Duobrii
Duobrii is a combination medication that contains halobetasol (a corticosteroid) and tazarotene (a retinoid). It's a prescription topical lotion that's FDA-approved to treat plaque psoriasis in adults. The directions for using the medication are to apply a thin amount over the affected area(s) of skin once per day. But avoid putting on the face, groin, and underarms. Side effects aren't common, but can include skin rash and pain at the site of application. Duobrii is brand name only and not available as a generic.
What is Duobrii (halobetasol / tazarotene) ?
What is Duobrii (halobetasol / tazarotene) used for?
Plaque psoriasis in adults
How Duobrii (halobetasol / tazarotene) works
Duobrii (halobetasol / tazarotene) is a combination of two medications that work together to treat plaque psoriasis.
Halobetasol is a corticosteroid. It eases inflammation (swelling, redness, and itchiness) in your skin and lessens thickening of psoriasis plaques.
Tazarotene is a retinoid, which is a form of vitamin A. It also helps thin out psoriasis plaques and lessens redness and itching.
tazarotene (Tazorac) instead?
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What are the side effects of Duobrii (halobetasol / tazarotene) ?
Common Side Effects
- Skin rash (7%)
- Pain where the medication was applied (3%)
Other Side Effects
- Inflamed hair follicles (folliculitis)
- Skin thinning
- Repeated skin picking
- Peeling skin
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Burning, itching, crusting, or peeling of treated skin
- Fragile or thinning skin that bruises easily
- Low adrenal gland function—nausea, vomiting, loss of appetite, unusual weakness or fatigue, dizziness
- Skin infection—skin redness, swelling, warmth, or pain
- Skin reactions on sun-exposed areas
- Small, red, pus-filled bumps on skin around hair follicles
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision lossSide effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Mild skin irritation, redness, or dryness
- Unexpected hair growth at application site
Pros and cons of Duobrii (halobetasol / tazarotene)
Pros
Applied once daily
Combines two medications into one lotion
Might see some improvements in as early as 2 weeks
Cons
For adults only; not studied in children
Not safe to use while pregnant or breastfeeding
Available as a brand-name product only
Pharmacist tips for Duobrii (halobetasol / tazarotene)
Apply Duobrii (halobetasol / tazarotene) once per day on the affected area(s). Make sure to apply enough amount to cover the skin with a thin layer of medication. The maximum dose is 50 grams of Duobrii per week. Your dermatologist can help you figure out how many grams to apply daily.
If you plan to shower or bathe before applying Duobrii (halobetasol / tazarotene) , dry your skin is completely before using the medication.
Duobrii (halobetasol / tazarotene) should be applied directly on your skin only. Don't apply the medication in your eyes, mouth, or vagina, or this could lead to side effects. Also, don't apply Duobrii (halobetasol / tazarotene) on skin that has eczema or on damaged skin, because this can cause further irritation.
Wash your hands well before and after you apply Duobrii (halobetasol / tazarotene) to your skin. This helps prevent the medication from getting in your eyes.
If you experience irritation, such as redness, peeling, or discomfort, check with your provider to see if you can apply Duobrii (halobetasol / tazarotene) less often or stop using it temporarily until your skin gets better.
Duobrii (halobetasol / tazarotene) can make your skin more sensitive to sun damage. Avoid direct sunlight, tanning beds, and sunlamps to prevent sunburn. Use sunscreen and wear protective clothing to lower your risk of sun damage.
Don't place bandages or dressings over the areas where you've applied Duobrii (halobetasol / tazarotene) unless your prescriber instructed you to. Wrapping the treated area with tight bandages or dressings can cause more medication to get absorbed into your body than intended. This can raise your risk of side effects, like burning and irritation.
Don't apply other topical steroids to the skin while you're using Duobrii (halobetasol / tazarotene) unless your prescriber specifically said it's safe for you. Applying more than one topical steroid can raise your risk for side effects.
If you're starting Duobrii (halobetasol / tazarotene) and able to become pregnant, your dermatologist will ask you to get a pregnancy test within 2 weeks of the beginning of treatment. In addition, you need to start this medication during a menstrual period. Because Duobrii (halobetasol / tazarotene) can cause harm during pregnancy, you can't use this medication if you're pregnant.
Make sure to tell your prescriber if you're pregnant or breastfeeding. It's generally recommended to avoid Duobrii (halobetasol / tazarotene) because studies suggest it can harm a baby. Females prescribed Duobrii (halobetasol / tazarotene) and who are able to get pregnant should use birth control during treatment.
Frequently asked questions about Duobrii (halobetasol / tazarotene)
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What are the risks and warnings for Duobrii (halobetasol / tazarotene) ?
