Name:  Retained on the skin for prolong period of time

 Do not permit the escape of moisture of the

Pharmaceutical Dosage skin to the atmosphere
 Difficult to wash: act as occlusive dressing
Chapter 10: Ointments, Creams, and Gels  They do not change noticeably upon aging
 Levigating agent: liquid petrolatum when powdered
Ointments, Creams, and Gels substance is incorporated into HC bases
 Petrolatum, USP (yellow petrolatum and
 Semisolid dosage forms for topical application petroleum jelly)
 Applied to the: skin, surface of the eye, nasally, vaginally  Purified mixture of semisolid HCs
or rectally obtained from petroleum
 Used for therapeutic effects of the agents they contain  Product: Vaseline (Chesebrough-
(emollients, protective barriers, and vehicles) Ponds)
 White Petrolatum, USP (white petrolatum
Topical Dermatological Products jelly)
 Wholly or nearly decolorized
 Drugs delivered into the skin for treatment of dermal purified mixture of semisolid HCs
disorder from petrolatum
 For local effects  Uses: diaper rash, dry skin
 Skin as the target organ  Commercial product: White Vaseline
(Chesebrough-Ponds)
Transdermal Products  Yellow Ointment, USP (simple ointment)
 Purified wax obtained from the
 Drugs delivered through the skin (percutaneous honeycomb of the bee Apis mellifera
absorption) to the general circulation  Has slightly greater viscosity than
 For systemic effects plain petrolatum
 Skin not the target organ  White Ointment
 Consists of white wax and white
Ointments petrolatum

 Semisolid preparations for external application to the Absorption Bases

skin or mucous membranes
 2 types those that:
Types of Ointments  Permit the incorporation of aqueous solutions
resulting in the formation of water in oil
 Medicated emulsions
 For treatments of cutaneous (skin disease)  Examples: hydrophilic
 For both local and systemic effects petrolatum and anhydrous
 Systemic drug absorption considered since lanolin
drugs:  Water in oil emulsions that permit the
 Enter the fetal blood supply incorporation of additional quantities of
 Breast milk can be transferred to the aqueous solutions
fetus or nursing mother  Examples: lanolin (as emollient)
 Examples: Sulfur Ointment, Zinc Oxide and cold cream
Ointment and Compound Resorcinol  Characteristics
 Non-medicated  Not easily removed from the skin with water
 Referred to as “ointment bases” washing
 Use as for their physical effects: protectant,  May possess some power of penetration into
emollient or lubricating effect or use as the deepest layers of the skin
vehicles in medicated ointments  Therefore are used for
 Example: White Ointment “endodermic” ointment
 Uses
Ointment Bases  As emollient but do not provide the degree of
occlusion
 Used for medicated ointments:  Incorporates aqueous solutions into oleaginous
 Physical effects bases
 Vehicles
 Four general groups: Types of Absorption Bases
 Oleaginous bases
 Absorption bases  Hydrophilic petrolatum
 Water-removable bases  Composed of stearyl alcohol, white wax,
 Water-soluble bases cholesterol, and white petrolatum
 Characteristics: ability to absorb water with the
Oleaginous or Hydrocarbon Bases formation of water in oil emulsion
 Commercial product: aquaphor (variation of
 Uses: emollient effect hydrophillic petrolatum)
 Effective as occlusive dressing  Anhydrous lanolin, USP
 Remain on the skin for long periods without drying out  May contain no more than 0.25% water
 Immiscibility with water (difficult to wash off)  Characteristics:
 Characteristics

