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INTRODUCTION

FOURDERM CREAM is a combination of Chlorhexidine gluconate, Clobetasol propionate, Miconazole nitrate, and Neomycin sulphate which belongs to the group of medicines called Antiseptic antibacterial agents, Topical corticosteroids, Antifungals, and Aminoglycoside antibiotics, respectively. FOURDERM CREAM is used to treat corticosteroid -responsive dermatoses (skin conditions that occurs due to corticosteroid medications), eczema (skin inflammation), and psoriasis (itchy dry skin) in affected individuals.

FOURDERM CREAM is not recommended for use in patients allergic to chlorhexidine gluconate, clobetasol propionate. miconazole nitrate, and/or neomycin sulphate. It is also not recommended for use in patients scheduled for brain/spinal cord/middle ear operation, and in patients suffering from skin problems (such as acne, rosacea, itching around anus/genitals).

Before applying FOURDERM CREAM, inform your doctor if you had previous bone symptoms (such as bone pain), previous allergic reaction with another steroid, broken/damaged skin, chronic leg ulcer, and/or psoriasis.

FOURDERM CREAM should be used with caution in pregnant and breastfeeding women. It is not recommended for use in children (aged below 12 years) and is advised to be used with caution in elderly patients (aged 65 years and above) after consulting your doctor.

The most common side effects of applying FOURDERM CREAM are burning, pain, irritation, and/or itching sensation at the site of application. Consult your doctor if any of these symptoms worsens.

USES OF FOURDERM CREAM

  • Treats corticosteroid-responsive dermatoses, eczema and psoriasis in affected individuals

HOW FOURDERM CREAM WORKS

FOURDERM CREAM provides relief from corticosteroid -responsive dermatoses, eczema. and psoriasis, where Chlorhexidine gluconate kills microorganisms by binding strongly with skin and preventing their growth, Clobetasol propionate prevents occurrence of swelling, redness & itchy skin (inflammatory reaction) by blocking the production of prostaglandins (chemical messengers responsible for inflammation), Miconazole prevents fungal infection by preventing the fungus from forming their own protective covering (thus resulting in their destruction) and Neomycin prevents bacterial infections by inhibiting bacterial protein synthesis which results in bacterial cell destruction thus treating corticosteroid -responsive dermatoses, eczema. and psoriasis in affected individuals.

DIRECTIONS FOR USE

Always apply FOURDERM CREAM, as directed by your physician. It is for external use only. On the affected area, apply a thin layer of this medicine. Treated areas on the face need not be covered with a plaster/bandage. Do not apply FOURDERM CREAM on your face beyond 5 days. Avoid applying FOURDERM CREAM around your eyes, including eyelids. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.

SIDE EFFECTS OF FOURDERM CREAM

COMMON

  •  burning, pain, irritation, and/or itching sensation at the site of application

UNCOMMON

  • stretch marks (due to thinning of skin)
  • noticeable blood vessels under skin surface

RARE

Stop applying FOURDERM CREAM and contact your doctor if you experience any of the following side effects:

  • signs of allergic reaction such as swelling of the face, lips, tongue/throat; red itchy skin rash, severe irritation, wheezing/difficulty breathing, reddening/blistering skin, feeling faint & dizzy, and/or strange metallic taste in mouth
  • psoriasis (itchy skin) with raised bumps filled with pus under the skin

HOW TO MANAGE SIDE EFFECTS

Skin Rash Or Itching

Try to pat or tap your skin instead of scratching it. Hold a damp towel to cool your skin. Wear loose clothing and avoid tight clothes, or clothes made from wool or synthetic fabrics. Avoid using perfumed soaps, deodorants or moisturizers and use skin softeners regularly.

WARNING & PRECAUTIONS

PREGNANCY

FOURDERM CREAM should be used with caution during pregnancy and in women planning for pregnancy. Consult your doctor before applying the medicine.

BREASTFEEDING

FOURDERM CREAM should be used with caution in breastfeeding women. The medicine should not be applied on the breast area while feeding the baby. Consult your doctor before applying the medicine.

DRIVING AND USING MACHINES

FOURDERM CREAM is unlikely to affect your ability to drive or operate machines. Consult your doctor before applying the medicine.

