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clotrimazole + betamethasone (Flotiran / Lotrisone / Lotricomb)

✓ Approved

Merck & Co. · NR3C1 · Small Molecule

What is clotrimazole + betamethasone?

clotrimazole + betamethasone is a small molecule developed by Merck & Co.. It is approved for therapeutic indications via unknown.

Drug Profile

Brand NamesFlotiran, Lotrisone, Lotricomb
CompanyMerck & Co.
Drug ClassSmall Molecule
Molecular TargetNR3C1,
RouteUnknown
StatusApproved
Sources: ClinicalTrials.gov, Merck & Co.

Mechanism of Action

Molecular Targets

clotrimazole + betamethasone acts on 2 molecular targets:

NR3C1nuclear receptor subfamily 3 group C member 1 (GR, GCCR)
sterol demethylase, Candida albicans (ERG11)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

clotrimazole + betamethasone is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Infections and infestationsWound infection fungal✓ Approved

Related Research Articles

PubMedCureus2026-09-20

Vulvovaginal Candidiasis in Pregnancy: Species Distribution and Antifungal Resistance Patterns to Commonly Used Topical Azoles at a Tertiary Care Center in Central India.

Bhadade Arati A AA, Karuna Tadepalli T, Singh Bharti B, Ramani Anirban A et al.

Vulvovaginal candidiasis (VVC) is a common fungal infection during pregnancy. Topical azoles, including clotrimazole and miconazole, are recommended as first-line therapy; however, data on the distribution of Candida species and their in vitro susceptibility to these agents remain limited. This study aimed to determine the species distribution of Candida causing VVC in pregnant women and evaluate the in vitro activity of clotrimazole and miconazole. This six-month observational cross-sectional study was conducted at a tertiary care center in Central India. High vaginal swabs were collected from 108 symptomatic pregnant women and examined by direct microscopy and culture. Candida isolates were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antifungal susceptibility testing for clotrimazole and miconazole was performed using the Etest method. Minimum inhibitory concentration (MIC) values were analyzed descriptively because clinical breakpoints (CBPs) and epidemiological cutoff values (ECVs) for these topical azoles were unavailable. Descriptive statistics included frequencies, percentages, mean, median, mode, and MIC ranges. Candida species were isolated from 45 of 108 pregnant women (41.67%). Candida albicans was the predominant isolate (36/45, 80.0%), followed by Nakaseomyces glabrata (4/45, 8.89%), Candida tropicalis (2/45, 4.44%), Pichia kudriavzevii (1/45, 2.22%), Candida parapsilosis (1/45, 2.22%), and Candida lusitaniae (1/45, 2.22%). Clotrimazole demonstrated lower MIC values than miconazole. Higher MIC values (>32 µg/mL), indicating reduced in vitro activity, were observed in nine (25.0%) Candida albicans isolates with miconazole, compared with one (2.78%) with clotrimazole. Candida albicans remained the predominant cause of VVC among pregnant women. Clotrimazole demonstrated lower MIC values than miconazole in this study, indicating greater in vitro activity based on the observed MIC distribution. Continued surveillance of antifungal susceptibility patterns and the establishment of validated CBPs for topical azoles against Candida species are essential for improving understanding of emerging antifungal resistance and supporting evidence-based management of VVC.

PMID 42763638
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PubMedCureus2026-09-19

Incidence and Time to Onset of Pseudophakic Cystoid Macular Edema (Irvine-Gass Syndrome) After 1,325 Consecutive Cataract Surgeries Performed by a Single Surgeon Over Four Years.

Matsuo Toshihiko T, Nakago-Matsuo Chie C

Objectives Macular edema after cataract surgery is known as pseudophakic cystoid macular edema or Irvine-Gass syndrome. The aim of this study was to determine the incidence and time to onset of cystoid macular edema after uncomplicated cataract surgery. Methods  A retrospective review was conducted of 1,325 consecutive cataract surgeries performed by a single surgeon at a single institution over four years, from January 2022 to December 2025. Results Among 1,325 eyes, one or more macular cysts were detected by optical coherence tomography in 27 eyes (2.0%) of 22 patients who complained of blurred vision or decreased visual acuity after having no symptoms immediately after surgery. The 22 patients (27 eyes: 12 right and 15 left) comprised 12 men and 10 women. Their ages at the time of surgery ranged from 57 to 82 years, with a median of 75.5 years. Of the 27 eyes that developed macular cysts, 13 eyes with no preoperative or intraoperative risk factors for inflammation received topical 0.1% bromfenac twice daily as the only postoperative anti-inflammatory treatment, together with topical antibacterial 0.5% moxifloxacin four times daily. In contrast, the remaining 14 eyes, which had risk factors for inflammation, such as exfoliation, floppy iris, poor mydriasis, extracapsular cataract extraction, or diabetes mellitus, received topical bromfenac twice daily and 0.1% betamethasone (or 0.1% fluorometholone in two eyes) four times daily, as well as topical moxifloxacin. The time from surgery to the diagnosis of macular cysts ranged from one week to eight months, with a median of two weeks, in the 13 eyes treated with topical bromfenac only. In the 14 eyes treated with the combination of topical bromfenac and betamethasone, the time to diagnosis ranged from two weeks to 13 months, with a median of two months. In 26 of the 27 eyes, the macular cysts disappeared and visual acuity returned to normal without residual symptoms within two weeks to seven months, with a median of one month, after topical betamethasone four times daily was initiated or resumed. Conclusions  Pseudophakic macular cysts developed during the postoperative course in eyes with no preoperative or intraoperative risk factors that received topical bromfenac alone. They also developed later in the postoperative course after the combination of topical bromfenac and betamethasone was discontinued in eyes with risk factors for inflammation. The macular cysts disappeared following the initiation or resumption of topical betamethasone, accompanied by recovery of visual acuity and resolution of symptoms.