1
  Insoluble in water but mixes
without separation with about
two times its weight in water
o incorporation of water results in
the formation of a water in oil
emulsion
 Synonym: refined wool fat
 Lanolin, USP
 Obtained from wool of sheep (Ovis aries)
 Purified wax-like substance: cleaned,
deodorized, and decolorized
 Processed to reduce contents of free lanolin
alcohols, any detergent and pesticide residues
 Characteristics:
o Water in oil emulsion that
contains between 25% to 30%
water
o Additional water may be
incorporated by mixing
 Synonym: hydrous wool fat
 Cold cream, USP
 Semisolid white water in oil emulsion prepared
with cetyl esters wax, white wax, mineral oil,
sodium borate, and purified water
 Uses: emollient and base
 Examples: Eucerin cream: a water in oil
emulsion of petrolatum, mineral oil, mineral
wax, wool wax, alcohol and bronopol
Water-Removable Bases (Water Washable Bases)
 Oil in water emulsion resembling creams
 Aqueous external phase
 Easily washed from skin
 Can absorb serous discharges
 Characteristics:
 Resemble creams in their appearance
 May be diluted with water or with aqueous
solution
 Can absorb serous discharges
 Certain medicinal agents may be better absorbed
in the skin
Types of Water-Removable Bases (Water Washable Bases)
 Hydrophilic ointment
 Sodium lauryl sulfate (emulsifying agent)
 Stearyl alcohol and white petrolatum (oleaginous
phase of the emulsion)
 Methylparaben and propylparaben (antimicrobial
preservatives)
 USE: employed as water removable vehicle for
medicinal substances
Water-Soluble Bases
 Do not contain oleaginous components
 Water washable, referred to as greaseless
 Soften greatly with water, large amount of aqueous
solutions not effectively incorporated
 Used for incorporation of solid substances
 Polyethylene Glycol Ointment
 Polymer of ethylene oxide and water
 Combining PEG 3350 (solid) with PEG 400
(liquid), results in a very pliable semisolid
ointment
Selection of the Appropriate Base
 Selection for use in the
formulation of an ointment depends on a number of factors:
 Desired released rate of the drug substance from
the ointment base
 Desirability of topical or percutaneous drug
absorption
 Desirability of occlusion of moisture from the
skin
 Stability of the drug in the ointment base
 Effect if any of the drug on the consistency or
other features of the ointment base
 Desire for a base that is easily removed by
washing off water
 Characteristic of the surface to which it is applied
 Selected: base that provides the best combination
of the most desired attributes
Preparation of Ointments:
 Incorporation
 Fusion
Incorporation
 Components mixed until a uniform preparation is
attained
 On a small scale (extemporaneous compounding):
components mixed using a mortar and pestle or spatula
to rub the ingredients together on an ointment slab
 Non-absorbent parchment paper used to cover the
working surface
Incorporation of Solid
 The particle size of a powder or crystalline material is
reduced before incorporation into the ointment base for
the final product not to be gritty
 Done by levigating (mineral oil) or mixing the solid
material in a vehicle in which it is insoluble to make a
smooth dispersion
Incorporation of Liquids
 Small amounts of an aqueous solution may be
incorporated into an oleaginous ointment
 Bases, even if hydrophilic have limits to retain liquids,
beyond: become too soft and semiliquid
 Alcohol solution (small volume) may be added easily to
oleaginous vehicle or emulsion bases
 Large scale: roller mills force coarsely formed ointments
through stainless steel rollers to produce ointments that
are uniform in composition and smooth in texture
 Small ointment mills: used also in product development
laboratories and in small batch manufacture
Ointment Roller Mill
 Suitable for grinding ointment, paste, paints, printer’s
ink, etc. in the pharmaceutical plastic industry
 The machine is conducted on a closed sheet iron base,
with in-built foot mounting, for floor positioning
Fusion Method
 All or some of the components of an ointment are
combined by being meted together and cooled with
constant stirring until congealed
 The heat labile substances and volatile constituents are
added last when temperature is low enough not to cause
decomposition
 Carried out:
 Small scale: porcelain dish or glass beaker
 Large scale: large steam-jacketed kettle
