Clobetasone

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Clobetasone
Clobetasone.svg
Clinical data
Trade namesEumovate
Other names(8S,9R,10S,13S,14S,16S,17R)-17-(2-Chloroacetyl)-9-fluoro-17-hydroxy-10,13,16-trimethyl-7,8,12,14,15,16-hexahydro-6H-cyclopenta[a]phenanthrene-3,11-dione
AHFS/Drugs.comMicromedex Detailed Consumer Information
Routes of
administration
topical
ATC code
Identifiers
  • (1R,2S,10S,11S,13S,14R,15S)-14-(2-chloroacetyl)-1-fluoro-14-hydroxy-2,13,15-trimethyltetracyclo[8.7.0.02,7.011,15]heptadeca-3,6-diene-5,17-dione
CAS Number
PubChem CID
ChemSpider
UNII
KEGG
ECHA InfoCard100.053.576 Edit this at Wikidata
Chemical and physical data
FormulaC22H26ClFO4
Molar mass408.89 g·mol−1
3D model (JSmol)
  • ClCC(=O)[C@@]2(O)[C@@H](C)C[C@H]1[C@H]4[C@](F)(C(=O)C[C@@]12C)[C@@]/3(/C(=C\C(=O)\C=C\3)CC4)C
  • InChI=1S/C22H26ClFO4/c1-12-8-16-15-5-4-13-9-14(25)6-7-19(13,2)21(15,24)17(26)10-20(16,3)22(12,28)18(27)11-23/h6-7,9,12,15-16,28H,4-5,8,10-11H2,1-3H3/t12-,15-,16-,19-,20-,21-,22-/m0/s1 checkY
  • Key:XXIFVOHLGBURIG-OZCCCYNHSA-N checkY
  (verify)

Clobetasone (INN[1]) is a corticosteroid used in dermatology, for treating such skin inflammation as seen in eczema, psoriasis and other forms of dermatitis, and ophthalmology. Topical clobetasone butyrate has shown minimal suppression of the hypothalamic–pituitary–adrenal axis.[2]

It is available as clobetasone butyrate under the brand names Eumosone or Eumovate[3] both manufactured by GlaxoSmithKline.

Trimovate also contains oxytetracycline, an antibiotic, and nystatin, an antifungal.[4]

Uses[edit]

In dermatology, topical clobetasone butyrate helps to reduce the itchiness and erythema associated with eczema and dermatitis.[5]

In ophthalmology, clobetasone butyrate 0.1% eye drops have been shown to be safe and effective in the treatment of dry eyes in Sjögren syndrome. Sjögren syndrome is an autoimmune disorder that affects the moisture producing glands of the body causing many symptoms including dry eyes.[6] When compared to other corticosteroid eye drops; clobetasone butyrate showed only minimal rises in intraocular pressure. Increased pressure within the eye can lead to glaucoma.[7][8][9]

Adverse effects[edit]

Side effects associated with clobetasone cream and ointment include: burning, irritation, itching, thinning of the skin, and changes in skin color.[5][10]

Trimovate Cream[edit]

Trimovate Cream is a yellow water-miscible cream containing clobetasone 17-butyrate 0.05% w/w, oxytetracycline 3.0% w/w as calcium oxytetracycline and nystatin 100,000 units per gram.[11]

Clobetasone (without antifungal or antibacterial compounds added) comes as cream or ointment. You can buy it from pharmacies or supermarkets.

  • Clobetasone cream is better for skin that is moist or weepy.
  • Clobetasone ointment is thicker and greasier and is better for dry or flaky areas of skin.

It may also be used to help keep your condition under control between courses of a stronger steroid – this is known as "maintenance therapy".

There is also a cream called clobetasol, which sounds similar to clobetasone. This is a much stronger steroid cream and is only available on prescription.

Clobetasone Butyrate is moderately potent. It is used for eczema and dermatitis of all types and for maintenance between courses of more potent corticosteroids.[12][13]

  • Clobetasone 17-butyrate is a moderately potent topical corticosteroid indicated for adults, elderly, children and infants for the relief of the inflammatory and

[14] of .[15]

Topical preparations combining clobetasone with nystatin and oxytetracycline are indicated for the treatment and management of steroid responsive dermatoses where candidal or bacterial infection is present, suspected or likely to occur.

Do not use clobetasone on children under 12 years old unless their doctor has prescribed it.

As a general rule, a fingertip unit of cream should be enough to treat an area of skin that is double the size of the palm of your hand.

For babies and children, the right amount of cream depends on their age. Your doctor or pharmacist can advise you.

These include the following:

Key facts:[16]

Clobetasone butyrate is a type of medicine known as a corticosteroid or steroid. Corticosteroids are not the same as anabolic steroids.

Do not put clobetasone on your face unless your doctor has prescribed it. It can make some skin problems of the face worse.

If you buy clobetasone from a pharmacy or supermarket, do not use it for longer than a week without talking to a pharmacist or doctor.

Clobetasone cream or ointment may be called by the brand names Eumovate® and Clobavate®.

When clobetasone is combined with an antibiotic (oxytetracycline) and an antifungal (nystatin) it's called by the brand name Trimovate®.

