Allantoin/Azelaic Acid 1589

Amiloxate (USAN, rINN) 3. Hughes CG. Oral PABA and vitiligo. J Am Acad Dermatol 1983; Avobenzone (USAN, rINN)
9: 770.
Amiloxato; Amiloxatum; E-1000; Isoamyl p-Methoxycinnamate. 4. Worobec S, LaChine A. Dangers of orally administered para- Avobenzona; Avobenzonum; Butylmethoxydibenzoylmethane;
Isopentyl p-methoxycinnamate; 3-(4-Methoxyphenyl)-2-prope- aminobenzoic acid. JAMA 1984; 251: 2348. 4-tert-Butyl-4′-methoxydibenzoylmethane. 1-(p-tert-Butylphe-
noic acid 3-methylbutyl ester. Pharmacokinetics nyl)-3-(p-methoxyphenyl)-1,3-propanedione; 1-[4-(1,1-dimeth-
Амилоксат If given orally, aminobenzoic acid is absorbed from the gastroin- ylethyl)phenyl]-3-(4-methoxyphenyl)-1,3-propanedione.
C 15 H 20O 3 = 248.3. testinal tract. It is metabolised in the liver and excreted in the
urine as unchanged drug and metabolites. Авобензон
C AS — 71617-10-2.
C 20 H 22 O 3 = 310.4.
Uses and Administration
Aminobenzoic acid is applied topically as a sunscreen (p.1576). C AS — 70356-09-1.
O Aminobenzoic acid and its derivatives effectively absorb light
throughout the UVB range but absorb little or no UVA light (for
definitions, see p.1580). Aminobenzoate sunscreens may there- CH3
H3C O O fore be used to prevent sunburn, but are unlikely to prevent drug- H 3C
related or other photosensitivity reactions associated with UVA O
CH3 H 3C CH3
light; combination with a benzophenone may give some added
H 3C protection against such photosensitivity.
Aminobenzoic acid has sometimes been included as a member
NOTE. Neo-Heliopan E 1000 is a trade name that has been used of the vitamin-B group, but deficiency of aminobenzoic acid in
man or animals has not been found.
for amiloxate.
Pharmacopoeias. In US. Aminobenzoic acid has been used with bentiromide (p.2264) in
the PABA or BTPABA test of pancreatic function. NOTE.Escalol 517, Eusolex 9020, Neo-Heliopan 357, and Parsol
USP 31 (Amiloxate). Store in airtight containers. 1789 are trade names that have been used for avobenzone.
Profile Pharmacopoeias. In US.
USP 31: Aminobenzoic Acid Gel; Aminobenzoic Acid Topical Solution.
Amiloxate, a substituted cinnamate, is a sunscreen (p.1576) with USP 31 (Avobenzone). M.p. 81° to 86°. Store in airtight con-
actions similar to those of octinoxate (p.1608). It is effective Proprietary Preparations some preparations are listed in Part 3.
tainers. Protect from light.
against UVB light (for definitions, see p.1580).
Preparations Profile
Ammonium Lactate (USAN) Avobenzone is a substituted dibenzoylmethane used by topical
Proprietary Preparations some preparations are listed in Part 3. application as a sunscreen (p.1576). Dibenzoylmethanes absorb
Amonio, lactato de; BMS-186091.
light in the UVA range (for definitions, see p.1580) and may
Аммония Лактат therefore be used with other sunscreens that absorb UVB light to
C 3 H 9 NO 3 = 107.1. prevent sunburn; they will also provide some protection against
Aminobenzoic Acid C AS — 52003-58-4. drug-related or other photosensitivity reactions associated with
Acide 4-Aminobenzoïque; Acidum 4-aminobenzoicum; Amben; ATC Vet — QA16QA04. UVA light.
4-Aminobensoesyra; 4-Aminobentsoehappo; 4-aminobenzoe-
_ Contact and photocontact allergic dermatitis has occasionally
sav; Aminobenzoico, ácido; 4-Aminobenzoinė ru gštis; Kwas 4- been reported with the topical use of dibenzoylmethane sun-
aminobenzoesowy; Kyselina 4-aminobenzoová; PAB; PABA; Pa- O NH4+
bacidum; Para-aminobenzoic Acid; Vitamin Bx; Vitamin H′. 4- O-
Aminobenzoic acid. Preparations
Аминобензойная Кислота Proprietary Preparations numerous preparations are listed in
C 7 H 7 NO 2 = 137.1. OH Part 3.
