Clocortolone Pivalate: The Front-Line Soothing Reliever for Skin Woes

Overview:

Clocortolone pivalate is a synthetic glucocorticoid corticosteroid, whereas glucocorticoid refers to the class of corticosteroids known as steroid hormones. This medication is highly marketed in Austria and the United States. It is a mid-potency (medium strength) topical corticosteroid that comes as a 0.1 percent emollient cream. This medication received its approval for its use in the treatment of various corticosteroid-responsive dermatoses. Dermatosis is a general word used for the description of any skin lesion or defect on the skin surface. So, it refers to the diseases of the skin (integumentary system).

Drug Group:

A topical corticosteroid is an anti-inflammatory formulation used for the control of dermatitis and many dermatological conditions. This plays a significant role in many skin diseases. They work by reducing inflammation and preventing tissue damage that can result in excessive inflammation.

For Patients:

What Is Eczema?

Eczema is a common skin condition characterized by dry and itchy patches of the skin. So, it is a non-contagious and inflammatory skin condition. There are many different forms of eczema. About 31 million American people experience some form of eczema. This condition can occur during childhood or adulthood, ranging from mild to severe. Newborn infants can even have eczema within their very first week or month of birth. Eczema in young children manifests as extremely dry patches of skin with itchiness that could result in blisters and skin infections from intense scratching. Adults experience eczema between the ages of 20 and 50. The typical symptoms of eczema include the following.

• Itchy skin.

• Dry and sensitive skin.

• Rashes.

• Inflammation.

• Discoloration of skin.

• Scaly patches.

• Blisters.

• Oozing or crusting.

• Skin infections.

• Swollen skin tissue.

How Does Clocortolone Pivalate Work?

The management of eczema depends upon the preference of the individual, the severity of the condition, and the type of eczema present. The dermatologist suggests treatment options, including a skincare routine, topical cream, or oral medications. The goal of the management of eczema is to relieve symptoms and itchiness.

Topical corticosteroid medication is generally prescribed for eczema and its several forms, including contact dermatitis, atopic dermatitis, nummulite eczema, seborrheic dermatitis, stasis dermatitis, and dyshidrotic eczema. Clocortolone pivalate is a medium-strength topical corticosteroid cream used to treat a range of skin conditions such as eczema, allergies, rash, and dermatitis. This medication helps reduce the itching, redness, and swelling associated with eczema. It works by reducing the inflammation in the body while calming down the immune system.

What Is the Dosage of Clocortolone Pivalate?

Clocortolone pivalate cream comes in a pump bottle and tube with appropriate strengths. It is recommended to apply Clocortolone cream sparingly to the affected skin areas about three times a day with gentle rubbing on them. This dosage can be modified to once daily or once every six hours, depending on the form and severity of the eczema to be treated.

What Are the Things to Inform the Doctor Before Using the Clocortolone Pivalate?

• One should inform the doctor if one is allergic to Clocortolone pivalate or other common corticosteroids.

• Also, inform the doctor if one is allergic to other active ingredients of the prescribed formulation.

• Inform the doctor about the medical condition and disease one has or ever had in the past.

• Be certain to inform the doctor if one has or ever had conditions such as skin infections, diabetes, glaucoma (a group of eye problems causing blindness or total vision loss due to damage in the optic nerve), cataract (cloudy formation of the clear lens of the eye), liver disease, and adrenal gland disorders.

• Be sure to mention if one develops or ever developed any skin reactions to steroid medication.

• Addedly, inform the doctor if one develops a thinning of the skin tissue or bruising after the application of any corticosteroid product.

• Tell the doctor if one has diabetes. Topical corticosteroids are likely to increase blood glucose levels.

• It is still undetermined whether Clocortolone cream will harm unborn babies. However, inform the doctor if one is pregnant or has any plans to conceive. Use a small amount of cream for only a short time if doctors prescribe it.

• It might not be safe to use Clocortolone pivalate cream while breastfeeding. Use only if the doctor says so. However, one should not apply to breasts.

How Is Clocortolone Pivalate Administered?

Adults:

• The doctors will prescribe how much Clocortolone should be used. Do not use more than the directions.

• This medication is meant for only topical application. Hence, this medicine should be used only on the skin.

• Rinse it off the medicine straight away if one gets any scrapes or cuts after application.

• Use cautiously, and do not get the Clocortolone pivalate cream in the eyes, mouth, and nose.

• Wash the hands thoroughly with good soap and water prior to and after each application of Clocortolone pivalate cream.

• Then, apply a thin layer of the Clocortolone cream to the inflamed or affected area.

• After the application, rub the area gently with care.

• Discontinue the use of this cream if any irritation occurs.

Children:

• Discuss with the pediatrician regarding the usage, safety, and efficacy of Clocortolone cream in children.

• The doctors prescribe this medication only for specified skin conditions. This cream is prescribed with significant precautions.

