact with foods or drinks?

There are no known interactions between hydrocortisone/pramoxine and foods or drinks.

It is unknown if drinking alcohol will affect hydrocortisone/pramoxine.

Does hydrocortisone/pramoxine interact with other medicines (drug interactions)?

There are no known interactions between hydrocortisone/pramoxine and other medicines. Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, skin products, and other supplements you are using.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much hydrocortisone/pramoxine?

If you or someone else has used too much hydrocortisone/pramoxine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of hydrocortisone/pramoxine?

If you miss your scheduled dose of hydrocortisone/pramoxine, apply it as soon as you remember. If it is almost time for your next scheduled dose, skip the missed dose and follow the original schedule. Do not apply hydrocortisone/pramoxine more often than prescribed. Do not apply double or extra doses.