PMID 42762026
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PubMedAnalytica chimica acta2026-09-19

Surfactant deep eutectic solvents for extraction and HPLC-PDA analysis of antipsoriatic drugs in spiked water and lipophilic topical matrices.

Alamir Samy G SG, Magdy Nancy N, Ibrahim Adel Ehab AE, Hussein Lobna A LA et al.

Deep eutectic solvents (DESs) have garnered attention in various disciplines due to their unique properties. In this work, different surfactants were screened as hydrogen-bond acceptors in combination with structurally related phenols as hydrogen-bond donors (HBDs), and successful and unsuccessful pairings were discussed. Literature on successfully paired surfactants was also reviewed. Nevertheless, the screening results and reported classifications, together with the observed aqueous behavior and variable extraction performance across different matrices, prompted further investigation of composition-behavior relationships of these systems. Five surfactant-phenolic DESs were synthesized by mixing o-cresol (CRS) or catechol with dodecyltrimethylammonium bromide (DTAB), cetyltrimethylammonium bromide (CTAB), or Brij35 at 75.0 °C for 30.0 min. Although more hydrophobic HBDs were used than in previous studies, the resulting DESs displayed transient aqueous dispersion after vortexing and subsequently re-separated on standing. Their viscosity (64.21-1389 mPa s) and conductivity (1.00-447.00 μS/cm) also varied. 1H/13C nuclear magnetic resonance and Fourier-transform infrared spectroscopy indicated hydrogen bonding between phenolic hydroxyl groups and bromide/ether acceptors, with features suggesting π-cation association in cationic-surfactant systems. To probe their practicality, a high-performance liquid chromatography method with photodiode array detection was developed for betamethasone valerate, halobetasol propionate, fusidic acid, and tazarotene, achieving separation within 6 min, and compared with five reported chromatographic methods. Validation per the International Council for Harmonisation Q2 (R1) guidelines demonstrated linearity (R2 0.9997-0.9999), accuracy (98.2-102.4%), and precision (≤2.0%), with robustness evaluated through experimental design. Brij35-based systems showed reduced extraction recoveries for lipophilic topical formulations. After additional screening, CRSCTAB and CRSDTAB DESs were used with spiked water samples as a hydrophilic proof-of-concept matrix, employing salting-out-assisted liquid-liquid microextraction using ammonium acetate. The results suggest provisional amphiphilic-like rather than conventional hydrophobic-DES behavior; however, thermal phase diagrams, equilibrium water-solubility measurements, and broader thermodynamic investigations remain necessary before any formal reclassification.

PMID 42763156
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PubMedTherapeutic advances in musculoskeletal disease2026-09-18

Predictors of intramuscular glucocorticoid bridge therapy failure in rheumatoid arthritis: a real-world observational study.

Xie Wenhui W, Gao Dai D, Huang Hong H, Zhang Zhuoli Z

Intramuscular glucocorticoid (GCs) bridge therapy is an equivalently recommended bridging strategy to oral GCs for rheumatoid arthritis (RA) under predefined tapering and discontinuation schemes. We aimed to investigate the risk factors of intramuscular GCs bridge therapy failure in RA. A retrospective analysis of collected data on RA patients initiating intramuscular betamethasone as bridging therapy. In this longitudinal real-world cohort study, 153 RA patients initiating intramuscular betamethasone as bridging therapy combined with csDMARDs (without concurrent biologics/JAK inhibitors) were included. Bridging strategy success under required: (1) GCs discontinuation within 3 months; (2) remission or low disease activity at discontinuation; (3) sustained control without short-term relapse post-discontinuation; (4) no transition to oral GCs and no initiation of b/tsDMARDs during the bridging period. Failure encompassed all other outcomes. Independent predictors were identified via multivariate logistic regression. Among 153 patients receiving intramuscular betamethasone as bridging therapy, 94 (61.4%) experienced bridge therapy failure versus 59 (38.6%) successes. The most common mode for bridging therapy failure was transition to oral GCs (n = 47). The failure group exhibited persistently higher disease activity over 12 months (p < 0.001). Disease activity at intramuscular GCs initiation was significantly elevated in the failure group (median Clinical Disease Activity Index (CDAI): 23.0 (14.8-34.0) vs 13.0 (8.0-22.0), p < 0.001). Multivariate analysis confirmed higher CDAI (OR = 1.05 per unit, 95% CI 1.02-1.10, p = 0.003) and concomitant leflunomide use at GCs initiation (OR = 2.78, 95% CI 1.22-6.25, p = 0.020) as independent failure predictors. High disease activity and concurrent leflunomide use at GCs initiation independently predict failure of intramuscular GCs bridge therapy in RA. Early risk stratification may optimize induction therapy selection and potentially improve bridge therapy success rates.

