BNF for Children (BNFC) 2018-2019

DERMATOLOGICAL DRUGS›ASTRINGENTS

Aluminium chloride hexahydrate

lINDICATIONS AND DOSE

Hyperhidrosis affecting axillae, hands or feet

▶TO THE SKIN

▶Child:Apply once daily, apply liquid formulation at

night to dry skin, wash off the following morning,

reduce frequency as condition improves—do not bathe

immediately before use

Hyperhidrosis|Bromidrosis|Intertrigo|Prevention of

tinea pedis and related conditions

▶TO THE SKIN

▶Child:Apply powder to dry skin

lUNLICENSED USELicensed for use in children (age range

not specified by manufacturer).

lCAUTIONSAvoid contact with eyes.avoid contact with

mucous membranes.avoid use on broken or irritated skin.

do not shave axillae or use depilatories within 12 hours of

application

lSIDE-EFFECTS

▶Frequency not knownSkin reactions

lPATIENT AND CARER ADVICEAvoid contact with clothing.

lEXCEPTIONS TO LEGAL CATEGORYA 30 mL pack of

aluminium chloride hexahydrate 20 % is on sale to the

public.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Liquid

CAUTIONARY AND ADVISORY LABELS 15

▶Aluminium chloride hexahydrate (Non-proprietary)

Aluminium chloride 200 mg per 1 mlAluminium chloride 20 %

solution| 60 mlpsDT = £ 2. 51

▶Anhydrol(Dermal Laboratories Ltd)

Aluminium chloride 200 mg per 1 mlAnhydrol Forte 20 % solution

| 60 mlp£ 2. 51 DT = £ 2. 51

▶Driclor(GlaxoSmithKline Consumer Healthcare)

Aluminium chloride 200 mg per 1 mlDriclor 20 % solution|

75 mlp£ 3. 01 DT = £ 3. 01

5 Pruritus

Topical local antipruritics

Overview

Pruritusmay be caused by systemic disease (such as

obstructive jaundice, endocrine disease, chronic renal

disease, iron deficiency, and certain malignant diseases),

skin disease (such as eczema, psoriasis, urticaria, and

scabies), drug hypersensitivity, or as a side-effect of opioid

analgesics. Where possible, the underlying cause should be

treated. Local antipruritics have a role in the treatment of

pruritus in palliative care. Pruritus caused by cholestasis

generally requires a bile acid sequestrant.

Anemollientmay be of value where the pruritus is

associated with dry skin. Preparations containing calamine

or crotamiton below are sometimes used but are of uncertain

value.

A topical preparation containing doxepin 5 %p. 753 is

licensed for the relief of pruritus in eczema in children over

12 years; it can cause drowsiness and there may be a risk of

sensitisation.

Topical antihistamines and local anaesthetics are only

marginally effective and occasionally cause sensitisation. For

insect stingsandinsect bites, a short course of a topical

corticosteroid is appropriate. Short-term treatment with a

sedating antihistaminemay help in insect stings and in

intractable pruritus where sedation is desirable. Calamine

preparations are of little value for the treatment of insect

stings or bites.

Inpruritus ani, the underlying cause such as faecal soiling,

eczema, psoriasis, or helminth infection should be treated.

Other drugs used for PruritusAlimemazine tartrate, p. 177.

Cetirizine hydrochloride, p. 174 .Chlorphenamine maleate,

p. 178 .Hydroxyzine hydrochloride, p. 179 .Levocetirizine

hydrochloride, p. 175

ANTIPRURITICS

Calamine with zinc oxide 31-Aug-2016

lINDICATIONS AND DOSE

Pruritus

▶TO THE SKIN

▶Child:(consult product literature)

IMPORTANT SAFETY INFORMATION

MHRA/CHM UPDATE (APRIL 2016): FIRE RISK WITH PARAFFIN-

BASED SKIN EMOLLIENTS ON DRESSINGS OR CLOTHING

See Emollient and barrier preparations p. 713.

lCONTRA-INDICATIONSAvoid application of preparations

containing zinc oxide prior to x-ray (zinc oxide may affect

outcome of x-ray)

lLESS SUITABLE FOR PRESCRIBINGLess suitable for

prescribing.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Cream

CAUTIONARY AND ADVISORY LABELS 15

▶Calamine with zinc oxide (Non-proprietary)

Phenoxyethanol 5 mg per 1 gram, Zinc oxide 30 mg per 1 gram,

Calamine 40 mg per 1 gram, Cetomacrogol emulsifying wax

50 mg per 1 gram, Self-emulsifying glyceryl monostearate 50 mg

per 1 gram, Liquid paraffin 200 mg per 1 gramAqueous calamine

cream| 100 gramG£ 1. 43 DT = £ 1. 43

▶Cala Soothe(Ennogen Healthcare Ltd)

Phenoxyethanol 5 mg per 1 gram, Zinc oxide 30 mg per 1 gram,

Calamine 40 mg per 1 gram, Cetomacrogol emulsifying wax

50 mg per 1 gram, Self-emulsifying glyceryl monostearate 50 mg

per 1 gram, Liquid paraffin 200 mg per 1 gramCala Soothe cream

| 100 ml £ 18. 80

Liquid

▶Calamine with zinc oxide (Non-proprietary)

Phenol liquefied 5 mg per 1 ml, Sodium citrate 5 mg per 1 ml,

Bentonite 30 mg per 1 ml, Glycerol 50 mg per 1 ml, Zinc oxide

50 mg per 1 ml, Calamine 150 mg per 1 mlCalamine lotion|

200 mlG£ 0. 94 – £ 1. 09 DT = £ 1. 09

▶Cala Soothe(Ennogen Healthcare Ltd)

Phenol liquefied 5 mg per 1 ml, Sodium citrate 5 mg per 1 ml,

Bentonite 30 mg per 1 ml, Glycerol 50 mg per 1 ml, Zinc oxide

50 mg per 1 ml, Calamine 150 mg per 1 mlCala Soothe lotion|

200 ml £ 19. 50 DT = £ 1. 09

Crotamiton

lINDICATIONS AND DOSE

Pruritus (including pruritus after scabies)

▶TO THE SKIN

▶Child 1 month–2 years (on doctor’s advice only):Apply

once daily

▶Child 3–17 years:Apply 2 – 3 times a day

lCONTRA-INDICATIONSAcute exudative dermatoses

752 Pruritus BNFC 2018 – 2019

Skin

13