ALLERGY

FOURDERM CREAM is not recommended for use if you are allergic to chlorhexidine gluconate, clobetasol propionate, miconazole nitrate, neomycin sulphate, and/or any other ingredients of this medicine.

OTHERS

FOURDERM CREAM is not recommended for use if you:

  • are scheduled for brain/spinal cord/middle ear operation
  • have skin problems such as acne, rosacea (severe flushing of skin on and around your nose), perioral dermatitis (spotty red rash around your mouth), itching around anus /genitals, infected/itchy skin, and/or widespread plaque psoriasis

Before applying FOURDERM CREAM, inform your doctor if you:

  • had a history of bone symptoms such as bone pain, swelling, and/or tenderness near the affected area
  • had previously suffered from an allergic reaction with another steroid
  • are planning to apply the medicine under an airtight dressing including a child’s nappy
  • have broken/damaged skin/skin folds
  • have a large surface area to apply the medicine
  • have psoriasis (itchy skin)
  • suffer from chronic leg ulcer
  • have the site of application as face, open wound, dry, chapped, irritated/sun-burned skin

Use in Pediatrics:

FOURDERM CREAM is not recommended for use in children (aged below 1 year). It should be used with caution in children and adolescents (aged 2 to 18 years).  Consult your doctor before applying the medicine.

Use in Geriatrics:

FOURDERM CREAM should be applied with caution in elderly patients (aged 65 years or above). Consult your doctor before applying FOURDERM CREAM.

INTERACTIONS

A. Drug-Drug Interactions:

Before applying FOURDERM CREAM, inform your doctor, if you are applying any of the following medicine:

  • ritonavir (medicine used to treat HIV infection)
  • itraconazole (medicine used to treat fungal infections)
  • anticoagulants (used to prevent blood clots) such as warfarin

Overdosage:

If you or anyone else applies too much of FOURDERM CREAM or accidentally swallows it, consult your doctor immediately or visit the nearby hospital.

SYNOPSIS

Drug :   Chlorhexidine gluconate, Clobetasol propionate, Miconazole nitrate, Neomycin sulphate
Pharmacological Category :   Antiseptic Antibacterial agents, Topical Corticosteroids, Antifungals, and Aminoglycoside antibiotics
Therapeutic Indication :   Fungal infections, minor bacterial skin infections,corticosteroid -responsive dermatoses,skin disease,microbial infection of living surface,allergic rhinitis (inflammation of nose),folliculitis (inflammation of hair follicle),furunculosis (boil), and paronychia (infection of tissue folds around nails)         
Dosage Forms :   Cream

MORE INFORMATION

  • Keep FOURDERM CREAM out of reach in children
  • Store FOURDERM CREAM at room temperature

FAQs ABOUT FOURDERM CREAM

Q: What FOURDERM CREAM is used for?

A: FOURDERM CREAM is used to treat, control, prevent & improve conditions and symptoms of fungal infections, minor bacterial skin infections, corticosteroid -responsive dermatoses, skin disease, microbial infection of living surface, allergic rhinitis (inflammation of nose), folliculitis (inflammation of hair follicle), furunculosis (boil), and paronychia (infection of tissue folds around nails).

Q: Is FOURDERM CREAM safe to be used in children?

A: FOURDERM CREAM is not recommended for use in children (below 1 year). It should be used with caution in children and adolescents (aged 2 to 18 years).  Consult your doctor before applying FOURDERM CREAM.

Q: Who should avoid applying FOURDERM CREAM?

A: FOURDERM CREAM is not recommended for use in patients allergic to chlorhexidine gluconate, clobetasol propionate. miconazole nitrate, or neomycin sulphate. It is also not recommended for use in patients scheduled for brain/spinal cord/middle ear operation, and in patients with skin problems such as acne, rosacea, perioral dermatitis (spotty red rash around mouth), itching around anus or genitals. It is also not indicated for use in children (below 1 years of age).

Q: Is FOURDERM CREAM safe to be used in pregnant and breastfeeding women?

A: FOURDERM CREAM should be used with caution in pregnant and breastfeeding women only if it is clearly necessary. Consult and inform your doctor before applying the medicine.

