Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g Cream, 15 g — NDC 00168-0258-15 package photo

Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g Cream, 15 g

by E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC · 15 g in 1 TUBE (0168-0258-15)
NDC 00168-0258-15
🏷️ FDA NDC (as labeled) 0168-0258-15 billing pads the labeler segment with a zero
This package
Contains15 g Cost per g$0.2096 NADAC Per package$3.14 / 15 g Pack sizes2 compare ↓
Also priced by: Medicaid pays $0.5217/unit · Part D plans $0.3646/unit — full pricing hub ↓
Also comes in: 45 g 00168-0258-46
Rx only Generic On market Non-controlled
🗂️ Data synced Aug 27, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

🆔 Identity & classification

FDA NDC (as labeled) 0168-0258-15
Product NDC 0168-0258
11-digit billing NDC 00168025815
NCPDP billing unit GM — per gram (weight)
RxCUI 308714
UNII G07GZ97H65, 826Y60901U
UPC 0301680258157
Application # ANDA075502
SPL Set ID 55db730a-df6d-4950-9c26-91b06bdcef36
Established class (EPC) Azole Antifungal
Chemical class Azoles
DEA schedule Non-controlled
Marketing category ANDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2001-06-05
Route TOPICAL
Dosage form CREAM
Substance CLOTRIMAZOLE; BETAMETHASONE DIPROPIONATE
GCN Seq No 036534
GCN 06919
HICL code 003197
Ingredient (HICL) Clotrimazole/Betamethasone Dip
HIC1 code Q
Therapeutic class — broad (HIC1) Ear/Eye/Nose/Rectum/Topical/Vagina/Other
HIC2 code Q5
Therapeutic class — intermediate (HIC2) Agents Acting Principally On The Skin
HIC3 code Q5M
Therapeutic class — specific (HIC3) Topical Antifungal/Anti-Inflammatory,Steroid Agent
AHFS code 84:04.08.08
AHFS class Azoles (Skin And Mucous Membrane)
FDB label name CLOTRIMAZOLE-BETAMETHASONE CRM
FDB brand name Clotrimazole-Betamethasone
Legend status F — Federal legend — prescription drug or device
TE code (Orange Book) AB · RLD · RS
Why two NDCs? The FDA registers this code as 0168-0258-15 — a 4-4-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the labeler segment → 00168-0258-15. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

🏷️ RxNorm drug class

This medicine belongs to the Corticosteroid class.

Pharmacologic class Corticosteroid
Drug family (ATC) Corticosteroids acting locally, Corticosteroids, Corticosteroids, potent (group III)
How it works Corticosteroid Hormone Receptor Agonists
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

🏭 Manufacturer & labeler

LabelerE. Fougera & Co. a division of Fougera Pharmaceuticals, LLC
Application holderFOUGERA PHARMACEUTICALS INC
FDA applicationANDA075502 (ANDA)
Labeler code00168
First marketedJun 2001
Product typeHuman Prescription Drug
Portfolio33 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

🩺 Clinical

Label name CLOTRIMAZOLE-BETAMETHASONE CRM Ingredient Clotrimazole/Betamethasone Dip
📖 What it is MedlinePlus · NLM

Betamethasone topical is used to treat the itching, redness, dryness, crusting, scaling, inflammation, and discomfort of various skin conditions, including psoriasis (a skin disease in which red, scaly patches form on some areas of the body) and eczema (a skin disease that causes the skin to be dry and itchy and to sometimes develop red, scaly rashes). Betamethasone is in a class of medications called corticosteroids. It works by activating natural substances in the skin to reduce swelling, redness, and itching.

Read the full MedlinePlus article ↗
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

🧪 Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.

  • UNII LKG8494WBH
    Benzyl alcohol is a clear liquid used as a preservative and solvent in medicines. It helps prevent bacterial and fungal growth and dissolves other ingredients to create uniform liquid formulations.
  • UNII 1R9DCZ5FOX
    A synthetic ingredient made by combining fatty alcohols with ethylene oxide. It helps oils and water mix together in the formula and makes the product smoother and easier to apply.
  • UNII 2DMT128M1S
    A waxy solid derived from plant or animal sources. It acts as an emulsifier to blend oil and water components, and also thickens the medicine to give it the right texture and consistency.
  • UNII T5L8T28FGP
    Mineral oil is a clear, odorless liquid derived from crude oil. It acts as a lubricant and emollient in medications, helping pills slide smoothly during manufacturing and aiding moisture retention in topical products.
  • UNII 4T6H12BN9U
    Petrolatum is a purified mineral oil-based jelly derived from petroleum. In medicines, it acts as an emollient, lubricant, and moisture barrier to soften skin, reduce friction, and help prevent water loss from formulations.
  • UNII 6DC9Q167V3
    Propylene glycol is a clear liquid derived from petroleum or vegetable sources. It acts as a solvent, humectant, and preservative in medicines, helping dissolve active ingredients and maintain product stability.
  • UNII 3980JIH2SW
    A salt form of phosphoric acid that acts as a buffer and pH adjuster in medicines. It helps keep the product at the correct acidity level for stability and effectiveness.
  • UNII 059QF0KO0R
    Water is a liquid solvent that dissolves and mixes ingredients together in liquid medicines, syrups, and injections. It helps distribute the active drug evenly throughout the product.

