Ciprofloxacin Hydrochloride 1.0% W/w + Metronidazole Benzoate 1.0% W/w + Terbinafine Hydrochloride 1.0% W/w + Clobetasol Propionate 0.05% W/w

Clean and dry the affected area before application. Apply a thin layer of the cream to the affected skin as directed by the physician. Wash hands before and after applying the medicine. Avoid contact with eyes, mouth, and mucous membranes.

Store below 25–30°C. Protect from heat and moisture. Keep the tube tightly closed. Keep out of reach of children.

Mild burning or irritation at the application site Redness Dry skin

Use with caution in: Children Long-term therapy Large skin areas

This medicine contains a strong corticosteroid (clobetasol) and should be used only for the duration prescribed. Avoid prolonged or excessive use. Do not apply on the face or sensitive areas unless advised by a doctor. Avoid occlusive dressings unless directed by a physician. If symptoms do not improve within a few days, consult a doctor.

Product Information: Cipro(R), ciprofloxacin hydrochloride tablets, ciprofloxacin oral suspension. Bayer Pharmaceuticals Corporation, West Haven, CT, 2004. Product Information: FLAGYL(R) oral tablets, metronidazole oral tablets. G.D. Searle (per FDA), New York, NY, 2013. 9. Product Information: LIKMEZ(TM) oral suspension, metronidazole oral suspension. Saptalis Pharmaceuticals LLC (per FDA), Hauppauge, NY, 2023. Product Information: TEMOVATE E(R) topical emollient cream, clobetasol propionate topical emollient cream. GlaxoSmithKline Consumer Healthcare LP, Pittsburgh, PA, 2002.

Ciprofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, preventing DNA replication and transcription. Metronidazole undergoes reductive activation in anaerobic microorganisms to form cytotoxic intermediates that disrupt DNA structure and inhibit nucleic acid synthesis. Terbinafine inhibits fungal squalene epoxidase, leading to accumulation of squalene and depletion of ergosterol in the fungal cell membrane. Clobetasol propionate exerts potent anti-inflammatory effects by inducing lipocortin-mediated inhibition of phospholipase A2 and suppressing inflammatory cytokine production.

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