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AI-Generated response:

what is the youngest age I can prescribe clobetasol for eczema?

Answer generated on June 4, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

Clobetasol can be prescribed for eczema in patients aged 12 years and older.

Safety and efficacy in pediatric patients under 12 years of age have not been established, and use in this age group is not recommended due to risks such as HPA axis suppression and Cushing's syndrome.[1-2]

  • Clobetasol is indicated for the relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses in patients 12 years of age or older.[3]

  • The recommended application is a thin layer topically to the affected skin area(s) twice daily, with a maximum dosage of 50 g/week.[4-6]

  • Treatment should not exceed 2 consecutive weeks, and therapy should be discontinued when control is achieved.[1-2]

  • Reassessment of the diagnosis is advised if no improvement is observed within 2 weeks.[1-2]

  • Pediatric patients are at a greater risk than adults of systemic side effects due to a higher ratio of skin surface area to body mass.[1-2]

Additional info

When considering prescribing clobetasol for eczema in pediatric patients, it is crucial to weigh the benefits against the potential risks. The high potency of clobetasol makes it effective in managing severe dermatoses but also poses a higher risk for side effects, especially in younger patients. Monitoring for signs of HPA axis suppression, Cushing's syndrome, and other systemic effects is advised. Alternative treatments with lower potency might be considered for younger children or for longer-term management to minimize risks. Always ensure that the treatment area and duration are limited as recommended to reduce systemic absorption and associated risks.

References

Reference 1

1.

Food and Drug Administration (DailyMed).

Publish date: October 4, 2020.

Pediatric Use Pediatric Use: Safety and effectiveness of clobetasol propionate cream in pediatric patients have not been established. Use in pediatric patients under 12 years of age is not recommended. Because of a higher ratio of skin surface area to body mass, pediatric patients are at a greater risk than adults of HPA axis suppression and Cushing's syndrome when they are treated with topical corticosteroids. They are therefore also at greater risk of adrenal insufficiency during or after withdrawal of treatment. Adverse effects including striae have been reported with inappropriate use of topical corticosteroids in infants and children. HPA axis suppression, Cushing's syndrome, linear growth retardation, delayed weight gain, and intracranial hypertension have been reported in children receiving topical corticosteroids. Manifestations of adrenal suppression in children include low plasma cortisol levels and an absence of response to ACTH stimulation. Manifestations of intracranial hypertension include bulging fontanelles, headaches, and bilateral papilledema.

Reference 2

2.

Food and Drug Administration (DailyMed).

Publish date: January 5, 2024.

Pediatric Use Pediatric Use: Safety and effectiveness of Clobetasol Propionate ANDA (clobetasol propionate) ointment in pediatric patients have not been established. Use in pediatric patients under 12 years of age is not recommended. Because of a higher ratio of skin surface area to body mass, pediatric patients are at a greater risk than adults of HPA axis suppression and Cushing's syndrome when they are treated with topical corticosteroids. They are therefore also at greater risk of adrenal insufficiency during or after withdrawal of treatment. Adverse effects including striae have been reported with inappropriate use of topical corticosteroids in infants and children. HPA axis suppression, Cushing's syndrome, linear growth retardation, delayed weight gain, and intracranial hypertension have been reported in children receiving topical corticosteroids. Manifestations of adrenal suppression in children include low plasma cortisol levels and an absence of response to ACTH stimulation. Manifestations of intracranial hypertension include bulging fontanelles, headaches, and bilateral papilledema.

Reference 3

3.

Food and Drug Administration (DailyMed). Clobetasol Propionate (emollient). 2021.

Publish date: July 4, 2021.

Indications And Usage 1 INDICATIONS AND USAGE Clobetasol Propionate (emollient) (clobetasol propionate) cream, 0.05% (emollient) is a corticosteroid indicated for: • The relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses in patients 12 years of age or older. (1.1) • The treatment of moderate to severe plaque-type psoriasis in patients 16 years of age and older. (1.2) Limitations of Use • Clobetasol Propionate (emollient) (clobetasol propionate) cream, 0.05% (emollient) should not be used in the treatment of rosacea or perioral dermatitis, and should not be used on the face, groin, or axillae. (1.3) • The total dosage should not exceed 50 grams per week. (1.3) • Avoid use if skin atrophy is present at the treatment site. (1.3) Clobetasol Propionate (emollient) (clobetasol propionate) cream, 0.05% (emollient) is a super-high potency corticosteroid indicated for: 1.1 Corticosteroid-Responsive Dermatoses Clobetasol Propionate (emollient) (clobetasol propionate) cream, 0.05% (emollient) is indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses in patients 12 years of age and older. Treatment should be limited to 2 consecutive weeks, and the total dosage should not exceed 50 grams per week. 1.2 Moderate to Severe Plaque-Type Psoriasis Clobetasol Propionate (emollient) (clobetasol propionate) cream, 0.05% (emollient) is indicated for the topical treatment of moderate to severe plaque-type psoriasis. Treatment beyond 4 consecutive weeks is not recommended. Use in pediatric patients under 16 years of age is not recommended.

