Exovate Cream

Indications

Exovate is recommended for the management of various dermatological conditions in adults, the elderly, and children over 1 year, including:

• Psoriasis (excluding extensive plaque psoriasis)
• Persistent dermatoses
• Lichen planus
• Discoid lupus erythematosus
• Skin conditions unresponsive to less potent steroids

For onychomycosis, combining Exovate with oral antifungal treatment is advised.

Composition

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

Pharmacology

Clobetasol Propionate is a highly potent topical corticosteroid with strong anti-inflammatory, anti-pruritic, and vasoconstrictive properties. It effectively reduces inflammation by inhibiting late-phase allergic reactions, decreasing mast cell density, and suppressing cytokine production.

Dosage

• Cream & Ointment: Apply a thin layer to affected areas twice daily. For resistant lesions, occlude with polythene film overnight if needed. Limit use to 2 consecutive weeks; the maximum dose should not exceed 50 g per week. For children, limit to short courses (less than 5 days) and review weekly.
• Spray: Apply once or twice daily to the scalp, with a maximum of 50 ml per week. Massage gently and discontinue if no improvement is seen after one week.
• Shampoo: Apply to dry scalp once daily, massage for 15 minutes, then rinse. Limit use to 4 consecutive weeks; do not exceed 50 g per week. Not recommended for those under 18 years.
• Scalp Solution: Apply once or twice daily to the scalp, ensuring the total dose does not exceed 50 ml per week. Massage gently into the scalp.

Administration

• Route: For external use only. Creams are suitable for moist or weeping areas; ointments for dry, scaly lesions.

Interaction

• Econazole: May interact with CYP3A4/2C9 inhibitors, affecting corticosteroid metabolism.
• Triamcinolone: Can alter plasma salicylate levels, increase bleeding risk with NSAIDs, and impact blood glucose levels.

Contraindications

Not suitable for rosacea, acne vulgaris, perioral dermatitis, primary cutaneous viral infections (e.g., herpes simplex), hypersensitivity to any ingredients, or certain skin infections.

Side Effects

Potential effects include local irritation, skin thinning, and hypercortisolism with long-term use. Rarely, it may provoke psoriasis pustular forms or pigmentation changes.

Pregnancy & Lactation

• Pregnancy: Limited data; use only if benefits outweigh risks.
• Lactation: Minimal excretion in breast milk; use with caution.

Precautions & Warnings

Avoid prolonged use, especially in children and on facial areas. Ensure the cream does not enter the eyes. Monitor for infections and avoid use in psoriasis without careful supervision.

Use in Special Populations

Long-term use in children under 12 years should be avoided due to increased risk of adrenal suppression.

Overdose Effects

Chronic overdosage may lead to hypercortisolism; discontinue use if symptoms occur.

Therapeutic Class

Topical corticosteroids

Storage Conditions

Store below 30°C, away from light and moisture. Keep out of reach of children.