Clodan shampoo for moderate to severe scalp psoriasis in adults

Clodan is a highly potent topical corticosteroid shampoo containing 0.05% clobetasol propionate. It is designed to treat moderate to severe scalp psoriasis in adults. Its super-high potency necessitates limited use to reduce risks of side effects and systemic absorption.

Clodan shampoo is specifically approved for the treatment of moderate to severe scalp psoriasis in patients 18 years of age and older. It is intended for topical application to affected scalp areas only, not for use on the face, axillae, or groin. Treatment duration should be limited to a maximum of 4 consecutive weeks, with a total weekly dosage not exceeding 50 grams (or 50 mL).

Use in patients younger than 18 years is not recommended due to a higher risk of hypothalamic-pituitary-adrenal (HPA) axis suppression.

clobetasol propionate

Clobetasol propionate acts as a super-high potency corticosteroid that reduces inflammation, redness, and scaling associated with psoriasis by suppressing immune responses in the skin.

Clodan shampoo is for topical use only on a dry scalp. Apply a thin film once daily to affected scalp areas and leave it on for 15 minutes before lathering and rinsing.

• Do not exceed 50 g (50 mL) per week.
• Treatment should not continue beyond 4 consecutive weeks.
• Avoid contact with face, eyes, lips, axillae, and groin.
• In case of accidental contact with eyes or lips, rinse thoroughly with water.
• Do not use occlusive dressings such as shower or bathing caps unless directed by a physician.
• If the psoriasis is not controlled after 4 weeks of treatment, consider switching to a less potent steroid or reevaluate the diagnosis.

None specified.

Potential serious risks and precautions

• Clodan is highly potent and has been shown to suppress the hypothalamic-pituitary-adrenal (HPA) axis even at low doses, which may cause adrenal insufficiency.
• Systemic absorption can result in Cushing's syndrome, hyperglycemia, and unmask latent diabetes mellitus.
• Patients using topical corticosteroids should be periodically monitored for HPA axis suppression; an ACTH stimulation test may be used for assessment.
• Use in children and adolescents is not recommended due to a higher risk of HPA axis suppression because of their larger skin surface area relative to body weight.
• Do not use on face, axillae, or groin; avoid contact with eyes and lips.
• If irritation or signs of dermatologic infection occur, discontinue use and treat infection appropriately before resuming.
• Local side effects may include skin atrophy, striae, telangiectasia, folliculitis, acneiform eruptions, hypopigmentation, perioral dermatitis, and allergic contact dermatitis. Some effects may be irreversible.
• Not recommended in patients with acne vulgaris, rosacea, or perioral dermatitis.

Common adverse reactions

• Burning or stinging sensation
• Itching (pruritus)
• Edema and folliculitis
• Acne and dry skin
• Irritant dermatitis
• Alopecia (hair loss)
• Urticaria (hives)
• Skin atrophy and telangiectasia
• Headache

Postmarketing reports include:

• Endocrine disorders such as Cushing's syndrome and adrenal suppression
• Eye effects: pain, blurred vision, irritation
• Dizziness and nausea
• Skin reactions: erythema, exfoliation, rash, irritation, hair color changes, allergic contact dermatitis, pain, tightness
• Psoriasis aggravation

Concurrent use of multiple corticosteroid-containing products may increase systemic exposure and risk of adverse effects.

Pregnancy

Clodan is classified as Pregnancy Category C. There are no adequate studies in pregnant women, and animal studies have shown teratogenic effects at doses lower than human doses. Use during pregnancy should only be considered if potential benefits outweigh risks to the fetus.

Lactation

Systemic corticosteroids are known to pass into human milk and may cause undesirable effects in nursing infants. It is not known if topical use results in significant systemic absorption. Caution is advised when administering to nursing mothers.

Systemic toxicity may manifest as reversible suppression of the hypothalamic-pituitary-adrenal axis, Cushing's syndrome, or hyperglycemia. Management involves discontinuation or reduction of corticosteroid use and supportive care as needed.