Generic Name

Clobetasol Propionate

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Classification

FDA Approved Indications

• Inflammatory and pruritic manifestations of dermatologic conditions responsive to corticosteroids, such as eczema, psoriasis, dermatitis

Mechanism of Action

Clobetasol propionate acts by activation of the glucocorticoid receptor, resulting in decreased inflammation, immune response, and capillary permeability in the affected skin areas.

Dosage and Administration

Adult: Apply a thin film to the affected area 2 times daily; duration varies depending on condition.

Pediatric: Use with caution; generally not recommended for children under 12 years due to risk of systemic absorption and side effects.

Geriatric: Use with caution; start with lower potency and monitor closely.

Renal Impairment: No specific adjustments recommended.

Hepatic Impairment: No specific adjustments recommended.

Pharmacokinetics

Absorption: Minimal when used topically.

Distribution: Primarily to skin tissues.

Metabolism: Metabolized in the liver.

Excretion: Renal excretion of metabolites.

Half Life: Approximately 16 hours in systemic circulation.

Contraindications

• Hypersensitivity to clobetasol or any components of the formulation.

Precautions

• Use with caution in skin infections, may mask infections or cause skin atrophy, avoid occlusive dressing unless directed. Avoid use on face, groin, or underarms unless directed by a healthcare provider. Not for use in children under 2 years of age.

Adverse Reactions - Common

• Skin irritation, burning, itching (Common)
• Dry skin, folliculitis (Uncommon)

Adverse Reactions - Serious

• Skin atrophy, striae, telangiectasia (Rare)
• Hypothalamic-pituitary-adrenal (HPA) axis suppression (Rare)
• Secondary infection (Rare)

Drug-Drug Interactions

• Potent CYP3A4 inhibitors may increase systemic corticosteroid levels.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Use exactly as prescribed.
• Do not use on face, groin, or underarms unless directed.
• Report any signs of skin thinning, redness, or infection.
• Do not cover the treated area with occlusive dressings unless advised.

Special Considerations

Black Box Warnings:

• Potential for HPA axis suppression with extensive or occlusive use.
• Avoid use on large surface areas for prolonged periods.

Genetic Factors: No specific genetic factors impacting use currently identified.

Lab Test Interference: May suppress local or systemic immune responses, potentially affecting skin tests or wound healing.

Overdose Management

Signs/Symptoms: Signs of systemic corticosteroid excess: weight gain, suppression of HPA axis, hyperglycemia.

Treatment: Discontinue use and provide supportive care. In case of systemic overdose, glucocorticoid replacement therapy may be necessary.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable until expiration date on the package.