8 inactive ingredients listed in the exact product block matched to this NDC.

Where does this data come from?
Data sourced from official FDA Structured Product Labeling (SPL) via DailyMedingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

💲 Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer gPer package
Retail pharmacies payNADAC · weekly $0.210 $3.14 / 15 g
Medicaid paysCMS SDUD · 12 mo $0.5217 $7.83 / 15 g
Medicare drug plans payPart D · Q2 2026 $0.3646 $5.47 / 15 g
NADAC price history (per g) — tap or hover for the price & month
Dec 2021 Jul 2022 Dec 2025 Aug 2026 $0.306 $0.194
▼ Down 32% over the last 24 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

🔁 Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/gthis 00168-0258-15 E. 15 g $0.210 AB Availability likely
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 00472-0379-15 Actavis 1 tube $0.210 AB Availability likely
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 16714-0496-01 NORTHSTAR 1 tube $0.210 AB Availability likely
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 51672-4048-01 Sun 1 tube $0.210 AB Availability likely
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 68462-0298-17 Glenmark 15 g $0.226 FDA listed +8%
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 50090-0741-00 A-S 1 tube AB FDA listed
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 50090-3121-00 A-S 1 tube AB FDA listed
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 50090-4876-00 A-S 1 tube AB FDA listed
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 50090-6474-00 A-S 1 tube AB FDA listed
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 63187-0095-15 Proficient 1 tube AB FDA listed
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 63629-8758-01 Bryant 1 tube AB FDA listed
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 68071-4134-04 NuCare 45 g FDA listed
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 68788-8419-01 Preferred 1 tube AB FDA listed
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 70518-2352-00 REMEDYREPACK 1 tube AB FDA listed
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 71205-0524-15 Proficient 15 g FDA listed
Clotrimazole And Betamethasone Dipropionate 10 mg/g; .5 mg/g 72189-0182-15 Direct 15 g FDA listed
Clotrimazole/Betameth .5 mg/g; 10 mg/g 72189-0518-15 Direct_Rx 15 g AB FDA listed
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 80425-0344-01 Advanced 1 tube AB FDA listed
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 85766-0196-15 Sportpharm 1 tube AB FDA listed
Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g 67296-2272-01 Redpharm 1 tube AB FDA listed
About this product: this is a generic version of the medicine. FDA equivalence ratings are shown when available, and other versions are listed above, least expensive first.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

Availability & generic status

🏛️
2001
On the market since
Jun 2001
📍
2026
Currently FDA-listed
25 years listed
🔓
·
Generic on the market
this product is a generic
This is a generic drug

