Exovate N Ointment

Indications

Exovate N is prescribed for:

• Short-term treatment of persistent eczemas.
• Neurodermatoses.
• Psoriasis (excluding widespread plaque psoriasis) in cases where secondary bacterial or fungal infections are present, suspected, or likely.
• Other inflammatory conditions unresponsive to less potent steroids.

Pharmacology

Clobetasol Propionate is a highly potent corticosteroid used to manage severe inflammatory skin conditions like eczema and psoriasis that do not improve with milder corticosteroids. Neomycin Sulphate is an aminoglycoside antibiotic effective against bacterial infections. Nystatin is an antifungal that disrupts fungal cell membranes, leading to cell death.

Clobetasol Propionate provides a strong anti-inflammatory effect on the skin, primarily through vasoconstriction and reduced collagen production. Neomycin inhibits bacterial protein synthesis by binding to ribosomal sub-units and causing errors in protein assembly. Nystatin binds to fungal cell membrane sterols, altering membrane permeability and causing leakage of intracellular components.

Dosage & Administration

• Adults: Apply a thin layer to the affected area once or twice daily until improvement is observed. For resistant lesions, especially with hyperkeratosis, enhancing the anti-inflammatory effect by occluding the treatment area with polythene may be beneficial. Do not use for more than 7 days without medical advice. If treatment beyond 4 weeks is necessary, review the patient’s condition regularly.
• Elderly: Safe for use in the elderly, but caution is advised in cases of reduced renal function due to potential systemic absorption of Neomycin Sulphate.
• Children: Suitable for children aged 2 years and older, with the same dosage as adults. Use is not recommended for neonates and infants under 2 years due to possible increased absorption.

Use medication as directed by your healthcare provider.

Interaction

Neomycin Sulphate may amplify the respiratory depressant effects of neuromuscular blocking agents with significant systemic absorption. However, systemic exposure to Neomycin Sulphate is typically minimal with proper use, making significant drug interactions unlikely. No adverse interactions have been reported with Clobetasol Propionate or Nystatin.

Contraindications

Do not use this medication for:

• Rosacea
• Acne vulgaris
• Perioral dermatitis
• Primary cutaneous viral infections (e.g., Herpes simplex, chickenpox)
• Known hypersensitivity to the preparation

Side Effects

Extended use or application over large areas may cause systemic absorption, leading to symptoms of hypercortisolism, particularly in children and when using occlusive dressings. Potential local effects include skin thinning, striae, and visible blood vessels. Reports of pigmentation changes and hypertrichosis with topical steroids have been noted.

Pregnancy & Lactation

There is limited data on the effects of topically applied Neomycin during pregnancy and lactation. Neomycin may cross the placenta, posing a theoretical risk of fetal toxicity. Clobetasol Propionate’s safety in lactating women has not been established. Therefore, use during pregnancy and lactation is not recommended.

Precautions & Warnings

Avoid prolonged continuous use, especially in children, due to the risk of adrenal suppression. Avoid contact with the eyes to prevent potential glaucoma. If accidental eye contact occurs, rinse thoroughly with water.

Overdose Effects

Acute overdose is highly unlikely. Chronic misuse could lead to hypercortisolism symptoms, requiring gradual discontinuation of topical steroids.

Therapeutic Class

Clobetasol / Clobetasone & Combined Preparations

Storage Conditions

Store below 25°C. Do not freeze. Keep out of reach of children.