C AS — 150-13-0.
ATC — D02BA01. Profile
ATC Vet — QD02BA01. Ammonium lactate is a humectant applied as a cream or lotion
containing 12% lactic acid neutralised with ammonium hydrox- Azelaic Acid (USAN, rINN)
ide. It is used in the treatment of dry scaly conditions of the skin
O OH including ichthyosis. Adverse effects of topical ammonium lac- Acide azélaïque; Ácido azelaico; Acidum azelaicum; Anchoic acid;
tate preparations include transient erythema, burning, and sting- Atselaiinihappo; Azelaik Asit; Azelainsyra; Lepargylic acid; ZK-
ing. Treated areas may be more sensitive to sunlight and expo- 62498. Nonanedioic acid; Heptane-1,7-dicarboxylic acid.
sure should be minimised.
Азелаиновая Кислота
C 9 H 16 O 4 = 188.2.
Proprietary Preparations (details are given in Part 3)
Arg.: Lacto-Cev; Lactrex; Braz.: Lac-Hydrin; Canad.: Lac-Hydrin; Chile: C AS — 123-99-9.
Kerapil†; Topilact 12†; Fr.: Kerapil†; Malaysia: Lanate; Mex.: Lac-Hydrin;
NH2 NZ: Lac-Hydrin; Lanate; Singapore: Lac-Hydrin; Lanate; USA: Amlactin; ATC — D10AX03.
Geri-Hydrolac; Kerasal AL; Lac-Hydrin; LAC-Lotion. ATC Vet — QD10AX03.
Pharmacopoeias. In Eur. (see p.vii) and US. Multi-ingredient: Arg.: Clobeplus; Clobesol LA; Lactiderm; Lactiderm
Ph. Eur. 6.2 (4-Aminobenzoic Acid; Aminobenzoic Acid BP HC†; Lacto-Cev Zn; Urecrem Hidro; Braz.: Lactrex; Chile: Ichtyosoft†;
KPL†; Lactrex†; Queratopil; Fr.: I-Soft†; Ichtyosoft†; Keralac Plus†; Zeniac
2008). White or slightly yellow crystalline powder. Slightly sol- LP Fort†; Zeniac LP†; Zeniac†; Indon.: Exfoliac; Ital.: Alfa Acid; Ipso Urea; O O
uble in water; freely soluble in alcohol; it dissolves in dilute so- Mex.: Lactrex; Port.: Lactonico†; Venez.: Lactrex.
lutions of alkali hydroxides. Protect from light.
USP 31 (Aminobenzoic Acid). White or slightly yellow, odour- HO OH
less crystals or crystalline powder. It discolours on exposure to
air or light. Slightly soluble in water and in chloroform; freely
soluble in alcohol and in solutions of alkali hydroxides or car- Arbutoside; Arbutyna; Beta-arbutin; Ursin. 4-Hydroxyphenyl-βD- Adverse Effects and Precautions
bonates; sparingly soluble in ether. Store in airtight containers. glucopyranoside. Topical application of azelaic acid may produce a tran-
Protect from light. Арбутин sient skin irritation such as burning, stinging, pruritus,
Adverse Effects and Precautions C 12 H 16 O 7 = 272.3.
C AS — 497-76-7 (beta-arbutin); 84380-01-8 (alpha-ar- dryness, and scaling. It is usually mild and disappears
Adverse skin reactions such as local irritation and contact derma- on continued treatment, but in a few patients the irrita-
titis have been reported after the topical use of aminobenzoate butin).
sunscreens. Aminobenzoate sunscreens should not be used by tion may persist, requiring reduced frequency of appli-
those with a history of photosensitivity or hypersensitivity reac- cation or temporary suspension of treatment. There
tions to structurally related drugs such as sulfonamides, thiazide HO have been rare reports of hypopigmentation, rash, and
diuretics, and ester-type local anaesthetics. photosensitivity. Azelaic acid should not be applied to
Aminobenzoic acid may stain clothing. O OH
O the eyes, mouth, or other mucous membranes.