Duobrii (halobetasol / tazarotene) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Harm to unborn babies
Risk factors: Currently pregnant or planning to become pregnant
Studies show tazarotene in Duobrii can cause harm (e.g., development issues) to your unborn baby, so this medication can't be used during pregnancy. If you're female and able to become pregnant, your prescriber will have you take a pregnancy test 2 weeks before starting Duobrii (halobetasol / tazarotene) . They'll have you start the medication during your menstrual period. While using Duobrii (halobetasol / tazarotene) , you need to use an effective form of birth control to prevent pregnancy.
Altered stress hormone levels
Risk factors: Applying Duobrii (halobetasol / tazarotene) to large areas of the body | Applying Duobrii (halobetasol / tazarotene) for a long time | Applying more than one topical steroid onto the skin | Covering the medicated area | Applying onto damaged skin | Liver problems | Young children
Duobrii contains halobetasol, a corticosteroid. This is a man-made version of cortisol, the stress hormone naturally made by the body. Using Duobrii (halobetasol / tazarotene) for a long time can lead to symptoms of too much stress hormone, including weight gain and higher blood sugar levels. The risk is higher if you apply the medication to larger areas of skin over longer periods of time and covering the treated area with tight bandages.
In addition, using Duobrii (halobetasol / tazarotene) over a longer period of time can cause your body to stop making its own stress hormone. When you stop this medication, it takes a while for the body to ramp up making its own stress hormone again. During this time, you might experience topical steroid withdrawal symptoms, such as itchy or burning skin. If you need to stop Duobrii (halobetasol / tazarotene) , your healthcare team can help you do so safely by lowering your dose slowly over time.
Apply Duobrii (halobetasol / tazarotene) only as directed. Don't apply too much medication and don't use it for a longer period of time than prescribed. Also don't cover the medicated area with bandages or dressings unless your prescriber tells you to. If your prescriber thinks that Duobrii (halobetasol / tazarotene) is affecting your body's hormone production, they might recommend that you apply it less often or switch you to a different medication.
Skin reactions and skin infections
Duobrii (halobetasol / tazarotene) can cause skin irritation, such as dry skin, redness, and stinging or burning. It can also cause certain skin reactions, such as thinning of the skin, stretch marks, spider veins, red bumps, or skin rash. Avoid Duobrii (halobetasol / tazarotene) on any areas of the skin with eczema because it can cause severe irritation. Let your prescriber know if you notice skin side effects or reactions that aren't getting better over time.
Duobrii (halobetasol / tazarotene) can also raise the risk of skin infections, which might require an antibiotic to treat. Stop using this medication and let your prescriber know if you notice skin redness, swelling, skin warmth, fever, or chills. These might be signs of an infection.
Sun sensitivity and risk of sunburn
Risk factors: Exposure to sunlight | Taking medications that raise the risk of sunburn
Duobrii (halobetasol / tazarotene) can make your skin more sensitive to the sun and raise your risk of sunburn. The risk is higher if you're taking other medications that raise your risk for sun sensitivity, such as thiazides, tetracyclines, and fluoroquinolones. Avoid exposing your skin to sunlight if possible. Use sunscreen and wear protective clothing when going outside. If you get sunburned, ask your prescriber about stopping Duobrii (halobetasol / tazarotene) until your skin heals.
Cataracts and glaucoma
Risk factors: History of cataracts or glaucoma | Vision issues
Though rare, using topical steroids like halobetasol in Duobrii can raise the risk of developing vision problems, like cataracts and glaucoma. Make sure your prescriber knows if you have any issues with your vision or eyes before you start using this medication. Tell your healthcare team or eye specialist if you start noticing vision problems while you're using Duobrii (halobetasol / tazarotene) .
Duobrii (halobetasol / tazarotene) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 100g of 0.01%/0.045% | 1 tube | $1006.30 | $1006.30 |
Typical dosing for Duobrii (halobetasol / tazarotene)
Duobrii lotion contains 0.01% of halobetasol and 0.045% of tazarotene.
Adults: Apply a thin layer once a day to cover the affected areas and rub in gently. The maximum dose is 50 grams per week. Your prescriber will help you understand how much is safe to use each week.
How much does Duobrii (halobetasol / tazarotene) cost?
Duobrii (halobetasol / tazarotene) contraindications
Currently pregnant
What are alternatives to Duobrii (halobetasol / tazarotene) ?
Plaque psoriasis in adults
Mild-to-moderate eczema in people 6 years and older - 0.15% cream only
Plaque psoriasis in people 6 years and older - 0.3% cream only
Seborrheic dermatitis in people 9 years and older - 0.3% foam only
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References
Best studies we foundAmerican Academy of Dermatology Association. (n.d.). Psoriasis treatment: A retinoid you apply to the skin.
Bausch Health US, LLC. (2020). Duobrii- halobetasol propionate and tazarotene lotion [package insert]. DailyMed.
MedlinePlus. (2024). Skin infections.
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