Betamethasone + Clioquinol


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : Topical Inflammatory skin conditions; Bacterial and fungal infections of the skin Each 1 g oint/cream contains betamethasone 1.22 mg and clioquinol 30 mg: Apply thinly and rub gently onto affected area(s) bid or tid.
Dosage Details
Topical/Cutaneous
Bacterial skin infections, Inflammatory skin conditions, Skin fungal infections
Adult: Available preparation:
Each 1 g of oint/cream contains betamethasone 1.22 mg and clioquinol 30 mg
Apply thinly and rub gently onto affected area(s) bid or tid, may reduce to once daily if condition improves.
Child: Same as adult dose. Max duration of therapy: 5 days.
Contraindications
Rosacea, acne vulgaris, perioral dermatitis, iodine sensitivity, perianal or genital pruritus, napkin eruptions, dermatitis, pruritus w/o inflammation, primary viral (e.g. herpes simplex, chicken pox), fungal, bacterial, or yeast infections, dermatoses in childn <1 yr.
Special Precautions
Patient w/ psoriasis. Childn. Pregnancy and lactation.
Adverse Reactions
Significant: Local hypersensitivity reactions; HPA axis suppression (e.g. Cushing’s syndrome), adrenal insufficiency, facial atrophic changes (long-term use); cataract, glaucoma; psoriasis relapse and tolerance, pustular psoriasis and systemic toxicity; prolonged local infection, risk of neurotoxicity (clioquinol).
Dermatologic: Burning, pruritus, pain, pigmentation changes, allergic contact dermatitis, hypertrichosis.
Patient Counseling Information
This drug may cause discolouration of skin, hair and cloth. Avoid long term use and abrupt withdrawal. Avoid use of occlusive dressing. Avoid application to the eyes.
MonitoringParameters
Monitor for hypothalamic-pituitary adrenal (HPA) axis and adrenal insufficiency.
Lab Interference
Betamethasone: May suppress the wheal and flare reaction to skin antigens.Clioquinol: May interfere w/ thyroid function tests [e.g. radioactive iodine and butanol extractable iodine, protein-bound iodine (PBI)]. May cause false-positive ferric chloride test for phenylketonuria.
Action
Description: Betamethasone is a corticosteroid w/ mainly glucocorticoid activity. It has anti-inflammatory, antipruritic and vasoconstrictive properties. It depresses the formation, release and activity of inflammatory mediators (e.g. kinins, histamine, prostaglandins) by induction of phospholipase A2 inhibitory proteins (e.g. lipocortins) and inhibition of arachidonic acid release.
Clioquinol is a halogenated hydroxyquinoline derivative. It has a broad spectrum of activity against fungi (e.g. candida, microsporum, trichophyton); and bacteriostatic against gm+ve bacteria (e.g. staphylococci) but has limited activity against gm-ve bacterias.
Pharmacokinetics:
Absorption: Betamethasone: Readily absorbed from the intact skin.
Clioquinol: Approx 1.5-4% is absorbed.
Distribution: Betamethasone: Rapidly distributed to all body tissues. Crosses the placenta and enters breast milk (small amounts). Plasma protein binding: Extensively bound mainly to globulin.
Metabolism: Betamethasone: Metabolised in the liver.
Excretion: Betamethasone: Via urine and faeces.
Clioquinol: Via urine mainly as glucuronide, and as sulphate metabolites (small amounts).
Chemical Structure

Chemical Structure Image
Betamethasone

Source: National Center for Biotechnology Information. PubChem Database. Betamethasone, CID=9782, https://pubchem.ncbi.nlm.nih.gov/compound/Betamethasone (accessed on Jan. 21, 2020)


Chemical Structure Image
Clioquinol

Source: National Center for Biotechnology Information. PubChem Database. Clioquinol, CID=2788, https://pubchem.ncbi.nlm.nih.gov/compound/Clioquinol (accessed on Jan. 21, 2020)

Storage
Store below 30°C.
References
AFT Pharmaceuticals Ltd. Locorten Vioform Ear Drops data sheet September 2016. Medsafe. http://www.medsafe.govt.nz/. Accessed 14/09/2017.

Anon. Betamethasone (Topical). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 14/09/2017.

Betamethasone valerate/Clioquinol 1 mg/30 mg/g Cream (Chemidex Pharma Limited). MHRA. https://products.mhra.gov.uk/. Accessed 13/09/2017.

Betamethasone valerate/Clioquinol 1 mg/30 mg/g Ointment (Chemidex Pharma Limited). MHRA . https://products.mhra.gov.uk/. Accessed 13/09/2017.

Buckingham R (ed). Betamethasone. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/09/2017.

Buckingham R (ed). Clioquinol. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/09/2017.

Buckingham R (ed). Pharmacokinetics of Corticosteroids. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 14/09/2017.

GlaxoSmithKline NZ Limited. Betnovate-C Cream and Ointment data sheet 11 December 2012. Medsafe. http://www.medsafe.govt.nz/. Accessed 13/09/2017.

Joint Formulary Committee. Betamethasone with Clioquinol. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/09/2017.

Disclaimer: This information is independently developed by MIMS based on Betamethasone + Clioquinol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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