Epiderm Triple Action Skin Care Cream – 30g

Indications
Treatment of various inflammatory dermatological disorders superadded with bacterial or superficial fungal infections of the skin.
 
Pharmacological Class
Betamethasone: Corticosteroid. Gentamicin: Aminoglycoside antibiotic. Tolnaftate: synthetic thiocarbamate. Iodochlorhydroxyquinoline: halogenated hydroxyquinoline.
 
Pharmacological Properties
Antifungal, anti-inflammatory & antibacterial. 
 
Mechanism of Action
Corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes. Gentamicin is an aminoglycoside that binds to 30s and 50s ribosomal subunits of susceptible bacteria disrupting protein synthesis, thus rendering the bacterial cell membrane defective. Tolnaftate is an antifungal which inhibits the growth of dermatophytes. Iodochlorhydroxyquinoline has antibacterial and antifungal activity.
 
Side Effects
Betamethasone: Dermal atrophy, local irritation, folliculitis, hypertrichosis. Abrupt withdrawal leading to acute adrenal insufficiency manifesting as malaise, weakness, mental changes, muscle and joint pains, dystonia, hypoglycemia, hypotension, dehydration and death. Gentamicin: Dizziness or vertigo; acute renal failure, interstitial nephritis, acute tubular necrosis; electrolyte imbalances; transient elevation of serum bilirubin and aminotransferases; purpura; nausea, vomiting; convulsions, mental depression, hallucinations. Tolnaftate: Irritation, pruritus, contact dermatitis. Iodochlorhydroxyquinoline: Cross-sensitivity with other halogenated hydroxyquinolines. May discolor fair hair.
 
Contraindications
Hypersensitivity; treatment of herpes simplex, vaccina or varicella, and in pregnancy. Children less than 2 years.
 
Observations
An increase in the number of daily applications may worsen the undesirable effects without improving the therapeutic effects. The total dosage of Betamethasone should not exceed 50gm per week. Patients should not be treated for more than 2 weeks at a time. Abrupt withdrawal may lead to rebound of the disease, hence dose to be reduced gradually prior to withdrawal of therapy. Do not apply on eczematous or broken skin and perforated tympanic membrane.