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standards of non-Merck sources.
Pronunciation
(AN thra lin)
U.S. Brand Names
Index Terms
Generic Available
No
Canadian Brand Names
Pharmacologic Category
Pharmacologic Category Synonyms
Use: Labeled Indications
Treatment of psoriasis (quiescent or chronic psoriasis)
Pregnancy Risk Factor
C
Lactation
Excretion in breast milk unknown/not recommended
Contraindications
Hypersensitivity to anthralin or any component of the formulation; acute psoriasis (acutely or actively inflamed psoriatic eruptions)
Warnings/Precautions
If redness is observed, reduce frequency of dosage or discontinue application; avoid eye contact; should generally not be applied to opposing skin surfaces that may rub or touch (eg, skin folds of the groin, axilla, and breasts) and high strengths should not be used on these sites; do not apply to genitalia. Use caution in patients with renal disease and in those having extensive and prolonged applications. May stain skin, hair, fingernails (temporary); or fabrics (may be permanent).
Adverse Reactions
Frequency not defined: Dermatologic: Transient primary irritation of uninvolved skin; temporary discoloration of skin, hair, and fingernails; contact allergic reactions; erythema
Drug Interactions
Corticosteroids: Long-term use of topical corticosteroids may destabilize psoriasis, and withdrawal may also give rise to a “rebound” phenomenon; allow an interval of at least 1 week between the discontinuance of topical corticosteroids and the commencement of therapy.
Storage
Store at controlled room temperature of 15°C to 30°C (59°F to 86°F). Avoid excessive heat.
Mechanism of Action
Reduction of the mitotic rate and proliferation of epidermal cells in psoriasis by inhibiting synthesis of nucleic protein from inhibition of DNA synthesis to affected areas
Dosage
Children (unlabeled) and Adults: Topical: Generally, apply once a day or as directed. The irritant potential of anthralin is directly related to the strength being used and each patient's individual tolerance. Always commence treatment using a short, daily contact time (5-10 minutes) for at least 1 week using the lowest strength possible. Contact time may be gradually increased (to 20-30 minutes) as tolerated.
Skin application: Apply sparingly only to psoriatic lesions and rub gently and carefully into the skin until absorbed. Avoid applying an excessive quantity which may cause unnecessary soiling and staining of the clothing or bed linen.
Scalp application: Comb hair to remove scalar debris, wet hair and, after suitably parting, rub cream well into the lesions, taking care to prevent the cream from spreading onto the forehead,
Remove by washing or showering; optimal period of contact will vary according to the strength used and the patient's response to treatment. Continue treatment until the skin is entirely clear (ie, when there is nothing to feel with the fingers and the texture is normal).
Administration: Topical
May apply using latex gloves to prevent staining of fingers. Apply directly to plaques; rub in gently but thoroughly; avoid application to unaffected skin. When applying to scalp, part hair in one-inch segments to reach plaques. Remove by washing after conclusion of prescribed contact period. When rinsing, take care to avoid contact with eyes. Immediately clean tub or shower to prevent staining. Dry off using old towel (stains on fabric may be permanent). Petroleum jelly may be used around the edges of plaques, in body folds, or skin creases to prevent irritation of unaffected skin.
Patient Education
For external use only. Use exactly as directed; do not overuse. Before using, wash and dry area gently. Wear gloves to apply a thin film to affected area and rub in gently. Remove by washing; may discolor fabric, skin, or hair. Use a porous dressing if necessary. For lesions on scalp, comb hair to remove scalar debris, part hair, and rub cream into lesions. Do not allow cream to spread to forehead or onto neck. Remove by washing hair. Avoid contact with eyes. Avoid exposing treated areas to direct sunlight; sunburn can occur. Optimal period of contact will vary according to strength used and response to treatment. Report increased swelling, redness, rash, itching, signs of infection, worsening of condition, or lack of healing. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to become pregnant. Breast-feeding is not recommended.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
None reported
Mental Health: Effects on Psychiatric Treatment
None reported
Nursing: Physical Assessment/Monitoring
When applied to large areas of skin or for extensive periods of time, monitor for adverse skin or systemic reactions. Assess knowledge/teach patient appropriate application and use and adverse symptoms to report.
Dosage Forms
Cream:
Dritho-Scalp®: 0.5% (50 g)
Psoriatec™: 1% (50 g)
Pricing: U.S. (www.drugstore.com)
Cream (Dritho-Scalp)
0.5% (50): $80.64
References
Farber EM and Nall L, “Childhood Psoriasis,” Cutis, 1999, 64(5):309-14.
Silverman A, Menter A, and Hairston JL, “Tars and Anthralins,” Dermatol Clin, 1995, 13(4):817-33.
International Brand Names
Lexi-Comp.com
Last full review/revision October 2006
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