Betamethasone + Clioquinol


Thông tin thuốc gốc
Chỉ định và Liều dùng
Topical/Cutaneous
Bacterial skin infections, Inflammatory skin conditions, Skin fungal infections
Adult: Available preparation:
Each 1 g of oint/cream contains betamethasone 1.22 mg and clioquinol 30 mg
Apply thinly and rub gently onto affected area(s) bid or tid, may reduce to once daily if condition improves.
Child: Same as adult dose. Max duration of therapy: 5 days.
Chống chỉ định
Rosacea, acne vulgaris, perioral dermatitis, iodine sensitivity, perianal or genital pruritus, napkin eruptions, dermatitis, pruritus w/o inflammation, primary viral (e.g. herpes simplex, chicken pox), fungal, bacterial, or yeast infections, dermatoses in childn <1 yr.
Thận trọng
Patient w/ psoriasis. Childn. Pregnancy and lactation.
Tác dụng không mong muốn
Significant: Local hypersensitivity reactions; HPA axis suppression (e.g. Cushing’s syndrome), adrenal insufficiency, facial atrophic changes (long-term use); cataract, glaucoma; psoriasis relapse and tolerance, pustular psoriasis and systemic toxicity; prolonged local infection, risk of neurotoxicity (clioquinol).
Dermatologic: Burning, pruritus, pain, pigmentation changes, allergic contact dermatitis, hypertrichosis.
Thông tin tư vấn bệnh nhân
This drug may cause discolouration of skin, hair and cloth. Avoid long term use and abrupt withdrawal. Avoid use of occlusive dressing. Avoid application to the eyes.
Chỉ số theo dõi
Monitor for hypothalamic-pituitary adrenal (HPA) axis and adrenal insufficiency.
Ảnh hưởng đến kết quả xét nghiệm
Betamethasone: May suppress the wheal and flare reaction to skin antigens.Clioquinol: May interfere w/ thyroid function tests [e.g. radioactive iodine and butanol extractable iodine, protein-bound iodine (PBI)]. May cause false-positive ferric chloride test for phenylketonuria.
Tác dụng
Description:
Mechanism of Action: Betamethasone is a corticosteroid w/ mainly glucocorticoid activity. It has anti-inflammatory, antipruritic and vasoconstrictive properties. It depresses the formation, release and activity of inflammatory mediators (e.g. kinins, histamine, prostaglandins) by induction of phospholipase A2 inhibitory proteins (e.g. lipocortins) and inhibition of arachidonic acid release.
Clioquinol is a halogenated hydroxyquinoline derivative. It has a broad spectrum of activity against fungi (e.g. candida, microsporum, trichophyton); and bacteriostatic against gm+ve bacteria (e.g. staphylococci) but has limited activity against gm-ve bacterias.
Pharmacokinetics:
Absorption: Betamethasone: Readily absorbed from the intact skin.
Clioquinol: Approx 1.5-4% is absorbed.
Distribution: Betamethasone: Rapidly distributed to all body tissues. Crosses the placenta and enters breast milk (small amounts). Plasma protein binding: Extensively bound mainly to globulin.
Metabolism: Betamethasone: Metabolised in the liver.
Excretion: Betamethasone: Via urine and faeces.
Clioquinol: Via urine mainly as glucuronide, and as sulphate metabolites (small amounts).
Đặc tính

Chemical Structure Image
Betamethasone

Source: National Center for Biotechnology Information. PubChem Database. Betamethasone, CID=9782, https://pubchem.ncbi.nlm.nih.gov/compound/Betamethasone (accessed on Jan. 21, 2020)


Chemical Structure Image
Clioquinol

Source: National Center for Biotechnology Information. PubChem Database. Clioquinol, CID=2788, https://pubchem.ncbi.nlm.nih.gov/compound/Clioquinol (accessed on Jan. 21, 2020)

Bảo quản
Store below 30°C.
Phân loại MIMS
Thuốc kháng khuẩn có corticoid dùng tại chỗ
Tài liệu tham khảo
AFT Pharmaceuticals Ltd. Locorten Vioform Ear Drops data sheet September 2016. Medsafe. http://www.medsafe.govt.nz/. Accessed 14/09/2017.

Anon. Betamethasone (Topical). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 14/09/2017.

Betamethasone valerate/Clioquinol 1 mg/30 mg/g Cream (Chemidex Pharma Limited). MHRA. https://products.mhra.gov.uk/. Accessed 13/09/2017.

Betamethasone valerate/Clioquinol 1 mg/30 mg/g Ointment (Chemidex Pharma Limited). MHRA . https://products.mhra.gov.uk/. Accessed 13/09/2017.

Buckingham R (ed). Betamethasone. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/09/2017.

Buckingham R (ed). Clioquinol. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/09/2017.

Buckingham R (ed). Pharmacokinetics of Corticosteroids. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 14/09/2017.

GlaxoSmithKline NZ Limited. Betnovate-C Cream and Ointment data sheet 11 December 2012. Medsafe. http://www.medsafe.govt.nz/. Accessed 13/09/2017.

Joint Formulary Committee. Betamethasone with Clioquinol. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/09/2017.

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