Cobesol

• Psoriasis (excluding widespread plaque psoriasis)
• Recalcitrant dermatoses
• Lichen planus
• Discoid lupus erythematosus
• Other skin conditions which do not respond satisfactorily to less potent steroids

Clobetasol Propionate is a very potent topical corticosteroid. It has anti-inflammatory, antipruritic and vasoconstrictive properties. It shows anti-inflammatory activity via multiple mechanisms to inhibit late phase allergic reactions. It decreases the density of mast cells, chemotaxis and activation of eosinophils. It also reduces cytokine production and inhibits the metabolism of arachidonic acid. Corticosteroids are thought to act by induction of phospholipase A2 inhibitory proteins (lipocortins), which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of arachidonic acid.

Adult Dose (Cream/Ointment): Apply a thin layer to affected areas twice daily and rub in gently and completely. Not to exceed 50 g/week. Treatment should be limited to 2 consecutive weeks.

Pediatric Dose (>1 year): Same as adult dose. Courses should be limited if possible to five days and reviewed weekly.

Scalp Application (Shampoo): Apply to dry scalp once daily, leave in place for 15 minutes, then lather and rinse thoroughly. Not to exceed 50 g/week. Treatment should be limited to 4 consecutive weeks.

Scalp Solution/Spray: Apply once or twice daily to affected areas and gently rub in. Not to exceed 50 ml/week. Discontinue if no response after one week.

Common Side Effects:

• Thinning of skin
• Application site reactions (burning, stinging, itching and redness)
• Striae (stretch marks)
• Dilatation of superficial blood vessels
• Pigmentation changes
• Hypertrichosis (excessive hair growth)

Serious Side Effects (long-term/large area use): Hypercortisolism (adrenal suppression), Cushing's syndrome.

[CONSULT YOUR DOCTOR] Clobetasol Propionate 0.05% topical may be unsafe to use during pregnancy. Topical administration of corticosteroids to pregnant animals can cause abnormalities of fetal development. Pregnancy Category C.

• Long-term continuous topical therapy should be avoided where possible, particularly in children (adrenal suppression can occur readily even without occlusion).
• If used on the face, courses should be limited to five days and occlusion should not be used (facial skin is more prone to atrophic changes).
• If applied to the eyelids, care is needed to ensure that the preparation does not enter the eye (glaucoma or cataract might result).
• Topical corticosteroids may be hazardous in psoriasis (rebound relapses, development of tolerance, risk of generalized pustular psoriasis).
• Appropriate antimicrobial therapy should be used whenever treating inflammatory lesions which have become infected.
• Caution during pregnancy and lactation.

Acute overdosage is very unlikely to occur. In the case of chronic overdosage or misuse, features of hypercortisolism may appear; topical steroids should be discontinued gradually.

Keep below 30°C temperature, protected from light and moisture. Do not freeze. Keep out of reach of children.