 Prepared by fusion:
 Medicated ointments and ointment bases (with
beeswax, paraffin, stearyl alcohol, and high
molecular weight PEG)
2
  Preparation of ointments with an emulsion
base: manufacturing involves melting and
emulsification
Stainless Steel Tank
 Creams and ointments in batch sizes up to 1500 kilos are
manufactured in stainless steel tanks.
Compendial Requirements (USP Tests) for Ointments
 Microbial content
 Topical applications are not required to be sterile
(except ophthalmic preparations)
 Strict adherence to environment control and
application of good manufacturing practices: to
minimize the microorganisms in unstrerilized
pharmaceutical products
 Antimicrobial preservatives in topical preparations:
methylparaben, propylparaben, phenols, benzoic
acid, sorbic acid amd quarternary ammonium salts
 Must meet the requirements of the test for absence
of Stap. Aureus and Pseudomonas aeruginosa
 For rectal, urethral, vaginal use: tested for yeast and
molds
 Minimum fill
 Determination of the net weight or volume of the
contents of containers: to ensure proper contents
compared with labeled amount
 Packaging, storage and labeling
 Packaging:
 Ointments and other semisolid preparation:
large-mouth ointment jars, metal or plastic
tubes
 Light-sensitive preparations: opaque of light-
resistant containers
 Storage
 Well-closed containers to product
contamination
 Labeling (USP):
 Include the type of base used
Additional Standards
 USP requires manufacturer: examine semisolid
preparation for viscosity and for in vitro drug release
Creams
 Semisolid preparations containing one or more medicinal
agents dissolved
 Dispersed either in W/O emulsion or O/W emulsion or in
another type of water-washable base
 Vanishing cream: O/W emulsions containing large
percentages of water and stearic acid or other
oleaginous components
 Primary application:
 Topical skin products used rectally and
vaginally
 Easier to spread and remove, preferred than
ointments
Examples of Ointments and Creams
 Anesthetics
 Benzocain: various
 Dibucaine: Nupercainal cream and ointment
 Astringent or protectant
 Zinc oxide: various
 Depigmenting agents
 Hydroquinone cream: Eldoopaque cream
 Scabicides
 Lindane: Kweel cream
 Sunscreen agent
 Dioxybenzone: Solvar cream and oxybenzone
Gels
 Semisolid system consisting of small or large molecules
in an aqueous liquid vehicle rendered jelly like by the
addition of a gelling agent.
 Gelling agent used:
 Synthetic
 Macromolecules
 Sometimes called jellies
 Gelling agents: carbomer 934, cellulose derivatives
(carboxymethyl-cellulose) and natural gums (tragacanth)
Single-Phase Gels
 Macromolecules uniformly distributed throughout a
liquid
 Example: Na CMC and tragacanth gel
Two-Phase Systems
 Gel mask consists of floccules of small distinct particles
 Example: Milk of Magnesia (often referred as magma)
Characteristics of Gels
 Thickens on standing, forming a thixotrope, shaken
before use to liquefy the gel and enable pouring
 Remain fairly uniform upon standing and does not
readily settle because of high degree of attraction
between the dispersed phase and water medium
 Aluminum hydroxide gel
 Formulated to contain drug substance:
 Solvents (alcohol and/or propylene)
 Antimicrobial preservatives (methylparaben or
chlorhexidine gluconate)
 Stabilizers (edentate disodium)
Uses of Gels
 Lubricant for catheters
 Bases for patch testing
 Examples:
 NaCl gel for electrocardiography
 Floucinonide Gel for anti-inflammatory
corticosteroid
 Na Fluoride & Phosphoric acid gel – dental care
prophylactic
 Tretionoin Gel for treatment of acne
Gels and Magmas
 Considered colloidal dispersion since they contain
particles of colloidal dimensions
Approriate Names (Colloidal Dispersion)
 SOLS: term to designate a dispersion of solid in either a
liquid, solid or gas dispersion medium
 Prefix hydro: water as dispersion medium so called
hydrosol
 Prefix alco: alcohol as the dispersion medium so
called alcosol
 Aerosol: dispersion of solid or liquid in gaseous
phase
Preparation of Gels
 By freshly precipitating the disperse phase upon reaching
an inorganic agent, a gelatinous precipitate results
 Example: Preparation of Al(OH)3 gel
AlCl3 + Na2CO3  NaHCO3
 By direct hydrating the inorganic material in water
Al2O3 + H2O  Al(OH)3
3
  Examples: Aluminum Hydroxide Gel, Alugel,
Amphogel, Ce-lu-gel, Cremalin, Hydroxal, Vanogel,
