Drug information of Alclometasone

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; reducing fibroblast proliferation, collagen deposition, and subsequent scar tissue formation

Alclometasone is a synthetic corticosteroid for topical dermatologic use. The corticosteroids constitute a class of primarily synthetic steroids used topically as anti-inflammatory and antipruritic agents. Alclometasone is a selective glucocorticoid receptor agonist.

Absorption

Topical: ~3% absorbed systemically after 8 hours when applied to intact skin

Onset of Action

Initial response ; Eczema: 5.3 days; Psoriasis: 6.7 days

Time to Peak

Peak response ;Eczema: 13.9 days; Psoriasis: 14.8 days

Inflammatory & Pruritic Skin Disorders

Apply thin film to affected area q8-12hr; discontinue treatment when control achieved

Reassess diagnosis if no improvement within 2 weeks

Hypersensitivity

Underlying infection

Herpes simplex, varicella, vaccinia

Acne, rosacea, perioral dermatitis

Ophthalmic use

Skin atrophy

Hypopigmentation

Miliaria

Cushing's syndrome

Dryness

Striae

Acneform lesions

Secondary infection

Irritation

HPA suppression (with higher potency used >2 wk)

-Chronic topical corticosteroid therapy may interfere with growth and development in children

-Pregnancy

-Breastfeeding

-Development of Kaposi's sarcoma with prolonged use reported (discontinue therapy if it occurs)

-Adrenal suppression may occur in younger patients or patients receiving high doses for prolonged periods

-Adrenal suppression: May cause hypercortisolism or suppression of hypothalamic-pituitary-adrenal (HPA) axis, particularly in younger children or in patients receiving high doses for prolonged periods. HPA axis suppression may lead to adrenal crisis

- Contact dermatitis: Allergic contact dermatitis can occur, it is usually diagnosed by failure to heal rather than clinical exacerbation.

- Immunosuppression: Prolonged use may result in fungal or bacterial superinfection; discontinue if dermatological infection persists despite appropriate antimicrobial therapy.

-Sensitization: Topical use has been associated with local sensitization (redness, irritation); discontinue if sensitization is noted.

-Topical corticosteroids may be absorbed percutaneously. Absorption of topical corticosteroids may cause manifestations of Cushing syndrome, hyperglycemia, or glycosuria. Absorption is increased by the use of occlusive dressings, application to denuded skin, or application to large surface areas.

-Use medium to very high potency for <2 wk to reduce local and systemic side effects

-Use low potency for chronic therapy

-Avoid medium to very high potency on face, folds, groin because can increase steroid absorption

-Use lower potency for peds

C

Animal studies have revealed evidence of teratogenicity when corticosteroids are administered systemically or topically. There are no adequate and well-controlled studies in pregnant women.