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Clodan: 7 things you should know

Medically reviewed by Carmen Fookes, BPharm. Last updated on Nov 13, 2020.

1. How it works

  • Clodan is a brand (trade) name for clobetasol propionate which is a super-high potency topical corticosteroid formulation that may be used to treat inflammation and itching caused by plaque psoriasis of the scalp.
  • Experts aren't sure exactly how clobetasol propionate, the active ingredient in Cloban, works, but they believe it may be inducing phospholipase A2 inhibitory proteins, collectively called lipocortins. These proteins are thought to control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
  • Clodan belongs to the class of medicines known as topical steroids.

2. Upsides

  • Clodan may be used to treat moderate to severe forms of scalp psoriasis in subjects 18 years of age and older.
  • Available as a convenient-to-use 0.05% shampoo for scalp psoriasis.
  • Treats inflammation and itching.
  • Clodan is supplied in tamper-evident tubes of 15g, 30g, 45 g, and 60 g.
  • Clodan is available as a generic under the name clobetasol propionate and also as other brands, such as Clobevate, Clobex, and Temovate.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Burning, itching, swelling, or irritation of the treated skin; dry or cracking skin; redness or crusting around the hair follicles; spider veins; stretch marks, thinning skin; rash or hives; acne; or temporary hair loss are the most common side effects reported.
  • Other side effects reported include headache, nausea, dizziness, blurred vision, tunnel vision, eye pain, or seeing halos around lights.
  • Clodan may increase the risk of developing an infection. See your doctor if you develop redness, warmth, swelling, oozing, or severe irritation of any treated skin. In people with a pre-existing infection, consider the concomitant administration of an appropriate antifungal or antibacterial agent. If no improvement is seen or the infection worsens, discontinue Clodan until the infection has been adequately controlled.
  • Allergic contact dermatitis, manifesting as irritation can develop and Clodan should be discontinued and appropriate therapy given. Symptoms usually include a failure of the skin to heal rather than an exacerbation of psoriasis.
  • Rarely, Clodan may cause an allergic reaction. Seek emergency medical help if you develop hives; difficultly breathing; or swelling of your face, lips, tongue, or throat.
  • Doctors should monitor people administering Clodan for possible signs of absorption through their skin. Symptoms may include weight gain in the face and shoulders, slow wound healing, skin discoloration, thinning skin, increased body hair, tiredness, mood changes, menstrual changes, and sexual changes.
  • Clodan shampoo should not be used in children and adolescents younger than 18 years of age because children can absorb larger amounts of this medicine through the skin and there is a high risk of hypothalamic-pituitary-adrenal (HPA) axis suppression.
  • Only use for the minimum time possible and no more than 4 consecutive weeks. The total dosage should not exceed 50 g (50 mL or 1.75 fl. oz.) per week. If complete disease control is not achieved after 4 weeks of treatment a less potent topical steroid may be substituted. If no improvement is seen reassess the diagnosis.
  • Clodan may not be suitable for people with any type of skin infection, a history of skin reactions to steroid medications, liver disease, or an adrenal gland disorder.
  • Clodan may increase levels of blood glucose (sugar) in the blood or urine. People with diabetes may need to monitor their blood sugar levels more carefully. Symptoms include increased thirst, increased urination, dry mouth, or fruity breath odor.
  • There is not enough data to know whether using Clodan on the skin will harm an unborn baby. Women who are pregnant should only use Clodan if the risks outweigh the benefits and only under a doctor's advice.
  • It may not be safe to breastfeed while using this medicine. If breastfeeding and your doctor has advised you to use Clodan do not apply to any areas of the chest likely to come into contact with the baby's mouth.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Clodan is a topical, super high-potency steroid shampoo that may be used to treat scalp psoriasis. It should be used strictly as directed, no more than 50mL applied to the scalp each week, and used for no longer than four consecutive weeks.