◊ Allergic and photoallergic contact dermatitis have been report- OH
ed after topical use of aminobenzoic acid or its esters.1 Early re- Uses and Administration
ports of such reactions led to the removal of these compounds
from sunscreen preparations (many are now described as ‘PA- OH Azelaic acid inhibits the growth of Propionibacterium
BA-free’), although padimate O still appears to be widely used.2 spp. and reduces keratinisation. It is used in the topical
Patients allergic to aminobenzoic acid may also react to structur- Profile treatment of mild to moderate inflammatory acne
ally related allergens such as para-aminobenzoic acid ester an- Arbutin is a glycosylated derivative of hydroquinone (p.1598) (p.1577) and for the inflammatory papules and pus-
aesthetics, sulfonamides, and paraphenylenediamine in hair extracted from bearberry (p.2263) and similar plants. It is used
tules of mild to moderate rosacea (p.1583). It has also
dyes.1,2 topically in concentrations of 1 to 5% as a depigmenting agent
for the skin in hyperpigmentation disorders. The higher concen- been tried in hyperpigmentary skin disorders such as
Skin reactions (vitiligo) have also been reported with oral ami-
nobenzoic acid3 and the adverse effects associated with the trations may lead to a paradoxical hyperpigmentation. melasma, and in malignant melanoma.
former use of high oral doses for various conditions have been Alpha-arbutin has been used similarly. In the treatment of acne azelaic acid is applied twice
highlighted.4 Preparations daily for up to 6 months as a 20% cream or 15% gel.
1. Scheuer E, Warshaw E. Sunscreen allergy: A review of epidemi- Proprietary Preparations (details are given in Part 3)
ology, clinical characteristics, and responsible allergens. Derma- Improvement usually occurs within four weeks.
titis 2006; 17: 3–11. Correction. ibid.; 162. Multi-ingredient: Arg.: Cellskinlab Phyto Spot; Melasoft†; Chile: Phyto
2. Mackie BS, Mackie LE. The PABA story. Australas J Dermatol
Corrective Gel; Phyto Spot; Port.: Despigmentante. For the treatment of mild to moderate rosacea, a 15%
1999; 40: 51–3. gel should be applied to the affected area twice daily
The symbol † denotes a preparation no longer actively marketed The symbol ⊗ denotes a substance whose use may be restricted in certain sports (see p.vii)

Skinoren. Becaplermin is ap.1 Becaplermin (BAN. almost white. Cutis 2006. Breathnach AS. and presence of reducing substances. Gr. Bekaplermiini. peeling. Int ble in water.1576).4 In one study O 25% of patients were considered to be hypersensitive from patch with nonhealing.: be destroyed by the addition of sodium hydroxide solution ◊ References.: Regranex. Eur. Hascoderm. Finevin. Liu RH. exposed to temperatures higher than 60° or cause fires in the ment of osteonecrosis of the jaw. plying it near the eyes. Contact dermatitis to benzoyl peroxide. to grinding.Afr. 2: 211–18. A study of acne treatments as risk factors for Proprietary Preparations (details are given in Part 3) skin cancer of the head and neck.: Skinoren. Chemilaic†. Malay. Melanin hyperpigmentation of skin: melasma. 21: 822–7. and transient lo- sia: Skinoren. Mandracchia VJ. The lotion is applied in a sufficient quantity to search on Cancer4 considers that there is inadequate evidence in tissue and promotes wound healing (p. Azelaic acid: a review of its pharmacological ex. (see p. 8: 323–6.4 Another study involving 204 patients with acne found that 3. as well as hu- ATC Vet — QD03AX06.3. nyl)-1. Belg. McGuire MK. Rietschel RL. Kraus AL. UK: Regran. Tinosorb S is a trade name that has been used for bemot- noren. Hydrous). 