Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
ALA-CORT vs ACLOVATE
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Topical corticosteroid that induces phospholipase A2 inhibitory proteins, collectively called lipocortins, which inhibit the release of arachidonic acid, thereby reducing prostaglandin and leukotriene synthesis, and exerting anti-inflammatory, antipruritic, and vasoconstrictive effects.
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.
Relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses (FDA),Off-label: Atopic dermatitis, psoriasis, contact dermatitis, lichen planus, discoid lupus erythematosus
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
Topical: Apply a thin film to affected area 3-4 times daily. Dosage strength: 0.5% cream or ointment.
Apply a thin film to affected skin areas twice daily. Not for ophthalmic, oral, or intravaginal use.
Terminal elimination half-life: 1–2 hours for hydrocortisone (active component), prolonged in liver disease or with concurrent CYP3A4 inhibitors.
Terminal elimination half-life: approximately 6-8 hours after topical application; systemic absorption is minimal under normal use.
Topically applied; systemic absorption is minimal but can be increased with use on large areas, occlusive dressings, or damaged skin. Absorbed portion is metabolized primarily in the liver via hepatic microsomal enzymes (CYP3A4) and excreted by the kidneys.
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.
Primarily hepatic metabolism (approximately 95%) followed by renal excretion of inactive metabolites (<5% unchanged). Biliary/fecal excretion is negligible.
Renal (primarily as metabolites, <5% unchanged), biliary/fecal (minor).
Hydrocortisone is approximately 90–95% bound to corticosteroid-binding globulin (CBG, transcortin) and albumin.
Approximately 90%, primarily to albumin and corticosteroid-binding globulin (CBG).
Apparent volume of distribution (Vd) is approximately 0.4–0.6 L/kg, indicating moderate tissue distribution and limited penetration into CNS.
Not well-characterized in topical use; after systemic absorption, Vd is approximately 1-2 L/kg, indicating distribution into tissues.
Topical: Bioavailability is negligible (<1%) through intact skin; may increase (up to 30%) with damaged skin or occlusive dressings. Rectal: Bioavailability is approximately 10–20% via mucosal absorption, with first-pass metabolism reducing systemic exposure.
Topical: approximately 1-3% systemic absorption on intact skin; increased up to 15% on occluded or damaged skin.
No adjustment required for topical use; systemic absorption minimal.
No dose adjustment required. Topical use with minimal systemic absorption.
No adjustment required for topical use; hepatic metabolism negligible.
No dose adjustment required. Topical use with minimal systemic absorption.
Children ≥2 years: Apply a thin film to affected area 2-3 times daily. Use lowest potency preparation; avoid prolonged use.
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.
Use lowest effective dose; monitor for skin atrophy and systemic effects due to thinner skin and increased percutaneous absorption.
Use with caution due to increased risk of skin atrophy and systemic absorption. Limit frequency and duration; avoid occlusive dressings.
None
No FDA black box warning.
Systemic absorption may cause reversible HPA axis suppression,Cushing's syndrome, hyperglycemia, and glucosuria with prolonged use,Local adverse reactions: atrophy, striae, telangiectasias, acneiform eruptions, perioral dermatitis,May mask signs of infection,Use with caution in pediatric patients due to increased susceptibility to HPA axis suppression,Avoid use on face, intertriginous areas, and under occlusive dressings unless directed by physician
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.
Hypersensitivity to any component of the formulation,Untreated bacterial, viral, fungal, or parasitic skin infections,Viral skin infections (e.g., herpes simplex, varicella) at treatment site,Perioral dermatitis,Rosacea
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).
No known food interactions with topical ALA-CORT.
No known food interactions with topical Aclovate.
FDA Pregnancy Category C. First trimester: No adequate human studies; animal studies show increased risk of cleft palate. Second/third trimester: Risk of intrauterine growth restriction, adrenal suppression in fetus. Avoid prolonged use.
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.
Provides small amounts in breast milk; M/P ratio unknown. At maternal doses up to 80 mg/day, no adverse effects reported in infants. Consider risk-benefit with high doses or prolonged therapy.
Safety unknown; likely minimal systemic absorption due to low potency. M/P ratio not established. Avoid application to breasts or large areas; use caution.
Pregnancy-induced pharmacokinetic changes (increased clearance, volume of distribution) may require increased dosing, but clinical response should guide adjustment. Avoid high doses and prolonged use.
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.
ALA-CORT (hydrocortisone acetate 2.5% and pramoxine HCl 1%) is a topical corticosteroid with anesthetic. Use for short-term relief of pruritus and inflammation in corticosteroid-responsive dermatoses. Avoid prolonged use on intertriginous or occluded areas. Limit to <2 weeks continuous use in adults to avoid skin atrophy. Not recommended for children <2 years.
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.
Apply a thin layer to affected area no more than 3-4 times daily.,Do not cover with bandages or plastic unless directed by doctor.,Avoid contact with eyes, mouth, or broken skin.,Discontinue and notify doctor if infection, irritation, or no improvement after 7 days.,Do not use for diaper dermatitis or under diapers/occlusive dressings.,Keep out of reach of children.
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.
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 ALA-CORT vs ACLOVATE, answered by our medical review team.
ALA-CORT is a Topical Corticosteroid that works by Topical corticosteroid that induces phospholipase A2 inhibitory proteins, collectively called lipocortins, which inhibit the release of arachidonic acid, thereby reducing prostaglandin and leukotriene synthesis, and exerting anti-inflammatory, antipruritic, and vasoconstrictive effects.. 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.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between ALA-CORT and ACLOVATE depend on the specific clinical indication. These are both Topical Corticosteroid agents and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of ALA-CORT is: Topical: Apply a thin film to affected area 3-4 times daily. Dosage strength: 0.5% cream or ointment.. The standard adult dose of ACLOVATE is: Apply a thin film to affected skin areas twice daily. Not for ophthalmic, oral, or intravaginal use.. 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 ALA-CORT and ACLOVATE 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. ALA-CORT is classified as Category C. FDA Pregnancy Category C. First trimester: No adequate human studies; animal studies show increased risk of cleft palate. Second/third trimester: Risk of intrauterine growth restri. 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 . Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.