Esapharma Movate

Indications

• Psoriasis
• Eczema
• Dermatitis
• Lichen planus
• Seborrheic dermatitis

Dosage

Adults: Apply a thin film to the affected area twice daily, ensuring not to exceed the recommended duration of treatment as indicated in the B

Mechanism of action

The short-term effects of corticosteroids like clobetasol include decreased vasodilation and permeability of capillaries, as well as reduced leukocyte migration to sites of inflammation. Clobetasol binds to the glucocorticoid receptor, which mediates changes in gene expression leading to multiple downstream effects over hours to days. It inhibits neutrophil apoptosis and demargination, reduces phospholipase A2 activity (decreasing the formation of arachidonic acid derivatives), and inhibits inflammatory transcription factors such as NF-Kappa B. This promotes anti-inflammatory genes like interleukin-10, resulting in a potent anti-inflammatory effect at lower doses and immunosuppressive effects at higher doses.

Pharmacodynamics

Clobetasol propionate binds to the glucocorticoid receptor to inhibit pro-inflammatory signals while promoting anti-inflammatory signals. It is generally applied twice daily, providing a long duration of action. Corticosteroids like clobetasol have a wide therapeutic window, allowing for doses that can be significantly higher than the body's natural production. Patients should be informed of the risks of hypothalamic-pituitary-adrenal axis suppression and increased susceptibility to infections when using corticosteroids.

Pharmacokinetics

Clobetasol propionate is well-absorbed through the skin, with its absorption depending on the vehicle used and the condition of the skin. It is metabolized primarily in the liver, and its elimination half-life allows for sustained effects when applied topically. Due to its potency, careful consideration must be given to the duration of treatment and the area of application to minimize systemic absorption and potential side effects.

Adverse effects

• Skin atrophy
• Striae
• Telangiectasia
• Acne
• Burning sensation
• Pruritus
• Allergic contact dermatitis

Precautions

• Use with caution in patients with a history of skin infections
• Avoid prolonged use to minimize the risk of systemic absorption and adrenal suppression
• Monitor for signs of local or systemic infections

Pregnancy

Clobetasol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Long-term use should be avoided.

Breast-feeding

Clobetasol may be excreted in breast milk. Caution should be exercised when administering to nursing mothers.

Storage

Store below 25 degrees Celsius. Protect from light and keep out of reach of children.

Formulations

• Topical cream
• Topical ointment
• Topical solution

Mechanism of action

The short term effects of corticosteroids are decreased vasodilation and permeability of capillaries, as well as decreased leukocyte migration to sites of inflammation. Corticosteroids binding to the glucocorticoid receptor mediates changes in gene expression that lead to multiple downstream effects over hours to days. Glucocorticoids inhibit neutrophil apoptosis and demargination; they inhibit phospholipase A2, which decreases the formation of arachidonic acid derivatives; they inhibit NF-Kappa B and other inflammatory transcription factors; they promote anti-inflammatory genes like interleukin-10. Lower doses of corticosteroids provide an anti-inflammatory effect, while higher doses are immunosuppressive. High doses of glucocorticoids for an extended period bind to the mineralocorticoid receptor, raising sodium levels and decreasing potassium levels.

Pharmacodynamics

Corticosteroids bind to the glucocorticoid receptor, inhibiting pro-inflammatory signals, and promoting anti-inflammatory signals. Clobetasol propionate is generally applied twice daily so the duration of action is long. Corticosteroids have a wide therapeutic window as patients may require doses that are multiples of what the body naturally produces. Patients taking corticosteroids should be counselled regarding the risk of hypothalamic-pituitary-adrenal axis suppression and increased susceptibility to infections.