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clobetasol propionate

Perrigo New York Inc

HIGHLIGHTS OF PRESCRIBING INFORMATIONThese highlights do not include all the information needed to use Clobetasol Propionate Foam, 0.05% (Emulsion) safely and effectively. See full prescribing information for Clobetasol Propionate Foam, 0.05% (Emulsion). Clobetasol Propionate Foam (Emollient Formulation) 0.05% For topical use Initial U.S. Approval: 1985INDICATIONS AND USAGE •Clobetasol Propionate Foam, 0.05% (Emulsion) is a corticosteroid indicated for the treatment of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses in patients 12 years of age or older. (1.1) Limitations of Use •Avoid face, axillae, or groin. (1.2) •Avoid use if skin atrophy is present at the treatment site. (1.2) DOSAGE AND ADMINISTRATIONClobetasol Propionate Foam, 0.05% (Emulsion) is not for oral, ophthalmic, or intravaginal use. Apply Clobetasol Propionate Foam, 0.05% (Emulsion) to the affected area(s) twice daily, morning and evening for up to 2 consecutive weeks. The maximum weekly dose should not exceed 50 g. (2.1) DOSAGE FORMS AND STRENGTHSWhite emulsion aerosol foam, 0.05%. (3) CONTRAINDICATIONSNone (4) WARNINGS AND PRECAUTIONS •Clobetasol Propionate Foam, 0.05% (Emulsion) has been shown to suppress the HPA axis. Systemic absorption of Clobetasol Propionate Foam, 0.05% (Emulsion) may produce reversible HPA axis suppression, Cushing’s syndrome, hyperglycemia, and unmask latent diabetes. (5.1) •Systemic absorption may require evaluation for HPA axis suppression. (5.1) •Modify use should HPA axis suppression develop. (5.1) •Potent corticosteroids, use on large areas, prolonged use or occlusive use may increase systemic absorption. (5.1) •Local adverse reactions may include atrophy, striae, irritation, acneiform eruptions, hypopigmentation, and allergic contact dermatitis and may be more likely to occur with occlusive use or more potent steroids. (5.2, 6.1) •The propellant in Clobetasol Propionate Foam, 0.05% (Emulsion) is flammable. Avoid fire, flame or smoking during and immediately following application. (5.4) •Children may be more susceptible to systemic toxicity when treated with topical corticosteroids. (5.1, 8.4) Side Effects •The most common adverse reactions (incidence ≥ 1%) are application site atrophy and application site reaction. (6.1) To report SUSPECTED ADVERSE REACTIONS, contact Perrigo at 1-866-634-9120 or www.perrigo.com and FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. See 17 for PATIENT COUNSELING INFORMATION and FDA-approved patient labeling. Revised: 06/2012


FULL PRESCRIBING INFORMATION: CONTENTS*




FULL PRESCRIBING INFORMATION

1 INDICATIONS AND USAGE

1.1 Indication

Clobetasol Propionate Foam, 0.05% (Emulsion) is indicated for the treatment of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses in patients 12 years of age or older.

1.2 Limitations of Use

  • •Clobetasol Propionate Foam, 0.05% (Emulsion) should not be applied to the face, axillae, or groin.
  • •Clobetasol Propionate Foam, 0.05% (Emulsion) should not be used if there is skin atrophy at the treatment site.
  • •Treatment should be limited to 2 consecutive weeks and patients should not use greater than 50 grams or more than 21 capfuls per week.

2 DOSAGE AND ADMINISTRATION

Clobetasol Propionate Foam, 0.05% (Emulsion) is not for oral, ophthalmic, or intravaginal use.

Apply a thin layer of Clobetasol Propionate Foam, 0.05% (Emulsion) to the affected area(s) twice daily, morning and evening for up to 2 consecutive weeks; therapy should be discontinued when control has been achieved. The maximum weekly dose should not exceed 50 g. or an amount greater than 21 capfuls per week. For proper dispensing of foam, shake the can, hold it upside down, and depress the actuator. Dispense a small amount of foam (about a capful) and gently massage the medication into the affected areas (excluding the face, groin, and axillae) until the foam is absorbed. Avoid contact with the eyes.

3 DOSAGE FORMS AND STRENGTHS

White emulsion aerosol foam, 0.05%

4 CONTRAINDICATIONS

None.

