Dithranol: Indication, Dosage, Side Effect, Precaution

Generic Medicine Info Patient Medicine Information

This information is not country-specific. Please refer to the Singapore prescribing information.

Generic Medicine Info

Indications and Dosage

Topical/Cutaneous
Psoriasis

Adult: For treatment of subacute and chronic cases, including psoriasis of the scalp: Short-contact therapy: As cream: Apply sparingly onto the affected lesions once daily. Initiate treatment using a short, daily contact time (5-10 minutes) for at least 1 week using the lowest strength possible, may gradually increase contact time to 30 minutes as tolerated. For scalp use, wash hair with shampoo and rinse, then apply cream onto the affected lesions while hair is still damp. Remove cream by washing or showering; rinse thoroughly with lukewarm water before washing with soap (skin) or shampoo (scalp). Optimal contact time may vary depending on the strength of the cream used and patient response. Treatment recommendations may vary among countries and available products (refer to specific product guidelines).

Contraindications

Acute pustular psoriasis or inflamed skin.

Special Precautions

Patient with fair skin. Recent administration of potent steroids. Pregnancy and lactation.

Adverse Reactions

Significant: Excessive redness or burning sensation of the skin; temporary staining of skin, hair, or fingernails.
Skin and subcutaneous tissue disorders: Lesional burning sensation (usually mild or moderate), perilesional erythema and burning. Rarely, skin rash.

Pregnancy Category (US FDA)

Topical: C

Patient Counseling Information

Do not apply to the face, genitalia, open sores, skin folds, eyes or mucous membrane. Always wash your hands thoroughly after use. Avoid applying to unaffected skin. Apply carefully to avoid staining of bed linen, clothing or other objects.

Overdosage

Symptoms: Burning and deep staining of the skin. Management: Rinse first with water only and then wash at a temperature not exceeding 30°C.

Drug Interactions

May enhance the effect of photosensitising drugs. Propylene glycol-containing agents may oxidise and inactivate dithranol.

Action

Description:
Mechanism of Action: Dithranol is an antracen derivative. Its mechanism of action is unknown; however, its action has been linked to its ability to generate free radicals. It reduces the mitotic rate and proliferation of epidermal cells in psoriasis by preventing nucleic protein synthesis from inhibition of DNA synthesis in affected areas.
Synonym(s): Anthralin.
Pharmacokinetics:
Absorption: Penetrates more into skin with compromised stratum corneum barrier than into intact skin. Max concentration is reached after 30-60 minutes of contact time.
Distribution: Highest concentration of unchanged drug is found in the horny layer of the skin for 24-48 hours and relatively small amounts of unoxidised dithranol and higher concentrations of dithranol dimer are found in the deep dermal layers.
Metabolism: Unstable dithranol is oxidised to danthron, dithranol dimer and further insoluble polymerisation products.
Excretion: Via urine (small amounts of oxidation products).

Chemical Structure

Storage

Store between 15-30°C.

MIMS Class

Psoriasis, Seborrhea & Ichthyosis Preparations

ATC Classification

D05AC01 - dithranol ; Belongs to the class of topical antracen derivative agent used in the treatment of psoriasis.

References

Anon. Dithranol [Anthralin]. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 22/12/2023.

Anthralin. Gold Standard Drug Database in ClinicalKey [online]. Elsevier Inc. https://www.clinicalkey.com. Accessed 23/01/2024.

Buckingham R (ed). Dithranol. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 22/12/2023.

Joint Formulary Committee. Dithranol (Anthralin). British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 22/12/2023.

Micanol Cream 1% (Northumbria Pharma Ltd.). MHRA. https://products.mhra.gov.uk. Accessed 22/12/2023.

Micanol Cream 3% (Northumbria Pharma Ltd.). MHRA. https://products.mhra.gov.uk. Accessed 23/01/2024.

Disclaimer: This information is independently developed by MIMS based on Dithranol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2024 MIMS. All rights reserved. Powered by MIMS.com