Xzema Cream 2%+0.1%
Xzema Cream 2%+0.1% Uses, Dosage, Side Effects, Food Interaction and all others data.
Betamethasone valerate is a potent topical corticosteroid. Topical corticosteroids have anti-inflammatory, antipruritic and vasoconstrictive actions when administered topically.
Corticosteroids bind to the glucocorticoid receptor inhibiting pro-inflammatory signals, while promoting anti-inflammatory signals. Corticosteroids have a wide therapeutic window as patients may require doses that are multiples of what the body naturally produces. Patients who require long-term treatment with a corticosteroid should be counselled regarding the risk of hypothalamic-pituitary-adrenal axis suppression and increased susceptibility to infections.
Fusidic acid is an antimicrobial agent that inhibits bacterial protein synthesis. Fusidic acid interferes with amino acid transfer from aminoacyl-tRNA to protein on the ribosomes. Fusidic acid is active against a wide range of gram-positive organisms. The sustained release formulation ensures prolonged contact with the conjunctival sac. Fusidic acid penetrates well into the aqueous humor.
Fusidic acid is a bacteriostatic antibiotic and helps prevent bacterial growth while the immune system clears the infection.
| Trade Name | Xzema Cream 2%+0.1% |
| Generic | Fusidic acid + Betamethasone |
| Weight | 2%+0.1% |
| Type | Cream |
| Therapeutic Class | Other Topical corticosteroids |
| Manufacturer | Orion Pharma Ltd. |
| Available Country | Bangladesh |
| Last Updated: | October 19, 2023 at 6:27 am |
Uses
This cream is indicated in eczema and dermatitis with secondary infections including atopic dermatitis, allergic and seborrhoeic dermatitis and primary irritant dermatitis.Xzema Cream 2%+0.1% is also used to associated treatment for these conditions: Acute Gouty Arthritis, Adrenal cortical hypofunctions, Alopecia Areata (AA), Ankylosing Spondylitis (AS), Berylliosis, Blepharitis allergic, Blepharoconjunctivitis, Bullous dermatitis herpetiformis, Bursitis, Congenital Adrenal Hyperplasia (CAH), Congenital Hypoplastic Anemia, Conjunctivitis, Corneal Inflammation, Dermatitis, Eczematous, Dermatomyositis, Dermatosis, Discoid Lupus Erythematosus (DLE), Edema of the cerebrum, Epicondylitis, Episcleritis, External ear inflammation, Eye allergy, Hypercalcemia of Malignancy, Inflammatory Reaction of the ear, Iridocyclitis, Iritis, Itching caused by Allergies, Keloid Scars, Keratitis interstitial, Keratoconjunctivitis, Leukemias, Lichen Planus (LP), Lichen simplex chronicus, Lupus Erythematosus, Malignant Lymphomas, Multiple sclerosis exacerbation, Mycosis Fungoides (MF), Necrobiosis lipoidica diabeticorum, Nephrotic Syndrome, Ocular Inflammation, Ocular injuries, Ophthalmia, Sympathetic, Pemphigus, Plaque psoriasis of the body, Plaque psoriasis of the scalp, Polymyositis, Post-Surgical Ocular Inflammation, Pruritus, Psoriasis, Psoriasis Vulgaris (Plaque Psoriasis), Psoriatic Arthritis, Psoriatic plaque, Pulmonary Tuberculosis (TB), Pure Red Cell Aplasia, Regional Enteritis, Rheumatoid Arthritis, Rheumatoid Arthritis, Juvenile, Scleritis, Secondary thrombocytopenia, Severe Asthma, Severe Atopic Dermatitis, Skin Infections, Stevens-Johnson Syndrome, Systemic Lupus Erythematosus (SLE), Temporal Arteritis, Trichinosis, Tuberculous Meningitis, Ulcerative Colitis, Uveitis, Verrucous Lichen Planus (LP), Acquired immune hemolytic anemia, Acute nonspecific tenosynovitis, Acute rheumatic carditis, Bacterial blepharitis, Corticosteroid-responsive dermatoses, Eczematous rash, Exfoliative erythroderma, Granuloma annulare lesions, Idiopathic eosinophilic pneumonias, Non-suppurative Thyroiditis, Ocular bacterial infections, Severe Allergic rhinitis, Severe Contact dermatitis, Severe Serum sickness, Severe Transfusion Reactions, Severe drug hypersensitivity reactions, Superficial ocular infections, Symptomatic Sarcoidosis, Synovitis of osteoarthritisBacterial Conjunctivitis, Eye and eyelid infections, Fungal skin infection, Skin Infections caused by Corynebacterium minutissimum infection, Skin Infections caused by Staphylococcus Aureus, Skin Infections caused by Streptococcus Infection, Skin Infections, Bacterial, Stye, Cutaneous dermatophyte infection, Eczematous rash, Mild Atopic dermatitis, Mild Dermatitis caused by Staphylococcus aureusis, Moderate Atopic dermatitis, Moderate Dermatitis caused by Staphylococcus aureusis, Ocular bacterial infections, Susceptible Bacterial Infections
How Xzema Cream 2%+0.1% works
Glucocorticoids inhibit neutrophil apoptosis and demargination, and inhibit NF-Kappa B and other inflammatory transcription factors. They also inhibit phospholipase A2, leading to decreased formation of arachidonic acid derivatives. In addition, glucocorticoids promote anti-inflammatory genes like interleukin-10.