• One should not put plastic pants or tight-fitted diapers on the child when treating the child in the diaper area.

• This might increase the quantity of medication passing through the skin tissue, resulting in an increased risk of serious side effects.

Elders:

• Elderly patients are at risk of experiencing skin damage through aging. So, this might increase the incidence and risk of side effects.

• Clocortolone cream should only be used for short periods and infrequently in older adults.

Important Warnings:

• Use cautiously when applying Clocortolone pivalate on the large surface areas of the skin tissue.

• Do not use this Clocortolone topical cream to treat other skin conditions other than the particular disease the doctor has prescribed it for.

• It is usually not recommended to put other skin care products or cosmetics on the Clocortolone-treated skin.

• Do not use large amounts of Clocortolone for longer periods.

• Periodic monitoring of hypothalamic pituitary adrenal (HPA) axis suppression might be required.

• One should not use the occlusive dressings with Clocortolone pivalate unless the doctor puts forth the advice. This can increase the risk and incidence of side effects.

• One should report to the healthcare provider if one experiences any side effects or unwanted reactions.

• It is not recommended to cover the Clocortolone treated area with a bandage or other kit unless the doctor advises on the same.

• One should not use this cream to treat the skin condition that the healthcare professionals have not examined.

• One must keep up all the appointments with the doctors when at Clocortolone therapy. The doctors will check the progress and the effects of this medication at periodic intervals.

NOTE: Do not share Clocortolone medication with others.

What Are the Side Effects of Clocortolone Pivalate?

Clocortolone pivalate cream is safe and effective to use. But, it can induce certain unwanted or unpleasant reactions in some people. The common and less serious side effects of Clocortolone medication include the following. These side effects generally do not require any medical treatment. However, report to the healthcare providers if they persist or remain bothersome, affecting daily functions.

• Dry skin.

• Redness of the skin.

• Scaling of the skin.

• Mild burning sensation.

• Itchiness.

• Stinging.

• Irritation of the treated skin.

• Unusual or increased hair growth on the body or face.

Serious Side Effects:

Clocortolone pivalate medication can sometimes induce serious side effects that require immediate medical attention and appropriate treatment. The serious side effects of Clocortolone pivalate include the following.

• Allergic reactions include skin rashes, hives, itching, and swelling of the face or tongue.

• Dark red-colored spots on the treated skin.

• Lack of healing of the underlying skin disease.

• Thinning of the skin.

• Easy bruising.

• Painful and red blisters filled with pus.

Missed Dose:

In case one misses the dose of Clocortolone pivalate application, then apply the missed dose as soon as one has the thought. However, apply the subsequent dosage of the regular schedule when it is almost time for the next one. One should not apply extra Clocortolone cream to compensate for the missed dosage.

Overdose:

If one thinks that one has used too much Clocortolone cream, seek professional help or contact the poison control emergency helpline as soon as possible. Moreover, if one experiences allergic reactions to Clocortolone cream, seek medical attention right away.

Storage

• Keep the Clocortolone pivalate cream out of the sight and reach of children.

• Store the package at a room temperature of 15 to 30 degrees Celsius.

• Consider keeping this medication away from moisture, light, and heat.

• One should dispose of the unused medication after its expiration date.

Dispose of unused and outdated medication in an eco-friendly way. Do not dispense them in the garbage, toilet flush, or runaways. Ask the healthcare providers or pharmacist how to dispose of the cream containers and leftover medicine safely.

For Doctors:

Clinical Data of Clocortolone Pivalate

• Drug Name: Clocortolone pivalate.

• Generic Name: Clocortolone pivalate.

• Other Names: Clocortolone trimethyl acetate.

• Drug Class: Corticosteroids, glucocorticoid.

• Route of Administration: Topical application.

• Chemical Formula: C27H36CIFO5.

• Molar Mass: 495.03 g.mol-1.

Indication:

Clocortolone pivalate is used for short-term and topical treatment of dermatoses and eczema.

Dose:

Clocortolone cream comes in topical cream with 0.1 percent strength. Applying Clocortolone cream 0.1 percent sparingly to the affected skin areas and rubbing it gently about three times a day is recommended. It is usually given for a temporary or short period. It is to be discontinued when the control or relief is achieved.

Dosing Considerations:

• Children are more susceptible to the systemic toxicity of Clocortolone. Hence, advise the parents to apply the minimum cream that is required for therapeutic efficacy.

• Occlusive dressings might be used only for managing recalcitrant and psoriasis types of skin problems.

• If any infection develops following the application of Clocortolone, the use of occlusive dressings should be removed and institute appropriate antimicrobial treatment.

What Are the Pharmacological Aspects of Clocortolone Pivalate?