5 WARNINGS AND PRECAUTIONS

5.1 Effects on Endocrine System

Clobetasol Propionate Foam, 0.05% (Emulsion) has been shown to suppress the HPA axis.

Systemic absorption of clobetasol propionate foam, 0.05% (emulsion) has caused reversible hypothalamic-pituitary-adrenal (HPA) axis suppression with the potential for clinical glucocorticosteroid insufficiency. This may occur during treatment or upon withdrawal of the topical corticosteroid. Use of Clobetasol Propionate Foam, 0.05% (Emulsion) for longer than 2 weeks may suppress the immune system. [see Nonclinical Toxicology (13.1).]

In a study including 37 subjects ages 12 and older with at least 30% body surface area (BSA), adrenal suppression was identified in 6 out of 37 subjects (16.2%) after two weeks of treatment with clobetasol propionate foam, 0.05% (emulsion). [see 12 CLINICAL PHARMACOLOGY ]

Because of the potential for systemic absorption, use of clobetasol propionate foam, 0.05% (emulsion) may require that patients be periodically evaluated for HPA axis suppression. Factors that predispose a patient using a topical corticosteroid to HPA axis suppression include the use of more potent steroids, use over large surface areas, use over prolonged periods, use under occlusion, use on an altered skin barrier, and use in patients with liver failure.

An ACTH stimulation test may be helpful in evaluating patients for HPA axis suppression. If HPA axis suppression is documented, an attempt should be made to gradually withdraw the drug, to reduce the frequency of application, or to substitute a less potent steroid. Manifestations of adrenal insufficiency may require systemic corticosteroids. Recovery of HPA axis function is generally prompt and complete upon discontinuation of topical corticosteroids.

Cushing’s syndrome, hyperglycemia, and unmasking of latent diabetes mellitus can also result from systemic absorption of topical corticosteroids.

Use of more than one corticosteroid-containing product at the same time may increase the total systemic corticosteroid exposure.

Pediatric patients may be more susceptible to systemic toxicity from equivalent doses because of their larger skin surface to body mass ratios. [see Use in Specific Populations (8.4). ]

5.2 Local Side Effects with Topical Corticosteroids

Local adverse reactions may be more likely to occur with occlusive use, prolonged use or use of higher potency corticosteroids. Reactions may include atrophy, striae, telangiectasias, burning, itching, irritation, dryness, folliculitis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, secondary infection, and miliaria. Some local adverse reactions may be irreversible.

Allergic contact dermatitis to any component of topical corticosteroids is usually diagnosed by a failure to heal rather than a clinical exacerbation. Clinical diagnosis of allergic contact dermatitis can be confirmed by patch testing.

If irritation develops, treatment with Clobetasol Propionate Foam, 0.05% (Emulsion) should be discontinued and appropriate therapy instituted.

5.3 Concomitant Skin Infections

Concomitant skin infections should be treated with an appropriate antimicrobial agent. If the infection persists, Clobetasol Propionate Foam, 0.05% (Emulsion) should be discontinued until the infection has been adequately treated.

5.4 Flammable Contents

The propellant in Clobetasol Propionate Foam, 0.05% (Emulsion) is flammable. Avoid fire, flame or smoking during and immediately following application. Do not puncture and/or incinerate the containers. Do not expose containers to heat and/or store at temperatures above 120°F (49°C).

6 ADVERSE REACTIONS

6.1 Clinical Trials Experience

In controlled clinical trials involving 821 subjects exposed to clobetasol propionate foam, 0.05% (emulsion) and vehicle foam, the pooled incidence of local adverse reactions in trials for atopic dermatitis and psoriasis with clobetasol propionate foam, 0.05% (emulsion) was 1.9% for application site atrophy and 1.6% for application site reaction. Most local adverse events were rated as mild to moderate and they were not affected by age, race, or gender. Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.

The following additional local adverse reactions have been reported with topical corticosteroids: folliculitis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, secondary infection, irritation, striae, and miliaria. They may occur more frequently with the use of occlusive dressings and higher potency corticosteroids, such as clobetasol propionate.

Cushing’s syndrome has been reported in infants and adults as a result of prolonged use of topical clobetasol propionate formulations.

6.2 Postmarketing Experience

The following adverse reactions have been identified during post-approval use of clobetasol formulations: erythema, pruritus, burning, alopecia, and dryness.

Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

8 USE IN SPECIFIC POPULATIONS

8.1 Pregnancy

Teratogenic Effects, Pregnancy Category C: There are no adequate and well-controlled studies of the teratogenic potential of clobetasol propionate in pregnant women. Clobetasol Propionate Foam, 0.05% (Emulsion) should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Corticosteroids have been shown to be teratogenic in laboratory animals when administered systemically at relatively low dosage levels. Some corticosteroids have been shown to be teratogenic after dermal application to laboratory animals.

Clobetasol propionate has not been tested for teratogenicity when applied topically; however, it is absorbed percutaneously, and when administered subcutaneously, it was a significant teratogen in both the rabbit and the mouse. Clobetasol propionate has greater teratogenic potential than steroids that are less potent.

Teratogenicity studies in mice using the subcutaneous route resulted in fetotoxicity at the highest dose tested (1 mg/kg) and teratogenicity at all dose levels tested down to 0.03 mg/kg. These doses are approximately 1.4 and 0.04 times, respectively, the human topical dose of clobetasol propionate foam, 0.05% (emulsion) based on body surface area comparisons. Abnormalities seen included cleft palate and skeletal abnormalities.

In rabbits, clobetasol propionate was teratogenic at doses of 0.003 and 0.01 mg/kg. These doses are approximately 0.02 and 0.05 times, respectively, the human topical dose of clobetasol propionate foam, 0.05% (emulsion) based on body surface area comparisons. Abnormalities seen included cleft palate, cranioschisis, and other skeletal abnormalities.

8.3 Nursing Mothers

Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk. Because many drugs are excreted in human milk, caution should be exercised when Clobetasol Propionate Foam, 0.05% (Emulsion) is administered to a nursing woman.

If used during lactation, Clobetasol Propionate Foam, 0.05% (Emulsion) should not be applied on the chest to avoid accidental ingestion by the infant.

8.4 Pediatric Use

Use in pediatric patients under 12 years of age is not recommended because of the risk of HPA axis suppression.

After two weeks of twice daily treatment with clobetasol propionate foam, 0.05% (emulsion), 7 of 15 patients (47%) aged 6 to 11 years of age demonstrated HPA axis suppression. The laboratory suppression was transient; in all subjects serum cortisol levels returned to normal when tested 4 weeks post treatment.

In 92 patients from 12 to 17 years of age, safety was similar to that observed in the adult population. Based on these data, no adjustment of dosage of Clobetasol Propionate Foam, 0.05% (Emulsion) in adolescent patients 12 to 17 years of age is warranted. [ see Warnings and Precautions (5.1).]

Because of a higher ratio of skin surface area to body mass, pediatric patients are at a greater risk than adults of HPA axis suppression and Cushing’s syndrome when they are treated with topical corticosteroids. They are therefore also at greater risk of adrenal insufficiency during and/or after withdrawal of treatment.

HPA axis suppression, Cushing’s syndrome, linear growth retardation, delayed weight gain, and intracranial hypertension have been reported in children receiving topical corticosteroids. Manifestations of adrenal suppression in children include low plasma cortisol levels and an absence of response to ACTH stimulation. Manifestations of intracranial hypertension include bulging fontanelles (in infants), headaches, and bilateral papilledema. Administration of topical corticosteroids to children should be limited to the least amount compatible with an effective therapeutic regimen. Chronic corticosteroid therapy may interfere with the growth and development of children.

Adverse effects including striae have been reported with inappropriate use of topical corticosteroids in infants and children.

8.5 Geriatric Use

A limited number of patients at or above 65 years of age have been treated with clobetasol propionate foam, 0.05% (emulsion) (n = 58) in US clinical trials. While the number of patients is too small to permit separate analysis of efficacy and safety, the adverse reactions reported in this population were similar to those reported by younger patients. Based on available data, no adjustment of dosage of Clobetasol Propionate Foam, 0.05% (Emulsion) in geriatric patients is warranted.

10 OVERDOSAGE

Topically applied Clobetasol Propionate Foam, 0.05% (Emulsion) can be absorbed in sufficient amounts to produce systemic effects.

11 DESCRIPTION

Clobetasol Propionate Foam, 0.05% (Emulsion), a petrolatum-based emulsion aerosol foam, contains the active ingredient clobetasol propionate, USP, a synthetic corticosteroid for topical dermatologic use. Clobetasol, an analog of prednisolone, has a high degree of glucocorticoid activity and a slight degree of mineralocorticoid activity.

