Top 300 Pharmacy Drug Cards

CLOTRIMAZOLE/BETAMETHASONE: Lotrisone, Various

Class: Anti-infective/Anti-inflammatory Combination

Dosage Forms. Topical Cream: (Clotrimazole/Betamethasone) 1%/0.05%, Topical Lotion: (Clotrimazole/Betamethasone) 1%/0.05%

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Common FDA Label Indication, Dosing, and Titration.

1. Tinea: Adults and children >12 y, apply to affected area bid, for a max of 2 wk (for tinea corporis or tinea cruris) or 4 wk (for tinea pedis)

Off-Label Uses. None

MOA. Clotrimazole inhibits biosynthesis of ergosterol or other sterols, damaging the fungal cell wall membrane and altering its permeability. Betamethasone dipropionate is a corticosteroid that stimulates synthesis of enzymes thought to be responsible for anti-inflammatory effects.

Drug Characteristics: Betamethasone/Clotrimazole

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Medication Safety Issues: Betamethasone/Clotrimazole

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Drug Interactions: Betamethasone/Clotrimazole. None known

Adverse Reactions: Betamethasone/Clotrimazole

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Efficacy Monitoring Parameters. Resolution of erythema and pruritus. Improvement in erythema and pruritus usually occurs within 3-5 d. If no improvement is seen after 1 wk of treatment for tinea cruris or tinea corporis, or after 2 wk of treatment for tinea pedis, then the diagnosis should be reviewed.

Toxicity Monitoring Parameters. Seek medical attention if severe skin irritation or rash.

Key Patient Counseling Points. Apply thin layer to affected area. If using lotion, shake well before use.

Clinical Pearls. Patients receiving the combination therapy show an earlier, better clinical response than patients treated with clotrimazole cream or betamethasone cream alone. Cure rates with clotrimazole/betamethasone are at least as good or better as compared to clotrimazole alone. Do not use with occlusive dressings or on larger areas. This can lead to systemic absorption of betamethasone and HPA suppression.