Clobetasol
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Clobetasol propionate
Temovate, Clobex, Cormax, Olux, Olux-E, Impoyz
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Summary
Common uses
Severe corticosteroid-responsive dermatoses (psoriasis, lichen planus, lichen sclerosus, severe atopic dermatitis flares)0, Oral lichen planus (topical paste / rinse)0
Pharmacy
Starting dose
Apply a thin film to affected area BID; limit to 2 weeks continuous use and ≤50 g/week (cream/ointment); ≤50 mL/week (foam/solution); avoid face, intertriginous areas
Preparations
Cream, ointment, lotion, foam, solution, shampoo, spray at 0.025-0.05%; emollient and non-emollient bases
US FDA Max
50 g/week (cream/ointment); 2-week continuous limit; 4-week maximum cumulative
Pharmacology
Routes
Topical
Onset
Hours to days for inflammation; substantial improvement within 1 week
Duration
Hours to days per application
Half-life
Not meaningfully described for topical use (systemic exposure varies with surface area, occlusion, skin integrity)[1]
Bioavailability
Topical with variable systemic absorption depending on body site, occlusion, and skin integrity; HPA-axis suppression is documented even with brief courses to large areas[1]
Pregnancy
Topical corticosteroids in pregnancy: use lowest potency and smallest area; super-potent agents like clobetasol are reserved for compelling indications.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Clobetasol is a Class I (super-potent) topical glucocorticoid receptor agonist with hundreds-fold higher topical potency than hydrocortisone; activation broadly suppresses inflammatory and immune gene expression in skin.0 Characteristic adverse effects with prolonged use or large-area application: skin atrophy, striae, telangiectasia, perioral dermatitis, rebound on discontinuation, HPA suppression, and (rarely) iatrogenic Cushing's. The 2-week limit and the surface-area ceiling are central to safe use[1].
References
edit- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Temovate (clobetasol propionate), GSK, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/019322s029,019323s029,019324s029,019325s029lbl.pdf