Halobetasol + Tazarotene topical
Indications
Halobetasol + Tazarotene topical is used for:
Plaque Psoriasis
Adult Dose
Plaque Psoriasis
Indicated for topical treatment of plaque psoriasis in adults
Apply a thin layer of lotion to affected areas qDay
Child Dose
Renal Dose
Administration
Apply thin layer to affected areas and rub gently
Do not use with occlusive dressings unless directed by a physician
Avoid application on the face, groin, or in the axillae
Contra Indications
Pregnancy
Precautions
Avoid use on eczematous skin; may cause severe irritation
Posterior subcapsular cataracts and glaucoma reported postmarketing with topical corticosteroid use
Use appropriate antimicrobial agent if skin infection is present or develops; if favorable response does not occur promptly, discontinue until infection adequately treated
Photosensitivity and risk for sunburn
Heightens sunburn susceptibility; avoid exposure to sunlight (eg, sunlamps); if medically necessary, minimize exposure during treatment; instruct patients to use sunscreens and protective clothing
Avoid use in patients with sunburn until fully recovered; exercise caution in patients with considerable sun exposure or with inherent sensitivity to sunlight
Caution if coadministered with drugs known to be photosensitizers (eg, thiazides, tetracyclines, fluoroquinolones, phenothiazines, sulfonamides)
Pregnancy-Lactation
Pregnancy
Contraindicated in women who are pregnant
Based on data from animal reproduction studies, retinoid pharmacology, and the potential for systemic absorption, fetal harm may occur when administered to a pregnant female
Safety in pregnant females has not been established
Consider potential risks to the fetus outweighs the potential benefit to the mother from topical lotion during pregnancy; discontinue lotion as soon as pregnancy is recognized
Observational studies suggest an increased risk of low birthweight in infants with the maternal use of potent or very potent topical corticosteroids
Pregnancy testing
Obtain a negative result for pregnancy within 2 weeks prior to therapy, which should begin during menstruation
Contraception
Advise females of reproductive potential to use effective contraception during treatment
Tazarotene
Teratogenic; unknown what level of exposure is required for teratogenicity in humans
Elicits teratogenic and developmental effects associated with retinoids after topical or systemic administration in rats and rabbits
Lactation
No data available on the presence of tazarotene, halobetasol propionate, or its metabolites in human milk, effects on the breastfed infant, or effects on milk production after treatment
After single topical doses of a 14C-tazarotene gel formulation to the skin of lactating rats, radioactivity was detected in rat milk
Unknown whether topical corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk
Advise breastfeeding women not to apply directly to nipple and areola to avoid direct infant exposure
Consider developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition
Interactions
Adverse Effects
Side effects of Halobetasol + Tazarotene topical :
1-10%
Contact dermatitis (7%)
Application site pain (3%)
Folliculitis (2%)
Skin atrophy (2%)
Excoriation (2%)
Rash (1%)
Skin abrasion (1%)
Skin exfoliation (1%)
Mechanism of Action
Precise mechanism of action in plaque psoriasis is unknown
Halobetasol: Corticosteroids play a role in cellular signaling, immune function, inflammation, and protein regulation
Tazarotene: A retinoid prodrug converts to its active form, tazarotenic acid, the carboxylic acid of tazarotene, by deesterification; tazarotenic acid binds to members of the retinoic acid receptor family