Dermex® Spray: Each gm spray contains Clobetasol Propionate BP 0.5 mg.
Clobetasol Propionate cream, ointment and topical spray is a synthetic corticosteroid for topical dermatologic use.
Mode of action:
Like other topical corticosteroids, clobetasol propionate has anti-inflammatory, antipruritic and vasoconstrictive properties. The mechanism of the anti-inflammatory activity of the topical steroids, in general, is unclear. However, corticosteroids are thought to act by induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
Pharmacokinetics:
Clobetasol propionate is absorbed through the skin in varying proportions of the applied dose depending upon the severity of the damage to the stratum corneum barrier that has resulted from the skin disease being treated.
For the topical treatment of moderate to severe plaque psoriasis affecting body surface area and scalp surface.
Dermex® Spray Scalp Application:
It should be applied to the affected scalp areas twice daily, once in morning and once at night. The total dosage should not exceed 50 gm (59 ml or 2 fluid ounces) per week. Do not use more than 26 sprays per application or 52 sprays per day.
Children: Under 18 years this preparation is not recommended.
No hazardous interactions have been reported with use of Clobetasol Propionate.
Overdosage:
Acute overdosage is very unlikely to occur. However, in the case of chronic overdosage or misuse the features of hypercortisolism may appear and in this situation topical steroids should be discontinued gradually.
This drug should be avoided in pregnant women. Mothers using large amounts of the drug should be aware of potential excretion in milk.
Long-term continuous therapy should be avoided where possible, particularly in infants and children, as adrenal suppression can occur even without occlusion. If clobetasol propionate is required for use in children, it is recommended that the treatment should be reviewed weekly. It should be noted that the infant’s napkin may act as an occlusive dressing. If used in childhood or on the face, courses should be limited if possible to five days and occlusion should not be used. The face, more than other areas of the body, may exhibit atrophic changes after prolonged treatment with potent topical corticosteroids. This must be borne in mind when treating such conditions as psoriasis, discoid lupus erythematosus and severe eczema. If applied to the eyelids, care is needed to ensure that the preparation does not enter the eye, as glaucoma might result. If clobetasol propionate cream does enter the eye, the affected eye should be bathed in copious amounts of water.
Topical steroids may be hazardous in psoriasis for a number of reasons including rebound relapses, development of tolerance, risk of generalised pustular psoriasis and development of local or systemic toxicity due to impaired barrier function of the skin. If used in psoriasis careful patient supervision is important.
Appropriate antimicrobial therapy should be used whenever treating inflammatory lesions which have become infected. Any spread of infection requires withdrawal of topical corticosteroid therapy and systemic administration of antimicrobial agents. Bacterial infection is encouraged by the warm, moist conditions induced by occlusive dressings, and so the skin should be cleansed before a fresh dressing is applied.
Keep out of reach of children. Store in a dry place, below 25°C temperature and protected from light.