This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

🗺️ Medicaid utilization & spend

📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for 00168-0258-15, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q4 2025 · 4 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
67.4K
Units reimbursed last 4 qtrs
1.7M
Gross reimbursed last 4 qtrs
$872.7K
Avg / prescription
$12.94
Avg / unit
$0.5217
Latest quarter Q4 2025
15.8KRx
Medicaid pays / g
$0.5217
gross reimbursed
vs
NADAC / g
$0.2096
acquisition cost
=
Spread
+$0.3121
+149% vs cost
What Medicaid paid per g (before rebates; includes the pharmacy’s dispensing fee) compared with NADAC — the average price pharmacies pay to buy the drug. A positive spread means Medicaid reimbursed more than the purchase price, before manufacturer rebates.
Fee-for-service vs managed care
39% FFS 61% MCO
Fee-for-service · 26,240 Rx Managed care · 41,180 Rx
State Medicaid map
Alaska: 1,590 units · 217 per 100k residents AK Maine: 9,555 units · 685 per 100k residents ME Washington: 19,125 units · 245 per 100k residents WA Idaho: 3,585 units · 183 per 100k residents ID Montana: 2,385 units · 211 per 100k residents MT North Dakota: 1,350 units · 172 per 100k residents ND Minnesota: 15,603 units · 272 per 100k residents MN Wisconsin: 31,980 units · 541 per 100k residents WI Michigan: 96,405 units · 960 per 100k residents MI New York: 298,875 units · 1,527 per 100k residents NY Vermont: 1,305 units · 202 per 100k residents VT New Hampshire: 3,705 units · 264 per 100k residents NH Oregon: 6,030 units · 142 per 100k residents OR Nevada: 11,835 units · 371 per 100k residents NV Wyoming: no data reported WY South Dakota: 2,315 units · 252 per 100k residents SD Iowa: 8,895 units · 277 per 100k residents IA Illinois: 3,150 units · 25.1 per 100k residents IL Indiana: 13,080 units · 191 per 100k residents IN Ohio: 48,210 units · 409 per 100k residents OH Pennsylvania: 72,405 units · 559 per 100k residents PA New Jersey: 212,822 units · 2,291 per 100k residents NJ Massachusetts: 21,991 units · 314 per 100k residents MA California: 156,311 units · 401 per 100k residents CA Utah: 3,180 units · 93.1 per 100k residents UT Colorado: 7,590 units · 129 per 100k residents CO Nebraska: 7,200 units · 364 per 100k residents NE Missouri: 16,220 units · 262 per 100k residents MO Kentucky: 32,405 units · 716 per 100k residents KY West Virginia: 7,620 units · 431 per 100k residents WV Virginia: 30,090 units · 345 per 100k residents VA Maryland: 39,753 units · 643 per 100k residents MD Connecticut: 75,465 units · 2,086 per 100k residents CT Rhode Island: 5,265 units · 481 per 100k residents RI Arizona: 6,135 units · 82.6 per 100k residents AZ New Mexico: 7,470 units · 353 per 100k residents NM Kansas: 4,395 units · 149 per 100k residents KS Arkansas: 8,505 units · 277 per 100k residents AR Tennessee: 22,980 units · 322 per 100k residents TN North Carolina: 76,005 units · 701 per 100k residents NC South Carolina: 11,040 units · 205 per 100k residents SC Delaware: 7,845 units · 761 per 100k residents DE Oklahoma: 11,295 units · 279 per 100k residents OK Louisiana: 68,747 units · 1,503 per 100k residents LA Mississippi: 9,450 units · 321 per 100k residents MS Alabama: 14,475 units · 283 per 100k residents AL Georgia: 37,755 units · 342 per 100k residents GA D.C.: 6,970 units · 1,027 per 100k residents DC Hawaii: no data reported HI Texas: 41,460 units · 136 per 100k residents TX Florida: 70,799 units · 313 per 100k residents FL
Units reimbursed · per 100k residents
25.12,291
gray = no data reported
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
🏆 Top states by units · per 100k residents
1 New Jersey 2,291 /100k
2 Connecticut 2,086 /100k
3 New York 1,527 /100k
4 Louisiana 1,503 /100k
5 D.C. 1,027 /100k
6 Michigan 960 /100k
7 Delaware 761 /100k
8 Kentucky 716 /100k
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.

💊 Medicaid utilization by pack size

Medicaid (SDUD) totals over the four most recent reported quarters for every package size of this drug — handy when a specific package (e.g. a starter/titration pack) carries little or no Medicaid volume on its own.
45 gs00168-0258-46 77,582 Rx · $1,410,559
15 gs this page00168-0258-15 67,420 Rx · $872,674
Drug total (last 4 qtrs): 145,002 Rx · 5,315,114 units · $2,283,234 gross reimbursed
Tap a pack size to open its page. Source: CMS State Drug Utilization Data, last 4 quarters.

🔬 Reported adverse events (FAERS)

Read carefully: FAERS reports are voluntary and unverified. Counts are not incidence, do not establish causation, are subject to reporting bias, and cannot be used to compare one drug to another. Shown for signal context only. Reports for Clotrimazole and Betamethasone Dipropionate — the ingredient across all brands.

Top reported reactions

Chronic Kidney Disease55
Fatigue37
Renal Failure34
Acute Kidney Injury24
Nausea24
Dyspnoea21
Pain20

Reporter sex

430 reports

Serious outcomes

Death34
Reports over time (by year) — tap or hover for the count & year
2019 2021 2023 2026 45 0
Most recent year is provisional (FAERS lags ~3 months).
Where does this data come from?
Adverse-event reports from the FDA Adverse Event Reporting System (FAERS) via openFDA. FAERS reports are voluntary and unverified — counts are not incidence and don’t establish causation.

