Indications

Aclobet-N is indicated for short-course treatment of several skin conditions where inflammation is complicated by secondary bacterial or fungal infections. These include:

• Recalcitrant eczemas (stubborn eczema that is difficult to treat).
• Neurodermatoses.
• Psoriasis (excluding widespread plaque psoriasis).
• Other inflammatory conditions that do not respond well to less potent steroids.

Pharmacology

Aclobet-N combines three active ingredients:

• Clobetasol Propionate: A very potent topical corticosteroid with strong anti-inflammatory, anti-pruritic (anti-itch), and vasoconstrictive properties. It works by reducing inflammation and decreasing collagen synthesis.
• Neomycin Sulphate: An aminoglycoside antibiotic that inhibits bacterial protein synthesis by binding to ribosomal subunits, thereby treating bacterial infections.
• Nystatin: An antifungal agent that kills fungi and yeasts by binding to sterols in their cell membranes, causing the membranes to become permeable and leak intracellular components.

Dosage & Administration

• Adults: Apply a thin layer to the affected area once or twice daily until improvement is seen. For very resistant lesions, an occlusive dressing can be used to enhance the effect, but treatment should not be continued for more than 7 days without medical supervision. The total course should not exceed 4 weeks without a patient review.
• Elderly: The same dosage as adults can be used, but caution is advised in cases of decreased kidney function where systemic absorption of Neomycin may occur.
• Children (2 years and over): The same dosage as adults can be used. This medication is not recommended for neonates and infants younger than 2 years due to the possibility of increased absorption.

Interaction

Neomycin Sulphate can potentially prolong the effects of certain neuromuscular blocking agents if significant systemic absorption occurs. However, this is unlikely with minimal topical use. No hazardous interactions have been reported with Clobetasol Propionate or Nystatin.

Contraindications

This medication is contraindicated in:

• Rosacea, acne vulgaris, and perioral dermatitis.
• Primary cutaneous viral infections (e.g., herpes simplex, chickenpox).
• Hypersensitivity to any component of the preparation.

Side Effects

Prolonged or extensive use, especially with occlusive dressings, can lead to sufficient systemic absorption to cause features of hypercortisolism. Local atrophic changes in the skin, such as thinning, stretch marks, and enlarged blood vessels, may also occur. Other reported side effects include pigmentation changes and excessive hair growth.

Pregnancy & Lactation

There is a theoretical risk of fetal toxicity from Neomycin if it crosses the placenta. Therefore, the use of this preparation is not recommended during pregnancy or lactation. The safety of Clobetasol Propionate has not been established in lactating mothers.

Precautions & Warnings

• Long-term continuous topical therapy should be avoided, particularly in infants and children, as it can cause adrenal suppression.
• When applied to the eyelids, care should be taken to prevent the cream from entering the eye, as this could lead to glaucoma. If contact occurs, wash the eye thoroughly with water.

Overdose Effects

Acute overdose is very unlikely. No overdose-related problems have been reported. However, chronic overuse or misuse may lead to hypercortisolism, in which case the topical steroids should be gradually discontinued under medical supervision.

Therapeutic Class

This medication is classified as a Clobetasol/Clobetasone & Combined Preparation.

Storage Conditions

Store below 25°C. Do not freeze. Keep out of the reach of children.