The drug Duobrii (Halobetasol and Tazarotene) combines a retinoid and a topical corticosteroid with significant efficacy. Plaque psoriasis patients utilise it as a topical therapy.
Halobetasol and Tazarotene Uses:
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Plaque psoriasis:
- Adults with plaque psoriasis should use it to treat the condition.
Duobrii (Halobetasol and Tazarotene) Dose in Adults
Duobrii (Halobetasol and Tazarotene) Dose in the therapy of Plaque psoriasis:
- Topical:
- Apply a thin layer of the lotion to the affected areas once a day.
- The total dosage should not exceed 50 gms per week.
- The treatment should be discontinued when control is achieved.
Use in Children:
Not indicated.
Pregnancy Risk Category: X
- Tazarotene should not be used during pregnancy. Before starting treatment, it is important to evaluate pregnant women with reproductive potential.
- Within two weeks of treatment starting, females must have a negative pregnancy test.
- Female patients who are susceptible to becoming pregnant should use appropriate contraception.
Use of halobetasol or tazarotene during breastfeeding
- Breastmilk can excrete systemic corticosteroids. It is unknown if tazarotene gets excreted in breastmilk.
- While breastfeeding, it should not be applied directly to the breasts or nipples.
- It is recommended that you use it with caution, considering the potential benefits to the mother as well as the possible risks for the infant.
Dose in Kidney disease:
There are no dosage adjustments provided in the manufacturer's labeling.
Dose in Liver disease:
There are no dosage adjustments provided in the manufacturer's labeling.
Side effects of Duobrii (Halobetasol and Tazarotene):
See individual agents for side effects:
Contraindications to Duobrii (Halobetasol and Tazarotene):
- Tazarotene is contraindicated during pregnancy. Female patients of reproductive potential should be evaluated for pregnancy before treatment initiation.
- Females should have a negative pregnancy test within two weeks of treatment initiation.
- Adequate contraception should be used in female patients who may become pregnant.
Halobetasol and tazarotene: Drug Interaction
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Risk Factor C (Monitor therapy) |
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Corticorelin |
The therapeutic benefit of corticorelin may be reduced by corticosteroids. In particular, recent or ongoing corticosteroid medication may reduce the plasma ACTH response to corticorelin. |
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Deferasirox |
Corticosteroids may intensify Deferasirox's negative/toxic effects. Particularly, there may be a higher risk of GI bleeding or ulcers. |
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Ritodrine |
Corticosteroids may intensify Ritodrine's harmful or hazardous effects. |
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Risk Factor D (Consider therapy modification) |
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Hyaluronidase |
The therapeutic benefit of hyaluronidase may be reduced by corticosteroids. Treatment: Standard doses of hyaluronidase may not produce the desired clinical response in patients using corticosteroids (especially at higher doses). Hyaluronidase may be needed at higher doses. |
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Risk Factor X (Avoid combination) |
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Aldesleukin |
The anti-cancer effects of corticosteroids may be diminished by aldesleukin. |
Monitoring parameters:
- Monitor for the clinical features of adrenal insufficiency and HPA axis suppression.
- Observe for fungal and bacterial infections especially when the treatment is prolonged.
- Monitor disease severity in patients with plaque psoriasis during the treatment. observe for improvement in skin induration, scaling, and reduction in the redness and erythema.
- Monitor for tolerance and the clinical response to the therapy.
- All female patients of reproductive potential should undergo a pregnancy test within two weeks before treatment initiation.
How to administer Duobrii (Halobetasol and Tazarotene)?
- It is indicated for external (topical) use only.
- Avoid applying it in or around the eyes, oral cavity, or for intravaginal use.
- Avoid applying occlusive dressings over the area unless advised by an expert.
- The areas should be cleaned and dried before applying them.
- A thin layer should be applied over the affected area and rubbed gently.
- Hands should be washed after applying it except when the hands are affected too.
Mechanism of action of Duobrii (Halobetasol and Tazarotene):
- Halobetasol is a strong topical corticosteroid that reduces inflammation by causing the production of arachidonic acid and lipocortins, which are phospholipase A2 inhibitory proteins. It causes a decrease in endogenous chemical mediators such as histamine, liposomal enzymes and prostaglandins. It acts as an anti-inflammatory drug that has vasoconstricting and antipruritic properties.
- Tazarotene is a synthetic, acetylenic retinoid that has some immunomodulatory and anti-inflammatory effects, however, it exerts its effects primarily via modulating the differentiation and proliferation of epithelial tissues.
See individual agents.
International Brand Names of Halobetasol and tazarotene:
- Duobrii
Halobetasol and Tazarotene Brand Names in Pakistan:
No Brands Available in Pakistan.
