Celcotriol CT (Clobetasol) Tablet Dosing
Apply Celcotriol to the affected area not more than 3 times daily, with a maximum weekly dose of 50 grams, and treatment duration should not exceed 2 weeks for most conditions. 1
Maximum Daily Frequency and Duration
- The FDA-approved maximum frequency is 3 applications per day to affected areas 1
- Treatment beyond 2 weeks is not recommended in standard prescribing information 2
- Weekly maximum dose is 50 grams to prevent systemic absorption and adverse effects 2
Critical Safety Considerations
Short-Term Use Protocol
- Clobetasol propionate is indicated for short-term treatment (less than 2 weeks) of inflammatory dermatoses 2
- Intermittent treatment courses may be used for widespread inflammatory conditions, but continuous use beyond 2 weeks requires special monitoring 2
- For stubborn localized inflammatory dermatoses, use clobetasol initially before transitioning to less potent preparations 2
High-Risk Areas to Avoid
- Never apply to flexural areas, scrotal skin, or facial skin (with rare exceptions such as discoid lupus erythematosus or actinic reticuloid) 2
- These areas have increased absorption and higher risk of skin atrophy and striae 2
Age Restrictions
- Contraindicated in infants, toddlers, and children under 12 years of age 2
- For children 6-12 years: do not use without consulting a physician 1
Monitoring Requirements for Extended Use
If treatment extends beyond 2 weeks (which should be exceptional):
- Manage patients as though they are on systemic steroids with appropriate monitoring 2
- Provide supplemental glucocorticoid administration during acute stress, surgery, or intercurrent infection 2
- Monitor for hypothalamic-pituitary-adrenal axis suppression, as this is a known systemic side effect 3
Common Adverse Effects to Counsel Patients About
- Skin atrophy and striae are the most common local side effects 2, 3
- Risk increases with prolonged use, higher doses, and application to high-absorption areas 2
- Systemic effects including HPA axis suppression can occur, particularly when exceeding 50 grams weekly 3
Clinical Pitfalls to Avoid
- Do not allow patients to self-manage beyond the initial 2-week prescription without physician review of the amount used per unit time 2
- Patients must receive explicit instructions about body areas to avoid and maximum weekly dosage 2
- The remarkable potency of clobetasol propionate (the most potent topical steroid available) requires careful patient education to prevent misuse 3