Contraindications[edit]

The following should not be treated with clobetasone with nystatin and oxytetracycline:

  • Patients with known history of hypersensitivity to clobetasone butyrate, nystatin, oxytetracycline or any components of the formulation
  • Primary cutaneous viral infections (Common viral skin infections include herpes simplex virus infection, herpes zoster, cutaneous and genital warts, and molluscum contagiosum.)[17]
  • Primary infected skin lesions caused by infection with fungi, bacteria or yeasts (Fungal infections of the skin commonly seen in family practice include the various forms of tinea: tinea corporis, tinea gladiatorum, tinea cruris, tinea pedis, tinea capitis, and tinea unguium (e.g., onychomycosis).)[17]
  • Cutaneous infections caused by Acinetobacter species (implicated in a number of hospital-acquired infections such as bacteremia, urinary tract infections (UTIs), secondary meningitis, infective endocarditis, and wound and burn infections.), methicillin resistant Staphylococcus aureus (MRSA), Pseudomonas species, Proteus species Serratia species or Group B streptococcal infection (Streptococcus B., Group B streptococcal infection, also known as Group B streptococcal disease or just Group B strep, is the infection caused by the bacterium Streptococcus agalactiae (S. agalactiae) also known as group B streptococcus or GBS)
  • Rosacea
  • Acne vulgaris
  • Pruritus without inflammation

Serious Contraindications[edit]

  • Pseudomembranous colitis - C. Diff. Colitis, also called: clostridium difficile colitis, or Pseudomembranous colitis has been reported with the use of antibiotics and may range in severity from mild to life-threatening.
  • Reversible hypothalamic-pituitary-adrenal (HPA) axis suppression - Manifestations of hypercortisolism (Cushing's syndrome) and reversible hypothalamic-pituitary-adrenal (HPA) axis suppression can occur in some individuals as a result of increased systemic absorption of topical corticosteroids. (The hypothalamic–pituitary–adrenal (HPA) axis is the complex relationship between the hypothalamus, the pituitary gland, and the adrenals; was previously called Adrenal Fatigue.)[18]

Fire Warning[edit]

Skin creams can dry onto your clothes and bedding. This makes them more likely to catch fire. Avoid naked flames. Do not smoke cigarettes or smoking products (chewing-gum is okay).

See also[edit]

References[edit]

  1. ^ "United Nations Statistics Division - Classifications Registry - Alphabetical index for HS 2002 Entries starting with 'C' (page 310 of 422)". Archived from the original on 2011-06-08. Retrieved 2007-12-11.
  2. ^ Munro DD, Wilson L (September 1975). "Clobetasone butyrate, a new topical corticosteroid: clinical activity and effects on pituitary-adrenal axis function and model of epidermal atrophy". British Medical Journal. 3 (5984): 626–8. doi:10.1136/bmj.3.5984.626. PMC 1674413. PMID 1164639.
  3. ^ "Eumovate cream/ointment". NetDoctor.co.uk. 2017-07-05.
  4. ^ "Trimovate". Electronic Medicines Compendium (EMC). Datapharm Ltd.
  5. ^ a b "Euvomate Medication Guide". GlaxoSmithKline. Archived from the original on 30 January 2014.
  6. ^ Aragona P, Spinella R, Rania L, Postorino E, Sommario MS, Roszkowska AM, Puzzolo D (2013). "Safety and efficacy of 0.1% clobetasone butyrate eyedrops in the treatment of dry eye in Sjögren syndrome". European Journal of Ophthalmology. 23 (3): 368–76. doi:10.5301/ejo.5000229. PMID 23225089. S2CID 20730843.
  7. ^ Ramsell TG, Bartholomew RS, Walker SR (January 1980). "Clinical evaluation of clobetasone butyrate: a comparative study of its effects in postoperative inflammation and on intraocular pressure". The British Journal of Ophthalmology. 64 (1): 43–5. doi:10.1136/bjo.64.1.43. PMC 1039346. PMID 6986899.
  8. ^ Wilhelmus KR, Hunter PA, Rice NS (October 1981). "Equivalence of topical clobetasone and dexamethasone in experimental corneal allograft rejection". The British Journal of Ophthalmology. 65 (10): 699–701. doi:10.1136/bjo.65.10.699. PMC 1039641. PMID 7032579.
  9. ^ Eilon LA, Walker SR (September 1981). "Clinical evaluation of clobetasone butyrate eye drops in the treatment of anterior uveitis and its effects on intraocular pressure". The British Journal of Ophthalmology. 65 (9): 644–7. doi:10.1136/bjo.65.9.644. PMC 1039614. PMID 7028089.
  10. ^ "Clobetason Butyrate". WebMD. Archived from the original on March 2, 2012.
  11. ^ https://emc-prod-ukwest-wa.azurewebsites.net/emc/product/9/smpc#gref
  12. ^ "Clobetasone Butyrate - an overview | ScienceDirect Topics". www.sciencedirect.com.
  13. ^ Waller, Derek G.; Sampson, Anthony P. (January 1, 2018). "49 - Skin disorders". In Waller, Derek G.; Sampson, Anthony P. (eds.). Medical Pharmacology and Therapeutics (Fifth ed.). Elsevier. pp. 561–568. doi:10.1016/B978-0-7020-7167-6.00049-X. ISBN 9780702071676 – via ScienceDirect.
  14. ^ "Pruritus and Systemic Disease: Background, Pathophysiology, Etiology". November 8, 2021 – via eMedicine. {{cite journal}}: Cite journal requires |journal= (help)
  15. ^ "Corticosteroid-responsive dermatoses | DrugBank Online". go.drugbank.com.
  16. ^ "Clobetasone: a steroid medicine to treat swelling and itching". nhs.uk. August 27, 2019. UKOpenGovernmentLicence.svg Text was copied from this source, which is available under an Open Government Licence v3.0. © Crown copyright.
  17. ^ a b Woolever, Donald Raj (February 7, 2020). "Skin Infections and Outpatient Burn Management: Fungal and Viral Skin Infections". FP Essentials. 489: 16–20. PMID 31995350 – via PubMed.
  18. ^ "Overcoming HPA Axis Suppression (Formerly Known as Adrenal Fatigue)". BodyLogicMD. October 23, 2017.