Aluminum Phosphate Gel (Phosphagel): antacid
Examples of Topical Gels
 Erythromycin and benzoyl peroxide topical gel:
Benzamycin
 Clindamycin topical gel: Cleocin T Topical Gel
 Benzoyl peroxide gel: Desquam-X 10 Gel-acne vulgaris
 Hydroquinone gel: Solaquin Forte Gel: bleach for
hyperpigmented skin
 Salicylic acid gel: Compound W Gel: keratolytic
 Desoximetasone gel: Topicort: anti-Inflammatory,
antipruritic agent
Miscellaneous Semi-solid Preparation
 Pastes
 Plasters
 Glycerogelatins
Pastes
 Semisolid preparation for application to the skin, for its
stiffness and impenetrability
 Remain in place after application and effectively
employed to absorb serous secretions
 Not suited for application to hairy parts of the body
 Example: zinc oxide paste (Lassar’s Plain Zinc Paste)
Types of Paste
 Dermatologic paste
 Paste for injection
Examples of Paste
1. Zinc oxide paste with acid: Lassar’s Paste: Salicylic acid
20g and ZnO paste q.s. to make 1000g
2. Zinc oxide paste: ZnO 250g, starch 250g, white
petrolatum 500g to make 1000g
3. Triamicinolone acetonide dental paste
Plasters
 Solid or semisolid adhesive masses spread on a backing
of paper, fabric, moleskin, or plastic
 Nonmedicated plaster: for protection and
mechanical support (Adhesive Plaster)
 Medicated plaster: provide effects at the site of
application (Salicylic acid plaster – removal of
corns on toes by the keratolytic action)
Purposes of Plasters
 To afford protection and mechanical support
 To furnish an occlusive macerating action
 To bring medication into close contact with surface of
skin
Example of Plaster
 Modern plasters are practically all machine made and are
available in colors such as flesh, striped, and others.
Examples of Medicated Plasters
 Salicylic acid plaster
 Salonpas
Back Plasters
 Made of heavy cotton or wool and cotton backing to
provide warmth and support
 Used to backache, sore shoulder, sore arms, and other
muscular aches
 Active constituents of back plasters is oleoresins of
capsicum
 Examples: Chili Plaster, Hot Salonpas
Cerates
 Unctouse preparations of such consistency that may be
easily spread at ordinary temperature upon muslin cloth
or similar material with spatula yet not soft to liquefy and
run when applied to the skin
 Contents: oil, hard, petrolatum and beeswax
 Examples: Cantharides cerates, rosin cerate, camphor
cerate, cerate of lead acetate, compound rosin cerate
Cataplasm
 Viscous preparation intended for warm, external
application to a body for purpose of reducing
inflammation
 Soft semisolid, external applications which either
stimulate a body surface or alleviate an inflamed area by
supplying medication substance in the presence of heat
and mixture.
 Example: numotizine
Cements
 Dental preparation employed primarily as temporary
coverings for exposed pulps and also for holding
medicinal agents in tooth cavities and rebasing of
dentures
Glycerogelatins
 Plastic masses containing 15% gelatin, 40% glycerin,
35% water and 10% added medicinal substance (zinc
oxide)
 For the long term application
 For treatment of varicose ulcers
 Official: zinc gelatin or zinc gelatin boot-form pressure
bandage (treatment of varicose ulcers)
Dressings
 External application resembling ointments in
consistency, but remaining semisolid at body
temperature, they liquefy at 50°C and remain pliable in
thin films below 28°C
Classes of Dressing
 Primary wound dressing or now as wet dressing
 Absorbents: surgical cotton and gauze
 Bandages
 Adhesive tapes
Examples of Dressings
 Paraffin Dressing: formerly official in the NF VI and
employed as an air-excluding, soft, pliable, analgesic,
splint-like covering for surface denuded by burns
 Petrolatum Gauze, USP: absorbent gauzr saturated with
white petrolatum
 Fruazone Gauza Pads-sterile: antibacterial dressings
containing nitrofurazone
 Surgical dressing: any material used as covering,
protective, or support for a diseased part: (1) Adhesive
bandages, USP; (2) Gauze bandage
Other Examples of Dressings
 Bandages
 Paper tapes
 Surgical tapes
Packaging Semisolid Preparation
 Topical dermatologic products
 Packaged in either jars or tubes
 Ophthalmic
 Nasal, vaginal, and rectal semisolids products
4
  Packaged in tubes
 Aluminum or plastic
 Ophthalmic ointments
 Packaged in small aluminum or collapsible
plastic tubes holding 3.5g
 Tubes: sterilizes before aseptically filled, fitted with
narrow-gauge
Plastic Tubes are made of:
