clobetasol (Temovate, Temovate E, Cormax, Clobex, Clobex Spray, Clarelux, Cormax Ointment, Cormax Scalp Application, Olux, Olux-E, Olux-E Foam)
Classes: Corticosteroids, Topical
Dosing and uses of Temovate, Temovate E (clobetasol)
Adult dosage forms and strengths
cream, gel, ointment, shampoo, liquid, lotion, solution, spray, or foam
- 0.05%
Corticosteroid-responsive Dermatoses
Cream/foam: Apply thin layer to affected areas q12hr and rub in gently and completely; not to exceed 50 g/week
Corticosteroid-responsive Dermatoses of the Scalp
Foam: Apply to affected area in scalp q12hr for up to 2 weeks; not to exceed 50 g or 50 mL/week
Scalp Psoriasis
Shampoo: Apply thin film to dry scalp qDay; leave in place for 15 min; add water, lather, and then rinse thoroughly
Mild to Moderate Plaque-type Psoriasis of Nonscalp Areas
Foam: Apply to affected area in scalp q12hr for up to 2 weeks; not to exceed 50 g/week
Moderate to Severe Plaque-type Psoriasis
Emollient/cream/lotion: Apply to affected area in scalp q12hr for up to 2 weeks if area is less than 10% of the body surface area; not to exceed 50 g/week
Spray: Apply by spraying onto affected area q12hr; rub into skin; should not be used for more than 4 weeks
Pediatric dosage forms and strengths
cream, gel, ointment, shampoo, liquid, lotion, solution, spray, or foam
- 0.05%
Corticosteroid-responsive Dermatoses
<12 years
- Safety & efficacy not established
>12 years
- Cream/foam: Apply thin layer to affected areas q12hr and rub in gently and completely; not to exceed 50 g/week
Corticosteroid-responsive Dermatoses of the Scalp
<12 years
- Safety & efficacy not established
>12 years
- Foam: Apply to affected area in scalp q12hr for up to 2 weeks; not to exceed 50 g or 50 mL/week
Scalp Psoriasis
<12 years
- Safety & efficacy not established
>12 years
- Shampoo: Apply thin film to dry scalp qDay; leave in place for 15 min; add water, lather, and then rinse thoroughly
Mild to Moderate Plaque-type Psoriasis of Nonscalp Areas
<12 years
- Safety & efficacy not established
>12 years
- Foam: Apply to affected area in scalp q12hr for up to 2 weeks; not to exceed 50 g/week
Temovate, Temovate E (clobetasol) adverse (side) effects
Frequency not defined
Skin atrophy
Striae
Burning
Cracking/fissuring of the skin
Erythema
Folliculitis
Irritation
Numbness
Pruritus
Stinging
Hypopigmentation (high potency topical steroids)
Intracranial hypertension reported in children with use of topical formulation
Adrenal suppression, Cushing syndrome, hyperglycemia
Acneform lesions
Secondary infection
Pigmentation changes
HPA suppression (with higher potency used >2 weeks); doses as low as 2 g/day can produce HPA suppression
Warnings
Contraindications
Viral, fungal, or tubercular skin lesions
Hypersensitivity
Ophthalmic use
Cautions
Chronic topical corticosteroid therapy may interfere with growth and development in children
May cause hypercorticism or suppression of hypothalamic-pituitary-adrenal (HPA) axis, especially in younger children or patients receiving high doses for prolonged periods
Allergic contact dermatitis reported with use; diagnosed by failure to heal rather than clinical exacerbation
Kaposi's sarcoma reported with prolonged corticosteroid treatment
Percutaneous absorption of corticosteroids may cause manifestations of Cushing's syndrome
Use lower potency in children; may absorb proportionally larger amounts after topical application and may cause systemic effects
Pregnancy and lactation
Pregnancy category: C
Lactation: Excretion in milk unknown; use with caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Temovate, Temovate E (clobetasol)
Mechanism of action
Corticosteroids decrease inflammation by stabilizing leukocyte lysosomal membranes, preventing release of destructive acid hydrolases from leukocytes; inhibiting macrophage accumulation in inflamed areas; reducing leukocyte adhesion to capillary endothelium; reducing capillary wall permeability and edema formation; decreasing complement components; antagonizing histamine activity and release of kinin from substrates; and reducing fibroblast proliferation, collagen deposition, and subsequent scar tissue formation
Pharmacokinetics
Absorption: Percutaneously
Metabolism: Hepatic
Excretion: Urine and feces
