betamethasone/clotrimazole

Action and Spectrum

Actions and spectrum:

betamethasone is a corticosteroid that reduces inflammation, itching, and redness. It works by suppressing the immune system’s response to the irritation or infection.

clotrimazole is an antifungal medication that stops the growth of fungi, including yeasts and molds. It works by inhibiting the production of ergosterol, a component of the fungal cell membrane

Drug Interaction

Adverse Reaction

Frequency defined:

1-10%

Dry skin (2%)

Local burning (2%)

Paresthesia (2%)

<1%

Edema

Skin atrophy

Skin ulceration

Bruising

Striae

Rash

Secondary infection

Acneiform eruption

Folliculitis

Frequency undefined

clotrimazole

Erythema

Blistering

Edema

Urticaria

Stinging

Peeling

Pruritus

General skin irritation

betamethasone

Burning

Irritation

Folliculitis

Acneiform eruptions

Perioral dermatitis

Skin maceration

Striae

HPA suppression

Itching

Dryness

Hypertrichosis

Hypopigmentation

Allergic contact dermatitis

Skin atrophy

Miliaria

Black Box Warning

Black box warning:

The prolonged use of betamethasone and clotrimazole may cause a range of serious side effects like skin thinning, adrenal suppression, increased intraocular pressure and increased risk of skin infections including bacterial, viral, and fungal infections.

Contraindication / Caution

Contraindication/Caution:

Contraindication

• Hypersensitivity: Patients who have a known hypersensitivity or allergy to betamethasone, clotrimazole, or any of the other ingredients in the medication should not use it.
• Viral skin infections: betamethasone/clotrimazole should not be used to treat viral skin infections such as herpes simplex, chickenpox, or shingles.
• Fungal nail infections: This medication is not indicated for the treatment of fungal nail infections.
• Tuberculosis: Betamethasone/clotrimazole should not be used in patients with tuberculosis of the skin.
• Acne rosacea: Topical corticosteroids, like betamethasone, can exacerbate acne rosacea, a skin condition characterized by redness and bumps on the face.
• Perianal and genital itching: The medication should not be used for perianal or genital itching.

Caution

• Pregnancy and breastfeeding: Pregnant or breastfeeding women should use betamethasone/clotrimazole only under the supervision of their healthcare provider, as the medication may be absorbed into the bloodstream and potentially harm the fetus or newborn.
• Diabetes: betamethasone can increase blood sugar levels and in patients with diabetes it should be used with caution.
• Cushing’s syndrome: Prolonged use of corticosteroids, like betamethasone, can lead to Cushing’s syndrome, a condition characterized by weight gain, moon-shaped face, and other symptoms.
• Eye contact: The medication should not be applied near the eyes, as it can increase intraocular pressure and potentially lead to glaucoma or cataracts.
• Other medications: Patients should inform their healthcare provider of any other medications they are taking, as some medications may interact with betamethasone/clotrimazole.
• Pediatric use: betamethasone/clotrimazole should be used with caution in children, as the medication can be absorbed into the bloodstream and potentially affect growth and development.

Comorbidities

• Cushing’s syndrome: Prolonged use of corticosteroids, like betamethasone, can lead to Cushing’s syndrome, a condition characterized by weight gain, moon-shaped face, and other symptoms.
• Infection: betamethasone can increase the risk of infections, and caution should be used in patients with an active infection.
• Liver or kidney disease: Liver or kidney disease: betamethasone/clotrimazole in patients with liver or kidney disease should be used with caution
• Hypertension: betamethasone can increase blood pressure and in patients with hypertension it should be used with caution.
• Osteoporosis: Prolonged use of corticosteroids, like betamethasone, can lead to osteoporosis, a condition characterized by bone loss and increased risk of fractures.

Pregnancy / Lactation

Pregnancy consideration:

pregnancy category C

Lactation: safety and efficacy is established

Pregnancy category:

Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester.

Category B: There is no evidence of risk to the fetus found in animal reproduction studies and there are not enough studies on pregnant women.

Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for an effect in humans, care must be taken for potential risks in pregnant women

Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms, but despite potential risks may be used only in emergency cases for potential benefits.

Category X: Drugs listed in this category outweigh risks over benefits These category drugs should be prohibited for pregnant women.

Category N: There is no data available for the drug under this category.

Pharmacology

Pharmacology:

betamethasone/clotrimazole is a combination medication that contains two active ingredients: betamethasone and clotrimazole. Betamethasone is a synthetic corticosteroid that works by reducing inflammation and suppressing the immune system, while clotrimazole works by inhibiting the growth and replication of fungal cells.

Pharmacodynamics:

betamethasone is a synthetic corticosteroid that works by reducing inflammation and suppressing the immune system. It binds to specific receptors in cells and modifies the expression of certain genes, which results in the inhibition of the production of various pro-inflammatory cytokines and chemokines. This leads to the reduction of inflammation, redness, and itching.
blotrimazole is an antifungal medication that works by inhibiting the growth and replication of fungal cells. It interferes with the synthesis of ergosterol, a key component of the fungal cell membrane. This leads to the disruption of the fungal cell membrane, which causes leakage of intracellular contents and eventual cell death.

Pharmacokinetics

Absorption:

betamethasone/clotrimazole is typically applied topically to the affected area, and absorption into the bloodstream is minimal. However, some absorption can occur, particularly with long-term use, or with the use of occlusive dressings.

Distribution:

Once absorbed, the medication is distributed throughout the body and metabolized in the liver. The metabolites are eliminated in the urine and feces.

Metabolism:

betamethasone is metabolized by the liver and excreted in the urine and feces, while clotrimazole is metabolized by the liver and excreted through feces.

Elimination:

The half-life of betamethasone is relatively short, approximately 36-54 hours, while the half-life of clotrimazole is longer, approximately 2 hours. The elimination half-life of the combination product is not well established, but it is likely the half-life of betamethasone.

Adminstartion

Administration:

• Wash and dry the affected area(s) of the skin before applying the medication.
• Apply a thin layer of the medication to the affected area(s) and gently rub it in.
• Wash your hands after applying the medication, unless you are treating your hands.
• Do not cover the affected area(s) with a bandage or other occlusive dressing, unless directed to do so by your healthcare provider.
• Use the medication for the full prescribed course of treatment, even if your symptoms improve before the treatment is complete.

Patient Information Leaflet

Patient information leaflet

Generic Name: betamethasone and clotrimazole

Pronounced: (bay-ta-meth-a-sone-and-kloe-trim-a-zole-top-ik-al)

Why do we use betamethasone/clotrimazole?

betamethasone/clotrimazole is a combination medication that is primarily used to treat skin conditions that involve both inflammation and fungal infections, such as tinea infections (ringworm), eczema, and psoriasis.

The medication combines the anti-inflammatory properties of betamethasone with the antifungal properties of clotrimazole to provide a dual approach to treating these conditions.