 High or low-density polyethylene (HDPE or LDPE) or a
blend of each
 Polypropylene (PP)
 Polyethylene terephthalate (PET)
 Various plastic, foil, and/paper laminates
Special features and Advantages of Plastic
 LPDE: soft and resilient with good moisture barrier
 HPDE: with superior moisture barrier but less resilient
 PP: has high level of heat resistance
 PET: offers transparency and high degree of product
chemical compatibility
Laminates
 With excellent moisture barrier because of the foil
content, high durability, and product compatibility
Ointment jars
 Clear or opaque glass or plastics
 Amber-colored, some are porcelain
Filling Ointment Jars
 Small scale pharmacy: weighted amount of ointment
transferred into the jar with a spatula
Filling and Crimping Machine
 A small-scale fully automatic filling and crimping
machine for collapsible metal tubes
Tube-filling Machine
 This machine automatically fills 125 tubes a minute with
proper amount, tightens cap, and orients each tube by
electric eye so that label faces forward then closes and
crimps the end.
Filling Ointment Tubes
 Tubes filled from the open back end of the tube opposite
from the cap end
 Manual filling of ointment tube requires:
 Prepare ointment on a wax or parchment: paper
rolled into a cylindrical shape, inserted into the open
end of the tube, pushed forward
 The spatula pressing against the lower portion of the
tube and making a crease below the ointment full,
the paper is slowly remove leaving the ointment in
the tube
 The bottom of the tube is flattened, folded and
sealed with a crimping tool or clip
Features and Use Dermatologic Preparations
 Drug penetration into the skin depends on a number of
factors:
 Physiochemical properties of the medicinal
substance
 Characteristics of the pharmaceutical vehicle
 Condition of the skin itself
 Oleaginous bases
 Greater occlusion and emollient effects than
hydrophilic or water-washable bases
 Pastes
 Greater occlusion and more effective than
ointments at absorbing serous discharge
 Creams
 O/W emulsions, spread more easily than
ointments and are easier to remove
 Water-soluble bases
 Non-greasy and are easily removed
Features and Uses of Ophthalmic Ointments and Gels
 Ophthalmic ointments must meet the:
 USP sterility tests
 Test for metal particles in ophthalmic
ointments
 Steam sterilization or ethylene oxide methods: not
capable of penetrating the ointment
 Dry heat sterilization: can penetrate the ointment base,
the high heat may pose a threat to the stability of the drug
 Antimicrobial preservatives: methylparaben,
prophylparaben, combination of phenylmercuric acetate,
chlorobutanol, benzalkonium chloride
 Strict methods of aseptic processing: drug and non-drug
component is rendered sterile, aseptically weighed and
incorporated in a final product
Features and Use of Nasal Ointment and Gels
 Introduce into the nasal passage for local effects on the
mucous membrane and underlying tissues
 Nasal route of administration: also for the systemic
absorption of the numbers of drugs:
 Butorphanol tartrate (Stadol NS, Bristol Myers,
Squibb)
 An analgesic
 Cyanocobalamine (Nascobat gel, Schwartz)
 A hematopoietic
 Narfaralin acetate (Synarel, Searle)
 For txt of endometriosis
 Nicotine (Nicotrol NS, McNeil)
 As an adjunct in smoking sensation
Features and Use of Rectal Preparation
 For anorectal conditions: ointments, gels, creams, and
creamlike aerosol foams, solutions (for enema and
irrigation) and suppositories
 Local condition of anorectal pruritus: inflammation, pain
and discomfort associated with hemorrhoids
 Example:
 Prochlorperazine as suppositories
 Zinc oxide
 Bases used in anorectal ointments and creams
 Combinations of polyethylene glycol 300 and
3350
 Emulsion cream bases using cetyl esters wax,
and butylated hydroxyanisole (BHA)
Features and Use of Vaginal Preparations
 Treatment of Conditons and Disease of the vulvovaginal
area: ointments, creams, cream-like foams, and gels
 Topical product to treat:
 Vulvovaginal infection, vaginitis,
conditions of endometrial atrophy
and for contraception with
spermatocidal agents.
 Pathogenic organisms:
o Trichomonas vaginalis
o Candida (Monilia) albicans
o Hemophilus vaginalis
 Anti-infective agents are: nystatin,
chlotrimazole, miconazole, clindamycin, and
sulfonamides
5
  Endometrial atrophy treated locally with:
hormones dienestrol and progesterone
