Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
ACLOVATE vs ACTICORT
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Aclovate (alclometasone dipropionate) is a synthetic corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictive properties. Its mechanism involves binding to glucocorticoid receptors, modulating gene expression to inhibit phospholipase A2, reducing arachidonic acid release, and decreasing prostaglandin and leukotriene synthesis.
Topical corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictive actions. Suppresses cytokine production and inflammatory mediators via glucocorticoid receptor binding.
Relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses (e.g., atopic dermatitis, contact dermatitis, eczema, psoriasis) - FDA approved,Off-label: Treatment of mild to moderate plaque psoriasis, seborrheic dermatitis, and lichen planus
Corticosteroid-responsive dermatoses (e.g., eczema, psoriasis, contact dermatitis),Off-label: atopic dermatitis, lichen planus, discoid lupus erythematosus
Apply a thin film to affected skin areas twice daily. Not for ophthalmic, oral, or intravaginal use.
5-60 mg orally once daily, or divided twice daily, depending on condition severity and response.
Terminal elimination half-life: approximately 6-8 hours after topical application; systemic absorption is minimal under normal use.
1.5-2.5 hours; prolonged in hepatic impairment (up to 10 hours) and renal impairment (up to 6 hours)
Aclovate is metabolized in the skin and liver via ester hydrolysis to inactive metabolites. Systemic metabolism primarily involves cytochrome P450 enzymes (CYP3A4) for any absorbed fraction, but extensive first-pass metabolism limits systemic exposure.
Hepatic metabolism via CYP3A4; inactive metabolites excreted renally and biliary.
Renal (primarily as metabolites, <5% unchanged), biliary/fecal (minor).
Renal (70% as unchanged drug and metabolites), biliary/fecal (30%)
Approximately 90%, primarily to albumin and corticosteroid-binding globulin (CBG).
90% bound to albumin and corticosteroid-binding globulin
Not well-characterized in topical use; after systemic absorption, Vd is approximately 1-2 L/kg, indicating distribution into tissues.
1.2-1.5 L/kg; indicates extensive tissue distribution
Topical: approximately 1-3% systemic absorption on intact skin; increased up to 15% on occluded or damaged skin.
Oral: 80-90%; IM: 100%
No dose adjustment required. Topical use with minimal systemic absorption.
No dose adjustment necessary for acute use; for chronic therapy in severe renal impairment (e GFR <30 m L/min/1.73 m2), consider dose reduction by 50% to minimize mineralocorticoid effects.
No dose adjustment required. Topical use with minimal systemic absorption.
Child-Pugh A: no adjustment; Child-Pugh B: reduce dose by 50%; Child-Pugh C: avoid use or reduce dose by 75% due to reduced clearance.
Use smallest amount effective for shortest duration. Avoid prolonged use, occlusive dressings, or application to large surface areas. Safety in children <1 year not established.
0.05-2 mg/kg/day orally divided every 6-8 hours, not to exceed 80 mg/day; adjust based on response and severity.
Use with caution due to increased risk of skin atrophy and systemic absorption. Limit frequency and duration; avoid occlusive dressings.
Initiate at lowest effective dose (e.g., 5 mg/day) and titrate slowly due to increased risk of osteoporosis, glucose intolerance, and immunosuppression; monitor for adverse effects.
No FDA black box warning.
None
Topical corticosteroids can cause hypothalamic-pituitary-adrenal (HPA) axis suppression, especially with prolonged use, large surface area, occlusion, or in pediatric patients.,Reversible HPA axis suppression may occur after discontinuation.,Systemic effects including Cushing's syndrome, hyperglycemia, and glucosuria have been reported.,Local adverse reactions: burning, itching, irritation, dryness, folliculitis, hypopigmentation, allergic contact dermatitis, maceration, secondary infection, skin atrophy, striae, and miliaria.,Use caution in patients with impaired skin integrity or areas of skin atrophy.,Pediatric patients may be more susceptible to systemic toxicity due to higher skin surface-to-body-weight ratio.
HPA axis suppression with prolonged use or large surface area,Local irritation and skin atrophy,Systemic absorption with occlusive dressings,Potential for rebound effects after discontinuation
Hypersensitivity to alclometasone dipropionate or any component of the formulation.,Untreated bacterial, fungal, or viral skin infections (e.g., herpes simplex, varicella, tuberculosis of the skin).
