halobetasol

halobetasol

 [hal″o-ba´tah-sol]
a very high potency synthetic corticosteroid used topically in the form of the propionate as an antiinflammatory and antipruritic agent.

halobetasol

(hal-oh-bay-ta-sol) ,

Ultravate

(trade name)

Classification

Therapeutic: anti inflammatories steroidal
Pharmacologic: corticosteroids
Pregnancy Category: C

Indications

Management of inflammation and pruritis associated with various allergic/immunologic skin problems.

Action

Suppresses normal immune response and inflammation.

Therapeutic effects

Suppression of dermatologic inflammation and immune processes.

Pharmacokinetics

Absorption: Minimal. Prolonged use on large surface areas or large amounts applied or use of occlusive dressings may increase systemic absorption.
Distribution: Remains primarily at site of action.
Metabolism and Excretion: Usually metabolized in skin.
Half-life: Unknown.

Time/action profile (response depends on condition being treated)

ROUTEONSETPEAKDURATION
Topicalmin–hrshrs–dayshrs–days

Contraindications/Precautions

Contraindicated in: Hypersensitivity or known intolerance to corticosteroids or components of vehicles (ointment or cream base, preservative, alcohol); Untreated bacterial or viral infections.
Use Cautiously in: Hepatic dysfunction; Diabetes mellitus, cataracts, glaucoma, or tuberculosis (use of large amounts of high-potency agents may worsen condition); Patients with pre-existing skin atrophy; Pregnancy, lactation, or children (chronic high-dose usage may result in adrenal suppression in mother, growth suppression in children; children may be more susceptible to adrenal and growth suppression).

Adverse Reactions/Side Effects

Dermatologic

  • allergic contact dermatitis
  • atrophy
  • burning
  • dryness
  • edema
  • folliculitis
  • hypersensitivity reactions
  • hypertrichosis
  • hypopigmentation
  • irritation
  • maceration
  • miliaria
  • perioral dermatitis
  • secondary infection
  • striae

Miscellaneous

  • adrenal suppression (use of occlusive dressings, long-term therapy)

Interactions

Drug-Drug interaction

None significant.

Route/Dosage

Topical (Adults) Apply to affected area(s) 1–2 times daily.

Availability

Cream: 0.05%
Ointment: 0.05%

Nursing implications

Nursing assessment

  • Assess affected skin prior to and daily during therapy. Note degree of inflammation and pruritus. Notify physician or other health care professional if symptoms of infection (increased pain, erythema, purulent exudate) develop.
  • Lab Test Considerations: Periodic adrenal function tests may be ordered to assess degree of hypothalamic-pituitary-adrenal (HPA) axis suppression in chronic topical therapy if suspected. Children and patients with dose applied to a large area, using an occlusive dressing, or using high-potency products are at highest risk for HPA suppression.
    • May cause increased serum and urine glucose concentrations if significant absorption occurs.

Potential Nursing Diagnoses

Risk for impaired skin integrity (Indications)
Risk for infection (Side Effects)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

  • Choice of vehicle depends on site and type of lesion. Ointments are more occlusive and preferred for dry, scaly lesions. Creams should be used on oozing or intertriginous areas, where the occlusive action of ointments might cause folliculitis or maceration. Creams may be preferred for aesthetic reasons even though they may be more drying to skin than ointments.
  • Topical: Apply ointmentand cream sparingly as a thin film to clean, slightly moist skin. Wash hands immediately after application. Apply occlusive dressing only if specified by physician or other health care professional.

Patient/Family Teaching

  • Instruct patient on correct technique of medication administration. Emphasize importance of avoiding the eyes. If a dose is missed, it should be applied as soon as remembered unless almost time for the next dose.
  • Caution patient to use only as directed. Avoid using cosmetics, bandages, dressings, or other skin products over the treated area unless directed by health care professional.
  • Caution women that medication should not be used extensively, in large amounts, or for protracted periods in patients who are pregnant or planning to become pregnant.
  • Advise patient to consult health care professional before using medicine for condition other than indicated.
  • Instruct patient to inform health care professional if symptoms of underlying disease return or worsen or if symptoms of infection develop.

Evaluation/Desired Outcomes

  • Resolution of skin inflammation, pruritus, or other dermatologic conditions.

halobetasol

/hal·o·be·ta·sol/ (hal″o-ba´tah-sol) a very high potency synthetic corticosteroid used topically in the form of the propionate salt as an antiinflammatory and antipruritic.

halobetasol

[hal′oba′täsol]
a very high-potency synthetic corticosteroid used topically in the form of the propionate as an antiinflammatory and antipruritic agent.
References in periodicals archive ?
WAILEA, HAWAII -- A fixed combination of halobetasol and tazarotene formulated as a once-daily lotion proved safe and effective for patients with moderate or severe plaque psoriasis in a phase II, randomized clinical trial, Linda Stein Gold, MD, reported at the Hawaii Dermatology Seminar provided by the Global Academy for Medical Education/Skin Disease Education Foundation.
2425] A combination with super potent topical clobetasol or halobetasol gave better results than with high potent topical betamethasone ointment.
The most common topical corticosteroids prescribed were clobetasol propionate (60%), mometasone furoate (16%), betamethasone dipropionate (10%), and halobetasol (9%) [Table 3].
Detabali prescribed Dermovate, Nutraderm, Cortizan, Iterax and Halobetasol Propionate for Elsie.
The most common of such corticosteroids are clobetasol, halobetasol, and betamethasone dipropionate in an augmented vehicle (betamethasone dipropionate in the usual vehicle is only a medium-high medication in terms of potency.
CLASE I (Muy potentes) Diflucortolona valerato 0,3% Clobetasol propionato 0,05% Halcinonido 0,1% Halobetasol propionato 0,05% CLASE II (Potentes) Beclometasona dipropionato 0,025%, crema, unguento Betametasona: dipropionato 0,05%, unguento valerato 0,1%, unguento Budesonida 0,05% Diflucortolona valerato 0,1% Metilprednisolona aceponato, 0,1% Mometasona furoato 0,1% Prednicarbato 0,25% CLASE III (Potencia moderada) Beclometasona dipropionato 0,025% locion Betametasona dipropionata 0,05% locion Hidrocortisona: aceponato 0,1% crema valerato 0,2% butirato 0,1% CLASE IV (Potencia baja) Fluocortina butilo 0,75% crema Hidrocortisona acetato 1% Metilprednisolona acetato 0,25% Tabla 6.
Very High Potency Augmented betamethasone dipropionate Clobetasol propionate Diflorasone diacetate Halobetasol propionate II.
In an open-label study in 120 patients with mild to severe plaque psoriasis, twice-daily dressing with Envela alone produced some improvements, but noticeably enhanced efficacy and penetration when combined with hydrocortisone 1% cream, tacrolimus, and halobetasol, said Dr.
Clobetasol or halobetasol ointment, or tacrolimus compounded in a 0.
Topical steroids such as halobetasol and betamethasone like a low pH environment, while the vitamin D analogs need high pH conditions to maintain stability.
The company said IDP-118 is the first and only topical lotion that contains a unique combination of halobetasol propionate and tazarotene for the treatment of plaque psoriasis.