Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD

GENERIC NAME: clotrimazole and betamethasone

BRAND NAME: Lotrisone

DRUG CLASS AND MECHANISM: Lotrisone is a cream or lotion consisting of a combination of the drugs clotrimazole and betamethasone. Clotrimazole is an anti-fungal drug related to fluconazole (Diflucan), ketoconazole (Nizoral), itraconazole (Sporanox), and miconazole (Micatin, Monistat). It prevents growth of several types of fungi by preventing production of the membranes that surround fungal cells. Betamethasone is a synthetic corticosteroid that is used topically on the skin. Corticosteroids suppress inflammation as well as the body's immune response.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Cream or lotion: 1% clotrimazole and 0.05% betamethasone

STORAGE: Lotrisone can be stored at room temperature, cream at 2-30 C (36-86 F) and lotion at 15-30 C (59-86 F).

PRESCRIBED FOR: Lotrisone is used for the treatment of local fungal infections such as tinea pedis ("athlete's foot"), tinea cruris ("jock itch"), or tinea corporis (fungal infections elsewhere on the body).

DOSING: Lotrisone cream is gently massaged into the affected skin and surrounding area in the morning and evening. The treated skin should not be bandaged, covered, or wrapped in order to avoid excessive absorption of Lotrisone into the body.

Lotrisone cream or lotion should not be used for more than 2 weeks for treatment of tinea corporis or tinea cruris. If there is no clinical improvement after one week of treatment, the diagnosis should be reviewed. Lotrisone should not be used longer than 4 weeks for treatment of tinea pedis. If there is no clinical improvement after 2 weeks of treatment, the diagnosis should be reviewed. These limits on duration of use are based on the clinical studies that were used by the FDA to approve Lotrisone and concerns that with longer use absorption of betamethasone might be enough to have effects on the body. Amounts greater than 45 g per week of Lotrisone cream or amounts greater than 45 mL per week of Lotrisone lotion should not be used.

DRUG INTERACTIONS: Long-term use or withdrawal of topical corticosteroids may aggravate psoriasis. Therefore, there should be an interval of at least 1 week between the discontinuance of topical steroids and the starting of psoriasis treatment with anthralin (Psoriatec).

PREGNANCY: Safety of using Lotrisone during pregnancy has not been evaluated.

NURSING MOTHERS: It is not known whether clotrimazole or betamethasone is secreted in breast milk.

SIDE EFFECTS: Local redness, stinging, blistering, peeling, swelling, itching, hives, and burning at the area of application may occur. Other side effects associated with Lotrisone include water retention (edema), decreased pigmentation, stretch marks and infection due to bacteria. Growth retardation, intracranial hypertension, Cushing's syndrome and skin atrophy have occurred in pediatric patients.