Reference 4

4.

Elsevier ClinicalKey Drug Monograph

Content last updated: December 0, 2023.

Indications And Dosage Children and Adolescents 12 to 17 years: Apply a thin layer topically to the affected scalp area(s) 2 times daily until symptoms resolve. Max: 50 mL/week. If no improvement within 2 weeks, reassess diagnosis. Proactive, intermittent application of topical corticosteroids 1 to 2 times weekly to areas that commonly flare is recommended to help prevent relapses. **for the treatment of GVHD** Topical dosage (cream, gel, foam, or ointment) Adults: Apply a thin layer topically to the affected skin area(s) 2 times daily. May be used under occlusion for palms of hand and soles of feet to enhance efficacy. Max: 50 g/week. Children and Adolescents 12 to 17 years: Apply a thin layer topically to the affected skin area(s) 2 times daily. May be used under occlusion for palms of hand and soles of feet to enhance efficacy. Max: 50 g/week. Topical dosage (lotion) Adults: Apply a thin layer topically to the affected skin area(s) 2 times daily. May be used under occlusion for palms of hand and soles of feet to enhance efficacy. Max: 50 g/week. Topical dosage (solution) Adults: Apply a thin layer topically to the affected scalp area(s) 2 times daily. Max: 50 mL/week. Children and Adolescents 12 to 17 years: Apply a thin layer topically to the affected scalp area(s) 2 times daily. Max: 50 mL/week. **for the general treatment of corticosteroid-responsive dermatoses** Topical dosage (cream, gel, foam, or ointment) Adults:

Indications And Dosage Proactive, intermittent application of topical corticosteroids 1 to 2 times weekly to areas that commonly flare is recommended to help prevent relapses. Children and Adolescents 12 to 17 years: Apply a thin layer topically to the affected skin area(s) 2 times daily until symptoms resolve. Max: 50 g/week. If no improvement within 2 weeks, reassess diagnosis. Proactive, intermittent application of topical corticosteroids 1 to 2 times weekly to areas that commonly flare is recommended to help prevent relapses. Topical dosage (lotion) Adults: Apply a thin layer topically to the affected skin area(s) 2 times daily until symptoms resolve. Max: 50 g/week. If no improvement within 2 weeks, reassess diagnosis. Proactive, intermittent application of topical corticosteroids 1 to 2 times weekly to areas that commonly flare is recommended to help prevent relapses. Topical dosage (solution) Adults: Apply a thin layer topically to the affected scalp area(s) 2 times daily until symptoms resolve. Max: 50 mL/week. If no improvement within 2 weeks, reassess diagnosis. Proactive, intermittent application of topical corticosteroids 1 to 2 times weekly to areas that commonly flare is recommended to help prevent relapses. Children and Adolescents 12 to 17 years: Apply a thin layer topically to the affected scalp area(s) 2 times daily until symptoms resolve. Max: 50 mL/week. If no improvement within 2 weeks, reassess diagnosis. Proactive, intermittent application of topical corticosteroids 1 to 2 times weekly to areas that commonly flare is recommended to help prevent relapses. **for the treatment of GVHD**

Indications And Dosage Proactive, intermittent application of topical corticosteroids 1 to 2 times weekly to areas that commonly flare is recommended to help prevent relapses. **for the treatment of GVHD** Topical dosage (cream, gel, foam, or ointment) Adults: Apply a thin layer topically to the affected skin area(s) 2 times daily. May be used under occlusion for palms of hand and soles of feet to enhance efficacy. Max: 50 g/week. Children and Adolescents 12 to 17 years: Apply a thin layer topically to the affected skin area(s) 2 times daily. May be used under occlusion for palms of hand and soles of feet to enhance efficacy. Max: 50 g/week. Topical dosage (lotion) Adults: Apply a thin layer topically to the affected skin area(s) 2 times daily. May be used under occlusion for palms of hand and soles of feet to enhance efficacy. Max: 50 g/week. Topical dosage (solution) Adults: Apply a thin layer topically to the affected scalp area(s) 2 times daily. Max: 50 mL/week. Children and Adolescents 12 to 17 years: Apply a thin layer topically to the affected scalp area(s) 2 times daily. Max: 50 mL/week.