Q: How FOURDERM CREAM works?

A: FOURDERM CREAM helps to treat, control, and prevent bacterial, fungal, skin, & allergic infections, where Chlorhexidine gluconate kills microorganisms by binding strongly with skin and preventing their growth, Clobetasol propionate prevents occurrence of swelling, redness & itchy skin (inflammatory reaction) by blocking the production of prostaglandins (chemical messengers responsible for inflammation), Miconazole prevents fungal infection by preventing the fungus from forming their own protective covering thus resulting in their destruction and Neomycin prevents bacterial infections by inhibiting bacterial protein synthesis which results in bacterial cell destruction thereby treating the infection and preventing its occurence.

REFERENCES

1. KD. Tripathi. Aminoglycoside Antibiotics, Antifungal, and Antiseptics, Disinfectants & Ectoparasiticides. Essentials of medical pharmacology. Seventh edition. 2013. Page – 750, 792, 900.

2. Arthiie Thangavelu, Sahaya Stelin Kaspar, Ramesh Periannan Kathirvelu, Bhuvaneshwari Srinivasan, Soundarya Srinivasan, and Rajasekar Sundram. Chlorhexidine: An Elixir for Periodontics. NIH National Library of Medicine. National Center for Biotechnology Information. PMC PubMed Central. [Revised in August 2020] [Accessed on 21st July 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7595540/

3. Clobetasol propionate. NIH National Library of Medicine. National Center for Biotechnology Information. PubChem [Revised in July 2022] [Accessed on 21st July 2022] https://pubchem.ncbi.nlm.nih.gov/compound/Clobetasol-propionate#section=Biological-Half-Life

4. Niel Veirup; Chris Kyriakopoulos. Neomycin. NIH National Library of Medicine. National Center for Biotechnology Information. StatPearls [Internet]. [Revised in May 2022] [Accessed on 21st July 2022] https://www.ncbi.nlm.nih.gov/books/NBK560603/

5. CLOBETASOL PROPIONATE- clobetasol propionate cream. DailyMed. NIH U.S. National Library of Medicine. [Revised in November 2021] [Accessed on 21st July 2022] https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=550d6cbd-88d0-c82b-f7c9-927064f2ba36

6. Thornton and Ross Ltd. Electronic Medicines Compendium (EMC). [Revised in August 2014] [Accessed on 21st July 2022] https://www.medicines.org.uk/emc/files/pil.4877.pdf

7. Glaxo Operations UK Limited. Electronic Medicines Compendium (EMC). [Revised in May 2022] [Accessed on 21st July 2022] https://www.medicines.org.uk/emc/files/pil.939.pdf

8. Janssen Pharmaceutica NV. Electronic Medicines Compendium (EMC). [Revised in August 2020] [Accessed on 21st July 2022] https://www.medicines.org.uk/emc/files/pil.1435.pdf

9. BACLEZENE- neomycin sulfate cream. DailyMed. NIH U.S. National Library of Medicine. [Revised in November 2017] [Accessed on 21st July 2022] https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=a82852eb-18e9-431a-b3d6-80abfdbf8662

10. Torque Pharmaceuticals Pvt Ltd. Clob-GM Cream. [Accessed on 21st July 2022] https://www.torquepharma.com/clob-gm-cream/

USEFUL DIAGNOSTIC TESTS

  • Patch test
  • Potassium hydroxide (KOH) microscopy

PRODUCT DETAILS

    Net Qty
    1 N
    Ingredient
    CHLORHEXIDINE GLUCONATE 0.2 % w/w+CLOBETASOL PROPIONATE 0.05 % w/w+MICONAZOLE NITRATE 2 % w/w+NEOMYCIN SULPHATE 0.5 % w/w
    Hsn Code
    30049029
ALTERNATE BRANDS
Fourderm Cream 10gm
Prescription Skin Infections Rx required
Rs.97.50
Fourderm Cream 20gm
Prescription Skin Infections Rx required
Rs.152.50
DISCLAIMER

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Fourderm Cream 5gm

Fourderm Cream 5gm Mkt: Cipla Ltd (Generics)

M.R.P.: Rs.56.65
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