MEDIPLEX INJECTION

Indications

• Papulopustular rosacea
• Inflammatory acne vulgaris

Dosage

Children: Refer to the BNF for Children for specific dosing recommendations.

Adults: For papulopustular rosacea, apply daily for up to 4 months. The treatment course may be repeated; discontinue if no improvement is observed after 3 months. For inflammatory acne vulgaris, apply twice daily, reduced to once daily or alternate days if irritation occurs.

Mechanism of action

Nicotinamide exhibits anti-inflammatory effects by inhibiting the release of pro-inflammatory cytokines and enhancing the barrier function of the skin. It is also involved in the NAD salvage pathway, which is essential for maintaining cellular energy levels and promoting cell repair mechanisms. Additionally, nicotinamide contributes to the synthesis of coenzymes involved in metabolic processes, including the conversion of niacin into NAD+.

Pharmacodynamics

Nicotinamide is known for its ability to improve skin hydration and reduce transepidermal water loss. It has been shown to decrease the appearance of acne lesions and rosacea by modulating inflammatory responses and accelerating cell turnover. Its antioxidant properties also help to protect the skin from oxidative stress and UV damage.

Pharmacokinetics

When applied topically, nicotinamide is absorbed through the skin layers, with minimal systemic absorption. Its peak plasma concentrations are generally low, and the drug has a half-life that varies depending on the route of administration. The metabolism of nicotinamide occurs primarily in the liver, where it is converted into its active forms, including NAD+. The elimination route is via the kidneys, with metabolites excreted in urine.

Contra-indications

• Pregnancy
• Severe acne involving large areas
• Severe skin reactions

Adverse effects

• Sunburn
• Skin reactions (common or very common)
• Cheilitis
• Eyelid oedema
• Flushing
• Dry skin
• Eye irritation
• Photosensitivity reactions
• Transient skin pigmentation changes

Interactions

• Clindamycin
• Topical retinoids
• Abrasive cleaners
• Comedogenic cosmetics

Precautions

• Avoid exposure to UV light, including sunlight and sunlamps
• Wash hands immediately after use
• Avoid contact with eyes and mucous membranes
• Use moisturizers to reduce the risk of skin irritation
• Discontinue treatment if severe irritation occurs

Pregnancy

Avoid use during pregnancy due to potential risks, as limited information is available regarding toxicity.

Breast-feeding

Amount of drug in milk after topical application is probably too small to be harmful; ensure infant does not come in contact with treated areas.

Storage

Store at room temperature away from moisture and light.

Formulations

• Cream
• Gel

Indications

• Dry skin
• Skin irritation
• Eczema
• Psoriasis
• Wound healing
• Hair conditioning

Dosage

Children: For pediatric use, refer to specific product guidelines as dosing may vary based on the formulation and age of the child.

Adults: Pathenol is typically used in topical preparations. The specific dosage depends on the formulation and the condition being treated. Refer to product-specific guidelines for detailed dosing information.

Mechanism of action

Pathenol acts as a precursor to coenzyme A and plays a role in the synthesis of fatty acids and the metabolism of carbohydrates and proteins. When applied topically, it is converted into pantothenic acid, which is essential for cellular processes and promotes the regeneration of skin cells. It also enhances the barrier function of the skin, aiding in moisture retention.

Pharmacodynamics

Pathenol exhibits moisturizing properties by attracting water to the skin, thereby improving hydration levels. It also has anti-inflammatory effects, which can help soothe irritated skin. Its ability to enhance skin barrier function contributes to its effectiveness in treating dry and damaged skin conditions.

Pharmacokinetics

Pathenol is readily absorbed through the skin when applied topically. It is metabolized to pantothenic acid, which is then utilized in various metabolic pathways. The systemic absorption is minimal, and the effects are primarily localized to the site of application.

Pregnancy

Pathenol is generally considered safe for use during pregnancy, but it is recommended to consult a healthcare provider before use.

Breast-feeding

Pathenol is excreted in breast milk, but it is typically regarded as safe for breastfeeding mothers. Consultation with a healthcare provider is advised.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.