";s:4:"text";s:4875:" 4.5 Interaction with other medicinal products and other forms of interaction6.6 Special precautions for disposal and other handling9.
4.2 Posology and method of administration. Following the application of a second dose of 30 g clobetasol propionate cream 500 micrograms/g mean peak plasma concentrations were slightly higher than the ointment and occurred 10 hours after application.In a separate study, mean peak plasma concentrations of approximately 2.3 ng/ml and 4.6 ng/ml occurred respectively in patients with psoriasis and eczema three hours after a single application of 25 g clobetasol propionate 500 micrograms/g ointment.
The extent of percutaneous absorption of topical corticosteroids is determined by many factors, including the vehicle and the integrity of the epidermal barrier. • In comparison with adults, children and infants may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic adverse effects. In the event of overdose, clobetasol should be withdrawn gradually by reducing the frequency of application or by substituting a less potent corticosteroid because of the risk of glucocorticosteroid insufficiency.Further management should be as clinically indicated or as recommended by the national poisons centre, where available.Pharmacotherapeutic group: Corticosteroids, very potent, dermatological preparations (group IV)Topical corticosteroids act as anti-inflammatory agents via multiple mechanisms to inhibit late phase allergic reactions including decreasing the density of mast cells, decreasing chemotaxis and activation of eosinophils, decreasing cytokine production by lymphocytes, monocytes, mast cells and eosinophils, and inhibiting the metabolism of arachidonic acid.Topical corticosteroids, have anti-inflammatory, antipruritic, and vasoconstrictive properties.Topical corticosteroids can be systemically absorbed from intact healthy skin. Washing clothing and bedding may reduce product build-up but not totally remove it.Co-administered drugs that can inhibit CYP3A4 (eg ritonavir and itraconazole) have been shown to inhibit the metabolism of corticosteroids leading to increased systemic exposure. Topical administration of corticosteroids to pregnant animals can cause abnormalities of foetal development (see section 5.3). Topical corticosteroids should be used with caution in psoriasis as rebound relapses, development of tolerances, risk of generalised pustular psoriasis and development of local or systemic toxicity due to impaired barrier function of the skin have been reported in some cases. If used on the face, treatment should be limited to 5 days.If applied to the eyelids, care is needed to ensure that the preparation does not enter the eye, as cataract and glaucoma might result from repeated exposure. It is not known whether the topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable amounts in breast milk.