Clobetasol
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Pharmacological properties
Clobetasol propionate is a highly active corticosteroids for topical use in dermatology. when applied topically, it has a non-specific anti-inflammatory effect, reduces the severity of itching and collagen synthesis in the skin.
Pharmacokinetics The resorption of clobetasol propionate through the skin has significant individual differences and may increase with the use of an occlusive dressing, applying the drug to inflamed or damaged skin. In individuals with healthy skin, average Cmax plasma clobetasol propionate 0.63 ng / ml in one study was observed 8 hours after the second application (13 hours after the first application) 30 g of 0.05% ointment (cream) of clobetasol propionate. After applying the second dose of 30 g of 0.05% ointment (cream) of clobetasol propionate medium Cmax in blood plasma were slightly higher than the first application of ointment (cream), and were observed after 10 hours. In another study, average Cmax(approximately 2.3 and 4.6 ng / ml) were observed, respectively, in patients with psoriasis and eczema 3 hours after a single application of 25 g of 0.05% ointment (cream) of clobetasol propionate.
After absorption through the skin, the drug is most likely metabolized in the same way as after systemic use. The systemic metabolism of clobetasol is not fully understood. Studies on the effect of clobetasol ointment (cream) have shown that the drug is highly active compared to other local corticosteroids.
Indications
Psoriasis (with the exception of its common plaque form - vulgar psoriasis), eczema, lichen planus, discoid lupus erythematosus, skin diseases that are resistant to therapy with less active corticosteroids.
Application
It is used for short-term treatment of therapy-resistant dermatoses in adults and children over the age of 1 year.
Ointment (cream) is applied a thin layer on the affected skin 1-2 times a day until clinical improvement. The total dose should not exceed 50 g of ointment (cream) for 1 week. Treatment with the drug should be discontinued immediately after clinical improvement is achieved. It is not recommended to continue therapy for more than 4 weeks, while it is necessary to constantly monitor the patients condition. If there is no effect from the use of the drug for 4 weeks, treatment should be corrected.
If therapy with GCS needs to be continued, it is recommended to switch to less active drugs.
In the treatment of resistant skin lesions, especially in cases of hyperkeratosis, the anti-inflammatory effect of Delors can be enhanced by the use (at night) of an occlusive dressing from a plastic film. Usually, one such procedure is sufficient, after which the drug is used in an open way.
Contraindications
Rosacea (rosacea), common acne (acne), perioral dermatitis, perianal or genital itching, viral skin lesions (caused by the herpes simplex virus or chicken pox), hypersensitivity to the components of the drug, skin lesions originally infected with fungi or bacteria, dermatoses in Children under the age of 1 year, including dermatitis and diaper rash.
Side effects
Immune system: very rarely - hypersensitivity. local hypersensitivity reactions: erythema, rash, itching, urticaria, burning sensation of the skin and allergic contact dermatitis can occur at the site of application and be similar to the symptoms for which the drug was used.
If signs of hypersensitivity occur, the use of the drug should be stopped immediately.
Endocrine system: very rarely - signs of hypercorticism.
As with other topical corticosteroids, prolonged use of the drug in large quantities or applying it to large areas of the skin can cause hypercorticism due to significant systemic absorption.This is most likely in infants and when using an occlusive dressing. In infants, diapers act as an occlusive dressing. If the weekly dose in adults does not exceed 50 g, inhibition of the function of the pituitary and adrenal cortex is reversible after interruption of the course of GCS therapy.
Cardiovascular system: infrequently - expansion of superficial blood vessels. Prolonged and intensive treatment with highly active GCS drugs can cause the expansion of the superficial blood vessels, especially when using hermetic dressings or rubbing the drug into the skin folds.
Skin and subcutaneous tissue: infrequently - local atrophy, atrophic striae on the skin; very rarely - thinning of the skin, change in pigmentation, hypertrichosis, exacerbation of the main symptoms, pustular form of psoriasis.
Prolonged and intensive treatment with highly active corticosteroids can cause atrophic changes in the skin (atrophic striae, thinning of the skin and expansion of the superficial blood vessels), especially during the application of the occlusive dressing. In isolated cases, treatment of psoriasis of corticosteroids (or cessation of corticosteroids therapy) can trigger the development of its pustular form.
special instructions
It is necessary to avoid prolonged use of delor in children, since they have an increased risk of inhibition of adrenal function even without the use of an occlusive dressing. the appropriateness of continuing therapy in children must be evaluated every week. it should be noted that diapers in children can be considered as an occlusive dressing.
Apply potent corticosteroids to the face carefully, as long-term use may cause skin atrophy.
Apply the drug on the skin of the eyelids carefully, avoiding the ointment in the eyes, as this can cause an attack of glaucoma.
In the treatment of infected skin lesions, antimicrobial therapy must be carried out in parallel.
Patients with psoriasis should be closely monitored by the doctor, since they may relapse, develop tolerance to treatment, the occurrence of generalized pustular psoriasis or systemic toxicosis due to a decrease in the protective function of the skin.
Prolonged use of potent topical GCS can lead to atrophic changes in the skin, especially the face. This must be borne in mind during the treatment of psoriasis, discoid lupus erythematosus and severe eczema. Any spread of infections requires termination of therapy with topical corticosteroids and the use of appropriate systemic antimicrobial therapy. Before applying hermetic dressings, it is necessary to clean the skin, because the heat and humidity that form under the dressing contribute to the development of a bacterial infection. Patients should wash their hands after using clobetasol propionate, if the drug is not prescribed to treat skin in the hands. Delor ointment should not be diluted.
During pregnancy and breastfeeding. The safety of the drug during pregnancy has not been established. During pregnancy, the drug is used only when the expected benefit to the mother outweighs the potential risk to the fetus. The drug should not be used in pregnant women at high doses and for a long time.
The safety of the use of clobetasol during breastfeeding has not been established, therefore, before starting treatment with the drug, breast-feeding must be stopped.
Children. The drug is contraindicated for the treatment of dermatoses in children under the age of 1 year.
The ability to influence the reaction rate when driving vehicles and working with other mechanisms. Does not affect.
Interactions
There is no data.
Overdose
Symptoms: the occurrence of acute overdose is unlikely, in case of chronic overdose or improper use of the drug, hypercorticism phenomena may occur.
Treatment: it is necessary to gradually stop the use of the drug, be sure to under medical supervision, given the risk of adrenal insufficiency.
Storage conditions
At a temperature not exceeding 30 ° C.
1352 Items
2020-07-30
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