Nyclobate NN Cream

Indication

Psoriasis, Eczema, Severe inflammatory skin disorders

Administration

Apply sparingly to the affected area once or twice daily until improvement occurs. As with other highly active topical steroid preparations therapy should be discontinued when control is achieved. Treatment should not be continued for more than 7 days without medical supervision. If a longer course is necessary, it is recommended that treatment should not be continued for more than 4 weeks without the patient's condition being reviewed.

Adult Dose

Topical/Cutaneous Severe inflammatory skin disorders Adult: As cream/ointment. Apply a thin layer onto the affected area(s) 1-2 times daily until improvement occurs. Not to be used for >7 days without medical supervision.

Child Dose

Topical/Cutaneous Severe inflammatory skin disorders Child: >2 yr: As cream/ointment. Apply a thin layer onto the affected area(s) 1-2 times daily until improvement occurs. Not to be used for >7 days without medical supervision.

Contraindication

Long-term treatment of ulcerative conditions, rosacea, pruritus; presence of acute infections. Hypersensitivity.

Mode of Action

Clobetasol Propionate is a highly active corticosteroid that has topical anti-inflammatory action brought about partly by vasoconstriction and reduced collagen synthesis. Neomycin is an aminoglycoside antibiotic that binds to ribosomal 30S and 50S subunits of susceptible bacteria, thus inhibiting protein synthesis; it also causes misreading of the genetic codes on the mRNA template. Nystatin works by binding to ergosterol in the cell membrane of fungus resulting in a change in the cell wall permeability and leakage of cellular components.

Precaution

Long-term continuous topical therapy should be avoided where possible, particularly in infants and children, as adrenal suppression can occur readily even without occlusion. If used in childhood, or on the face, courses should be limited to 5 days and occlusion should not be used. If applied to the eyelids, care is needed to ensure that the preparation does not enter the eye. If used in psoriasis careful patient supervision is important. Scalp Application: Keep away from eye. Flammable. Do not use or dry the hair near a fire or flame.

Side Effect

Perioral dermatitis, striae esp in flexures. Dermal and epidermal atrophy esp on the face, steroid purpura. Potentially Fatal: Prolonged usage of large amount of clobetasol propionate can lead to sufficient systemic levels to produce adrenal suppression, Cushing's syndrome, diabetes and hypertension.

Interaction

If there is substantial systemic absorption, neomycin may prolong and intensify respiratory depressant effects of neuromuscular blockers.