📦 Packaging — all sizes for this product

Package NDCDescription Per unit Per pack Marketing startStatus
00168-0258-15 You're viewing this 15 g in 1 TUBE (0168-0258-15) $0.2096 / g $3.14 2001-06-05 Active
00168-0258-46 45 g in 1 TUBE (0168-0258-46) $0.1814 / g $8.16 2001-06-05 Active

You're viewing the smallest of 2 pack sizes for this product.

Per g, this pack runs about 16% above the cheapest pack (45 g, $0.1814 vs $0.2096 NADAC).

This pack accounts for about 46% of this product's recent Medicaid fills; most go to the 45 gs pack. See all packs ↓

Pack size FAQ

What quantity is in NDC 00168-0258-15?
NDC 00168-0258-15 contains 15 g — 15 g in 1 tube.
What is the difference between NDC 00168-0258-15 and NDC 00168-0258-46?
Both are Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g Cream — the drug itself is identical. NDC 00168-0258-15 is the 15 g package, while NDC 00168-0258-46 is the 45 g package. Per-g NADAC also differs: $0.2096 here vs $0.1814 for the 45 g pack.
What NDC number is used to bill for this package of Clotrimazole and Betamethasone Dipropionate 10 mg/g; .5 mg/g Cream?
Bill NDC 00168-0258-15 — the 11-digit billing format is 00168025815. Pharmacy and medical claims use the 11-digit form; the FDA label may print a shorter form of the same code.

Prices are the latest CMS NADAC pharmacy acquisition cost per NDC; per-pack figures are per-unit × pack quantity, shown only when the pack is denominated in the same measure NADAC prices.

📄 Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage 111 words

1 INDICATIONS AND USAGE Clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) is a combination of an azole antifungal and corticosteroid and is indicated for the topical treatment of symptomatic inflammatory tinea pedis, tinea cruris, and tinea corporis due to Epidermophyton floccosum , Trichophyton mentagrophytes , and Trichophyton rubrum in patients 17 years and older. Clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) contains a combination of clotrimazole, an azole antifungal, and betamethasone dipropionate, a corticosteroid, and is indicated for the topical treatment of symptomatic inflammatory tinea pedis, tinea cruris, and tinea corporis due to Epidermophyton floccosum , Trichophyton mentagrophytes , and Trichophyton rubrum in patients 17 years and older.

( 1 )

⏱️ Dosage and Administration ~1 min read

2 DOSAGE AND ADMINISTRATION Treatment of tinea corporis or tinea cruris: • Apply a thin film of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) into the affected skin areas twice a day for one week. • Do not use more than 45 grams per week. Do not use with occlusive dressings. • If a patient shows no clinical improvement after 1 week of treatment with clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base), the diagnosis should be reviewed. • Do not use longer than 2 weeks. Treatment of tinea pedis: • Gently massage a sufficient amount of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) into the affected skin areas twice a day for two weeks. • Do not use more than 45 grams per week.

Do not use with occlusive dressings. • If a patient shows no clinical improvement after 2 weeks of treatment with clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) the diagnosis should be reviewed. • Do not use longer than 4 weeks. Clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) is for topical use only. It is not for oral, ophthalmic, or intravaginal use.

Avoid contact with eyes. Wash hands after each application. • Tinea pedis : Apply a thin film to the affected skin areas twice a day for 2 weeks. Do not use longer than 4 weeks.

( 2 ) • Tinea cruris and tinea corporis : Apply a thin film to the affected skin area twice a day for 1 week. Do not use longer than 2 weeks. ( 2 ) • Do not use with occlusive dressings unless directed by a physician.

( 2 ) • Not for ophthalmic, oral or intravaginal use. ( 2 )

💊 Dosage Forms and Strengths 87 words

3 DOSAGE FORMS AND STRENGTHS Cream, 1%/0.05%. Each gram of clotrimazole and betamethasone dipropionate cream USP, 1%/0.05% (base) contains 10 mg of clotrimazole, USP and 0.64 mg of betamethasone dipropionate, USP (equivalent to 0.5 mg of betamethasone) in a white to off-white cream base. • Cream, 1%/0.05%. ( 3 ) • Each gram of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) contains 10 mg of clotrimazole, and 0.64 mg of betamethasone dipropionate, (equivalent to 0.5 mg of betamethasone) in white to off-white cream base.