Indications And Dosage **Maximum Dosage Limits:** • Adults 50 mL/week scalp or topical solutions and shampoo; 59 mL/week spray solution; 50 g/week other topicals. • Geriatric 50 mL/week scalp or topical solutions and shampoo; 59 mL/week spray solution; 50 g/week other topicals. • Adolescents > = 16 years: Safety and efficacy of lotion, shampoo, and spray solution have not been established; 50 g/week of other formulations. 13 to < 16 years: Safety and efficacy of emollient cream, lotion, shampoo, and spray solution have not been established; 50 g/week of other formulations. • Children >= 12 years: Safety and efficacy of emollient cream, lotion, shampoo, and spray solution have not been established; 50 g/week of other formulations. < 12 years: Safety and efficacy have not been established. • Infants Safety and efficacy have not been established. • Neonates Safety and efficacy have not been established.

Reference 5

5.

Elsevier ClinicalKey Clinical Overview

Treatment Proactive, intermittent application 1 to 2 times weekly to areas that commonly flare may reduce relapses. Betamethasone Dipropionate Topical ointment; Adults: Apply a thin layer topically to the affected skin area(s) once or twice daily until symptoms resolve. Proactive, intermittent application 1 to 2 times weekly to areas that commonly flare may reduce relapses. Triamcinolone acetonide 0.5% Triamcinolone Acetonide Topical ointment; Children and Adolescents: Apply a thin layer topically to the affected skin area(s) 2 times daily until symptoms resolve. Proactive, intermittent application 1 to 2 times weekly to areas that commonly flare may reduce relapses. Triamcinolone Acetonide Topical ointment; Adults: Apply a thin layer topically to the affected skin area(s) 2 times daily until symptoms resolve. Proactive, intermittent application 1 to 2 times weekly to areas that commonly flare may reduce relapses. Class I (very high potency) Clobetasol propionate 0.05% Clobetasol Propionate Topical ointment; Children and Adolescents 12 to 17 years: Apply a thin layer topically to the affected skin area(s) 2 times daily until symptoms resolve. Max: 50 g/week. Proactive, intermittent application 1 to 2 times weekly to areas that commonly flare may reduce relapses. Clobetasol Propionate Topical ointment; Adults: Apply a thin layer topically to the affected skin area(s) 2 times daily until symptoms resolve. Max: 50 g/week. Proactive, intermittent application 1 to 2 times weekly to areas that commonly flare may reduce relapses. Halobetasol propionate 0.05%

Reference 6

6.

Elsevier ClinicalKey Clinical Overview

Treatment Fluocinonide Topical ointment; Adults: Apply a thin layer topically to the affected skin area(s) 2 to 4 times daily. Topical dosage (0.1% cream) Ultrahigh potency Fluocinonide Topical cream; Children and Adolescents 12 to 17 years: Apply a thin layer topically to the affected skin area(s) once or twice daily. Max: 60 g/week. Fluocinonide Topical cream; Adults: Apply a thin layer topically to the affected skin area(s) once or twice daily. Max: 60 g/week. Clobetasol Ultrahigh potency Topical dosage (0.05% non-emollient cream, foam, gel, or ointment) Clobetasol Propionate Topical ointment; Children and Adolescent 12 to 17 years: Apply a thin layer topically to the affected skin area(s) twice daily. Max: 50 g/week. Clobetasol Propionate Topical ointment; Adults: Apply a thin layer topically to the affected skin area(s) twice daily. Max: 50 g/week. Topical dosage (0.05% emollient cream) Clobetasol Propionate Topical cream; Adolescent 16 to 17 years: Apply a thin layer topically to the affected skin area(s) twice daily. Max: 50 g/week. Clobetasol Propionate Topical cream; Adults: Apply a thin layer topically to the affected skin area(s) twice daily. Max: 50 g/week. Vitamin D analogs Calcipotriene Calcipotriene Topical ointment; Children and Adolescents 2 to 17 years†: Apply a thin layer topically to the affected skin area(s) twice daily. Adult Max: 100 g/week/m2.

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