Clobetasol Propionate 0.05% topical

Indications

Clobetasol Propionate 0.05% topical is used for: Corticosteroid-responsive Dermatoses, Psoriasis, Scalp Psoriasis, Plaque-type Psoriasis, Vitiligo, Eczema, Alopecia areata, Herpes labialis, Lichen sclerosus, Lichen, Mycosis fungoides, Corticosteroid-responsive dermatoses

Adult Dose

Corticosteroid-responsive Dermatoses Cream: Apply thin layer to affected areas q12hr and rub in gently and completely; not to exceed 50 g/week Scalp Psoriasis Shampoo: Apply thin film to dry scalp qDay; leave in place for 15 min; add water, lather, and then rinse thoroughly Moderate to Severe Plaque-type Psoriasis Cream/lotion: Apply to affected area in scalp q12hr for up to 2 weeks if area is less than 10% of the body surface area; not to exceed 50 g/week

Child Dose

<12 years Safety & efficacy not established >12 years Corticosteroid-responsive Dermatoses Cream: Apply thin layer to affected areas q12hr and rub in gently and completely; not to exceed 50 g/week Scalp Psoriasis Shampoo: Apply thin film to dry scalp qDay; leave in place for 15 min; add water, lather, and then rinse thoroughly Moderate to Severe Plaque-type Psoriasis Cream/lotion: Apply to affected area in scalp q12hr for up to 2 weeks if area is less than 10% of the body surface area; not to exceed 50 g/week

Renal Dose

Administration

Contra Indications

Childn <12 yrs. Long-term treatment of ulcerative conditions, rosacea, pruritus; It is contraindicated in rosacea, acne vulgaris, perioral dermatitis, primary cutaneous viral infections (eg. herpes simplex, chickenpox), otitis externa with a perforated eardrum, hypersensitivity to the preparations. Scalp application is contraindicated in infection of the scalp.

Precautions

Long-term continuous topical therapy should be avoided where possible, particularly in infants and children, as adrenal suppression can occur readily even without occlusion. If used in childhood, or on the face, courses should be limited to 5 days and occlusion should not be used. If applied to the eyelids, care is needed to ensure that the preparation does not enter the eye. If used in psoriasis careful patient supervision is important. Scalp Application: Keep away from eye. Flammable. Do not use or dry the hair near a fire or flame. Scalp Shampoo: Do not use on areas other than the scalp. Keep away from eye. Lactation: Excretion in milk unknown; use with caution

Pregnancy-Lactation

Interactions

Increased systemic exposure w/ CYP3A4 inhibitors (eg ritonavir & itraconazole).

Adverse Effects

Side effects of Clobetasol Propionate 0.05% topical : Perioral dermatitis, striae esp in flexures. Dermal and epidermal atrophy esp on the face, steroid purpura. Burning, Cracking/fissuring of the skin, Erythema, Folliculitis, Irritation, Numbness, Pruritus, Stinging, Hypopigmentation (high potency topical steroids) Potentially Fatal: Prolonged usage of large amount of clobetasol propionate can lead to sufficient systemic levels to produce adrenal suppression, Cushing's syndrome, diabetes and hypertension.

Mechanism of Action

Clobetasol is a very potent corticosteroid used in short-term treatment of various inflammatory skin conditions. Corticosteroids decrease inflammation by stabilizing leukocyte lysosomal membranes, preventing release of destructive acid hydrolases from leukocytes; inhibiting macrophage accumulation in inflamed areas; reducing leukocyte adhesion to capillary endothelium; reducing capillary wall permeability and edema formation; decreasing complement components; antagonizing histamine activity and release of kinin from substrates; and reducing fibroblast proliferation, collagen deposition, and subsequent scar tissue formation.