PMID 42756649
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PubMedTherapeutic advances in musculoskeletal disease2026-09-13

Bridging with a single glucocorticoid injection in psoriatic arthritis: Real-world evidence of short-term effectiveness, safety, and enhanced response in high-inflammatory burden patients.

Chen Yuan Y, Shang Yajie Y, Zhang Xiaohui X, Xie Wenhui W et al.

The use of adjunctive systemic glucocorticoids (GC) as bridging therapy in psoriatic arthritis (PsA) remains controversial due to limited disease-specific evidence and safety concerns. Although clinical experience suggests potential benefits in selected patients, clear criteria for appropriate use are lacking. The unique pharmacokinetic profile of intramuscular compound betamethasone offers a bridging strategy but has been insufficiently studied. To investigate the real-world effectiveness and safety of single intramuscular GC injection as a bridging therapy for active PsA, and identify clinical characteristics associated with greater therapeutic response. A retrospective observational comparative study using longitudinal clinical data. Data were derived from the PKUPsA cohort. Patients receiving a single intramuscular compound betamethasone injection alongside background disease-modifying antirheumatic drugs (DMARDs) were compared with controls not receiving GC. Changes in disease activity, patient-reported outcomes, and adverse events were assessed at 1 month and over 6 months. Negative binomial regression and interaction analysis were used to assess treatment effects and explore differential responses. Of 183 enrolled patients (81 GC, 102 control), the GC group showed higher baseline tender joint count (TJC), Disease Activity in Psoriatic Arthritis (DAPSA), ESR and CRP, but lower Psoriasis Area and Severity Index (PASI). At month 1, the GC group demonstrated greater SJC improvements (ΔSJC: 1 [0 to 2] vs. 0 [0 to 1], P=0.02). Adjusted negative binomial regression confirmed a conditional effect of GC on SJC at month 1, with Johnson-Neyman analysis indicating significance at baseline SJC > 6.6. Treatment benefits were consistent across subgroups and sustained over 6 months. Reported adverse events, including transient PASI increases, were not attributed to GC. A single-dose intramuscular injection of compound betamethasone may provide articular improvements with a favorable short-term safety profile. Greater benefits in patients with high-inflammatory burden support its role as a bridging therapy.

PMID 42732267
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PubMedJournal of foot and ankle research2026-09-13

Corticosteroid Injection Practices of Australian Podiatrists for Common Foot and Ankle Conditions.

Couesnon Christopher B CB, Cotchett Matthew M, Blood Naomi N, Whittaker Glen A GA

Corticosteroid injections are commonly used to manage foot and ankle conditions; however, there is limited evidence guiding corticosteroid selection, dosing, imaging guidance and injection techniques. This study aimed to describe current corticosteroid injection practices among Australian podiatrists and podiatric surgeons. A descriptive cross-sectional survey was distributed via REDCap to Australian podiatrists and podiatric surgeons endorsed to prescribe scheduled medicines. The questions were developed using an iterative process and focused on demographic and professional characteristics, administrative factors and injection practices for plantar fascia, intermetatarsal and intra-articular injections. The survey was conducted between January 2025 and April 2026 and reported according to the Consensus-Based Checklist for Reporting of Survey Studies (CROSS). Descriptive statistics were used to summarise injection practices for plantar fascia, intermetatarsal and intra-articular injections. Forty-five people participated in the study, and 33 completed the survey in full. Participants had a mean of 17.1 years in practice and 9.6 years administering corticosteroid injections. Most participants were endorsed podiatrists (64%), with the remainder being podiatric surgeons (33%). Participants reported administering a mean maximum of three corticosteroid injections per patient annually and recommending a mean interval of 3 months between injections. Betamethasone 5.7 mg/mL was the most common corticosteroid across all injection sites and was frequently combined with ropivacaine or bupivacaine. Ultrasound guidance was used by 50% of participants for plantar fascia injections, 39% for intermetatarsal injections and 46% for intra-articular injections. Symptom relief was perceived to last between 3 and 6 months, whereas adverse effects were recalled to be infrequent and most commonly included steroid flare and post-injection pain. Australian podiatrists and podiatric surgeons reported consistency in some corticosteroid injection practices and variability in others. These findings provide an initial descriptive benchmark of corticosteroid injection practice in Australian podiatry and may inform future clinical guidelines and research.

PMID 42728771
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