( 3 )

Contraindications 8 words

4 CONTRAINDICATIONS None. • None. ( 4 )

⚠️ Warnings and Cautions ~2 min read

5 WARNINGS AND PRECAUTIONS • Clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) can cause reversible HPA axis suppression with the potential for glucocorticosteroid insufficiency during and after withdrawal of the treatment. Risk factor(s) are: use of high-potency topical corticosteroid, use over a large surface area or to areas under occlusion, prolonged use, altered skin barrier, liver failure, and young age. Modify use should HPA axis suppression develop.

( 5.1 , 8.4 ) • Pediatric patients may be more susceptible to systemic toxicity. ( 5.1 , 8.4 ) • The use of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) in the treatment of diaper dermatitis is not recommended. ( 5.2 ) • Topical corticosteroid products may increase the risk of cataracts and glaucoma.

If visual symptoms occur, consider referral to an ophthalmologist. ( 5.3 )

5.1Effects on Endocrine System Clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) can cause reversible hypothalamic-pituitary-adrenal (HPA) axis suppression with the potential for glucocorticosteroid insufficiency. This may occur during treatment or after withdrawal of treatment. Cushing's syndrome and hyperglycemia may also occur due to the systemic effect of corticosteroids while on treatment.

Factors that predispose a patient to HPA axis suppression include the use of high-potency steroids, large treatment surface areas, prolonged use, use of occlusive dressing, altered skin barrier, liver failure, and young age. Because of the potential for systemic corticosteroid effects, patients may need to be periodically evaluated for HPA axis suppression. This may be done by using the adrenocorticotropic hormone (ACTH) stimulation test.

In a small trial, clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) was applied using large dosages, 7 g daily for 14 days (BID) to the crural area of normal adult subjects. Three of the 8 normal subjects on whom clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) was applied exhibited low morning plasma cortisol levels during treatment. One of these subjects had an abnormal cosyntropin test.

The effect on morning plasma cortisol was transient and subjects recovered 1 week after discontinuing dosing. In addition, 2 separate trials in pediatric subjects demonstrated adrenal suppression as determined by cosyntropin testing [see Use in Specific Populations (8.4) ] . If HPA axis suppression is documented, gradually withdraw the drug, reduce the frequency of application, or substitute with a less potent corticosteroid.

Pediatric patients may be more susceptible to systemic toxicity due to their larger skin-surface-to-body mass ratios [see Use in Specific Populations (8.4) ] .

5.2Diaper Dermatitis The use of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) in the treatment of diaper dermatitis is not recommended.

5.3Ophthalmic Adverse Reactions Use of topical corticosteroids may increase the risk of posterior subcapsular cataracts and glaucoma. Cataracts and glaucoma have been reported in postmarketing experience with the use of topical corticosteroid products, including topical betamethasone products [see Adverse Reactions (6.2) ]. Avoid contact of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) with eyes.

Advise patients to report any visual symptoms and consider referral to an ophthalmologist for evaluation.

🤒 Adverse Reactions ~1 min read

6 ADVERSE REACTIONS Most common adverse reactions reported for clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) were paraesthesia in 1.9% of patients and rash, edema, and secondary infections each in less than 1% of patients. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Fougera Pharmaceuticals Inc. at 1-800-645-9833 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

6.1Clinical Trial Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. In clinical trials common adverse reaction reported for clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) was paresthesia in 1.9% of patients. Adverse reactions reported at a frequency < 1% included rash, edema, and secondary infection.

6.2Postmarketing Experience Because adverse reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. The following local adverse reactions have been reported with topical corticosteroids: itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, skin atrophy, striae, miliaria, capillary fragility (ecchymoses), telangiectasia, and sensitization (local reactions upon repeated application of product).

Ophthalmic adverse reactions of blurred vision, cataracts, glaucoma, increased intraocular pressure, and central serous chorioretinopathy have been reported with the use of topical corticosteroids, including topical betamethasone products. Adverse reactions reported with the use of clotrimazole are: erythema, stinging, blistering, peeling, edema, pruritus, urticaria, and general irritation of the skin.

👥 Use in Specific Populations ~3 min read

8 USE IN SPECIFIC POPULATIONS

8.1Pregnancy Risk Summary There are no available data on topical betamethasone dipropionate or clotrimazole use in pregnant women to identify a clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Observational studies suggest an increased risk of low birthweight infants with the use of potent or very potent topical corticosteroid during pregnancy . Advise pregnant women that clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base)may increase the risk of having a low birthweight infant and to use clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) on the smallest area of skin and for the shortest duration possible.

There have been no reproduction studies performed in animals or humans with the combination of clotrimazole and betamethasone dipropionate. In an animal reproduction study, betamethasone dipropionate caused malformations (i.e., umbilical hernias, cephalocele, and cleft palate) in pregnant rabbits when given by the intramuscular route during organogenesis [see Data]. The available data do not allow the calculation of relevant comparisons between the systemic exposure of clotrimazole and/or betamethasone dipropionate observed in the animal studies to the systemic exposure that would be expected in humans after topical use of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base).