Clobetasol propionate is 21-chloro-9-fluoro-11ß,17-dihydroxy-16ß-methylpregna-1,4-diene-3,20-dione 17-propionate, with the empirical formula C25H32ClFO5, and a molecular weight of 466.97.

The following is the chemical structure:

Clobetasol propionate is a white to cream-colored crystalline powder, practically insoluble in water.

Each gram of Clobetasol Propionate Foam, 0.05% (Emulsion) contains 0.5 mg clobetasol propionate, USP. The foam also contains anhydrous citric acid, cetyl alcohol, cyclomethicone, glycerin, isopropyl myristate, polyoxyl 20 cetostearyl ether, potassium citrate monohydrate, propylene glycol, purified water, sorbitan monolaurate, and phenoxyethanol as a preservative.

Clobetasol Propionate Foam, 0.05% (Emulsion) is dispensed from an aluminum can pressurized with a hydrocarbon (propane/butane) propellant.

12 CLINICAL PHARMACOLOGY

12.1 Mechanism of Action

Corticosteroids play a role in cellular signaling, immune function, inflammation, and protein regulation; however, the precise mechanism of action in corticosteroid-responsive dermatoses is unknown.

The contribution to efficacy by individual components of the vehicle has not been established.

12.2 Pharmacodynamics

In a study evaluating the potential for HPA axis suppression, using the cosyntropin stimulation test, clobetasol propionate foam, 0.05% (emulsion) demonstrated reversible adrenal suppression after two weeks of twice daily use in patients with atopic dermatitis of at least 30% body surface area (BSA). The proportion of subjects twelve years of age and older demonstrating HPA axis suppression was 16.2% (6 out of 37). In this study HPA axis suppression was defined as serum cortisol level ≤18 mcg/dL 30-min post cosyntropin stimulation. The laboratory suppression was transient; in all subjects serum cortisol levels returned to normal when tested 4 weeks post treatment. [see Warnings and Precautions (5.1) and Use In Specific Populations (8.4).]

12.3 Pharmacokinetics

Topical corticosteroids can be absorbed from intact healthy skin. The extent of percutaneous absorption of topical corticosteroids is determined by many factors, including the product formulation and the integrity of the epidermal barrier. Occlusion, inflammation, and/or other disease processes in the skin may increase percutaneous absorption. The use of pharmacodynamic endpoints for assessing the systemic exposure of topical corticosteroids may be necessary due to the fact that circulating levels are often below the level of detection. Once absorbed through the skin, topical corticosteroids are metabolized, primarily in the liver, and are then excreted by the kidneys. Some corticosteroids and their metabolites are also excreted in the bile.

Following twice daily application of clobetasol propionate foam, 0.05% (emulsion) for one week to 32 adult patients with mild to moderate plaque-type psoriasis, mean peak plasma concentrations (±SD) of 59 ± 36 pg/mL of clobetasol were observed at around 5 hours post-dose on day 8.

13 NONCLINICAL TOXICOLOGY

13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility

Long-term animal studies have not been performed to evaluate the carcinogenic potential of clobetasol propionate foam, 0.05% (emulsion) or clobetasol propionate. In a 90-day repeat-dose toxicity study in rats, topical administration of clobetasol propionate foam, 0.05% (emulsion) at dose concentrations from 0.001 – 0.1% or from 0.03 to 0.3 mg/kg/day of clobetasol propionate resulted in a toxicity profile consistent with long term exposure to corticosteroids including adrenal atrophy, histopathological changes in several organs systems indicative of severe immune suppression and opportunistic fungal and bacterial infections. A NOAEL could not be determined in this study. Although the clinical relevance of the findings in animals to humans is not clear, sustained glucocorticoid-related immune suppression may increase the risk of infection and possibly the risk for carcinogenesis.

Clobetasol propionate was non-mutagenic in four different test systems: the Ames test, the mouse lymphoma test, the Saccharomyces cerevisiae gene conversion assay, and the E. coli B WP2 fluctuation test. In the in vivo mouse micronucleus test, a positive finding was observed at 24 hours, but not at 48 hours, following oral administration at a dose of 2000 mg/kg.

Studies in the rat following subcutaneous administration of clobetasol propionate at dosage levels up to 0.05 mg/kg per day revealed that the females exhibited an increase in the number of resorbed embryos and a decrease in the number of living fetuses at the highest dose.