 Contraceptive preparations contained
spermicidal agents such as: nonoxynol-9 and
octoxynol with cervical diaphragm
 Vaginal gels are preserved with antimicrobial
agents: E.g. Vulva (Mycelex-7 Vaginal Cream,
Bayer)
Table 10.1: Dermatologic Ointments and Creams by Therapeutic
Category
 Preparation
 Adrenocortical steroids
 Aclometasone dipropionate cream and
ointment
o Corresponding commercial product:
Aclovate Cream and Ointment
(GlaxoSmithKline)
o Usual strength of active ingredient:
0.05% cream and ointment
o Use: relief of inflammatory
dermatoses
 Fluocinolone acetonide cream and
ointment
o Corresponding commercial product:
Synalar Cream and Ointment
(Roche)
o Usual strength of active ingredient:
0.025% cream and ointment
o Use: relief of inflammatory
dermatoses
 Hydrocortisone acetate cream and
ointment
o Corresponding commercial product:
Cortaid Cream and Ointment
(Pharmacia & Upjohn)
o Usual strength of active ingredient:
0.5% and 1%
o Use: relief of inflammatory
dermatoses
 Triamcinolone acetonide cream and
ointment
o Corresponding commercial product:
Aristocort A Cream and Ointment
(Fujisawa)
o Usual strength of active: 0.01%
ointment; 0.1%, 0.025%, 0.5% cream
o Use: relief of inflammatory
dermatoses
 Adrenocorticoid - antifungal combination
 Betamethasone, clotrimazole cream
o Corresponding commercial product:
Lotrisone Cream (Schering-Plough)
o Usual strength of active ingredient:
1% betamethasone, 0.05%
clotrimazole
o Use: relief, treatment of
inflammatory pruritic manifestations
that may be complicated by fungal
overgrowth
 Analgesic
 Capsaicin cream
o Corresponding commercial product:
Zostrix Cream (Medicis)
o Usual strength of active ingredient:
0.025%
o Use: relief of arthritic pain
 Antiacne
 Tretinoin cream
o Corresponding commercial product:
Retin-A (Ortho McNeil)
o Strength: 0.025%, 0.05%, 0.1%
o Usual strength of active ingredient:
derivative of Vitamin A for topical
treatment of acne vulgaris
 Antianginal
 Nitroglycerin ointment
o Corresponding commercial product:
Nitro-Bid Ointment (Hoechst Marion
Roussel)
o Usual strength of active ingredient:
2%
o Use: reduces workload of heart by
smooth muscle relaxation of
peripheral arteries and veins
 Antibacterial or anti-infectives
 Gentamicin sulfate cream, ointment
o Corresponding commercial product:
Garamycin Cream and Ointment
(Schering-Plough)
o Usual strength of active ingredient:
0.1%
o Use: local treatment of skin
infections by susceptible
microorganisms
 Nystatin cream
o Corresponding commercial product:
Mycostatin Cream (Apothecon)
o Usual strength of active ingredient:
0.5% 100,000 U/g
o Use: local treatment of skin
infections by susceptible
microorganisms
 Polymyxin B sulfate, bacitracin zinc,
neomycin ointment
o Corresponding commercial product:
Neosporin Ointment
(GlaxoSmithKline)
o Usual strength of active ingredient:
5,000 U/g polymyxin B, 400 U/g
bacitracin zinc; 3.5 mg/g neomycin
o Use: treatment of minor cuts, scrapes
 Antifungals
 Miconazole nitrate cream
o Corresponding commercial product:
Monistat-Derm Cream (Ortho
McNeil)
o Usual strength of active ingredient:
2%
o Use: cutaneous candidiasis, tinea
infections of Trichophyton spp.
 Tolnaftate cream
o Corresponding commercial product:
Tinactin Cream (Schering-Plough)
o Usual strength of active ingredient:
1%
o Use: topical treatment of tinea pedis,
tinea corporis, tinea manuum
 Antineoplastic
 Fluorouracil cream
o Corresponding commercial product:
Efudex Cream (Roche)
o Usual strength of active ingredient:
5%
o Use: treatment of multiple actinic,
solar keratoses
 Antipruritic, analgesic
 Lidocaine ointment
6
 o Corresponding commercial product: o Corresponding commercial product:
Xylocaine Ointment (Astra) Eldopaque Cream (ICN)
o Strength: 2.5% o Usual strength of active ingredient:
o Use: relief of pain, itching of minor 4%
skin irritation, insect bites o Use: temporary bleaching of skin
 Astringent, protectant with freckles, old age spots,
 Zinc oxide ointment chloasma
o Corresponding commercial product:  Scabicide
Desitin Ointment (Pfizer)  Crotamiton cream
o Usual strength of active ingredient: o Corresponding commercial product:
40% Eurax Cream (Westwood-Squibb)
o Use: topical astringent, protective in o Usual strength of active ingredient:
skin conditions such as diaper rash 10%
 Depigmenting agents o Use: eradication of scabies,
 Hydroquinone cream symptomatic treatment of pruritus

