Home Steroid Information Steroid classes – Class A, B, C, D of Corticosteroids & Cross-Reactions

Steroid classes – Class A, B, C, D of Corticosteroids & Cross-Reactions

Posted by admin in Steroid Information Category. Reviewed and Updated: 27 June, 2019

Corticosteroids can cause side effects of steroids including allergies. These drugs are divided into several classes by chemical structure. This division is convenient for determining the allergic reactions of the patient to a particular medication. Let’s try to clarify this issue.

Classes of Steroids (Corticosteroids)

Corticosteroid classification is based on their structure. Experts use a specific compound when screening hormones to determine their reactions. They conduct a patch test to find out if an individual is allergic to a particular topical steroid. If its result is positive then the person is also hypersensitive to other preparations within the same class.

Class A

  • Hydrocortisone (acetate). This medicine has anti-inflammatory, anti-allergic and anti-edematous effects. Hydrocortisone steroid cream is used in the treatment of dermatitis, inflammatory skin processes, infected wounds.
  • Methylprednisolone. Being an analog of prednisolone it is close to it by activity but does not have mineralocorticoid (sodium retention) action, which provides better tolerability.
  • Prednisolone. It is a synthetic drug belonging to the group of glucocorticosteroids, which has anti-allergic, anti-inflammatory, immunosuppressive action, surpassing that of cortisone The medication is produced in several forms: ointment, tablets, and injections.
  • Tixocortol pivalate. These corticosteroids are used for corticosteroid allergen skin tests.
  • Oral cloprednol. It is a synthetic glucocorticosteroid that has a systemic effect. In the 1970s, it was researched for the treatment of asthma. However, now it is not prescribed, apparently because of its potential danger and/or low efficiency.
  • Oral fludrocortisone acetate. It is an active synthetic mineralocorticoid. Indications for its use include primary adrenocortical insufficiency (Addison’s disease, a condition after complete adrenalectomy), secondary adrenocortical insufficiency, adrenogenital syndrome.
  • Oral methylprednisolone. The description of methylprednisolone has been presented above. This form has a systemic effect.
  • Oral prednisolone. Prednisolone tablets can be used after injection-based relief of acute conditions and in other cases.

The test substance for determining the tolerability of all the above medicines is tixocortol pivalate.

Class B

  • Amcinonide (Cyclocort, Amcinonide Taro, Amciderm). This glucocorticoid is intended for external use. Indications include non-infectious inflammatory skin diseases and itching.
  • Desonide (Desonate, Desowen, Verdeso). It is a corticosteroid drug used to reduce the severity of symptoms, including irritation, inflammation, swelling, redness of the skin, and itching, caused by certain skin conditions.
  • Fluocinolone acetonide (SYNALAR®, Dermotic, Derma-Smoothe). It is a medicine which is also used in dermatology with the purpose of treating inflammation of the skin.
  • Halcinonide (Halog, Halciderm). This topical corticosteroid has a very pronounced effect, which is why it was included in group II under US classification.
  • Triamcinolone (acetonide, diacetate). It is used to treat a variety of diseases, not just the skin ones. The medication is produced in the form of an ointment, tablets, or cream.
  • Oral budesonide. It is used to treat certain intestinal diseases. While budesonide does not cure these diseases, it can reduce some symptoms like pain and diarrhea.
  • Oral triamcinolone. It is a prescription medication that is used to treat painful lesions in the mouth.

The test substances for determining the tolerance to the above medicines are budesonide and triamcinolone.

Class C

  • Clocortolone pivalate (Cloderm). It is a topical medication available in the form of cream and is used to treat eczema.
  • Desoximetasone (Desoxi Gel/Cream, Topicort, Topicorte, Topcort). It is a topical medication for handling dermatitis.
  • Oral betamethasone. It is a drug with a systemic action for treating several diseases, eg rheumatoid arthritis. Betamethasone 500 microgram soluble tablets are used as a mouthwash for fighting mouth ulcers and oral lichen planus.
  • Oral dexamethasone (Dexatab, Decadron, Decan). It is a popular medication which is used, in particular for allergies, asthma, kidney disorders, etc.

Class D1

  • Alclometasone dipropionate (Aclovate). This skin steroid is used to treat inflammation and itching caused by several skin conditions like allergic reactions and eczema.
  • Betamethasone dipropionate (Diprosone, Celestamine, Procort). It is applied in the form of a cream, ointment, lotion or gel to treat itching and other insignificant skin conditions like eczema.
  • Betamethasone valerate (Audavate, Fucibet, Betnovate, Celestone). It is also a topical remedy used to relieve redness, itching, swelling, and other uncomfortable sensations caused by skin diseases.
  • Clobetasol propionate (Clobex, Clovate, Clobet, Propysalic, Temovate, Dermovate). Not only testosterone propionate is released in the form of propionic acid. Clobetasol is another example. This med is a topical one, it is used for skin conditions.
  • Clobetasone butyrate. It is another topical steroidal preparation. Its trade names include Eumosone and Eumovate.
  • Diflorasone diacetate (Florone, Psorcon). It also belongs to the topical steroid group.
  • Fluticasone propionate (Dymista, Flonase, AirDuo Respiclick with salmeterol MDPI). It is most often used as a steroid nasal spray, although it is also useful for skin conditions.
  • Mometasone furoate (Asmanex, Sinuva, Propel, Elocon). It is used for skin diseases, asthma, nose disorders.
  • Oral/IM betamethasone. It is used to treat various systemic diseases.
    The test substance for determining the tolerance to these medicines is clobetasol-17-propionate.

Class D2

  • Hydrocortisone buteprate (a topical steroid). It is available under Ala-Scalpt, Sarnol HC, and Nutracort (with parabens).
  • Hydrocortisone butyrate (a topical cortisone-like medicine, which is available in 2 main forms). According to RXWiki, it may be found in the following brand names: Locoid Solution, Anucort-HC, Acticort, Anusert HC-1, Beta HC, Biocorneum, Dermolate, Aquanil.
  • Hydrocortisone valerate (a topical product). Its names are Westcort (annulled) and HydroVal.
  • Prednicarbate (a relatively new topical steroid drug). Its marketed names include Batmen, Dermin, Prebel, Prednicutan, Prednitop Crunale, Sama Lidostar, Titibe, and Skinpred.
  • Hydrocortisone valerate (a medium-strength topical corticosteroid).
    The test substance for these meds is hydrocortisone-17-butyrate (17-O-butyrylcortisol), a non-fluorinated corticosteroid.


People can be allergic to corticosteroids belonging to one or several classes. Specialists distinguish the following cross-reactions: Class A with Class D2; Budesonide with Class D2.