Known hypersensitivity to components,Untreated bacterial/fungal infections,Viral skin infections (e.g., herpes simplex, varicella),Perioral dermatitis, rosacea
No known food interactions with topical Aclovate.
No clinically significant food interactions. Alcohol may increase systemic absorption if tympanic membrane is perforated, but generally avoid alcohol-based ear drops if perforation suspected.
Topical corticosteroids like ACLOVATE (alclometasone dipropionate) are generally considered low risk in pregnancy, but systemic absorption can occur. Class C: Fetal risk cannot be ruled out. Avoid extensive use or prolonged treatment, especially in first trimester. Second and third trimester: Use only if clearly needed, minimal area and duration.
First trimester: Increased risk of cleft palate and cardiac defects (OR 1.3-3.5). Second/third trimesters: Risk of fetal growth restriction, adrenal suppression, and oligohydramnios with chronic use. Avoid use unless maternal benefit outweighs risks.
Safety unknown; likely minimal systemic absorption due to low potency. M/P ratio not established. Avoid application to breasts or large areas; use caution.
Prednisone enters breast milk at low levels (M/P ratio ~0.1-0.3). At maternal doses ≤20 mg/day, the infant dose is <10% of maternal weight-adjusted dose. Consider risk of adrenal suppression in infant with high-dose, long-term therapy. AAP rates as compatible with breastfeeding.
No standard dose adjustment required; however, limit potency, frequency, and duration to lowest effective due to altered skin permeability. No pharmacokinetic changes necessitate dose change.
No empirical dose adjustment required; however, pharmacokinetic changes (increased Vd, hepatic metabolism) may reduce efficacy. Doses may need to be increased by 20-30% in third trimester if disease activity increases. Taper to lowest effective dose.
Topical corticosteroids like Aclovate are classified as low-potency (Group VI). They are suitable for thin skin areas (e.g., face, flexures) and for children. Avoid prolonged use without interruption to minimize systemic absorption, especially in pediatric patients due to higher skin surface area-to-body weight ratio.
ACTICORT (hydrocortisone/neomycin/polymyxin B) is a topical combination used for inflammatory ear conditions. Avoid prolonged use (>10 days) to prevent sensitization and overgrowth of non-susceptible organisms. Tympanic membrane perforation is a contraindication due to ototoxicity risk. Use the otic solution not the ophthalmic suspension for ear infections.
Apply a thin layer to affected skin only, not to normal surrounding skin.,Do not cover with bandages or dressings unless directed by your doctor.,Use for the prescribed duration; do not use longer than 2 weeks at a time.,Avoid contact with eyes, mouth, and open wounds.,Report any signs of skin thinning, redness, or irritation to your healthcare provider.
Instill drops while lying down with affected ear upward, then remain in position for 5 minutes.,Do not touch dropper to ear or any surface to avoid contamination.,Complete full course even if symptoms improve; do not use longer than prescribed.,Report worsening redness, swelling, or hearing loss immediately.,Avoid getting water in ear during treatment; use a cotton ball soaked in petroleum jelly to protect ear when showering.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about ACLOVATE vs ACTICORT, answered by our medical review team.
ACLOVATE is a Topical Corticosteroid that works by Aclovate (alclometasone dipropionate) is a synthetic corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictive properties. Its mechanism involves binding to glucocorticoid receptors, modulating gene expression to inhibit phospholipase A2, reducing arachidonic acid release, and decreasing prostaglandin and leukotriene synthesis.. ACTICORT is a Corticosteroid that works by Topical corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictive actions. Suppresses cytokine production and inflammatory mediators via glucocorticoid receptor binding.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between ACLOVATE and ACTICORT depend on the specific clinical indication. These are agents from distinct pharmacological classes and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of ACLOVATE is: Apply a thin film to affected skin areas twice daily. Not for ophthalmic, oral, or intravaginal use.. The standard adult dose of ACTICORT is: 5-60 mg orally once daily, or divided twice daily, depending on condition severity and response.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between ACLOVATE and ACTICORT in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. ACLOVATE is classified as Category C. Topical corticosteroids like ACLOVATE (alclometasone dipropionate) are generally considered low risk in pregnancy, but systemic absorption can occur. Class C: Fetal risk cannot be . ACTICORT is classified as Category C. First trimester: Increased risk of cleft palate and cardiac defects (OR 1.3-3.5). Second/third trimesters: Risk of fetal growth restriction, adrenal suppression, and oligohydramnio. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.