Corticosteroids like betamethasone can act through nongenomic and genomic pathways. The genomic pathway is slower and occurs when glucocorticoids activate glucocorticoid receptors and initiate downstream effects that promote transcription of anti-inflammatory genes including phosphoenolpyruvate carboxykinase (PEPCK), IL-1-receptor antagonist, and tyrosine amino transferase (TAT). On the other hand, the nongenomic pathway is able to elicit a quicker response by modulating T-cell, platelet and monocyte activity through the use of existing membrane-bound receptors and second messengers.
Fusidic acid works by interfering with bacterial protein synthesis, specifically by preventing the translocation of the elongation factor G (EF-G) from the ribosome. It also can inhibit chloramphenicol acetyltransferase enzymes.
Dosage
Xzema Cream 2%+0.1% dosage
Adults: It should be applied 2 times daily and gently massaged into the affected areas for 2 weeks. A shorter course should be considered if symptoms improve.Children: It is not recommended in children under 3 years of age.Side Effects
Possible side effects are allergic reactions, headache, skin rash, redness or itching, unusual tiredness or weakness, yellow eyes or skin.Toxicity
Chronic high doses of glucocorticoids can lead to the development of cataracts, glaucoma, hypertension, water retention, hyperlipidemia, peptic ulcer, pancreatitis, myopathy, osteoporosis, mood changes, psychosis, dermal atrophy, allergy, acne, hypertrichosis, immune suppression, decreased resistance to infection, moon face, hyperglycemia, hypocalcemia, hypophosphatemia, metabolic acidosis, growth suppression, and secondary adrenal insufficiency. Overdose may be treated by adjusting the dose or stopping the corticosteroid as well as initiating symptomatic and supportive treatment.
Precaution
Long term continuous therapy should be avoided, particularly in the face, on flexures and intertriginous areas and in infants and children.Interaction
Other topical (skin-applied) medications contain corticosteroids.Volume of Distribution
In a study that included Indian women of reproductive age, the volume of distribution following a single intramuscular dose of betamethasone phosphate was 94,584±23,539 mL(s).
Elimination Route
The absorption and potency of any topical corticosteroid including betamethasone depends on the vehicle in which the steroid is delivered. For example, betamethasone dipropionate 0.05% ointment is classified as a highly potent topical steroid, while betamethasone dipropionate 0.05% cream or lotion is considered to be moderately potent.
There are several structural modifications that can determine the potency of a topical corticosteroid. For example, corticosteroids containing a halogen at specific carbons, or that contain esters are more potent due to enhanced lipophilicity. As such, there is a marked difference between topical products containing betamethasone dipropionate vs. betamethasone valerate. Betamethasone dipropionate contains 2 esters which enhances its potency, while betamethasone valerate has only one ester and is less potent.
It should be noted that the use of occlusive dressings with topical steroids significantly increases the absorption, increasing the risk for adverse effects.
Sodium fusidic acid tablets have a 91% oral bioavailability. Absorption of the film-coated tablets is complete when compared to a solution, however oral absorption is variable. Oral fusidic acid hemihydrate (suspension) achieved a 22.5% bioavailability in pediatric patients following a 20 milligram/kilogram dose.
Half Life
In a study that included Indian women of reproductive age, the half-life following a single intramuscular dose of betamethasone phosphate was 10.2 ± 2.5 hours.
Approximately 5 to 6 hours in adults.
Clearance
In a study that included Indian women of reproductive age, the CL/F following a single intramuscular dose of betamethasone phosphate was 6,466 ± 805 mL/hour.
Elimination Route
Corticosteroids are eliminated predominantly in the urine.
Pregnancy & Breastfeeding use
Fusidic acid and betamethasone should not be used in pregnancy. Both of them have been detected in the breast milk, so nursing mothers are advised not to use the drug.Contraindication
Topical hydrocortisone is contraindicated in viral tuberculosis and fungal skin infections. Hypersensitivity to any of the components.Special Warning
Use in children: Safety & effectiveness in children below the age of 2 years have not been established.
Acute Overdose
Long-term intensive topical use may lead to systemic effects
Storage Condition
Keep out of reach of children. Store in a dry place, below 25˚C temperature and protected from light.Innovators Monograph
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