5. Tips

  • Apply Clodan shampoo exactly as directed and only to your scalp. Do not use the shampoo on your face, groin, or armpits, and do not take by mouth. If the shampoo accidentally gets into your eyes or mouth, rinse them thoroughly with water.
  • Do not apply Clodan to broken or infected skin and avoid applying it to open wounds. Always wash your hands thoroughly after applying Clodan.
  • Apply Codan shampoo to a dry (not wet) scalp. Move the hair away from the affected areas on the scalp and then apply a small amount of shampoo to the area and rub in gently. Squeeze the bottle gently to let the product naturally flow from the bottle. Spread the product so that the entire lesion is covered with a thin uniform film. Massage gently into the lesion and repeat for additional lesion(s). Wash your hands thoroughly after applying Clodan. Leave on for 15 minutes before lathering your hair and rinsing it clean with water. Make sure you also rinse all other parts of the body that came in contact with the shampoo (eg, neck and shoulders). Although no additional shampoo is necessary to cleanse your hair, you may use a non-medicated shampoo if desired.
  • Do not cover the treated area with a shower or swimming cap or any other covering unless your doctor tells you to because this may increase how much of the product is absorbed through your skin.
  • Do not apply more than 50 mL (1.75 fl. oz.) of shampoo per week. Do not use for longer than 4 consecutive weeks. If your condition clears up before 4 weeks, then stop using Clodan. Excessive use of Clodan can lead to thinning skin, easy bruising, changes in body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.
  • Call your doctor if you develop an infection, redness, if your symptoms do not improve, or if they get worse.
  • Do not apply any other topical steroid medications to the same areas that you are treating with Clodan unless your doctor tells you to.
  • Do not use Clodan on your face. Clodan is classed as a super potent topical corticosteroid and lower potency corticosteroids, such as hydrocortisone are more appropriate to use on the face if one is deemed necessary. You should always use the lowest potency corticosteroid that is effective for your skin condition for the shortest possible time.
  • Clodan should not be used to treat acne; bacterial, fungal, or viral skin infections (such as herpes simplex, shingles, or chickenpox); bites or stings; eyelid conditions; mild dermatitis; perioral dermatitis; phimosis (a tight foreskin of the penis); rosacea; scabies; skin conditions caused by vaccinations, tuberculosis, or syphilis.
  • Using more shampoo than recommended, or applying Clodan for longer than four weeks can lead to side effects such as skin thinning, growth retardation in children, cataracts, or glaucoma, or suppression of the hypothalamic-pituitary-adrenal axis.
  • If you have surgery scheduled, tell your doctor you are using Clodan.
  • Store at room temperature 68° to 77°F (20° - 25°C) as much as possible; however, occasional lower or higher temperatures are permitted between 59° and 86°F (15° - 30°C).

6. Response and Effectiveness

  • Some improvement in symptoms of plaque psoriasis such as inflammation (redness) and itching, should be noticed within one to three days. Other symptoms, such as dryness, crusting, or scaling may take a bit longer to resolve, but improvement should occur within a week.
  • Treatment with Clodan should not exceed four weeks and no more than 50 mL of shampoo should be used per week.
  • If no improvement is seen after two weeks, then your doctor should reassess your scalp condition, because there may be another reason for your rash other than what has been initially diagnosed.
  • Clodan is not effective against other types of skin rashes caused by fungi, viruses, scabies, acne, rosacea, or other conditions.
  • The effect of Clodan 0.05% shampoo on HPA axis suppression was evaluated in one trial in adolescents 12 to 17 years of age. In this trial, 5 of 12 evaluable subjects developed suppression of their HPA axis following 4 weeks of treatment.

7. Interactions

Clodan is unlikely to interact with any other drugs that are taken orally because it is applied topically to the skin. However, excessive use of Clodan may increase the risk of absorption of Clodan, and possible interactions.

The product information for Clodan lists only minor interactions. These include:

  • acid suppressants, such as famotidine, or omeprazole (corticosteroids can increase irritation of the stomach)
  • diabetic medications, such as insulin, glyburide, glimepiride, or glipizide (Clodan may increase blood sugar levels)
  • oral or topical corticosteroids, such as prednisone (may increase the risk of HPA suppression).

Note that this list is not all-inclusive and includes only common medications that may interact with Clodan. You should refer to the prescribing information for Clodan for a complete list of interactions. Tell each of your health care providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

References

Clodan Shampoo (clobetasol propionate). Updated 11/2019. Medimetriks Pharmaceuticals https://www.drugs.com/pro/clodan-shampoo.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Clodan only for the indication prescribed.

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