Xderm

Clobetasol Propionate Topical preparation

Presentation

• Xderm cream: Each gm cream contains Clobetasol Propionate BP 0.5 mg.
• Xderm ointment: Each gm ointment contains Clobetasol Propionate BP 0.5 mg.

Description

• Xderm is the preparation of Clobetasol Propionate BP, an analog of prednisolone, which has a high degree of glucocorticoid activity and a slight degree of mineralocorticoid activity.

Pharmacology

Xderm has both local anti-inflammatory and immunosuppressive activity. Thus Xderm inhibits the adherence of neutrophils and monocyte-macrophages to the capillary endothelial cells of the inflamed area. The drug blocks the effect of macrophage migration inhibitory factor and decreases the activation of plasminogen to plasmin. Xderm also reduces the number of human leukocyte antigens DR+/+T6+ by inhibiting phospholipase A2 activity via the formation of lipocortin. Clobetasol reduces the formation of prostaglandins and leukotrienes in the local tissues.

Indications

Xderm is indicated in the following conditions 

1. Initial control of all forms of hyperacute eczema in all age groups.

2. Chronic hyperkeratotic eczema of the hands and feet and patches of chronic lichen simplex.

3. Chronic hyperkeratotic psoriasis of any area of the body.

4. Severe acute photosensitivity.

5. Acute contact dermatitis,

6. Hypertrophic lichen planus.

7. Localized bullous disorders. 8. Kelloid scarring.

9. Pretibial myxedema. 10. Vitiligo.

11. Suppression of reactions after cryotherapy. 

Dosage and Application

Xderm should be applied with gentle rubbing of the affected skin areas twice daily, Once absorbed through the skin, topical corticosteroids enter pharmacokinetic pathways similarly to systemically administered corticosteroids, For acute dermatitis twice daily application may be appropriate for short periods of time e. g. 1-2 weeks, although evidence now suggests that once-daily application is sufficient. Long-term treatment should probably be limited to intermittent plus therapy as skin atrophy has been shown to persist for 3 days after a single application.

Dosage should not normally exceed 50 gm per week and the duration of a course should not be more than 4 weeks. The potency can be further enhanced by the use of occlusive dressings.

Side-Effects

The use of large amounts of cream for a long period of time over very large areas of the body can lead to adrenal suppression, Cushing syndrome; hypercorticism; pigmentation; and atrophic changes. such as thinning, striae, etc. 

Contraindications

Xderm is contraindicated in the following conditions

1. Cutaneous infections such as impetigo, tinea corporis, and herpes simplex,

2. Infestations such as scabies.

3. Acne vulgaris, Rosacea, Gravitational ulceration,

4. Children under 1 year,

5. Hypersensitivity, Peri-oral dermatitis.

Precautions

Avoid long-term use, particularly in children, in whom adrenal suppression occurs readily. If Xderm is required for use in children it is recommended that the treatment should be weekly reviewed. Avoid prolonged application to the face, because the face unlike other areas of the body exhibits more atrophic changes with potent corticosteroids. Discontinue the use if there is a spread of infection. Avoid contact with eyes.

Use in Pregnancy and Lactation

Xderm should be avoided in pregnant women. Mothers using large amounts of the drug should be aware of potential excretion in milk.

Use in Children

The drug may be used in pediatric patients in appropriate doses, but large amounts for prolonged periods should be avoided. It is contraindicated in children under 1 year. 

Information for patients

The medication is to be used as directed by the physician and should not be used longer than the prescribed time period. It is for external use only. The treated skin area should not be bandaged or otherwise covered or wrapped so as to be occlusive. This medication should not be used for any disorder other than that for which it was prescribed. Patients should report any signs of local adverse reactions to the physicians.

Storage

• Keep in a cool (below 30° C) and dry place. Close the mouth of the tube well after each application.

Commercial Pack

• Xderm cream: Each collapsible aluminum tube contains 10 gm of cream.
• Xderm ointment: Each collapsible aluminum tube contains 10 gm ointment.

Biopharma Ltd. Produces XDERM 10 GM OINTMENT it is a trusted product for alleviating various discomforts, and it's commonly found in pharmacies and stores.