26: 223–31. Preparations Body odour. Singa. et al. USAN. Cz. Mex. allergic reactions to the drug on further testing. NZ: Acnederm. Thiboutot D. Zelface. Benzoyl peroxide reactions in an acne 7. NSC-675. Exazen. peroxide was about 15% but only 1% of the patients had true ticenter open-label study. with an increased risk of facial cancer. Store in the original container. acne. Leyden JJ. Thai. Azelaic acid in the treatment of papulopustular Бемотрицинол but should be destroyed by the addition of sodium hydroxide so- rosacea: a systematic review of randomized controlled patients treated with 3 or more tubes of becaplermin gel (tube zoil-peroxid. Goa KL. rINN) a water content of about 26%. Benzoilo peroksidas. for up to 20 weeks.2 A comprehensive Profile review3 that included in-vitro and animal studies. RWJ-60235.: Regranex.1590 Dermatological Drugs and Sunscreens for a period of up to 12 weeks. treated to reduce static charges. Bémotrizinol. If continued protection is required the lotion may be classifiable as to its carcinogenicity to humans. Port.1 However. An unusual unpleasant body odour in a patient Proprietary Preparations some preparations are listed in Part 3. in the repair of cartilage. Hong Kong: Qualicren. Guzman-Gardearzabal E. Dibenzoyl peroxide. Hong Kong: Acned. p. is a barrier man data. Skinoren. Benzoyl peroxide. Fin. Contact Dermatitis 1977. 57 (suppl): 36–45. Switz.8. Improvement usually Preparations that has a device for the release of excess pressure. Zumilin. Austral. Zorkenil. Azelac. described as an organoclay compound. Caution is required when ap- Finacea. Opilet. Nevins M. Skinoren. infection has cleared. Becaplermin: recombinant platelet de. Port.1580). There has been concern at the implications of Bekaplermin. et al. Regul Toxicol Pharmacol 1995. not appear to correlate either with the clinical irritation produced 2. be mistaken for irritation or worsening of the acne. Mex. 76: 2205–15.: Skinoren. Skinoren. J Periodontol 2005. Contact ibid. treatment should be re-assessed. Benzoyil Peroksit. Adv Therapy 2000. QD11AX90. the International Agency for Re- factor (rhPDGF-BB) that enhances the formation of granulation poison sumac. poison oak. quency of application or temporary suspension of Hung. et al. tion of a crystal of potassium iodide does not result in the release 1. US licensed product information warns Benzoyl Peroxide (USAN) 4. oxid. Practically insolu. C 38 H 49N 3 O 5 = 627. Quaternium 18-bentonite. USA: Ivy Block. Di. or cancer in humans. Pol. Benzoyl peroxide appears to induce contact ◊ References. N Israel: Skinoderm. Switz. Бензоил Пероксид. (10%). properties and therapeutic efficacy in acne and hyperpigmentary of free iodine after acidification with dilute hydrochloric acid.2 (Benzoyl Peroxide. et al. Skinoren. Azelaxine. Ski. 77 (suppl): 12–16.: Cutacelan†. infected during therapy. ble at: http://monographs. also concluded that there was no evidence to associate Profile preparation that is applied topically as a 5% lotion to prevent al. 77 (sup. 1. Availa- that an increased rate of death from all cancers has been seen in Bensoylperoxid. fractures.: taining benzoyl peroxide. Smiell JM. was attributed to the topical use of benzoyl peroxide. It contains not less Dermatitis 1982. 6. study group.: Regranex. Contact sensitisation has Skinoren. In zantyl. Becaplerminum. 304: 1366. Acne and allergic contact dermatitis. Neocutis. et al. Bemotrizinolum. slightly soluble in alcohol.: Acne-Derm.: Dermazil. Bemotrizinol (USAN.: Azelderm. Recombinant human platelet-derived Bentoquatam (USAN) some animal studies showing benzoyl peroxide to possess some growth factor B. Benzoylper. Platelet-derived growth factor stimulates bone and not less than 20% of water. Multi-ingredient: USA: GEM 21S. 142: 1047–52. O O during treatment.: Regranex. J Periodontics Restorative Dent 2006.: Regranex. percussion.5 However. Carcinogenicity. Benzoylis peroxidum. Int. to air and may explode if the water content is too low. Forcilen†. Body odor from topical benzoyl peroxide. Neth. S. Regranex. Spain: Regranex.: Finacea.4-diyl]bis{5-[(2-ethylhexyl)oxy]phenol}. Cz. Fitton A. against UVA light (for definitions. Embil JM.: Finacea. Skinoren. It is applied once daily. Wieman TJ. Becaplermin should not be applied to ulcers where neoplasms 3.: Zeroac. Contact Dermatitis 1982. USA: Regranex. Kligman AM.: Ski. USA: Azelex. Spain: Finacea. Destruction can be considered to be complete if the Arch Dermatol 2006. Bemotrizinol is used as a sunscreen (p. Noreskin. lution (10%). tumour-promoting activity. hypersensitivity quite often when used to treat leg ulcers. Efficacy and safety of becaplermin (recom. et al. and in ether. form a visible coating 15 minutes before possible contact with humans and its overall evaluation is that benzoyl peroxide is not plied topically as a 0.1 but it ATC Vet — QD10AE01. ATC — D10AE01. Cutis 2006. ity. covered by a moist saline removed. Unused ma- occurs in 4 to 8 weeks. IARC monographs on the eval- uation of carcinogenic risks to humans volume 71 1999.: Skinoren. Sparingly soluble in wa- 4. Rus. Malaysia: Acnederm Lotion. Proprietary Preparations (details are given in Part 3) terial should not be returned to its original container but should Austria: Regranex. Ger. FAT-70884. USP 31 (Hydrous Benzoyl Peroxide). 2007. re-applied every 4 hours or at any time if the visible coating is 1. Ben. Indon. Molberg P. 4: 75–8. UK: Finacea. Israel: Regranex.: Aknoren. promoter benzoyl peroxide for acne treatment. Clin Po- diatr Med Surg 2001. Protect from light. C AS — 94-36-0 (anhydrous benzoyl peroxide). . Swed. Bis-ethylhexyloxyphenol ular powder with a characteristic odour. which usually resolves on continued use. 4.: Cutacelan. or heat. Benzoyl peroxide: lack of sensitization. rash. N Engl J Med 1981. H C CH been reported in some patients using preparations con- noren. membranes. in a container that has been treated to reduce static charges and Dermatitis 1996. C AS — 187393-00-6. Bentsoyyliperoksidi. Destruction can be considered to be complete if the addi- granex. Multi-ingredient: Austral. Skinoren. 27: 88.: Skinoren.433). Bentoquatam. Peróxido de benzoilo. treatment. Zeliderm. Burke B. Venez. The hydrous form is a white gran- 3. and other therapies. Treatment of chronic ulcers in the incidence of false-positive irritant skin reactions to benzoyl the lower extremities with topical becaplermin gel . Expert Opin Biol Ther 2002. Denm. soluble in acetone. than 70% and not more than 77% of anhydrous benzoyl peroxide 2. Store at 2° to 8° 5. It is effective pore: Acnederm. ide. Qualilaic. NOTE. Cevigen.: Skinoren. et al. ness neuropathic diabetic skin ulcers (see Diabetic Complica. Finacea.01%: a mul. Hogan DJ.: Skinoren.pdf (accessed 27/09/07) size not specified). Drugs 1991.: Acnederm Medicated. 2. Braz. a retrospective survey in Бекаплермин Бентокватам Canada concluded that there was no indication that the normal C AS — 165101-51-9. Singapore: Skinoren.5-triazine-2. OH N N OH some patients the irritation may require reduced fre- Zelicrema. IARC/WHO.vii). Del Rosso JQ.: Finacea. Fr. Contact rived growth factor. Skin dryness. Norw. et al.: Ski- Adverse Effects and Precautions noren. Prevolac†.2′-[6-(4-Methoxyphe- disorders other than inflammatory rosacea. Unused material should not be returned to its original container pl): 22–4. volume71. Finacea. rizinol. Skin cancer: risk to individuals using the tumour tions. Philipp. The use of becaplermin (rhPDGF-BB) gel (anhydrous benzoyl peroxide) has been concern that hypersensitivity to benzoyl peroxide may for chronic nonhealing ulcers: a retrospective analysis. It contains not less than topical treatment with