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    Clobetasol Foam

    Drug - Clobetasol Foam 0.05%

    March 2009

    AVAILABLE AS: Olux, Olux E, Olux-E Complete Pack and generic clobetasol foam
    Medication Class: topical corticosteroid - very high potency
    DFC review date: 02/02/09

    Both Brand and generic formulations of Clobetasol Foam are prior authorized.
    Clobetasol foam is available as both brand and generic.
    Olux-E is available only as a branded product.

    Brand Names                              Generic name
    Clobex                                          clobetasol propionate
    Olux
    Olux-Olux-E
    Olux-E

    Criteria

    • Patient is 12 years of age or older
    • Patient has a clinically documented corticosteroid‐responsive dermatoses (e.g., atopic dermatitis, plaque psoriasis, eczema)
    • Must have tried for a minimum of 2 weeks and failed a less potent corticosteroid and at least one other very high potency corticosteroid (see Addendum) OR
    • Have dermatoses of the scalp and other dosage forms (solution, shampoo) have not been effective

    Maximum 100 grams allowed per prescription

    • Total dosage should not exceed 50 gm per week because of the potential for the drug to suppress the hypothalamic-pituitary-adrenal (HPA) axis
    • Maximum duration of therapy should not exceed 2 consecutive weeks. In a controlled pharmacokinetic study, some subjects experienced reversible suppression of the adrenal glands following 14 days of Olux Foam therapy

    Rationale

    Clobetasol propionate foam, either brand or generic, is the most expensive very high potency corticosteroid by about 20 times.

    GENERIC NAME COMPARES TO
    CLASS 1 – Very High Potency
    Betamethasone dipropionate Diprolene Ointment, 0.05%
    Clobetasol propionate Clobex Lotion/Spray/Shampoo, 0.05%
    Cormax Cream/Solution, 0.05%
    Olux E Foam, 0.05%, Olux Foam, 0.05%;-- prior authorized
    Temovate Cream/Ointment/Solution, 0.05%
    Diflorasone diacetate Psorcon ointment, 0.05%; Psorcon E ointment, 0.05%
    Fluocinonide Vanos Cream, 0.1%
    Halobetasol propionate Ultravate Cream/Ointment, 0.05%
    CLASS 2 - Potent
    Betamethasone dipropionate Diprolene Cream AF, 0.05%
    Desoximetasone Topicort Cream/Ointment, 0.25%; Topicort Gel, 0.05%
    Diflorasone diacetate Florone Ointment, 0.05%; Psorcon Cream 0.05%
    Fluocinonide Lidex Cream/Gel/Ointment, 0.05%
    Halcinonide Halog Ointment/Cream, 0.1%
    Mometasone furoate Elocon Ointment, 0.1%
    CLASS 3- Upper Mid-Strength
    Betamethasone valerate Luxiq Foam, 0.12%
    Desoximetasone Topicort LP Cream, 0.05%
    Fluocinonide Lidex-E Cream, 0.05%
    Fluticasone propionate Cutivate Ointment, 0.005%
    CLASS 4 – Mid Strength
    Fluocinolone acetonide Synalar Ointment, 0.03%
    Flurandrenolide Cordran Ointment, 0.05%
    Hydrocortisone valerate Westcort Ointment, 0.2%
    Mometasone furoate Elocon Cream, 0.1%
    Triamcinolone acetonide Kenalog Cream/Spray, 0.1%
    CLASS 5 – Lower Mid Strength
    Desonide DesOwen Lotion, 0.05%
    Fluocinolone acetonide Capex Shampoo, 0.01%; Synalar Cream, 0.03/0.01%
    Flurandrenolide Cordran Cream/Lotion/Tape, 0.05%
    Fluticasone propionate Cutivate Cream/Lotion, 0.05%
    Hydrocortisone Locoid Cream/Lotion/Ointment/Solution, 0.1%; generics
    Hydrocortisone valerate Westcort Cream, 0.2%
    Prednicarbate DermAtop Cream, 0.1%
    CLASS 6 -Mild
    Alclometasone dipropionate Aclovate Cream/Ointment, 0.05%
    Desonide Desonate gel, 0.05%
    Desonide Verdeso Foam, 0.05%
    Alclometasone dipropionate Aclovate Cream/Ointment, 0.05%
    Fluocinolone acetonide Derma-Smoothe/FS Oil, 0.01%; Synalar Cream/Solution, 0.01%

    Least potent not listed

    Questions?

    MHCP Provider Call Center 651-431-2700 or 800-366-5411

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