HOE Beprosalic Lotion

HOE Beprosalic Lotion is a topical lotion made by HOE Pharmaceuticals Sdn. Bhd., a Malaysian pharmaceutical manufacturer. It combines two active ingredients in one preparation: betamethasone dipropionate (equivalent to betamethasone 0.05% w/w), a topical corticosteroid, and salicylic acid, a keratolytic agent that softens and loosens the outer layer of skin. The lotion is intended for application to the skin and scalp only, and it is not to be swallowed.

Because the product contains a corticosteroid, it belongs in a different safety bracket from ordinary moisturising lotions, and the way it is applied matters as much as what it contains. Topical corticosteroids can be absorbed through the skin, particularly on thin skin, over large areas, under dressings or in children, which is why the label advises a thin layer, a limited duration and avoiding the face, eyes and broken skin unless a doctor directs otherwise. The salicylic acid component is also a salicylate, so it adds its own cautions for people who are sensitive to aspirin-type medicines.

HOE Beprosalic Lotion is also available in an ointment form from the same manufacturer, so please check that the pack you order is the lotion. The DoctorOnCall listing carries a 30 mL pack, and the exact salicylic acid strength should be confirmed from the carton you receive. As with all OTC medicines, read the pack label, keep the bottle out of reach of children, and speak to a pharmacist or doctor before using it if you are pregnant, breastfeeding, using other steroid products, or applying it to a child.

HOE Beprosalic Lotion is for external use on the skin and scalp only. Wash and dry your hands before and after applying, and avoid contact with the eyes, mouth and other mucous membranes.

• Apply a thin layer (or a few drops on the scalp) to the affected area only, and rub it in gently.
• Use once or twice daily, or exactly as directed by your doctor or pharmacist.
• On the scalp, part the hair and apply directly to the skin, not to the hair strands, and avoid letting the lotion run onto the face or into the eyes.
• Do not cover the treated area with an airtight or tight-fitting dressing unless a doctor has told you to do so.
• Do not apply to the face, groin or underarms, to broken or infected skin, or to large areas of the body unless specifically directed by a doctor.
• Do not use for longer than the period recommended by your doctor or pharmacist.

The usual label directions are a thin layer applied to the affected area once or twice daily, or as directed by a doctor or pharmacist. The lowest effective amount should be used for the shortest possible time.

• Adults: a thin layer once or twice daily as directed. Avoid applying more than is needed to cover the area.
• Children: use only if directed by a doctor, because children absorb more steroid through the skin relative to their body size.
• Missed application: apply it when remembered, but skip it if the next application is almost due. Do not apply extra lotion to make up for a missed one.
• Duration: do not use continuously for longer than the period advised by your doctor or pharmacist, and do not stop and restart repeatedly without advice.
• Accidental swallowing or heavy over-application: contact a doctor or poison centre for advice.

HOE Beprosalic Lotion generally remains stable for up to about 36 months from the date of manufacture when unopened and stored correctly. Always follow the expiry date printed on the bottle and carton, and do not use the lotion after that date.

Store at room temperature, below 30°C, away from direct sunlight, heat and moisture. Keep the bottle tightly closed, and keep it out of the sight and reach of children.

• Known hypersensitivity (allergy) to betamethasone, salicylic acid, other corticosteroids, other salicylates or any ingredient in the lotion.
• Viral skin infections such as cold sores (herpes simplex), shingles or chickenpox, and untreated fungal or bacterial skin infections.
• Tuberculosis of the skin or skin reactions after vaccination at the site.
• Rosacea, acne vulgaris and perioral dermatitis.
• Open wounds, ulcers or broken skin at the application site.
• Application to the eyes, eyelids, or mucous membranes.

• Other topical steroids and skin products: Do not use other corticosteroid creams, ointments or lotions, or other medicated skin products such as benzoyl peroxide, retinoids or other salicylic acid products, on the same area unless directed by a doctor, as this can raise the risk of irritation and absorption.
• Strong CYP3A4 inhibitors: Medicines such as ritonavir, itraconazole and clarithromycin may increase the body’s exposure to corticosteroid if a lot of lotion is absorbed, so tell your doctor if you take them.
• Oral salicylates and anticoagulants: If the lotion is used over large areas, absorbed salicylic acid may add to the effects of aspirin, other salicylates, warfarin, or methotrexate, so seek professional advice in this situation.
• Diabetes medicines: Significant steroid absorption can raise blood sugar, so people with diabetes should speak to their doctor if large areas are treated.
• Food and alcohol: No food or alcohol interactions are expected with topical use of the lotion.

• Check the pack to confirm that you have the lotion and not the ointment, and confirm the active ingredients and strengths on the carton.
• Wash your hands before and after applying so that the lotion is not transferred to the eyes, face or other people, especially young children.
• Use only a thin layer and only on the area your doctor or pharmacist has directed, rather than a generous coating over healthy skin.
• Keep a note of the date you started using the lotion, so that you can be sure not to continue beyond the recommended duration.
• Avoid tight bandages, plastic wraps or shower caps on the treated scalp or skin unless a doctor has told you to use them.
• Check the skin regularly, and speak to a doctor or pharmacist if you notice thinning, stretch marks, pus, spreading redness or any irritation that gets worse.

Precautions: Do not apply the lotion to the face, eyelids, groin or underarms, or on broken or infected skin unless a doctor has directed it. Avoid large areas, long-term use and airtight dressings, which increase absorption of the steroid. People who are sensitive to aspirin or other salicylates should be particularly careful. Children, older adults and people with thin or fragile skin are more prone to side effects and should use it only as directed by a doctor. Speak to a doctor or pharmacist before use during pregnancy or breastfeeding, and do not apply to the breast area if breastfeeding. Tell your doctor if you have diabetes, glaucoma, cataract or a weakened immune system.

When to See a Doctor or Pharmacist: Speak to a doctor if the skin looks worse after a short period of use, if it becomes red, swollen, painful or starts to ooze, or if you notice thinning of the skin or stretch marks. Stop the lotion and seek urgent help for a spreading rash, hives, swelling of the face, difficulty breathing, ringing in the ears, blurred vision or any sign that the steroid is being absorbed into the body. Seek advice before restarting the lotion if you have stopped for a while.