A potent triple-action topical combination used for inflammatory dermatoses complicated by bacterial and fungal infections. Clobetasol is a super-high potency corticosteroid providing rapid anti-inflammatory and immunosuppressive effects. Gentamicin is a bactericidal aminoglycoside antibiotic effective against common skin pathogens. Miconazole is a broad-spectrum imidazole antifungal effective against dermatophytes and yeasts like Candida.
Adult: Apply a thin film to the affected area 2 times daily, or as directed by the physician. Treatment should not exceed 4 weeks continuously. The total weekly dose should not exceed 50 grams.
Note: 1. Wash and dry the affected area gently. 2. Take a small amount (pea-sized for an area the size of the palm) and apply as a thin film. 3. Rub in gently until absorbed. 4. Wash hands after application unless hands are the treatment site. 5. Do not cover with occlusive dressings unless specifically advised by the doctor. 6. Do not use on the face, groin, or axillae unless prescribed for a limited period.
The combination provides a synergistic approach to treating complex dermatoses. Clobetasol inhibits phospholipase A2, reducing prostaglandin and leukotriene synthesis, leading to potent vasoconstriction, anti-inflammatory, anti-pruritic, and immunosuppressive effects. Gentamicin binds to the 30S ribosomal subunit of susceptible bacteria, inhibiting protein synthesis and causing bacterial cell death. Miconazole inhibits the synthesis of ergosterol, a critical component of fungal cell membranes, leading to increased membrane permeability and fungal cell death.
Pregnancy: Category C (US FDA). Topical corticosteroids, especially potent ones, can be absorbed in amounts sufficient to produce systemic effects. Animal studies show teratogenicity. Use only if potential benefit justifies potential risk to the fetus. Avoid large doses, prolonged use, or occlusive dressings.
Driving: No known effects on driving ability.
| Other Topical Corticosteroids | Increased risk of local and systemic steroid side effects. | Major |
| Systemic Aminoglycosides (e.g., Amikacin, Streptomycin) | Increased risk of ototoxicity and nephrotoxicity if gentamicin is systemically absorbed. | Major |
| Warfarin and other Coumarin Anticoagulants | Miconazole (if absorbed) can inhibit metabolism, potentiating anticoagulant effect and increasing INR/bleeding risk. | Major |
| Oral Hypoglycemics (Sulfonylureas) or Insulin | Clobetasol (if absorbed) can cause hyperglycemia, antagonizing their effect. Miconazole may potentiate sulfonylureas. | Moderate |
| Phenytoin, Phenobarbital, Rifampicin | May induce metabolism of clobetasol, reducing its efficacy. | Moderate |
| Potassium-depleting diuretics (e.g., Furosemide, Hydrochlorothiazide) | Clobetasol (if absorbed) can exacerbate hypokalemia. | Moderate |
Same composition (Clobetasol (0.05% w/w) + Gentamicin (0.1% w/w) + Miconazole (2% w/w)), different brands: