Dritho-Scalp, Micanol (anthralin) dosing, indications, interactions, adverse effects, and more

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Sections anthralin
Dosing & Uses
Adverse Effects
Warnings
Pregnancy
Pharmacology
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Patient Handout
Formulary

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

cream

0.5%
1%
1.2%

Psoriasis

1% cream: Rub cream qDay well into psoriatic lesions in skin until absorbed; avoid applying excessive quantity

0.5% scalp cream: Apply as directed after washing hair and remove by washing or showering

Safety & efficacy not established

Frequency Not Defined

Allergic reactions around surrounding uninvolved skin

Temporary discoloration of skin

Lesion soreness

Staining of hair, skin, and fingernails

Contraindications

Hypersensitivity

Acute or actively inflamed psoriatic eruptions

Cautions

Avoid contact with eyes or mucous membranes

If redness observed reduce frequency of application or discontinue therapy

May stain fingernails, hair, or fabrics

Use with caution in patients with extensive and prolonged applications

Pregnancy & Lactation

Pregnancy Category: C

Lactation: Excretion in milk unknown/not recommended

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.

Mechanism of Action

Not fully understood

Inhibits cell proliferation putatively through inhibition of DNA synthesis as well as from its strong reducing properties

Anti-psoriatic action may be partly through inactivating epidermal 12-lipoxygenase & reducing levels of endothelial cell adhesion molecules which are markedly elevated in psoriasis

BRAND	FORM.	UNIT PRICE	PILL IMAGE
Drithocreme HP topical -	1 % cream

Patient Handout

ANTHRALIN - TOPICAL

(AN-thra-lin)

COMMON BRAND NAME(S): Drithocreme

USES: This medication is used for the treatment of long-term psoriasis. Anthralin is a man-made version of a natural substance found in goa powder, which is from the araroba tree. It works by slowing down the growth of skin cells. This product does not contain a corticosteroid or coal tar. It is not meant to be used for a severe outbreak of psoriasis. Do not use this drug if the skin is inflamed or irritated.

HOW TO USE: Exactly follow all directions from your doctor and pharmacist. Learn how to apply the medicine, how long to leave it on the scalp or skin, and how to avoid staining.This medication is for use on the skin and/or scalp.To prevent discoloration of fingernails, apply this medication using plastic gloves.Apply a thin layer to the area with psoriasis, usually once daily. Avoid the normal skin/scalp. Rub in well. If normal skin surrounding the treated areas becomes too irritated, you may cover the normal skin with petroleum jelly to protect it.To treat the scalp, wash hair first with a shampoo to remove loose scales. Rinse off the shampoo, then apply this medication as directed, only on the psoriasis area.Follow your doctor's directions for how long to leave the drug on the skin/scalp (usually starting at 10-30 minutes per treatment), then remove the drug. First, rinse with cool-to-lukewarm water (less than 80 degrees F/27 degrees C). Then, if you are treating the scalp, shampoo the scalp, and if you are treating the skin, wash the treated skin by taking a bath or shower using soap and hot water.After using this medicine, rinse hands right away with lukewarm water, then wash with soap and warm water.Do not allow the drug to come in contact with eyes, mucous membranes (such as lips, mouth, nose), or genital area. If this occurs, flush with plenty of cool-to-lukewarm water. If irritation occurs, contact your doctor right away.Caution is advised when applying on the areas between toes and fingers, on the face, or in skin folds. If too much irritation occurs after using this medication, stop using this medication and tell your doctor.Treatment is usually continued until the affected area is entirely clear.Tell your doctor if your condition lasts or gets worse.

SIDE EFFECTS: Temporary redness or irritation of the treated skin may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: increased soreness of skin, spread of psoriasis.This medication may temporarily discolor fingernails or discolor gray/white hair. It will also stain skin and fabrics (see also Precautions section).A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using anthralin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease.To prevent staining of clothing or bed linen, a protective dressing may be useful. To prevent staining of the tub or shower (after washing off the medicine), rinse tub/shower with lukewarm water. Then use a cleanser to remove any deposits left on the surface.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

OVERDOSE: This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for another skin condition unless told to do so by your doctor. A different medication may be necessary in that case.Before rinsing, it might be helpful to use a wet wipe to remove extra medication.

MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

STORAGE: Store at room temperature away from light. Keep container tightly closed. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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.

View explanations for tiers and restrictions

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.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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