AboutDr Alan Galbraith Expertise I can answer most questions on most drugs. Answers can be given in either technical or layperson terminology. My main areas of interest are psychiatric, gastrointestinal and cardiovascular drugs.
Experience I have been a university lecturer/head of department for almost thirty years, but am now retired. My research interests were alcohol, smoking and cardiovascular disease.
Organizations Institute of Biology, London.
Publications Author of "Fundamentals of Pharmacology" 5th Edition published in November 2007 by Pearson Education, Australia.
Question QUESTION: Respected Sir, I am highly indebted to your web and your section for providing correct guidance about drugs in the past. You are rendering selfless service to the suffering humanity and working for the cause of patient education. Hello I am from India with lot of best regards. I have a psoriasis under control. In 2000, it started with head and then spread to back, hands and legs. Initially from 2000 to 2004 I was treated with Clobetasole with Salicylic cream. Thereafter my doctor switched over to Betamethasone 0.05% USP Salicylic Acid IP 6.00% cream as well as lotion. While it is under control with Betamethasone and Salicylic acid, Recently dermatologist has changed it to mometasone with salicylic acid which is very costly Can you educate me as to whether mometasone is as effective as clobetasole
ANSWER: Dear Asis
Very strange that I get two more or less identical questions from India within 20 minutes!
Anyway I need to know whether you mean clobetasol propionate or clobetasone butyrate before I can answer properly.
I'll reply tomorrow as it s late in Australia.
Regards
Dr Alan Galbraith
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QUESTION: Dear Sir,
it is clobetasol propionate.
Answer Dear Asis
Clobetasol propionate is more potent than the mometasone so should work better and I see no valid reason to change to the mometasone, especially when it is more expensive. Likewise I see no reason to switch from the betamethasone. These creams are used sometimes for many years in cases of psoriasis but sometimes can have detrimental effects on the skin and some due to absorption into the circulation. With the latter ointments cause more problems than the creams though. The main effect on the skin is atrophy (shrinkage and lack of tone. The systemic effects are reversible but you'd be better discussing this with your doctor as they are complicarted and I do not want to alarm you by giving you a list of symptoms which may not occur and are difficult to explain in layterms over the Internet, They involve suppression of adrenal gland function and you could Google adrenal insufficiency for details. If your dermatologist wants to change you to a less potent corticosteroid there are many much cheaper than mometasone. I will say that betamethasone rarely causes severe problems even after very prolonged use.
