Potent corticosteroid + imidazole antifungal Pregnancy: Inadequate evidence of safety in pregnancy; clotrimazole showed no teratogenic effect in animals but is foetotoxic at high oral doses, and topical corticosteroids in pregnant animals can cause cleft palate and intra-uterine growth retardation, so there may be a very small risk in the human foetus. Use in pregnancy only if the benefit justifies the potential risk, and not extensively (large amounts or long periods). Breast-feeding: excretion in human milk unknown — exercise caution.

Betamethasone with clotrimazole

Brand names: Lotriderm

A topical fixed-combination cream pairing the potent corticosteroid betamethasone with the imidazole antifungal clotrimazole, used for inflamed fungal skin infections such as tinea or candidal intertrigo where inflammation is prominent.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Topical application of the cream to the affected area

Route: Topical administration only

Frequency: Twice daily

Adults and children over the age of 12 years. Duration: two weeks for tinea cruris, tinea corporis and candidiasis; four weeks for tinea pedis. Not recommended for children under the age of twelve years, and the safety and effectiveness in children below 12 has not been established. If used on the face, courses should be limited to 5 days; if used in children, courses should be limited to 5 days and long-term continuous therapy should be avoided in all children irrespective of age. Should NOT be used with occlusive dressing or adhesive dressing. Local and systemic toxicity is common especially following long continued use on large areas of damaged skin and in flexures. Not intended for ophthalmic use. Source SPC is for Lotriderm 0.05% w/w / 1.0% w/w Cream (betamethasone dipropionate with clotrimazole).

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

History of sensitivity to any of the components, or to other corticosteroids or imidazoles
Facial rosacea
Acne vulgaris
Perioral dermatitis
Napkin eruptions
Bacterial or viral infections

Side effects

Burning and stinging, maculopapular rash, oedema, paraesthesia and secondary infection
Clotrimazole component: erythema, stinging, blistering, peeling, oedema, pruritus, urticaria and general skin irritation
Betamethasone dipropionate component: itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hyperpigmentation/hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin
Betamethasone dipropionate component: skin atrophy, striae, miliaria, capillary fragility (ecchymoses), blurred vision, sensitisation
In children receiving topical corticosteroids: HPA axis suppression, Cushing's syndrome and intracranial hypertension have been reported

Interactions

There are no known interactions

Clinical monograph

How it works

Betamethasone suppresses local inflammation, vasodilatation and immune activity, while clotrimazole inhibits fungal ergosterol synthesis to disrupt the cell membrane of dermatophytes and yeasts.

Prescribing in practice

The corticosteroid component can mask and worsen an untreated infection, so use should be short-term and limited to genuinely inflamed fungal disease rather than as a routine antifungal.
Avoid prolonged application to the face, flexures or large areas, and avoid occlusion, which increases corticosteroid potency and absorption.
Not appropriate as monotherapy for established dermatophyte infection if inflammation is minimal — a plain antifungal is preferred.

Monitoring

Review the response after a short course and reassess the diagnosis if the rash fails to clear or recurs, considering skin scrapings for mycology.

Counselling the patient

Apply a thin layer to the affected area as directed and do not cover with airtight dressings unless told to.
Stop and seek advice if the area becomes more sore, weepy or fails to improve.

Evidence & guidelines

Use is guided by SPC recommendations and standard dermatology practice for inflamed superficial fungal infection; consult current prescribing references.

Reference: NICE CKS Tinea; BAD; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways