Pronunciation: (hal-oh-BAY-ta-sol)Class: Corticosteroid, Topical
Trade Names:Ultravate- Cream 0.05%- Ointment 0.05%
Very high-potency topical glucocorticoid with anti-inflammatory, antipruritic, and vasoconstrictive properties. Thought to act by inducing phospholipase A 2 inhibitory proteins, thus controlling biosynthesis of potent mediators of inflammation.
Topical steroids can be absorbed from intact skin. Occlusive dressings, inflammation, and other disease processes in the skin increase percutaneous absorption of topical steroids.
Once absorbed, corticosteroids are variably bound to plasma protein.
Corticosteroids are metabolized primarily in the liver.
Corticosteroids are excreted primarily by the kidneys and to varying amounts into the bile.
Indications and Usage
Relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses.
Dosage and AdministrationAdults and Children (older than 12 yr of age)
Topical Apply to affected area once or twice daily. Not recommended for more than 2 consecutive wk or more than 50 g/wk.
- For topical use only. Not for ophthalmic, oral, or intravaginal use.
- Do not apply to face, groin, or axillae unless directed by health care provider.
- Apply medication sparingly but in sufficient quantity to cover affected area(s); rub in gently.
- Do not cover with occlusive dressing unless ordered by health care provider.
- Avoid contact with the eyes. If medication does come into contact with the eyes, wash them with large amounts of cool water.
Store cream and ointment at controlled room temperature (59° to 86°F).
None well documented.
Laboratory Test Interactions
None well documented.
Burning; dry skin; erythema; itching; leukoderma; rash; skin atrophy; stinging; vesicles.
Assess and document skin condition before initial application and periodically throughout treatment. Inform health care provider if condition does not improve, worsens, or if application site reactions develop.
Category C .
Undetermined effect. Exercise caution when topical corticosteroids are administered to a breastfeeding woman.
Safety and efficacy not established for children younger than 12 yr of age. Because of higher ratio of skin surface area to body mass, children are at higher risk than adults for hypothalamic-pituitary-adrenal (HPA) axis suppression and Cushing syndrome when they are treated with topical corticosteroids.
Large doses applied to large surface area or under an occlusive dressing may lead to HPA suppression. If HPA axis suppression is noted, consider drug withdrawal, reduced frequency of application, or substitution of a less potent steroid. Recovery of HPA axis function is generally prompt and complete upon discontinuation of the corticosteroid. Signs and symptoms of withdrawal may require supplemental systemic corticosteroids.
Prolonged use of topical corticosteroids may produce atrophy of the skin and subcutaneous tissues.
For external use. Not recommended for use on the face, groin, or axillae. Not recommended for rosacea or perioral dermatitis.
Adverse effects may occur more frequently when occlusive dressings are used.
Use with appropriate antimicrobials in the presence of skin infections.
- Advise patient to apply medication 1 to 2 times/day as directed by health care provider.
- Caution patient not to apply in greater quantity or more frequently than prescribed by health care provider.
- Teach patient or caregiver the following application technique: wash or soak the affected area before applying medication, unless it irritates the affected area(s); wash hands; apply sufficient cream or ointment to cover affected area(s) sparingly then gently massage into skin; wash hands after applying.
- Advise patient who has been advised to use an occlusive dressing to cover the area with plastic wrap (such as Saran Wrap or Handi-Wrap ) after applying medication to affected area(s). The plastic may be held in place with a gauze or elastic bandage or adhesive tape on the normal skin beside the treated area. Advise patient instead of using plastic wrap, plastic gloves may be used for the hands, plastic bags for the feet, or a shower cap for the scalp; leave the plastic wrapping or covering in place as long as instructed by health care provider. Instruct patient to cleanse the skin and reapply the medication each time a new plastic wrapping is applied.
- Advise patient if an application is missed, to apply it as soon as remembered and then continue on regular schedule. If it is almost time for the next application, instruct patient to skip the application and continue on regular schedule. Caution patient not to apply double doses.
- Caution patient not to apply to face, underarms, or groin area unless directed by health care provider.
- Caution caregiver of pediatric patient not to use tight-fitting diapers or plastic pants on a child being treated in the diaper area.
- Caution patient not to bandage, cover, or wrap treated skin areas or use cosmetics or other skin products over treated areas unless advised by health care provider.
- Caution patient to avoid contact with the eyes. Advise patient that if medication does come into contact with the eyes to wash them with large amounts of cool water and to contact health care provider if eye irritation occurs.
- Advise patient that symptoms should begin to improve soon after starting treatment and to notify health care provider if condition does not improve, worsens, or if application site reactions (eg, burning, stinging, redness, itching) develop.
- Advise patient that therapy is usually discontinued when control has been achieved.
Copyright © 2009 Wolters Kluwer Health.
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