The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively.

Data Animal Data Clotrimazole Studies in pregnant rats treated during organogenesis with intravaginal doses up to 100 mg/kg/day revealed no evidence of fetotoxicity due to clotrimazole exposure. No increase in fetal malformations was noted in pregnant rats receiving oral (gastric tube) clotrimazole doses up to 100 mg/kg/day during gestation Days 6 to 15. However, clotrimazole dosed at 100 mg/kg/day was embryotoxic (increased resorptions), fetotoxic (reduced fetal weights), and maternally toxic (reduced body weight gain) to rats.

Clotrimazole dosed at 200 mg/kg/day was maternally lethal, and therefore, fetuses were not evaluated in this group. Also in this study, doses up to 50 mg/kg/day had no adverse effects on dams or fetuses. However, in the combined fertility, embryofetal development, and postnatal development study conducted in rats, 50 mg/kg/day clotrimazole was associated with reduced maternal weight gain and reduced numbers of offspring reared to 4 weeks [see Nonclinical Toxicology (13.1) ].

Oral clotrimazole doses of 25, 50, 100, and 200 mg/kg/day did not cause malformations in pregnant mice. No evidence of maternal toxicity or embryotoxicity was seen in pregnant rabbits dosed orally during organogenesis with 60, 120, or 180 mg/kg/day. Betamethasone Dipropionate Betamethasone dipropionate caused malformations when given to pregnant rabbits during organogenesis by the intramuscular route at doses of 0.05 mg/kg/day.

The abnormalities observed included umbilical hernias, cephalocele, and cleft palates.

8.2Lactation Risk Summary There are no data regarding the excretion of betamethasone dipropionate or clotrimazole into breast milk, the effects on the breastfed infant, or the effects on milk production after topical application to women who are breastfeeding. It is possible that topical administration of betamethasone dipropionate could result in sufficient systemic absorption to produce detectable quantities in human milk. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base)…

🤰 Pregnancy ~2 min read

8.1Pregnancy Risk Summary There are no available data on topical betamethasone dipropionate or clotrimazole use in pregnant women to identify a clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Observational studies suggest an increased risk of low birthweight infants with the use of potent or very potent topical corticosteroid during pregnancy . Advise pregnant women that clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base)may increase the risk of having a low birthweight infant and to use clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) on the smallest area of skin and for the shortest duration possible.

There have been no reproduction studies performed in animals or humans with the combination of clotrimazole and betamethasone dipropionate. In an animal reproduction study, betamethasone dipropionate caused malformations (i.e., umbilical hernias, cephalocele, and cleft palate) in pregnant rabbits when given by the intramuscular route during organogenesis [see Data]. The available data do not allow the calculation of relevant comparisons between the systemic exposure of clotrimazole and/or betamethasone dipropionate observed in the animal studies to the systemic exposure that would be expected in humans after topical use of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base).

The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively.

Data Animal Data Clotrimazole Studies in pregnant rats treated during organogenesis with intravaginal doses up to 100 mg/kg/day revealed no evidence of fetotoxicity due to clotrimazole exposure. No increase in fetal malformations was noted in pregnant rats receiving oral (gastric tube) clotrimazole doses up to 100 mg/kg/day during gestation Days 6 to 15. However, clotrimazole dosed at 100 mg/kg/day was embryotoxic (increased resorptions), fetotoxic (reduced fetal weights), and maternally toxic (reduced body weight gain) to rats.

Clotrimazole dosed at 200 mg/kg/day was maternally lethal, and therefore, fetuses were not evaluated in this group. Also in this study, doses up to 50 mg/kg/day had no adverse effects on dams or fetuses. However, in the combined fertility, embryofetal development, and postnatal development study conducted in rats, 50 mg/kg/day clotrimazole was associated with reduced maternal weight gain and reduced numbers of offspring reared to 4 weeks [see Nonclinical Toxicology (13.1) ].

Oral clotrimazole doses of 25, 50, 100, and 200 mg/kg/day did not cause malformations in pregnant mice. No evidence of maternal toxicity or embryotoxicity was seen in pregnant rabbits dosed orally during organogenesis with 60, 120, or 180 mg/kg/day. Betamethasone Dipropionate Betamethasone dipropionate caused malformations when given to pregnant rabbits during organogenesis by the intramuscular route at doses of 0.05 mg/kg/day.

The abnormalities observed included umbilical hernias, cephalocele, and cleft palates.

🧒 Pediatric Use ~1 min read

8.4Pediatric Use The use of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) in patients under 17 years of age is not recommended. Adverse events consistent with corticosteroid use have been observed in pediatric patients treated with clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base). In open-label trials, 17 of 43 (39.5%) evaluable pediatric subjects (aged 12 to 16 years old) using clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) for treatment of tinea pedis demonstrated adrenal suppression as determined by cosyntropin testing.

In another open-label trial, 8 of 17 (47.1%) evaluable pediatric subjects (aged 12 to 16 years old) using clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) for treatment of tinea cruris demonstrated adrenal suppression as determined by cosyntropin testing. Because of a higher ratio of skin surface area to body mass, pediatric patients are at a greater risk than adults of HPA axis suppression when they are treated with topical corticosteroids. They are, therefore also at greater risk of adrenal insufficiency during and/or after withdrawal of treatment.

Pediatric patients may be more susceptible than adults to skin atrophy, including striae, when they are treated with topical corticosteroids. HPA axis suppression, Cushing's syndrome, linear growth retardation, delayed weight gain, and intracranial hypertension have been reported in pediatric patients receiving topical corticosteroids [see Warnings and Precautions (5.1) ] . Avoid use of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) in the treatment of diaper dermatitis.

🧓 Geriatric Use 109 words

8.5Geriatric Use Clinical studies of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. However, greater sensitivity of some older individuals cannot be ruled out. The use of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) under occlusion, such as in diaper dermatitis, is not recommended.

Postmarket adverse event reporting for clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) in patients aged 65 and above includes reports of skin atrophy and rare reports of skin ulceration. Caution should be exercised with the use of these corticosteroid-containing topical products on thinning skin .

🧬 Clinical Pharmacology ~2 min read

12 CLINICAL PHARMACOLOGY

12.1Mechanism of Action Clotrimazole is an azole antifungal [see Clinical Pharmacology (12.4) ] . Betamethasone dipropionate is a corticosteroid. Corticosteroids play a role in cellular signaling, immune function, inflammation, and protein regulation; however, the precise mechanism of action for the treatment of tinea pedis, tinea cruris and tinea corporis is unknown.

12.2Pharmacodynamics Vasoconstrictor Assay Studies performed with clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) indicate that these topical combination antifungal/corticosteroids may have vasoconstrictor potencies in a range that is comparable to high-potency topical corticosteroids. However, similar blanching scores do not necessarily imply therapeutic equivalence.

12.3Pharmacokinetics Skin penetration and systemic absorption of clotrimazole and betamethasone dipropionate following topical application of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) has not been studied. The extent of percutaneous absorption of topical corticosteroids is determined by many factors, including the vehicle, the integrity of the epidermal barrier, and the use of occlusive dressings . Topical corticosteroids can be absorbed from normal intact skin.

Inflammation and/or other disease processes in the skin may increase percutaneous absorption of topical corticosteroids. Occlusive dressings substantially increase the percutaneous absorption of topical corticosteroids [see Dosage and Administration (2) ] . Once absorbed through the skin, the pharmacokinetics of topical corticosteroids are similar to systemically administered corticosteroids.

Corticosteroids are bound to plasma proteins in varying degrees. Corticosteroids are metabolized primarily in the liver and are then excreted by the kidneys. Some of the topical corticosteroids and their metabolites are also excreted into the bile.

12.4Microbiology Mechanism of Action Clotrimazole, an azole antifungal agent, inhibits 14-α-demethylation of lanosterol in fungi by binding to one of the cytochrome P-450 enzymes. This leads to the accumulation of 14-α-methylsterols and reduced concentrations of ergosterol, a sterol essential for a normal fungal cytoplasmic membrane. The methylsterols may affect the electron transport system, thereby inhibiting growth of fungi.

Activity In Vitro and In Vivo Clotrimazole has been shown to be active against most strains of the following dermatophytes, both in vitro and in clinical infections, Epidermophyton floccosum , Trichophyton mentagrophytes , and Trichophyton rubrum [see Indications and Usage (1) ]. Drug Resistance Strains of dermatophytes having a natural resistance to clotrimazole have not been reported. Resistance to azoles, including clotrimazole, has been reported in some Candida species.

No single-step or multiple-step resistance to clotrimazole has developed during successive passages of Trichophyton mentagrophytes .

🧬 Mechanism of Action 52 words

12.1Mechanism of Action Clotrimazole is an azole antifungal [see Clinical Pharmacology (12.4) ] . Betamethasone dipropionate is a corticosteroid. Corticosteroids play a role in cellular signaling, immune function, inflammation, and protein regulation; however, the precise mechanism of action for the treatment of tinea pedis, tinea cruris and tinea corporis is unknown.

📦 How Supplied / Storage and Handling 51 words

16 HOW SUPPLIED/STORAGE AND HANDLING Clotrimazole and Betamethasone Dipropionate Cream USP, 1%/0.05% (base) is supplied as follows: NDC 0168-0258-15, 15 gram tubes NDC 0168-0258-46, 45 gram tubes Store at 20° to 25°C (68° to 77°F); excursions permitted to 15° to 30°C (59° to 86°F) [see USP Controlled Room Temperature]. Rx only

📦 Storage and Handling 46 words

Clotrimazole and Betamethasone Dipropionate Cream USP, 1%/0.05% (base) is supplied as follows: NDC 0168-0258-15, 15 gram tubes NDC 0168-0258-46, 45 gram tubes Store at 20° to 25°C (68° to 77°F); excursions permitted to 15° to 30°C (59° to 86°F) [see USP Controlled Room Temperature]. Rx only

📋 Description 160 words

11 DESCRIPTION Clotrimazole and betamethasone dipropionate cream USP, 1%/0.05% (base) contains combinations of clotrimazole, an azole antifungal, and betamethasone dipropionate, a corticosteroid, for topical use. Chemically, clotrimazole is 1–(o-chloro-α,α-diphenylbenzyl) imidazole, with the molecular formula C 22 H 17 CLN 2 , a molecular weight of 344.84, and the following structural formula: Clotrimazole is an odorless, white crystalline powder, insoluble in water and soluble in ethanol. Betamethasone dipropionate has 9-fluoro-11β,17,21-trihydroxy-16β-methylpregna-1,4-diene-3,20-dione 17,21-dipropionate, with the molecular formula C 28 H 37 FO 7 , a molecular weight of 504.59, and the following structural formula: Betamethasone dipropionate is a white to creamy-white, odorless crystalline powder, insoluble in water.

Each gram of clotrimazole and betamethasone dipropionate cream USP, 1%/0.05% (base) contains 10 mg clotrimazole, USP and 0.64 mg betamethasone dipropionate, USP (equivalent to 0.5 mg betamethasone), in a hydrophilic cream consisting of purified water, mineral oil, white petrolatum, cetostearyl alcohol, ceteareth-30, propylene glycol, monobasic sodium phosphate monohydrate, and benzyl alcohol as a preservative. ChemicalStructure ChemicalStructure

💬 Information for Patients ~2 min read

17 PATIENT COUNSELING INFORMATION Advise the patient to read the FDA-approved patient labeling ( Patient Information ). Inform the patient of the following: Pregnancy Advise pregnant women that clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) may increase the risk of having a low birthweight infant and to use clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) on the smallest area of skin and for the shortest duration possible [see Use in Specific Populations (8.1) ] . Lactation Advise a woman to use clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) on the smallest area of skin and for the shortest duration possible while breastfeeding.

Advise breastfeeding women not to apply clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) directly to the nipple and areola to avoid direct infant exposure [see Use in Specific Populations (8.2) ]. Important Administration Instructions Inform patients of the following: • Use clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base)as directed by the physician. It is for external use only. • Avoid contact with the eyes, the mouth, or intravaginally. • Advise patients to report any visual symptoms to their healthcare providers. • Do not use clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) on the face or underarms. • Do not use more than 45 grams of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) per week. • When using clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) in the groin area, patients should use the medication for 2 weeks only, and apply the cream sparingly.

Patients should wear loose-fitting clothing. Notify the physician if the condition persists after 2 weeks. • Do not use clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) for any disorder other than that for which it was prescribed. • Do not bandage, cover or wrap the treatment area unless directed by the physician. Avoid use of clotrimazole and betamethasone dipropionate cream, 1%/0.05% (base) in the diaper area, as diapers or plastic pants may constitute occlusive dressing. • Report any signs of local adverse reactions to the physician.

Advise patients that local reactions and skin atrophy are more likely to occur with occlusive use or prolonged use. • This medication is to be used for the full prescribed treatment time, even though the symptoms may have improved. Notify the physician if there is no improvement after 1 week of treatment for tinea cruris or tinea corporis, or after 2 weeks for tinea pedis. E.

FOUGERA & CO. A division of Fougera PHARMACEUTICALS INC. Melville, New York 11747 46254616A R08/19 #52

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
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