Salacyn

SALACYN- salicylic acid cream
SALACYN- salicylic acid lotion
Stratus Pharamceuticals, Inc

Disclaimer: This drug has not been found by FDA to be safe and effective, and this labeling has not been approved by FDA. For further information about unapproved drugs, click here.

(6% Salicylic Acid)

Rx only

FOR DERMATOLOGICAL USE ONLY. NOT FOR OPHTHALMIC, ORAL OR INTRAVAGINAL USE.

DESCRIPTION

SALACYN™ 6% CREAM contains 6% Salicyclic Acid USP incorporated into a specially formulated oil and water emulsion vehicle consisting of Ammonium Lactate, Cetearyl Alcohol and PEG-3 Distearoylamidoethylmonium Methosulfate and Polysorbate 60, Cetearyl Alcohol, Cetyl Alcohol, Dimethicone 350, Disodium EDTA, Glycerin, Glyceryl Stearate SE, Methylparaben, Mineral Oil, PEG-100 Stearate, Phenoxyethanol, Propylparaben, Purified Water and Trolamine.

SALACYN™ 6% LOTION contains 6% w/w Salicylic Acid USP incorporated into a specially formulated oil and water emulsion vehicle consisting of of Ammonium Lactate, Cetearyl Alcohol and PEG-3 Distearoylamidoethylmonium Methosulfate and Polysorbate 60, Cetyl Alcohol, Dimethicone 350, Disodium EDTA, Glycerin, Glyceryl Stearate SE, Methylparben, Mineral Oil, PEG-100 Stearate, Propylparaben, Purified Water and Trolamine.

Salicylic Acid is the 2-hydroxy derivative of benzoic acid having the following structure:

Chemical StructureChemical Structure

CLINICAL PHARMACOLOGY

Salicylic Acid has been shown to produce desquamation of the horny layer of the skin while not effecting qualitative or quantitative changes in the structure of the viable epidermis. The mechanism of action has been attributed to a dissolution of intercellular cement substance. In a study of the percutaneous absorption of salicylic acid in a 6% salicylic acid gel in four patients with extensive active psoriasis. Taylor and Halprin showed that the peak serum salicylate levels never exceeded 5 mg/100 ml even though more than 60% of the applied salicylic acid was absorbed. Systemic toxic reactions are usually associated with much higher serum levels (30 to 40 mg/100ml). Peak serum levels occurred within five hours of the topical application under occlusion. The sites were occluded for 10 hours over the entire body surface below the neck. Since salicylates are distributed in the extracellular space, patients with a contracted excellular space due to dehydration or diuretics have higher salicylate levels than those with a normal extracellular space. (SEE PRECAUTIONS).

The major metabolites identified in the urine after topical administration are salicyluric acid (52%), salicylate glucuronides (42%) and free salicylic acid (6%). The urinary metabolites after percutaneous absorption differ from those after oral salicylate administration; those derived from percutaneous absorption contain more salicylate glucuronides and less salicyluric and salicylic acid. Almost 95% of a single dose of salicylate is excreted within 24 hours of its entrance into the extracellular space.

Fifty to eighty percent of salicylate is protein bound to albumin. Salicylates compete with the binding of several drugs and can modify the action of these drugs; by similar competitive mechanisms other drugs can influence the serum levels of salicylate. (SEE PRECAUTIONS).

Salacyn Indications and Usage

FOR DERMATOLOGIC USE

SALACYN™ 6% is a topical aid in the removal of excessive keratin in hyperkeratotic skin disorders including verrucae, and the various ichthyoses (vulgaris, sex-linked and lamellar), keratosis palmaris and plantaris keratosis pilaris, pityriasis rubra pilaris and psoriasis (including body, scalp, palms and soles).

FOR PODIATRIC USE

SALACYN™ 6% is a topical aid in the removal of excessive keratin on dorsal and plantar hyperkeratotic lesions. Topical preparations of 6% salicylic acid have been reported to be useful adjunctive therapy for verrucae plantares.

CONTRAINDICATIONS

SALACYN™ 6% should not be used in any patient known to be sensitive to salicylic acid or any other listed ingredients. SALACYN™ 6% should not be used in children under 2 years of age.

WARNINGS

Prolonged and repeated daily use over large areas, especially in children and those patients with significant renal or hepatic impariment could result in salicylism. Concomitant use of other drugs which may contribute to elevated serum salucylate levels should be avoided where the potential for toxicity is present. In children under 12 years of age and those patients with renal of hepatic impairment to the area to be treated should be limited and the patient monitored closely for signs of salicylate toxicity; nausea, vomiting, dizziness, loss of hearing, tinnitus, lethargy, hyperpnea, diarrhea, and psychic disturbances. In the event of salicylic acid toxicity, the use of SALACYN™ 6% should be discontinued. Fluids should be administered to promote urinary execration. Treatment with sodium bicarbonate (oral or intravenous) should be instituted as appropriate. Patients should be cautioned against the 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 an 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 the product other than is needed to cover the affected area will not result in a more rapid therapeutic benefit.

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

PRECAUTIONS

For external use only. Avoid contact with eyes and other mucous membranes.

DRUG INTERACTIONS

The following interactions are from a published review and include reports concerning both oral and topical salicylate administration. The relationship of these interactions to the use of SALACYN™ 6% is not known.

  1. Due to the competition of salicylate with other drugs for binding to the serum albumin the following drug interactions may occur:
    DRUGDISCRIPTION OF INTERACTION
    SulfonylureasHypoglycemia potentiated
    MethotrexateDecreases tubular reabsorption; clinical toxicity from methotrexate can result.
    Oral AnticoagulantsIncreased bleeding
  2. Drugs changing salicylate levels by altering renal tubular reabsorption:
    DRUGDISCRIPTION OF INTERACTION
    CorticosteroidsDecreases plasma salicylate level; tapering doses of steroids may promote salicylism.
    Acidifying agentsIncreases plasma salicylate levels.
    Alkcanizing agentsDecreased plasma salicylate levels.
  3. Drugs with completed interactions with salicylates:
    DRUGDISCRIPTION OF INTERACTION
    HeparinSalicylate decreases platelet adhesiveness and inteferes with hemostasis in heparin treated patients.
    PyrazinamideInhibits pyrazinamide induced hyperuricemia.
    Uricosuric AgentsEffect of probenemide, sulfinpyrazone and phenylbutazone inhibited.

The following alterations of laboratory tests have been reported during salicylate therapy:

LABORATORY TESTS EFFECT OF SALICYLATES
Thyroid Function Decreased PBI; increased T3 uptake.
Urinary Sugar False negative with glucose oxidase; false positive with Clinitest with high-dose salicylate therapy (2-5g q.d.).
5-Hydroxyindole acetic acid False negative with fluorometric test.
Acetone, ketone bodies False positive FeCl3 in Gerhardt reaction; red color persist with boiling.
17-OH corticosteroids False reduced values with >4.8g. q.d. salicylate.
Vanilmandelic acid False reduced values.
Uric acid May increase or decrease depending on dose.
Prothrombin Decreased levels; slightly increased prothrombin time.
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