1. Pharmacodynamics: Clocortolone belongs to a class of drugs called topical corticosteroids. Clocortolone possesses anti-inflammatory, vasoconstrictive, and anti-pruritus properties like other topical corticosteroid drugs. Following the absorption through skin tissue, topical corticosteroids generally undergo the same pharmacokinetic pathways as systemically administered corticosteroids. Clocortolone possesses moderate potency among all topical corticosteroids. Hence, it should not be used with any occlusive dressing. The guidelines recommend that the Clocortolone therapy is limited to two consecutive weeks, and the treatment should come to an end when sufficient results have been attained.

2. Mechanism of Action: The absolute mechanism of the anti-inflammatory action of topical steroids remains undetermined for the treatment of steroid/responsive dermatoses and other significant skin conditions. Nevertheless, corticosteroids are known to work by the installation of lipocortins, particularly the phospholipase A2 inhibitory proteins. It is believed that such proteins aid in the regulation of biosynthesis of potent mediators of inflammatory conditions, including leukotrienes and prostaglandins. This is achieved by inhibiting the release of the precursor called arachidonic acid.

Arachidonic acid is generally released through phospholipase A2 from their membrane phospholipids. The transcriptional changes within the enzyme are facilitated by the drug that is binding first with the glucocorticoid receptor. The complex formed could travel to the nucleus of the cell, which then binds to the deoxyribonucleic acid (DNA), inducing genetic activation and gene repression.

Pharmacokinetics:

• Topical corticosteroids, including Clocortolone, are absorbed from the intact healthy skin tissue.

• Many factors contribute to the determination of the extent of percutaneous absorption of topical corticosteroids.

• The significant factors include the integrity of the epidermal barrier and mode of action.

• Inflammation, occlusion, and other skin diseases might also increase the percutaneous absorption of Clocortolone.

Toxicity:

Topically administered Clocortolone in adequate amounts can be absorbed to manifest systemic effects. The symptoms of an overdose of Clocortolone include thinning of the skin tissue and suppression of the adrenal cortex. However, it possesses an inadequate ability to respond to stress.

Adverse Effects:

Clocortolone pivalate is safe and effective to use. However, it can sometimes cause adverse effects. The potential adverse effects of Clocortolone pivalate include the following.

• Striae.

• Skin atrophy.

• Itching.

• Erythema.

• Dryness.

• Papular rashes.

• Irritation.

• Hypertrichosis (excessive hair growth in the body).

• Pigmentation problems.

• Hypothalamic-pituitary-adrenal (HPA) suppression.

• Acneiform lesions.

• Macerations (skin maceration).

What Are the Contraindications of Clocortolone Pivalate?

The contraindications of Clocortolone pivalate are listed below.

• Hypersensitivity to Clocortolone or other corticosteroids.

• Underlying infections like fungal, viral, and trabecular.

• Ophthalmic uses.

Warnings and Precautions:

• Children might show marked susceptibility to corticosteroid-induced hypothalamic pituitary adrenal (HPA) axis and Cushing’s syndrome. This can be due to the greater skin surface area ratio to the body weight.

• Consider using medium to high potency for less than two weeks. This helps decrease the incidence of local and systemic side effects.

• Contact dermatitis might occur, failing treatment.

• Kaposi’s sarcoma has been reported with long-term use of corticosteroid treatment.

• Consider using low potency Clocortolone pivalate for prolonged therapy.

• The use of Clocortolone pivalate in children might result in a proportionally larger amount of absorption, causing systemic effects.

• Avoid medium to high potency of Clocortolone pivalate for the face, groin, and folds due to increased steroid absorption.

What Are the Drug Interactions of Clocortolone Pivalate?

Clocortolone can interact with certain drugs, resulting in unwanted reactions. A few drug interactions of Clocortolone pivalate are discussed below.

• Benzthiazide: The incidence and severity of electrolyte imbalance could be increased when combined with Clocortolone.

• Digoxin: There can be an increase in the risk and severity of the adverse effects when used in conjugation with Digoxin.

• Disopyramide: The incidence and severity of hyperglycemia could be increased when combined with Clocortolone.

• Voriconazole: There can be an increase in the serum concentration of Voriconazole when combined with Voriconazole.

Specific Considerations:

• Fertility: Long-term and qualitative studies have not been conducted to assess the effect of topical corticosteroids on fertility.

• Pregnancy: No well-controlled studies on the teratogenic effects of the topical application of corticosteroids have been performed on pregnant women. However, topical corticosteroids should be used only for the potential benefits if Clocortolone justifies the possible risks to the fetus. These class drugs are not recommended for use for extensive periods in pregnant patients (large amounts for prolonged periods).

• Lactating Mothers: It is still undetermined whether topical corticosteroids cause adequate systemic absorption to be found in detectable quantities in human milk. However, Caution is to be exercised when administering topical corticosteroids to a lactating mother.

• Pediatric: The pediatric population might manifest greater susceptibility to the topical corticosteroid-allied HPA axis suppression than the adults due to the ratio of larger skin surface area to the body weight.