A potent, broad-spectrum, fixed-dose combination topical preparation designed for the treatment of complex, mixed, or secondarily infected inflammatory dermatoses, particularly in the Indian context where such presentations are common. It combines a super-potent corticosteroid (Clobetasol) with antibacterial (Gentamicin), antifungal (Clotrimazole, Tolnaftate), and antibacterial/antifungal (Clioquinol) agents to address inflammation, bacterial infection, and fungal infection simultaneously.
Adult: Apply a thin film to the affected area 1-2 times daily. Duration should be limited to 2 weeks maximum for body/limbs. For face, groin, and axillae, use should not exceed 1 week.
Note: Wash and dry the area thoroughly. Apply a pea-sized amount for an area the size of the palm. Gently rub in. Wash hands after application unless hands are being treated. Do not bandage or cover with airtight dressings unless specifically advised by a doctor.
This combination exerts a multifaceted action: 1) Clobetasol: Potent anti-inflammatory, immunosuppressive, antipruritic, and vasoconstrictive effects by inhibiting phospholipase A2, reducing prostaglandin/leukotriene synthesis, and inhibiting cytokine release. 2) Gentamicin: Bactericidal action against Gram-negative and some Gram-positive bacteria by binding to 30S ribosomal subunit, inhibiting protein synthesis. 3) Clotrimazole: Fungistatic/Fungicidal action against Candida and dermatophytes by inhibiting ergosterol synthesis, damaging fungal cell membrane. 4) Clioquinol: Antibacterial and antifungal (particularly against Malassezia) action via chelation of essential metal ions (Fe, Cu). 5) Tolnaftate: Fungistatic action against dermatophytes (Trichophyton, Microsporum, Epidermophyton) by inhibiting squalene epoxidase, disrupting ergosterol synthesis.
Pregnancy: Category C (US FDA). Clobetasol is contraindicated in first trimester unless absolutely necessary. Use in second/third trimester only if potential benefit justifies potential fetal risk. Avoid large areas, prolonged use, or occlusive dressings. Topical corticosteroids can be absorbed in amounts sufficient to cause systemic effects. Other components have limited safety data.
Driving: No effect on driving ability.
| Other Topical Corticosteroids | Increased risk of local and systemic adverse effects | Major |
| Oral Corticosteroids (e.g., Prednisolone) | Additive systemic corticosteroid effects, increased risk of HPA suppression | Major |
| Other Aminoglycosides (e.g., IV Amikacin) | Potential additive ototoxicity and nephrotoxicity if significant systemic absorption occurs | Moderate |
| Warfarin | Clobetasol may alter INR; monitor | Moderate |
| Diuretics (e.g., Furosemide) | Increased risk of hypokalemia with corticosteroids | Moderate |
| Immunosuppressants (e.g., Cyclosporine) | Increased risk of infection | Moderate |
Same composition (Clobetasol (0.05% w/w) + Gentamicin (0.1% w/w) + Clotrimazole (1% w/w) + Clioquinol (Iodochlorhydroxyquin) (1% w/w) + Tolnaftate (1% w/w)), different brands: