Introduction About QUADRILINE CREAM

QUADRILINE CREAM is a combination of Betamethasone, Clotrimazole and Neomycin which belongs to the group of medicines called Anti-inflammatory, Antifungal and Antibiotic. It is used for the symptomatic management of inflammatory and allergic diseases such as chronic dermatitis of extremities (skin inflammation of hands and feet), balanoposthitis (inflammation of foreskin and head of the penis), eczematoid dermatitis (dry, itchy, inflamed skin), contact dermatitis (itchy rash), follicular dermatitis (inflammation of hair follicles), nonspecific pruritis (itching), parakeratosis, anal itching, intertrigo (skin inflammation of groin or between skin folds).

QUADRILINE CREAM is also used for the management of  impetigo (red sores on the face), neurodermatitis (skin condition characterized by chronic itching and scaling), angular stomatitis (red swollen patches in the corners of the mouth), photosensitivity dermatitis (abnormal reaction to sunlight), dermatitis (skin inflammation), lichenified inguinal dermatophytosis (fungal infection of groins), tinea corporis (ringworm or fungal infection of the body), tinea cruris (fungal  infection of the groins, inner thighs), tinea pedis (fungal infection of the feet) and candidiasis (fungal skin infection).

QUADRILINE CREAM is not recommended for use if you have viral infections (herpes or chickenpox), acne or rosacea (skin condition affecting the face) and inflammation of skin around the mouth, nappy rash. Contact your doctor before applying it.

QUADRILINE CREAM should be used in pregnant women only if it is considered clearly necessary. It should be used with caution in breastfeeding women. Contact your doctor before applying it.

QUADRILINE CREAM is not recommended for use in children under 12 years of age. The most common side effects of using QUADRILINE CREAM are burning, irritation, tingling or stinging sensation, dry skin, pimple-like bumps, tenderness & flaking of the managed skin. Contact your physician if any of the symptoms worsen.

Uses Of QUADRILINE CREAM

Manage:

• chronic dermatitis of extremities
• balanoposthitis
• eczematoid dermatitis
• contact dermatitis, follicular dermatitis
• nonspecific pruritis
• parakeratosis
• anal pruritis
• intertrigo
• impetigo
• neurodermatitis
• angular stomatitis
• photosensitivity dermatitis
• dermatitis
• lichenified inguinal dermatophytosis
• tinea corporis, tinea cruris, tinea pedis
• candidiasis

How QUADRILINE CREAM Works

QUADRILINE CREAM helps to manage infection, where Betamethasone is an anti-inflammatory which blocks the production of certain chemical messengers (prostaglandins) that make the skin red, swollen and itchy. Clotrimazole is an antifungal which stops the growth of fungi while Neomycin is an antibiotic which stops the growth of bacteria in the skin. Together, manages skin infection effectively.

How to use QUADRILINE CREAM

Apply QUADRILINE CREAM as directed by your physician. It is for external use only. Clean and dry the skin area to be managed. Apply a thin layer of the medicine to the affected area of the skin and rub it gently. Wash your hands after using unless you are using this medication to manage the hands.

Do not cover or wrap, bandage the skin unless directed by the doctor. Wear loose-fitting clothes after applying the medication to the groin area. Avoid contact with the eyes, nose, mouth or inside the vagina. If you do get the medication in those areas, wash with plenty of water.

Side Effects Of QUADRILINE CREAM

How To Manage Side Effects

Itchy skin:

Avoid hot bath because hot water can irritate your skin further. Do not scratch the affected area. Use sunscreen and wear protective clothing while going outside. Use unscented moisturizers to soothe and hydrate the affected area. Contact your doctor if itching worsen.

Headache:

Rest and relax. Drink plenty of fluids such as water or ORS (Oral Rehydrating Solution) and apply a pain-relieving balm on the head if necessary. Contact your doctor if your headache did not improve.

Warning & Precautions

Pregnancy

QUADRILINE CREAM should be used in pregnant women only if it is considered clearly necessary. Contact your doctor before applying QUADRILINE CREAM.

Breastfeeding

QUADRILINE CREAM should be used with caution in breastfeeding women as it may pass through the breast milk. Contact your doctor before applying QUADRILINE CREAM.

Allergy

Do not apply QUADRILINE CREAM if you are allergic to Betamethasone, Clotrimazole, Neomycin or to other corticosteroids or imidazoles or to other ingredients of this medicine.

Interactions

A. Drug-Drug interactions:

Before applying QUADRILINE CREAM, inform your doctor if you are taking any of the following medicines:

• amphotericin B (medicines used for fungal infections)
• carbamazepine, phenytoin (medicines used to manage fits)
• lofexidine (used to manage opioid withdrawal symptoms)
• oxandrolone (used to promote muscle tissue)
• perindopril, Aliskiren, metyrosine (medicines used for high blood pressure)
• rifampicin (used to manage tuberculosis)
• acarbose (used to manage diabetes mellitus)
• atracurium, doxacurium, pancuronium (medicines used in anaesthesia)
• digoxin (used for heart failure)
• fluorouracil, methotrexate (medicines used to manage cancer)
• gentamycin (used to manage bacterial infections)
• cyanocobalamin, hydroxocobalamin, mecobalamin (vitamin supplements) 
• gestodene, contraceptives (medicines used to manage pregnancy)

Overdosage:

If you or anyone else accidentally use too much of QUADRILINE CREAM or if you or a child accidentally swallow the medicine, consult your doctor immediately or visit the nearby hospital. Overdosage of QUADRILINE CREAM can supress hypothalamic pituitary-adrenal function resulting in secondary adrenal insufficiency (deficiency of Adrenocorticotrophic hormone) and produce symptoms of hypercorticism including Cushing disease (a condition in which too much cortisol hormone in the body).

Synopsis

More Information

• Keep QUADRILINE CREAM out of reach of children
• Store QUADRILINE CREAM below 30°C

FAQs About QUADRILINE CREAM

Q: How often can I use QUADRILINE CREAM?

A: Apply QUADRILINE CREAM as directed by your physician. It is for external use only. Clean and dry the skin area to be managed. Apply a thin layer of the medicine to the affected area of the skin and rub it gently, usually twice daily (in the morning and evening) or as directed by your doctor.

Q: How long can I use QUADRILINE CREAM?

A: The dosage and length of management with QUADRILINE CREAM depends on the type of infection being managed. Ringworm or jock itch is usually managed for 2 weeks and athlete's foot is usually managed for 4 weeks. Do not use more than prescribed amount of cream unless directed and closely monitored by your doctor. Do not apply more often or use longer than prescribed. This may increase the risk of side effects of QUADRILINE CREAM.

Q: Can I stop using QUADRILINE CREAM if my symptoms improve?

A: Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day. Continue to use this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the QUADRILINE CREAM too early may result in a return of the infection. Inform your doctor if your condition worsens or does not improve after 1 week of management for jock itch or ringworm or 2 weeks of management for athlete's foot.

Q: What precautions have to be taken while using QUADRILINE CREAM?

A: QUADRILINE CREAM should not be used on the face and contact with eyes should be avoided. Do not apply a bandage or dressing on the area being managed, as this will increase absorption of the medicine and increase the risk of side-effects. QUADRILINE CREAM should only be used for the condition it is prescribed for. Do not use QUADRILINE CREAM for any other condition without consulting your doctor. Do not give it to other people even if their condition appears to be the same.

Q: What are the possible side effects of applying QUADRILINE CREAM?

A: The most common side effects of using QUADRILINE CREAM are burning, irritation, tingling or stinging sensation, dry skin, pimple-like bumps, tenderness & flaking of the managed skin. Contact your physician if any of the symptoms worsen.

Q: Does QUADRILINE CREAM cause growth retardation?

A: Do not use QUADRILINE CREAM in children under 12 years of age unless advised by your doctor. If you use more than the prescribed amount of QUADRILINE CREAM or when you use it for longer than is recommended, it can affect your child’s hormones. Rarely this may lead to delayed growth and development, a moon face or rounding of the face, a build-up of pressure around the brain which can produce a bulging of the fontanelle (the soft spot in the top of the skull) in infants, a constant thumping headache and blurred vision or other visual disturbances. Contact your doctor before applying QUADRILINE CREAM.

References

1. K.D. Tripathi. Corticosteroids, Antifungal drugs & Aminoglycoside Antibiotics. Essentials of medical pharmacology. Seventh edition. 2013. Page – 289,792, 750.

2. Bethesda (MD). Betamethasone. NIH National Library of Medicine, National Center for Biotechnology Information. PubChem Compound Summary. 2004. [Accessed on 21st June 2022] https://pubchem.ncbi.nlm.nih.gov/compound/9782

3. Bethesda (MD). Clotrimazole. NIH National Library of Medicine, National Center for Biotechnology Information. PubChem Compound Summary. 2004. [Accessed on 21st June 2022] https://pubchem.ncbi.nlm.nih.gov/compound/2812

4. Osworth Nigeria ltd. Betamethasone, Clotrimazole, Neomycin. [Accessed on 21st June 2022] https://www.nafdac.gov.ng/wp-content/uploads/Files/SMPC/Jan2_2022/Clotrimazole-Betamethasone-Neomycin-Cream.pdf

5. S Kant Healthcare Ltd. Betamethasone, Clotrimazole, Neomycin. [Accessed on 21st June 2022] https://www.nafdac.gov.ng/wp-content/uploads/Files/SMPC/a_v5/MEDIZONE-SmPC.pdf

6. Milan Laboratories (India) Pvt. Ltd. Betamethasone, Clotrimazole, Neomycin. [Revised in September2017] [Accessed on 21st June 2022] https://fdaghana.gov.gh/img/smpc/Milzol%20Plus%20Topical%20Cream%20(Clotrimazole,%20Betamethasone%20Dipropionate,%20Neomycin%20sulfate,%20Chlorocresol).pdf

7. Milan Laboratories (India) Pvt. Ltd. Betamethasone, Clotrimazole, Neomycin. [Accessed on 21st June 2022] https://fdaghana.gov.gh/img/pils/MILZOL%20PLUS%20(Triple%20Action%20Cream).pdf

8. Ceoderm (Betamethasone, Clotrimazole, Neomycin). Leeford.in. [Accessed on 21st June 2022] https://www.leeford.in/product/1248/ceoderm

Useful Diagnostic Tests

• ACTH stimulation
• Plasma cortisol
• Urinary free cortisol