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Olux: 7 things you should know

Medically reviewed by Carmen Fookes, BPharm. Last updated on Nov 16, 2020.

1. How it works

  • Olux 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 or scalp conditions that respond to steroid medication.
  • Experts aren't sure exactly how clobetasol propionate, the active ingredient in Olux, 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.
  • Olux belongs to the class of medicines known as topical steroids.

2. Upsides

  • Olux foam may be used to treat moderate to severe forms of scalp psoriasis in subjects 12 years of age and older.
  • Olux may also be used to treat mild to moderate plaque psoriasis of other regions of the body apart from the face and the excluding the face and intertriginous areas (these are the areas of the body where two skin areas may touch or rub together, such as in front of the elbows, behind the knees, the anogenital region, skin folds of the breasts and between the digits.
  • Available as a convenient-to-use and easy to apply 0.05% aerosol foam.
  • Treats inflammation and itching.
  • Olux is available as a generic under the name clobetasol propionate foam.

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. Olux foam may increase the risks of glaucoma and posterior subcapsular cataract. Avoid contact with the eyes. Advise patients to report any visual symptoms and consider referral to an ophthalmologist for evaluation.
  • Olux foam is flammable and people using Olux should not smoke or expose themselves to a flame or heat source during and immediately after application.
  • Olux 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 Olux until the infection has been adequately controlled.
  • Allergic contact dermatitis, manifesting as irritation can develop and Olux should be discontinued and appropriate therapy given. Symptoms usually include a failure of the skin to heal rather than an exacerbation of psoriasis.
  • Rarely, Olux 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 Olux 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.
  • Olux foam should not be used in children and adolescents younger than 12 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 2 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 2 weeks of treatment with Olux a less potent topical steroid may be substituted. If no improvement is seen reassess the diagnosis.
  • Olux 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.
  • Olux 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 Olux on the scalp or skin will harm an unborn baby. Women who are pregnant should only use Olux 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 Olux 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

Olux is a topical, super high-potency steroid foam that may be used to treat plaque psoriasis of the scalp and most other body areas in patients aged 12 years and older. It should be used strictly as directed, no more than 50g applied each week and used for no longer than two consecutive weeks. Olux foam is flammable and people who have applied Olux foam to their bodies should keep away from a heat source or a fire, and should not smoke while they are applying Olux and immediately after application.

5. Tips

  • Apply Olux foam exactly as directed and only to your scalp or the areas of your body with psoriasis that your doctor has told you to apply it to. Do not use the foam on your face, groin, armpits, or other areas of your body where your skin touches or rubs together. Do not take by mouth. If the foam accidentally gets into your eyes or mouth, rinse them thoroughly with water.
  • Hold the can upside down and depress the actuator. Dispense directly onto the affected area, if possible. Dispensing directly onto hands is not recommended (unless the hands are the affected area), as the foam will begin to melt immediately upon contact with warm skin.
  • Olux foam may increase your risk of glaucoma or cataracts. Report any visual symptoms to your doctor who may refer you to an ophthalmologist for evaluation.
  • Do not apply Olux to broken or infected skin and avoid applying it to open wounds. Always wash your hands thoroughly after applying Olux.
  • Do not smoke after applying Olux as the foam is flammable and your hair or areas of skin could catch fire. Do not go near a heat source or open flame during or immediately following application.
  • Apply Olux foam to a dry (not wet) scalp. Move the hair away from the affected areas on the scalp and then apply a small amount of foam to the area and rub in gently. 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 Olux.
  • 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 grams (1.75 fl. oz.) of foam (the equivalent of 21 capfuls) per week. Do not use for longer than 2 consecutive weeks. If your condition clears up before 2 weeks, then stop using Olux. Excessive use of Olux 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 Olux unless your doctor tells you to.
  • Do not use Olux on your face. Olux 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.
  • Olux 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 foam than recommended, or applying Olux for longer than two 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 Olux.
  • Olux foam is flammable. Do not expose to heat or temperatures above 120°F (49°C). Store at room temperature 68° to 77°F (20° to 25°C) as much as possible. The contents of Olux foam are under pressure. Do not puncture or incinerate the container.
  • Tell your doctor if you are pregnant, plan to become pregnant, or breastfeeding as Olux may not be suitable for you.

6. Response and Effectiveness

  • Some improvements in the 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. 63% reported treatment success after using Olux foam for two weeks for scalp psoriasis. 28% reported treatment success for non-scalp psoriasis.
  • At the end of a trial for scalp psoriasis, 68% were clear of scaling, 44% were clear of redness, and 66% had reduced plaque thickness. At the end of a trial for non-scalp psoriasis, 73% were clear of scaling, 63% were clear of redness, and 32% had reduced plaque thickness.
  • Treatment with Olux foam should not exceed two weeks and no more than 50 mL/grams of foam should be used per week.
  • If no improvement is seen after two weeks, then your doctor should reassess your condition, because there may be another reason for your rash other than what has been initially diagnosed.
  • Olux is not effective against other types of skin rashes caused by fungi, viruses, scabies, acne, rosacea, or other conditions.
  • The effect of Olux 0.05% foam on HPA axis suppression was evaluated in 13 subjects who applied Olux foam to at least 20% of their affected body surface area for 14 days. In this trial, 5 of 13 subjects developed HPA axis suppression.
  • In a trial evaluating the effects of Olux Foam on the HPA axis, 13 subjects applied Olux Foam to at least 20% of involved body surface area for 14 days. HPA axis suppression was identified in 5 out of 13 subjects (38%). If HPA axis suppression is documented, gradually withdraw Olux, reduce the frequency of application, or substitute with a less potent corticosteroid. Children may be more susceptible to HPA axis suppression due to their larger skin surface to body mass ratios.

7. Interactions

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

The product information for Olux 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 (Olux 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 Olux. You should refer to the prescribing information for Olux 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

Olux (clobetasol propionate). [Package Insert]. Updated 03/2020. Mylan Pharmaceuticals Inc. https://www.drugs.com/pro/olux.html

Further information

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

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