14 CLINICAL STUDIES

In a randomized study of subjects 12 years of age and older with moderate to severe atopic dermatitis, 251 subjects were treated with clobetasol propionate foam, 0.05% (emulsion) and 126 subjects were treated with vehicle foam. Subjects were treated twice daily for two weeks. At the end of treatment, 131 of 251 subjects (52%) treated with clobetasol propionate foam, 0.05% (emulsion) compared with 18 of 126 subjects (14%) treated with vehicle foam achieved treatment success. Treatment success was defined by an Investigator’s Static Global Assessment (ISGA) score of clear (0) or almost clear (1) with at least 2 grades improvement from baseline, and scores of absent or minimal (0 or 1) for erythema and induration/papulation.

In an additional randomized study of subjects 12 years of age and older with mild to moderate plaque-type psoriasis, 253 subjects were treated with clobetasol propionate foam, 0.05% (emulsion) and 123 subjects were treated with vehicle foam. Subjects were treated twice daily for two weeks. At the end of treatment, 41 of 253 subjects (16%) treated with clobetasol propionate foam, 0.05% (emulsion) compared with 5 of 123 subjects (4%) treated with vehicle foam achieved treatment success. Treatment success was defined by an Investigator’s Static Global Assessment (ISGA) score of clear (0) or almost clear (1) with at least 2 grades improvement from baseline, scores of none or faint/minimal (0 or 1) for erythema and scaling, and a score of none (0) for plaque thickness.

16 HOW SUPPLIED/STORAGE AND HANDLING

16.1 How Supplied

Clobetasol Propionate Foam, 0.05% (Emulsion) is supplied as follows:

  • •50 g aluminum can NDC 45802-637-32
  • •100 g aluminum can NDC 45802-637-33

16.2 Storage and Handling

Store at controlled room temperature 68°F to 77°F (20°C to 25°C).

FLAMMABLE. AVOID FIRE, FLAME OR SMOKING DURING AND IMMEDIATELY FOLLOWING APPLICATION. Contents under pressure. Do not puncture or incinerate. Do not expose to heat or store at temperatures above 120°F (49°C).

Keep out of reach of children.

17 PATIENT COUNSELING INFORMATION

[See FDA-Approved Patient Labeling (Patient Information)]

Patients using topical corticosteroids should receive the following information and instructions:

  • •This medication is to be used as directed by the physician. It is for external use only. Unless directed by the prescriber, it should not be used on the face, or in skin-fold areas, such as the underarms or groin. Avoid contact with the eyes or other mucous membranes. Wash hands after use.
  • •This medication should not be used for any disorder other than that for which it was prescribed.
  • •The treated skin area should not be bandaged, wrapped, or otherwise covered so as to be occlusive unless directed by the physician.
  • •Patients should report any signs of local or systemic adverse reactions to the physician.
  • •Patients should inform their physicians that they are using Clobetasol Propionate Foam, 0.05% (Emulsion) if surgery is contemplated.
  • •As with other corticosteroids, therapy should be discontinued when control is achieved. If no improvement is seen within 2 weeks, contact the physician.
  • •Patients should not use more than 50 grams per week of Clobetasol Propionate Foam, 0.05% (Emulsion), or an amount greater than 21 capfuls per week. [see Dosage and Administration (2).]
  • •This medication is flammable; avoid heat, flame or smoking when applying this product.

PATIENT INFORMATION

Clobetasol Propionate Foam (Emollient Formulation) 0.05%

Read the Patient Information that comes with Clobetasol Propionate Foam, 0.05% (Emulsion) before you start using it and each time you get a refill. There may be new information. This leaflet does not take the place of talking with your doctor about your condition or treatment.

What is Clobetasol Propionate Foam, 0.05% (Emulsion)?

Clobetasol Propionate Foam, 0.05% (Emulsion) is a prescription corticosteroid medicine used on the skin (topical) to treat adults and children 12 years and older with certain skin conditions that cause red, flaky, and itchy skin.

Clobetasol Propionate Foam, 0.05% (Emulsion) should not be used:

  • •on your face, underarms, or groin area
  • •if you have skin thinning (atrophy) at the treatment area

You should not use Clobetasol Propionate Foam, 0.05% (Emulsion) for longer than 2 weeks in a row.

You should not use more than 50 grams or 21 capfuls of Clobetasol Propionate Foam, 0.05% (Emulsion) in 1 week.

What should I tell my doctor before using Clobetasol Propionate Foam, 0.05% (Emulsion)?

Before you use Clobetasol Propionate Foam, 0.05% (Emulsion), tell your doctor if you:

  • •have had irritation or other skin reaction to a steroid medicine in the past
  • •have a skin infection. You may need medicine to treat the skin infection before using Clobetasol Propionate Foam, 0.05% (Emulsion).
  • •have diabetes
  • •have adrenal gland problems
  • •have liver problems
  • •plan to have surgery
  • •have any other medical condition
  • •are pregnant or plan to become pregnant. It is not known if Clobetasol Propionate Foam, 0.05% (Emulsion) will harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant.
  • •are breast-feeding or plan to breast-feed. It is not known if Clobetasol Propionate Foam, 0.05% (Emulsion) passes into your breast milk.

Do not apply Clobetasol Propionate Foam, 0.05% (Emulsion) to your chest area if you are breastfeeding a baby. This will help to prevent the baby from accidentally getting Clobetasol Propionate Foam, 0.05% (Emulsion) into their mouth.

Tell your doctor about all the medicine you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take other corticosteroid medicines by mouth or use other products on your skin that contain corticosteroids. Ask your doctor or pharmacist if you are not sure.

Know the medicines you take. Keep a list of your medicines with you to show your doctor and pharmacist when you get a new medicine.

How should I use Clobetasol Propionate Foam, 0.05% (Emulsion)?

  • •See “What is Clobetasol Propionate Foam, 0.05% (Emulsion)?”
  • •Use Clobetasol Propionate Foam, 0.05% (Emulsion) exactly as your doctor tells you to use it. See the “Instructions for applying Clobetasol Propionate Foam, 0.05% (Emulsion)”.
  • •This medicine is for use on the skin only. Do not get Clobetasol Propionate Foam, 0.05% (Emulsion) in your eyes, mouth, or vagina.
  • •Apply Clobetasol Propionate Foam, 0.05% (Emulsion) 2 times each day, one time in the morning and one time at night, or as directed by your doctor.
  • •Do not bandage or cover your treated area unless your doctor tells you to.
  • •Do not use Clobetasol Propionate Foam, 0.05% (Emulsion) for longer than 2 weeks in a row.
  • •Talk to your doctor if your skin does not improve after 2 weeks of treatment with Clobetasol Propionate Foam, 0.05% (Emulsion).
  • •See your doctor regularly to check your symptoms and side effects while taking Clobetasol Propionate Foam, 0.05% (Emulsion).
  • •Clobetasol Propionate Foam, 0.05% (Emulsion) is flammable. Avoid heat, flame, or smoking during and right after using Clobetasol Propionate Foam, 0.05% (Emulsion).

Instructions for applying Clobetasol Propionate Foam, 0.05% (Emulsion)

6. Avoid getting Clobetasol Propionate Foam, 0.05% (Emulsion) in or near your mouth, eyes, or vagina; if contact happens, rinse well with water. Wash your hands well after applying Clobetasol Propionate Foam, 0.05% (Emulsion) (excluding affected areas of hands).

What should I avoid while using Clobetasol Propionate Foam, 0.05% (Emulsion)?

Clobetasol Propionate Foam, 0.05% (Emulsion) is flammable. Avoid heat, flame, or smoking during and right after you apply it to your skin.

If you are taking other corticosteroid medicines, either by mouth or injection, your doctor may advise you to stop taking them once you begin using Clobetasol Propionate Foam, 0.05% (Emulsion).

What are the possible side effects of Clobetasol Propionate Foam, 0.05% (Emulsion)?

Clobetasol Propionate Foam, 0.05% (Emulsion) may cause serious side effects, including:

  • Symptoms of a disorder where the adrenal gland does not make enough of certain hormones (adrenal insufficiency) during treatment or after stopping treatment. Your doctor may do blood tests to check you for adrenal insufficiency while you are using Clobetasol Propionate Foam, 0.05% (Emulsion). Tell your doctor if you have any of these persistent symptoms of adrenal insufficiency:
  • •tiredness that worsens and does not go away
  • •muscle weakness
  • •loss of appetite
  • •nausea or vomiting
  • •dizziness or fainting
  • •irritability and depression
  • •weight loss
  • Cushing’s syndrome, when the body is exposed to too much of the hormone cortisol. Your doctor may do tests to check for this. Symptoms can include:
  • •weight gain, especially around your upper back and midsection
  • •tiredness and muscle weakness
  • •roundness of your face (moon face)
  • •slow healing of cuts, insect bites and infections
  • •depression, anxiety and irritability
  • •new or worsening high blood pressure
  • high blood sugar (hyperglycemia) or diabetes mellitus that has not been diagnosed can happen with treatment. Your doctor may do tests to check you for this.
  • skin problems, including reactions where the medicine is applied, skin infections, and allergic reactions (allergic contact dermatitis). Tell your doctor if you get any new skin problems.
  • effects on growth and weight in children.

The most common side effects of Clobetasol Propionate Foam, 0.05% (Emulsion) include:

  • •thinning of skin
  • •burning
  • •redness
  • •itching
  • •dryness

Tell your doctor if you have any reaction on your treated skin such as pain, tenderness, swelling, or healing problems.

These are not all the side effects of Clobetasol Propionate Foam, 0.05% (Emulsion). Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or www.fda.gov/medwatch, or to Perrigo at 1-866-634-9120.

How should I store Clobetasol Propionate Foam, 0.05% (Emulsion)?

  • •Store the Clobetasol Propionate Foam, 0.05% (Emulsion) at room temperature, between 68°F to 77°F (20°C to 25°C). Clobetasol Propionate Foam, 0.05% (Emulsion) is flammable. Keep the can away from fire and heat.
  • •Do not pierce or burn the Clobetasol Propionate Foam, 0.05% (Emulsion) can. Never throw the can into a fire, even if the can is empty.

Keep Clobetasol Propionate Foam, 0.05% (Emulsion) and all medicines out of the reach of children.

General information about Clobetasol Propionate Foam, 0.05% (Emulsion)

Medicines are sometimes prescribed for purposes other than those listed in Patient Information leaflets. Do not use Clobetasol Propionate Foam, 0.05% (Emulsion) for a condition for which it was not prescribed. Do not give Clobetasol Propionate Foam, 0.05% (Emulsion) to other people, even if they have the same condition that you have. It may harm them.

This Patient Information leaflet summarizes the most important information about Clobetasol Propionate Foam, 0.05% (Emulsion). If you would like more information, talk with your doctor. You can ask your doctor or pharmacist for information about Clobetasol Propionate Foam, 0.05% (Emulsion) that is written for health professionals.

What are the ingredients in Clobetasol Propionate Foam, 0.05% (Emulsion)?

Active ingredient: clobetasol propionate, USP, 0.05%

Inactive Ingredients: anhydrous citric acid, cetyl alcohol, cyclomethicone, glycerin, isopropyl myristate, polyoxyl 20 cetostearyl ether, potassium citrate monohydrate, propylene glycol, purified water, sorbitan monolaurate, and phenoxyethanol as a preservative, pressurized with a hydrocarbon (propane/butane) propellant.

Revised Month Year 06/2012

Rx Only

Made In Israel

Manufactured by Perrigo

Yeruham 80500, Israel

Distributed By

PERRIGO®

Allegan, MI 49010

www.perrigo.com

Rev. 06/12

:6C700 RC J1

Package/Label Display Panel

Rx Only

Clobetasol Propionate Foam (Emollient Formulation) 0.05%

For Topical Use Only.

Not For Ophthalmic, Oral, or Intravaginal Use.

clobetasol propionate

clobetasol propionate AEROSOL, FOAM

Product Information

Product Type Human prescription drug label Item Code (Source) NDC:45802-637
Route of Administration TOPICAL DEA Schedule

Active Ingredient/Active Moiety

Ingredient Name Basis of Strength Strength
CLOBETASOL PROPIONATE clobetasol 0.5 mg

Inactive Ingredients

Ingredient Name Strength
ANHYDROUS CITRIC ACID
CETYL ALCOHOL
cyclomethicone
GLYCERIN
ISOPROPYL MYRISTATE
POLYOXYL 20 CETOSTEARYL ETHER
propylene glycol
water
SORBITAN MONOLAURATE
PHENOXYETHANOL

Packaging

# Item Code Package Description Marketing Start Date Marketing End Date
1 100 in 1 CAN
2 50 in 1 CAN
3 NDC:45802-637-32 1 in 1 CARTON

Marketing Information

Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
ANDA ANDA201402 2013-02-01


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