A potent topical combination product containing a super-high potency corticosteroid (Clobetasol propionate) and an aminoglycoside antibiotic (Neomycin sulphate). It is primarily used for the short-term treatment of severe, acute inflammatory dermatoses where secondary bacterial infection is present or suspected. Clobetasol provides rapid anti-inflammatory, anti-pruritic, and vasoconstrictive effects, while Neomycin provides bactericidal action against common skin pathogens, particularly gram-positive bacteria like Staphylococcus aureus.
Adult: Apply a thin film to the affected area once or twice daily. Frequency should be reduced as the condition improves. Total treatment duration should not exceed 2 weeks. The weekly dose should not exceed 50 grams.
Note: 1. Wash and dry the affected area gently. 2. Apply a thin layer and rub in lightly until it disappears. 3. Do not cover with occlusive dressings unless specifically directed by a physician. 4. Wash hands after application unless hands are the treatment area. 5. Avoid contact with eyes, mouth, nose, and mucous membranes.
Clobetasol propionate binds to intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus. This complex modulates gene transcription, leading to the synthesis of anti-inflammatory proteins (lipocortins) and inhibition of the production of pro-inflammatory mediators (cytokines, leukotrienes, prostaglandins). It also causes vasoconstriction. Neomycin sulphate is a bactericidal antibiotic that binds irreversibly to the 30S ribosomal subunit of susceptible bacteria, inhibiting protein synthesis and leading to bacterial cell death.
Pregnancy: Category C (US FDA). Topical corticosteroids, especially potent ones, can be absorbed in amounts sufficient to cause systemic effects. Animal studies show teratogenicity. Use only if the potential benefit justifies the potential risk to the fetus. Avoid large areas, prolonged use, or occlusive dressings.
Driving: No known effects on driving ability from topical use.
| Other Topical Corticosteroids | Additive risk of local and systemic side effects, including HPA suppression. | Major |
| Other Aminoglycosides (e.g., Gentamicin, Amikacin) - Systemic | Increased risk of ototoxicity and nephrotoxicity if neomycin is absorbed systemically. | Major |
| Loop Diuretics (e.g., Furosemide) | Increased risk of ototoxicity with systemically absorbed neomycin. | Moderate |
| Neuromuscular Blocking Agents | Neomycin may potentiate neuromuscular blockade, leading to respiratory depression. | Moderate |
| CYP3A4 Inhibitors (e.g., Ketoconazole, Itraconazole, Clarithromycin) | May increase systemic levels of clobetasol if absorbed, increasing side effects. | Moderate |
Same composition (Clobetasol (0.05% w/w) + Neomycin (0.5% w/w)), different brands: