Clovate Scalp Solution

Indications

Clovate is a potent topical corticosteroid suitable for adults, elderly, and children over 1 year. It is used in the treatment of various dermatoses, including:

• Psoriasis (excluding widespread plaque psoriasis)
• Recalcitrant dermatoses
• Lichen planus
• Discoid lupus erythematosus
• Other skin conditions unresponsive to less potent steroids

Always use Clovate as per the guidance of a registered healthcare provider.

Composition

• Clobetasol Propionate Cream: 0.5 mg per gram (0.05% w/w)
• Clobetasol Propionate Ointment: 0.5 mg per gram (0.05% w/w)
• Clobetasol Propionate Scalp Application: 0.5 mg per gram (0.05% w/w)
• Clobetasol Propionate Shampoo: 0.5 mg per gram (0.05% w/w)
• Clobetasol Propionate Lotion: 0.5 mg per gram (0.05% w/w)
• Clobetasol Propionate Spray: 0.5 mg per gram (0.05% w/w)

Pharmacology

Clobetasol Propionate is a highly potent topical corticosteroid known for its anti-inflammatory, antipruritic, and vasoconstrictive effects. It works by inhibiting late-phase allergic reactions, reducing mast cells, and suppressing eosinophil activation. Additionally, it decreases cytokine production and inhibits the metabolism of arachidonic acid, thus alleviating symptoms of various inflammatory skin conditions.

Dosage

• Cream/Ointment: Apply a thin layer to the affected area twice daily. For stubborn lesions, occlusion with polythene film may enhance results. Limit treatment to 2 weeks and avoid exceeding 50g per week.
• Spray: Apply to the scalp once or twice daily, ensuring the total weekly dose does not exceed 50 ml. Discontinue if no improvement is seen after a week.
• Shampoo: Apply to a dry scalp, massaging it into affected areas. Leave for 15 minutes before rinsing. Limit treatment to 4 weeks and do not exceed 50g per week. Not recommended for individuals under 18.
• Scalp Solution: Similar to the spray, apply once or twice daily and ensure the weekly dose does not exceed 50 ml. Discontinue treatment if no response is observed within a week.

Always use under the guidance of a healthcare professional.

Administration

• Route: Topical (cutaneous).
• Creams are ideal for moist or weeping surfaces, while ointments are suited for dry, scaly, or lichenified lesions.

Consult your healthcare provider for tailored instructions.

Drug Interactions

Drugs inhibiting CYP3A4 (e.g., ritonavir, itraconazole) may increase the systemic exposure to Clobetasol Propionate, leading to higher absorption.

Contraindications

Clovate should not be used in the following cases:

• Rosacea, acne vulgaris, perioral dermatitis
• Primary cutaneous viral infections (e.g., herpes simplex, chickenpox)
• Known hypersensitivity to Clobetasol Propionate
• Infected skin lesions caused by fungi or bacteria
• Dermatoses in infants under 1 year

Side Effects

Possible side effects include:

• Prolonged use may lead to systemic absorption and signs of hypercorticism.
• Local skin atrophy, thinning, striae, and dilation of superficial blood vessels.
• Rarely, psoriasis may flare up in a pustular form.
• Potential for pigmentation changes or increased hair growth.
  If hypersensitivity occurs, discontinue use immediately.

Pregnancy & Lactation

Limited data on Clobetasol Propionate use during pregnancy. Use only if the potential benefits outweigh the risks. The drug’s excretion in breast milk is unknown, so caution is advised for nursing mothers.

Precautions & Warnings

• Long-term use should be avoided, especially in infants and children, to prevent adrenal suppression.
• Prolonged treatment on the face may lead to atrophic skin changes.
• Avoid applying near the eyes to prevent risks of glaucoma or cataract.
• In psoriasis, monitor closely to avoid rebound relapses and systemic toxicity.
• If infections occur, use antimicrobial therapy and discontinue corticosteroids if needed.

Use in Special Populations

• Children: Limit use to prevent adrenal suppression, especially for long-term therapy.
• Infants: Avoid continuous use of topical corticosteroids due to potential systemic effects.

Overdose Effects

Overdose is unlikely with topical use, but chronic overuse may lead to symptoms of hypercortisolism. Discontinue if symptoms occur.

Therapeutic Class

Other Topical Corticosteroids

Storage Conditions

Store below 30°C, away from light and moisture. Do not freeze. Keep out of reach of children.