salicylic acid topical (Rx, OTC)

Brand and Other Names:Compound W, Compound W for Kids, more...Dr. Scholl's Advanced Pain Relief Corn Removers, Dr. Scholl's Callus Removers, Dr. Scholl's Clear Away, Dr. Scholl's Clear Away OneStep, Dr. Scholl's Clear Away Plantar, Dr. Scholl's Corn Removers, Dr. Scholl's Moisturizing Corn Remover Kit, Dr. Scholl's OneStep Corn Removers, DuoPlant, Durasal, Keralyt, Mediplast, Trans-Ver-Sal AdultPatch, Trans-Ver-Sal PediaPatch, Trans-Ver-Sal PlantarPatch, Sal-Acid, Virasal, Psoriasin Medicated Wash

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

topical liquid

  • 0.5%
  • 1%
  • 2%
  • 3%
  • 6%
  • 12.6%
  • 13.6%
  • 16.7%
  • 17%
  • 17.6%
  • 26%
  • 27.5%

gel

  • 2%
  • 6%
  • 17%

lotion

  • 3%
  • 6%

cream

  • 2%
  • 6%

aerosol/foam

  • 6%

soap

  • 2%
  • 3%

strips

  • 40%

pad

  • 40%

disk

  • 40%

plaster

  • 40%

patch

  • 15%
  • 40%

Plantar Warts/Calluses/Corn

Hydrate skin prior to application by soaking in warm water for 5 min, then use a cloth, brush, or emery board to loosened wart tissue; dry skin thoroughly

Liquid (27.5%): Protect surrounding unaffected skin with petrolatum, then apply liquid to each wart and allow to dry before applying a second application; repeat two application process once or twice daily for up to 6 weeks

Liquid (17%) or gel: Apply to clean dry area at each wart and allow to dry; apply qDay or q12hr up to 12 weeks

Gel (6%): Apply to affected area qDay; may apply at night and rinse off in the morning

Foam: Apply to affected area q12hr; rub into skin until completely absorbed

Patch (15%): Apply directly over affected area qHS and remove in the morning for up to 12 weeks; patch should be trimmed to cover affected area

Patch (40%): Apply directly over affected area and leave in place for 48hr; may repeat for up to 12 weeks; may trim patch to cover affected area or secure with adhesive strips

Plasters/strips: Apply as directed per individual product

Product content varies, check individual labeling

Seborrheic Dermatitis/Psoriasis

Ointment (3%): Apply to plaques or scales on skin up to q6hr (not for use on scalp or face)

Cream (2.5%): Apply to affected area q6-8hr; may be left in place overnight depending on the product

Shampoo (1.8-3%): Massage product into wet hair or affected area and leave in place for several minutes; rinse thoroughly; may apply two or three times/week or as directed by a healthcare professional; may be left in place overnight depending on the product

Foam: Apply to affected area q12hr; rub into skin until completely absorbed

Keratolytic for treating skin/scalp seborrhea or psoriasis

Dosage Forms & Strengths

topical liquid

  • 0.5%
  • 1%
  • 2%
  • 3%
  • 6%
  • 12.6%
  • 13.6%
  • 16.7%
  • 17%
  • 17.6%
  • 26%
  • 27.5%

gel

  • 2%
  • 6%
  • 17%

lotion

  • 3%
  • 6%

cream

  • 2%
  • 6%

aerosol/foam

  • 6%

soap

  • 2%
  • 3%

strips

  • 40%

pad

  • 40%

disk

  • 40%

plaster

  • 40%

patch

  • 15%
  • 40%

Plantar Warts/Calluses/Corn

<12 years

  • Safety & efficacy not established

>12 years

  • Hydrate skin prior to application by soaking in warm water for 5 min, then use a cloth, brush, or emery board to loosened wart tissue; dry skin thoroughly
  • Liquid (27.5%): Protect surrounding unaffected skin with petrolatum, then apply liquid to each wart and allow to dry before applying a second application; repeat two application process once or twice daily for up to 6 weeks
  • Liquid (17%) or gel: Apply to clean dry area at each wart and allow to dry; apply qDay or q12hr up to 12 weeks
  • Gel (6%): Apply to affected area qDay; may apply at night and rinse off in the morning
  • Foam: Apply to affected area q12hr; rub into skin until completely absorbed
  • Patch (15%): Apply directly over affected area qHS and remove in the morning for up to 12 weeks; patch should be trimmed to cover affected area
  • Patch (40%): Apply directly over affected area and leave in place for 48hr; may repeat for up to 12 weeks; may trim patch to cover affected area or secure with adhesive strips
  • Plasters/strips: Apply as directed per individual product Product content varies, check individual labeling
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Adverse Effects

Frequency Not Defined

Stinging/burning of skin

Dizziness

Headache

Tinnitus

Mental confusion

Peeling

Scaling

Burning/irritaion on normal tissue at site of exposure

Hyperventilation

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Warnings

Contraindications

Hypersensitivity

Prolonged use or application to large areas (risk for salicylism)

Children < 2 years

Virasal

  • Impaired circulaiton (diabetes)
  • Warts with hair growth or on face
  • Birthmarks
  • Moles

Cautions

External topical use only

Avoid contact with eyes

Caution in infants, diabetics, or those with impaired circulation (diabetes)

Prolonged use over large areas, especially in children and those patients with significant renal or hepatic impairment, could result in salicylism

Avoid concomitant use of other drugs which may contribute to elevated serum salicylate levels when the potential for toxicity is present

In children <12 years and patients with renal or hepatic impairment, area to be treated should be limited and patient monitored closely for signs of salicylate toxicity, including nausea, vomiting, dizziness, loss of hearing, tinnitus, lethargy, hyperpnea, diarrhea, and psychic disturbances

In event of salicylic acid toxicity, discontinue use of SA 6%

Fluids should be administered to promote urinary excretion; treatment with sodium bicarbonate (oral or intravenous) should be instituted as appropriate

Patients should be cautioned against use of oral aspirin and other salicylate containing medications, such as sports injury creams, to avoid additional excessive exposure to salicylic acid

Where needed, aspirin should be replaced by alternative non-steroidal anti-inflammatory agent that is not salicylate based

Patients should be advised not to apply occlusive dressings, clothing or other occlusive topical products such as petrolatum-based ointments to prevent excessive systemic exposure to salicylic acid

Excessive application of product other than what is needed to cover affected area will not result in a more rapid therapeutic benefit

Due to potential risk of developing Reye's syndrome, salicylate products should not be used in children and teenagers with varicella or influenza, unless directed by physician

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Pregnancy & Lactation

Pregnancy

Drug shown to be teratogenic in rats and monkeys; difficult to extrapolate from oral doses of acetylsalicylic acid used in these studies to topical administration as the oral dose to monkeys may represent six times the maximal daily human dose of salicylic acid when applied topically over a large body surface; there are no adequate and well-controlled studies in pregnant women.

Use SA 6% during pregnancy only if potential benefit justifies potential risk to fetus

Lactation

Because of potential for serious adverse reactions in nursing infants from mother's use of SA 6%, a decision should be made whether to discontinue nursing or discontinue drug, taking into account importance of drug to mother; if used by nursing mothers, should not be used on chest area to avoid accidental contamination of child

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

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Pharmacology

Mechanism of Action

Dissolves the intracellular cement that causes the hyperkeratotic tissue to swell, macerate, soften, and desquamate

Product is keratolytic at 3-6% and destructive at concentrations >6%; concentrations of 6-60% are used to remove corns and warts in the treatment of psoriasis and other keratotic disorders

Pharmacokinetics

Absorption: None with normal percutaneous use

Peak plasma time: Within 5 hours with occlusion is used

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Images

BRAND FORM. UNIT PRICE PILL IMAGE
Compound W topical
-
17 % liquid
Keralyt topical
-
6 % shampoo
Keralyt topical
-
3 % gel
UltraSal-ER topical
-
28.5 % solution
DHS Sal topical
-
3 % shampoo
salicylic acid topical
-
28.5 % solution
salicylic acid topical
-
6 % lotion
salicylic acid topical
-
6 % cream
salicylic acid topical
-
6 % foam
salicylic acid topical
-
6 % lotion
salicylic acid topical
-
6 % shampoo
salicylic acid topical
-
27.5 % liquid
salicylic acid topical
-
6 % gel
Neutrogena T/Sal topical
-
3 % shampoo
Neutrogena Oil-Free Acne Wash topical
-
2 % liquid
Virasal topical
-
27.5 % liquid
MG217 Psoriasis (salicylic acid) topical
-
3 % cream
Mediplast Corn-Callus-Wart Remover topical
-
40 % transdermal system
Keralyt Scalp Complete topical
-
6-6 % shampoo
Duofilm topical
-
17 % liquid
Wart Remover topical
-
17 % liquid
Wart Remover topical
-
17 % gel
Wart Remover topical
-
17 % liquid
Keralyt Rx topical
-
6 % gel
Keralyt Rx topical
-
6 % gel
Salvax topical
-
6 % foam
Salvax topical
-
6 % foam
Dr Scholl's Clear Away topical
-
40 % transdermal system

Copyright © 2010 First DataBank, Inc.

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Patient Handout

A Patient Handout is not currently available for this monograph.
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Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.