Clinical medicine profile
Clioquinol / Dexamethasone
Corticosteroid [EPC], Standardized Chemical Allergen [EPC]
- Route
- ORAL / IV / IM / INHALED / TOPICAL / NASAL / OPHTHALMIC
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Use on rosacea acne, peri-oral dermatitis, scabies, leg ulcers, tuberculous, untreated viral, bacterial or fungal infections, reaction to smallpox vaccination, first three months of pregnancy, continous prophylactic use.
Precautions
- Limit use in children or on face to maximum of 5 days.
- It should be withdrawn gradually following prolonged therapy.
- Unless fully unavoidable, potent corticosteroids should not be used on the face as they may precipitate a rosacea-like disorder and aggravate any pre-existing rosacea, avoid use in an occluded area, near the eye, use in the presence of skin infections without concomitant use of anti-microbial, children under 1yr, on weeping foci.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
DIRECTIONS Apply a small amount once or twice daily, preferable after showering and or bowel movements and at night before sleep
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Fluid retention/hypertension — care in renal disease.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Prednisone needs hepatic activation to prednisolone.
Use, effects & interactions
Indications
- Uses ICHYBUM is a medicated cream used to help relieve the symptoms of pruritis ani and other afflictions involving chronic itching around the anus Clinical selection for Clioquinol / Dexamethasone should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Corticosteroid [EPC], Standardized Chemical Allergen [EPC].
- Confirm site-specific dose, duration and monitoring before prescribing.
Adverse effects
- Local irritation e.g burning sensation and itching, erythema rare, dryness of the skin, aggravation of concurrent untreated infections, thinning of the skin (this may be reversible), loss of skin elasticity, folliculitis, change in skin pigmentation, telangiectasia, purpura and steroid acne, increased growth of hair, severe pituitary-adrenal axis suppression and hypercotism, cushoid state, growth retardation, benign intra-cranial hypertension.
Drug interactions
Open multi-drug checker ↗- Cliquinol is effective against fungal e.g. candida, microsporum, trichophyton, gram-positive bacteria e.g. staphylococcus and has moderate inhibitory effect on gram-negative bacteria.
- Fixed-dose/multi-ingredient product.
- Clinical details partially inherited from component monographs: Clioquinol / Dexamethasone, Dexamethasone.
- Confirm combination SmPC for exact dosing.
Mechanism & disposition
Combination product.
Read complete mechanism
Combination product. Component mechanism (Dexamethasone): It diffuses across cell membranes and forms a complex with specific cytoplasmic receptors. These complexes then enter the cell nucleus, binds to DNA, and stimulate transcription of messenger RNA [mRNA]. Messenger RNA leads to protein synthesis of various enzymes that are responsible for the effects of systemic corticosteroids. Betamethasone may suppress transcription of mRNA in some cells like lymphocytes.
Hours–days
Agent and route dependent
ORAL / IV / IM / INHALED / TOPICAL / NASAL / OPHTHALMIC
Pregnancy, lactation & diet
[From component Dexamethasone] Pregnancy Teratogenic Effects: Pregnancy Category C. Corticosteroids have been shown to be teratogenic in many species when given in doses equivalent to the human dose. Animal studies in which corticosteroids have been given to pregnant mice, rats, and rabbits have yielded an increased incidence of cleft palate in the offspring. There are no adequate and well-controlled studies in pregnant women. Corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Infants born to mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism.
[From component Dexamethasone] Nursing Mothers Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. Because of the potential for serious adverse reactions in nursing infants from corticosteroids, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| No reviewed brand listings are linked yet. | |||
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.