Table 10.2: Examples of Topical Gels

Active Ingredient Proprietary Product Gelling Agent Route and Use
Acetic acid Aci-Jel (Ortho McNeil) Tragacanth, acacia Vaginal; restoration and
maintenance of acidity
Becaplermin Regranex Gel (Ortho McNeil) Sodium, CMC Dermatologic; recombinant
human platelet-derived growth
factor; promotes healing of
diabetic ulcers of lower extremity
Benzoyl peroxide Desquam-X Gel (Westwood- Carbomer 940 Dermatologic; acne vulgaris
Squibb)
Clindamycin Cleocin T Topical Gel Carbomer 934P Dermatologic; acne vulgaris
(Pharmacia & Upjohn)

Clobetasol propionate Temovate Gel (GlaxoSmithKline) Carbomer 934P Dermatologic; antipruritic

Cyanocobalamin Nascobal (Schwartz Pharma) Methylcellulose Nasal; hematologic

Desoximetasone Topicort Gel (Medicis Carbomer 940 Dermatologic; anti-inflammatory,

Dermatologics) antipruritic
Metronidazole Metro-Gel Vaginal (Galderma) Carbomer 934P Vaginal; bacterial vaginosis

Podofilox Condylox Gel (Oclassen) Hydroxypropyl cellulose Rectal; anogenital warts

Progesterone Crinone Gel (Serono) Carbomer 934P Vaginal; bioadhesive gel for
progesterone supplementation
and replacement
Timolol maleate Timoptic-XE (Merck) Gelrite gellan gum Opthalmic gel-forming solution
used in treatment of elevated
intraocular pressure
Tretinoin Retin-A Gel (Ortho McNeil) Hydroxypropyl cellulose Dermatologic; acne vulgaris

o
oTable 10.3: Examples of Ophthalmic Ointments
Commercial Product Active Ingredient Category
Chloramphenicol ophthalmic Chloromycetin Opthalmic 1% Antibacterial, antibiotic
Ointment (Parke-Davis)

Dexamethasone sodium Decadron Phosphate Opthalmic 0.05% Anti-inflammatory,

phosphate ophthalmic Ointment (Merck) adrenocortical steroid

Gentamicin sulfate ophthalmic Garamycin Opthalmic Ointment 0.3% Antibacterial, antibiotic

(Schering-Plough)

Isoflurophate ophthalmic Floropryl Sterile Opthalmic 0.025% Cholinesterase inhibitor

Ointment (Merck)

Polymyxin B-bacitracin Polysporin Opthalmic Ointment Per gram: polymyxin B sulfate, Antimicrobial
ophthalmic (Monarch) 10,000 U; bacitracin zinc, 500 U

Polymyxin B-bacitracin- Neosporin Opthalmic Ointment Per gram: polymyxin B sulfate, Antimicrobial
neomycin ophthalmic (Monarch) 5,000 U; bacitracin zinc, 400 U;
neomycin sulfate, 5 mg

7
Sulfacetamide sodium ophthalmic Sodium Sulamyd Opthalmic 10%, 30% Antibacterial
Ointment (Schering-Plough)

Tobramycin ophthalmic Tobrex Opthalmic Ointment 0.3% Antibacterial, antibiotic

(Alcon)

Vidarabine ophthalmic Vira-A Opthalmic Ointment 3% Antiviral

(Monarch)

o
o Table 10.4: Examples of Rectal and Vaginal Creams and Ointments
Active Ingredient Product Type Primary Use
Rectal
Anusol (GlaxoSmithKline) Starch Ointment Hemorrhoid treatment

Tronolane (Ross) Pramoxine HCl Cream Hemorrhoidal, analgesic,

antipruritic
Vaginal
Mycelex-7 (Bayer) Clotrimazole Cream Antifungal

AVC (Novavax) Sulfanilamide Cream Vulvovaginitis (Candida

albicans)

Cleocin (Pharmacia & Upjohn) Clindamycin PO4 Cream Bacterial vaginosis

Terazol 7 (Ortho McNeil) Terconazole Cream Antifungal (Candida albicans)

Ogen (Pharmacia & Upjohn) Estropipate Cream Estrogenic for vulvar, vaginal
Premarin (Wyeth-Ayerst) atrophy
Conjugated estrogens Cream Atrophic vaginitis, kraurosis
vulvae