Buergli Clobetasol

Clobetasol propionate

Short term treatment of more resistant inflammatory & pruritic manifestations of steroid responsive dermatoses unresponsive to less potent corticosteroids including psoriasis (excluding widespread plaque psoriasis), recalcitrant dermatoses, lichen planus, discoid lupus erythematosus & other skin conditions which do not respond satisfactorily to less potent steroids.

Adult, elderly & childn >1 yr Apply thinly & gently rub in using only enough to cover entire affected area once daily or bid until improvement occurs (in more responsive conditions, w/in few days), then reduce frequency of application or change treatment to less potent prep. Use repeated short courses to control exacerbations. Max: 50 g/wk. Recalcitrant dermatoses Patient who frequently relapse Intermittent dosing (once daily, twice wkly, w/o occlusion) may be considered once acute episode has been treated effectively w/ continuous course of topical corticosteroid. To be combined w/ routine daily use of emollients. Duration of treatment for childn & infants & application to the face Limit courses to 5 days w/o occlusion.

Hypersensitivity. Untreated cutaneous infections, rosacea, acne vulgaris, pruritus w/o inflammation, perianal & genital pruritus, perioral dermatitis. Dermatoses in childn <1 yr, including dermatitis & nappy eruptions.

History of local hypersensitivity to other corticosteroids. W/draw gradually by reducing frequency of application, or by substituting less potent corticosteroid if manifestations of hypercortisolism (Cushing's syndrome) & reversible hypothalamic-pituitary-adrenal axis suppression, leading to glucocorticosteroid insufficiency, can occur in some individuals as result of increased systemic absorption. Abrupt w/drawal of treatment may result in glucocorticosteroid insufficiency. Application to a large surface area; on occluded areas of skin (eg, intertriginous areas or under occlusive dressings), thin skin areas (eg, face), broken skin or other conditions where skin barrier may be impaired. Infection risk w/ occlusion. Psoriasis. Concomitant infection; use appropriate antimicrobial therapy whenever treating inflammatory lesions which have become infected, & w/draw therapy & administer appropriate antimicrobial therapy in any spread of infection. Higher occurrence of local hypersensitivity reactions & increased risk of local infection when used to treat dermatitis around chronic leg ulcers. Application to face may lead to atrophic changes. Ensure that prep does not enter the eye if applied to eyelids as cataract & glaucoma might result from repeated exposure. Visual disturbance. Consider ophth evaluation if patient presents w/ symptoms eg, blurred vision or other visual disturbances. Effect can be enhanced by occluding treatment area w/ polythene film in more resistant lesions, especially where there is hyperkeratosis. Re-evaluate treatment & diagnosis if condition worsens or does not improve w/in 2-4 wk. Do not continue treatment for >4 wk. Use less potent prep if continuous treatment is necessary. Discontinue therapy gradually once control is achieved & continue w/ emollient as maintenance therapy. Rebound of pre-existing dermatoses can occur w/ abrupt discontinuation. Pregnancy. Do not apply to the breasts during lactation. Avoid long-term continuous therapy in infants & childn <12 yr as adrenal suppression can occur. More susceptible to develop atrophic changes w/ use in childn.

Pruritus, local skin burning/skin pain. Skin atrophy, striae, telangiectasias.

Inhibited metabolism leading to increased systemic exposure w/ CYP3A4 inhibitors (eg, ritonavir & itraconazole).

Topical Corticosteroids

D07AD01 - clobetasol ; Belongs to the class of very potent (group IV) corticosteroids. Used in the treatment of dermatological diseases.

Rx