LABELLA MEDICATED SOAP

Indications

• Wound healing
• Skin irritations
• Dry skin conditions
• Eczema
• Psoriasis

Dosage

Children: Refer to the BNF for Children for appropriate dosing and formulation guidance for paediatric use.

Adults: Refer to specific product guidelines for application frequency and amount, as allantoin is typically used in topical formulations.

Mechanism of action

Although there is no well-controlled data to formally substantiate its method of action, studies suggest that allantoin may induce a histological wound healing profile. This profile includes increased vasodilation, inflammatory exudate presence, and enhanced numbers of inflammatory cells, angiogenesis, fibroblast proliferation, and collagen deposition in wound sites treated with allantoin compared to untreated ones.

Pharmacodynamics

Ongoing studies indicate that allantoin possesses moisturizing and keratolytic effects. It can increase the water content of the extracellular matrix and promote the desquamation of the upper layers of dead skin cells. These activities are believed to support cell proliferation and facilitate wound healing.

Pharmacokinetics

The pharmacokinetics of allantoin are not well characterized in controlled studies. However, its application as a topical agent suggests localized effects with minimal systemic absorption, facilitating its use in dermatological applications without significant systemic effects.

Pregnancy

There is limited data on the safety of allantoin in pregnancy. Use should be based on a risk-benefit assessment.

Breast-feeding

Limited data available, use with caution and consult a healthcare professional.

Storage

Store in a cool, dry place away from moisture and direct sunlight.

Formulations

• Topical cream
• Ointment
• Gel

Indications

• Prevention of vitamin E deficiency
• Antioxidant therapy
• Support in conditions related to oxidative stress

Dosage

Children: Refer to BNF for Children for specific dosage guidelines.

Adults: Refer to BNF for specific dosage guidelines.

Mechanism of action

Tocopherol acts as a radical scavenger, primarily functioning as an antioxidant for lipid bilayers. It donates hydrogen atoms to free radicals, trapping them and preventing cellular damage. Its effectiveness is influenced by its location within the membrane and its interaction with cytosolic reductants like ascorbate. Tocopherol can trap multiple radicals, including alkyl and peroxy radicals.

Pharmacodynamics

The antioxidant properties of tocopherol lead to significant pharmacodynamic effects, including the inhibition of cell death through modulation of protein kinase C (PKC). Tocopherol also exhibits anti-inflammatory effects, which can be attributed to its influence on cytokines, prostaglandins, prostanoids, and thromboxanes. These interactions may contribute to its protective effects in various pathological conditions.

Pharmacokinetics

Tocopherol is absorbed in the intestines and its bioavailability can be influenced by dietary fat intake. It is transported in the plasma primarily bound to lipoproteins. Tocopherol is stored in adipose tissue and the liver, and its elimination occurs through bile and urine. The half-life of tocopherol can vary depending on the individual's nutritional status and other factors.

Pregnancy

Tocopherol is generally considered safe during pregnancy, but it is advisable to consult a healthcare provider before use.

Breast-feeding

Tocopherol is excreted in breast milk, and while it is considered safe, a healthcare provider should be consulted for specific recommendations.

Storage

Store in a cool, dry place away from direct sunlight.

Indications

• Topical antiseptic in skin preparations
• Disinfectant in personal care products
• Antibacterial agent in household cleaning products
• Used in dental hygiene products

Dosage

Children: Refer to specific product guidelines for children, as concentrations and formulations can vary significantly based on age and product type.

Adults: Refer to specific product guidelines for particular formulations and concentrations, as dosing can vary widely depending on the intended use and formulation.

Mechanism of action

Triclosan exerts its antimicrobial effects primarily by inhibiting the enzyme enoyl-acyl carrier protein reductase (FabI), which is crucial in the fatty acid synthesis pathway of bacteria. By blocking this enzyme, triclosan disrupts the production of fatty acids necessary for bacterial cell membrane integrity and function, leading to cell death. This mechanism is effective against a wide range of Gram-positive and Gram-negative bacteria, as well as certain fungi.

Pharmacodynamics

The pharmacodynamic properties of triclosan are characterized by its bactericidal and fungicidal activities. Its effectiveness is influenced by concentration, exposure time, and the type of microorganisms present. Triclosan has been shown to exhibit time-dependent killing, where prolonged exposure enhances its antimicrobial efficacy. However, the emergence of resistance due to overuse is a concern, as some bacterial strains have developed reduced susceptibility to triclosan.

Pharmacokinetics

Triclosan is poorly absorbed through the skin and gastrointestinal tract, with limited systemic circulation when used topically. It is primarily metabolized in the liver and excreted via urine and feces. The half-life of triclosan can vary, but it is generally considered to be in the range of several hours. Its distribution is largely localized at the site of application, minimizing systemic effects, although it can bioaccumulate in the environment and in human tissues over time.

Adverse effects

• Skin irritation
• Allergic reactions
• Contact dermatitis
• Photosensitivity

Precautions

• Use with caution in patients with known hypersensitivity to triclosan or similar compounds.
• Avoid contact with eyes and mucous membranes.
• Not recommended for prolonged use or in high concentrations.

Pregnancy

Triclosan should be used during pregnancy only if clearly needed. The effects on fetal development are not well established.

Breast-feeding

Triclosan is excreted in breast milk. Caution should be exercised when administering to nursing mothers.

Storage

Store at room temperature, away from direct sunlight and moisture.

Formulations

• Topical creams
• Lotions
• Soaps
• Gels
• Toothpaste

Mechanism of action

There is no well controlled data that can formally substantiate the method of action. However, ongoing studies suggest that there may exist a histological wound healing profile induced by allantoin in rats that leads to the amelioration and fastening of the reestablishment of normal skin. This facilitation of wound healing is supported by observations that wounds inflicted to rat subjects to which topical allantoin preparations were applied histologically demonstrated increased vasodilation, presence of inflammatory exudates, number of inflammatory cells, angiogenesis, fibroblast proliferation, and increased collagen deposition when compared to rat subjects with wounds that did not receive any allantoin administration.

Pharmacodynamics

There is no well controlled and appropriate data that can formally substantiate the pharmacodynamic properties of allantoin. Nevertheless, ongoing studies suggest that allantoin possesses moisturizing and keratolytic effects, as well as abilities to increase the water content of the extracellular matrix and enhance the desquamation of upper layers of dead skin cells, all of which are activities that can promote cell proliferation and facilitate wound healing.

Mechanism of action

Tocopherol acts as a radical scavenger. It mainly acts as an antioxidant for lipid bilayers. Tocopherol's functions depend on the H-atom donating ability, location, and movement within the membrane, as well as the efficiency in the radical recycling by some cytosolic reductants such as ascorbate. Tocopherol actions are related to the trap of radicals, and it has been shown that even in the absence of substituents in the ortho-positions, tocopherol can trap more than two radicals. The type of radicals available for tocopherol are alkyl and peroxy.

Pharmacodynamics

The antioxidant effects of tocopherol can be translated into different changes at the pharmacodynamic level. In vitro studies have shown that this antioxidant activity can produce modification in protein kinase C (PKC) which will later be translated into an inhibition of cell death. Some other derivate effects are the anti-inflammatory properties of tocopherol which can be related to the modulation of cytokines or prostaglandins, prostanoids and thromboxanes.