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Adverse Reactions Dermatologic: Acne, allergic dermatitis, hypopigmentation, perioral dermatitis, skin atrophy, striae, miliaria Endocrine & metabolic: HPA axis suppression, Cushing's syndrome, growth retardation Local: Burning, erythema, itching, irritation, dryness, folliculitis, papular rash Miscellaneous: Secondary infection Contraindications Hypersensitivity to alclometasone or any component; viral, fungal, or tubercular skin lesions; herpes (including varicella) Precautions Safety and efficacy have not been established in children <1 year of age; not for use in treatment of diaper dermatitis; generally not for routine use on the face, underarms, or groin areas Warnings Infants and small children, due to larger surface area to body weight ratio and particularly if applying to >20% of body surface area, may be more susceptible to adrenal axis suppression from topical corticosteroid therapy; systemic effects may occur when used on large areas of the body, denuded areas, for prolonged periods of time, or with an occlusive dressing. Hypothalamic pituitary adrenal (HPA) axis suppression may occur; acute adrenal insufficiency may occur with abrupt withdrawal after long term use or with stress; withdrawal or discontinuation should be done carefully; patients with HPA axis suppression may require doses of systemic glucocorticosteroids prior to, during, and after unusual stress (eg, surgery). Metabolism/Transport Effects None known. Drug Interactions (For additional information: Launch Lexi-Interact™ Drug Interactions Program ) Aldesleukin: Corticosteroids may diminish the antineoplastic effect of Aldesleukin. Risk X: Avoid combination Corticorelin: Corticosteroids may diminish the therapeutic effect of Corticorelin. Specifically, the plasma ACTH response to corticorelin may be blunted by recent or current corticosteroid therapy. Risk C: Monitor therapy Deferasirox: Corticosteroids may enhance the adverse/toxic effect of Deferasirox. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased. Risk C: Monitor therapy Hyaluronidase: Corticosteroids may diminish the therapeutic effect of Hyaluronidase. Management: Patients receiving corticosteroids (particularly at larger doses) may not experience the desired clinical response to standard doses of hyaluronidase. Larger doses of hyaluronidase may be required. Risk D: Consider therapy modification

Hyaluronidase: Corticosteroids may diminish the therapeutic effect of Hyaluronidase. Management: Patients receiving corticosteroids (particularly at larger doses) may not experience the desired clinical response to standard doses of hyaluronidase. Larger doses of hyaluronidase may be required. Risk D: Consider therapy modification Telaprevir: Corticosteroids may decrease the serum concentration of Telaprevir. Telaprevir may increase the serum concentration of Corticosteroids. Management: Concurrent use of telaprevir and systemic corticosteroids is not recommended. When possible, consider alternatives. If used together, employ extra caution and monitor closely for excessive corticosteroid effects and diminished telaprevir effects. Risk D: Consider therapy modification Pregnancy Risk Factor C ( show table ) Pregnancy Implications Some corticosteroids were found to be teratogenic following topical application in animal reproduction studies. Topical products are not recommended for extensive use, in large quantities, or for long periods of time in pregnant women. Monitoring Parameters Clinical signs and symptoms of improvement in condition; assessment of HPA suppression if treatment for prolonged periods Mechanism of Action Possesses anti-inflammatory, antiproliferative, and immunosuppressive properties Pharmacodynamics Initial response: Eczema: 5.3 days Psoriasis: 6.7 days Peak response: Eczema: 13.9 days Psoriasis: 14.8 days Pharmacokinetics (Adult data unless noted) Absorption: Topical: 3% (when left on intact skin without an occlusive dressing for 8 hours); large variation in absorption depending upon anatomical sites: Forearm 1%; scalp 4%; scrotum 36% Metabolism: Liver, extensive Patient Information (For additional information see "Alclometasone: Patient drug information" ) Before applying, gently wash area to reduce risk of infection. Apply a thin film to cleansed area and rub in gently and thoroughly until medication vanishes. Do not use for longer than directed; notify physician if condition being treated persists or worsens. Use of UpToDate is subject to the Subscription and License Agreement . Topic 12988 Version 36.0 © 2013 UpToDate, Inc. All rights reserved. | Subscription and License Agreement | Release: 21.6- C21.56 Licensed to: AsanBook Dig. Med. Lib. | Support Tag: [0504-203.80.222.8-0C172D990F-S244013.14]