Sunday, March 2, 2008

Alclometasone:

U.S. BRAND NAMES — Aclovate®
PHARMACOLOGIC CATEGORY Corticosteroid, Topical
DOSING: ADULTS — Steroid-responsive dermatoses: Topical: Apply a thin film to the affected area 2-3 times/day. Therapy should be discontinued when control is achieved; if no improvement is seen, reassessment of diagnosis may be necessary.
DOSING: PEDIATRIC — Children 1 year of age: Refer to adult dosing.
(For additional information see "Alclometasone: Pediatric drug information")
DOSING: ELDERLY — Refer to adult dosing.
DOSAGE FORMS — Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Cream, as dipropionate: 0.05% (15 g, 45 g, 60 g)
Ointment, as dipropionate: 0.05% (15 g, 45 g, 60 g)
DOSAGE FORMS: CONCISE Cream: 0.05% (15 g, 45 g, 60 g) Aclovate®: 0.05% (15 g, 45 g, 60 g)
Ointment: 0.05% (15 g, 45 g, 60 g) Aclovate®: 0.05% (15 g, 45 g, 60 g)
GENERIC EQUIVALENT AVAILABLE — Yes
ADMINISTRATION — For external use only. Do not use on open wounds. Should not be used in the presence of open or weeping lesions. Apply sparingly to occlusive dressings.
USE — Treatment of inflammation of corticosteroid-responsive dermatosis (low potency topical corticosteroid)
ADVERSE REACTIONS SIGNIFICANT — Frequency not defined.
Dermatologic: Acne, allergic dermatitis, hypopigmentation, maceration of the skin, skin atrophy, striae, miliaria, telangiectasia
Endocrine & metabolic: HPA suppression, Cushing's syndrome, growth retardation
Local: Burning, erythema, itching, irritation, dryness, folliculitis, hypertrichosis
Systemic: HPA axis suppression, Cushing's syndrome, hyperglycemia; these reactions occur more frequently with occlusive dressings
Miscellaneous: Secondary infection
CONTRAINDICATIONS — Hypersensitivity to alclometasone or any component of the formulation; viral, fungal, or tubercular skin lesions
WARNINGS / PRECAUTIONS Concerns related to adverse effects: Adrenal suppression: Systemic absorption of topical corticosteroids may cause hypothalamic-pituitary-adrenal (HPA) axis suppression (reversible) particularly in younger children. HPA axis suppression may lead to adrenal crisis. Risk is increased when used over large surface areas, for prolonged periods, or with occlusive dressings. Contact dermatitis: Allergic contact dermatitis can occur, it is usually diagnosed by failure to heal rather than clinical exacerbation. Kaposi's sarcoma: Prolonged treatment with corticosteroids has been associated with the development of Kaposi's sarcoma (case reports); if noted, discontinuation of therapy should be considered. Systemic effects: Adverse systemic effects including hyperglycemia, glycosuria, fluid and electrolyte changes, and HPA suppression may occur when used on large surface areas, for prolonged periods, or with an occlusive dressing.
Special populations: Pediatrics: Safety and efficacy have not been established in children <1 year of age. Chronic use of corticosteroids in children may interfere with growth and development.
DRUG INTERACTIONS — No data reported
PREGNANCY RISK FACTOR — C (show table)
PRICING — (data from drugstore.com)Cream (Aclovate) 0.05% (15): $27.31 0.05% (45): $50.64 0.05% (60): $61.60
Cream (Alclometasone Dipropionate) 0.05% (45): $38.99
Ointment (Aclovate) 0.05% (15): $27.31 0.05% (45): $50.64 0.05% (60): $61.60
TOXICOLOGY / OVERDOSE COMPREHENSIVE — Symptoms include cushingoid appearance (systemic), muscle weakness (systemic), osteoporosis (systemic) all with long-term use only. When consumed in excessive quantities for prolonged periods, systemic hypercorticism and adrenal suppression may occur; in those cases, discontinuation and withdrawal of the corticosteroid should be done judiciously.
MECHANISM OF ACTION — Stimulates the synthesis of enzymes needed to decrease inflammation, suppress mitotic activity, and cause vasoconstriction
PATIENT INFORMATION — Before applying, gently wash area to reduce risk of infection. Apply a thin film to cleansed area and rub in gently and thoroughly until medication vanishes. Avoid exposure to sunlight; severe sunburn may occur.
(For additional information see "Alclometasone: Patient drug information")

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