azelaic acid. Methoxyphenol Triazine. Contact sensitization to benzoyl perox- er randomized controlled trial. A white or 3. Becaplermina. Ger. Hypersensitivity. Benzoyl peroxide: an integrated human safety are present or to clinically infected ulcers.: Re. Irl. Ital. Br J Dermatol 1991.: Regranex. Gr. Efficacy and safety of a topical gel formulation is unclear how often this occurs when used in the treatment of of recombinant human platelet-derived growth factor-BB (beca. lower extremity diabetic ulcers: a combined analysis of four randomized studies. particularly at the start of treatment. in chloroform. et al. ble in dichloromethane with separation of water.: Acnezaic†. Balato N. Pharmacopoeias. Peroxyde de benzoyle. soluble in acetone. Skinoren. 1. ulcers. Skinoren. 62: 458–9. there 4. It rapidly loses water on exposure Acta Derm Venereol (Stockh) 1982. addition of a crystal of potassium iodide does not result in the re- Preparations lease of free iodine.1585). and tendon injuries. skin irritation. NZ: H C O O CH cal oedema may also occur. In Chin. bleaching property.iarc.. use of benzoyl peroxide in the treatment of acne was associated ATC — D03AX06. rINN) 1. amorphous or granular powder. Profile Patients should be alerted to benzoyl peroxide’s erm. Handling. 8: 338. BEMT. Sonalent. becaplermin should be stopped until the 21: 87–107. the topical use of benzoyl peroxide with the development of skin Becaplermin is a recombinant human platelet-derived growth lergic contact dermatitis caused by poison ivy. If no meaningful healing Preparations 1985. Zeliris. the plants. Cutis 65% and not more than 82% of anhydrous benzoyl peroxide with 1996. Topical application of benzoyl peroxide may produce Skinoren. 125: weeks of therapy. et al. 34: 68–9. et al.4 in some studies suggests that up to 76% of plermin) in patients with chronic neuropathic diabetic ulcers: a patients may be hypersensitive to benzoyl peroxide but this does phase III randomized placebo-controlled double-blind study.: Aza 20. Canad. Correction. 5. 18: 189–209.2. Azelderm. Dermizan. 41: 780–98. Eur. skin disorders. or binant human platelet-derived growth factor-BB) in patients with the reported incidence of hypersensitivity. Skinoren.: Skinoren (Скинорен).: Alen.: Skinoren. If the ulcer becomes assessment for carcinogenicity. Vena GA. a new treatment for healing diabetic foot Ph. Skinoren. Пероксид Бензоила C 14 H 10O 4 = 242. Bécaplermine. and to the neck and other sensitive areas.2. Azedose. fill and rate of attachment level gain: results of a large multicent. Austria: Skinoren. Elewski B. However. 3: 273–5.2 Patch testing3. rhPDGF-BB promotes healing of periodon- tal defects: 24-month clinical and radiographic observations. process (decrease in ulcer size of about 30%) is evident after 10 2. O abetes Care 1998. and US.: Regranex. Jones GRN.3 5. Proprietary Preparations (details are given in Part 3) OCH Arg. see p. and osteoporosis. Skinoren. Hum Toxicol gauze dressing. 6. Skinoren. Finacea. Hydrous benzoyl peroxide con- phate matrix to promote bone and tissue growth in the treatment taining water to reduce the risk of explosion may still explode if of periodontal disease. 343–8. It is also under investigation in the treat. Kenedril. Wound Repair Regen 1999. ligament. the mouth and other mucous celan.. testing but only 2 of 44 patients developed clinical hypersensitiv- 7: 335–46. Finacea. Turk. 2.: Finacea.01% gel in the management of full thick. 17: 184–9.: Cuta.: Azelan. Ital. Cunliffe WJ. Nagai MK. A clinical overview of azelaic acid. The use of topical azelaic acid for common skin ter and in alcohol. Benzoyl peroxide powder may explode if subjected Becaplermin is used with a resorbable synthetic calcium phos. C AS — 1340-69-8. solu. Duncan SH. Fr.