patient information leaflet dithrocream

PATIENT INFORMATION LEAFLET

What you should know about Dithrocream™

(dithranol)

Read these instructions carefully before use

About your treatment

The name of your psoriasis treatment is Dithrocream. It is available in five strengths, which have colour coded packs, as follows:

Dithrocream 0.1 % w/w : pale blue
Dithrocream 0.25% w/w : red
Dithrocream 0.5% w/w : purple
Dithrocream 1.0% w/w : brown
Dithrocream 2.0% w/w : yellow

The active ingredient in Dithrocream is dithranol. Each strength contains 0.1% w/w, 0.25% w/w, 0.5% w/w, 1.0% w/w or 2.0% w/w dithranol, as indicated in the product name. The other ingredients in Dithrocream are white soft paraffin, salicylic acid, cetostearyl alcohol, chlorocresol, ascorbic acid, sodium laurilsulfate and purified water; Dithrocream 2.0% w/w also contains liquid paraffin. Dithrocream is a pale yellow cream. This tube contains 50 g of product.

The active ingredient, dithranol, is an anti-psoriatic, and helps to treat psoriasis by restoring normal skin development.

When NOT to apply Dithrocream

DO NOT use to treat acute and/or pustular psoriasis which feels sore and looks angry.
DO NOT use to treat areas of psoriasis on your face.
DO NOT use if you are sensitive to any of its ingredients (as listed on page 1).

BEFORE you apply Dithrocream

You should not normally use this product to treat psoriasis in areas of folded skin, such as in the groin or underneath the breasts, unless your doctor has specifically directed you to do so. If you have been given a high strength Dithrocream for use in these areas (0.5% w/w, 1.0% w/w or 2.0% w/w), return to your doctor for further advice.
If you have regularly been using topical corticosteroids to treat your psoriasis, you should allow yourself a treatment-free interval of at least one week before starting to use Dithrocream. A bland emollient may usefully be applied during the intervening period.
Salicylic Acid is a mild irritant which can occasionally cause dermatitis.

For your safety

Dithrocream may cause temporary staining of the skin and/or hair. Contact with fabrics, plastics and other materials may cause permanent staining and should be avoided.
Although there is no experimental evidence to support the safety of the drug in pregnancy or when breast feeding, no adverse effects have been reported.
There is no evidence of adverse drug effects when used in children, however, use cautiously with regular supervision.
Dithrocream is for external use only. Keep it away from your eyes, nose and mouth.
Dithranol can act as a laxative if accidentally swallowed, in which case a stomach washout and supportive treatment in hospital are required.
Always wash hands thoroughly after use.

How to apply Dithrocream

Dithrocream is for external use only.

Where the response to Dithrocream has not previously been established, always start treatment with Dithrocream 0.1% w/w, continuing for at least one week and then, if recommended, increase to 0.25% w/w followed by the 0.5% w/w, the 1.0% w/w, and finally the 2.0% w/w strength. Dithrocream 0.5% w/w, Dithrocream 1.0% w/w and Dithrocream 2.0% w/w are for use only under the supervision of a doctor, and the 1.0% w/w and 2.0% w/w strengths should normally only be used for short contact periods (see below).

Directions for use

To open the tube, unscrew the cap and invert to pierce membrane.

Dithrocream should be applied once every 24 hours, at any convenient time of the day or evening, and then removed by washing off, usually no more than one hour after application (Short Contact Therapy). Alternatively, if so directed by your doctor, it may be applied at night before retiring and washed off in the morning.

It is very important to apply Dithrocream sparingly, and only to the affected areas. Rub the cream gently into the skin until completely absorbed. Avoid applying an excessive amount of the cream, which may cause unnecessary soiling and staining of clothing and/or bed linen. Always wash hands immediately after use. After each period of treatment, a bath/shower should be taken to remove any residual cream. To prevent the possibility of discolouration, particularly where Dithrocream 1.0% w/w or 2.0% w/w has been used, always rinse the bath/shower with hot water immediately after washing/showering and then use a suitable cleanser to remove any deposit from the surface of the bath or shower.

For use on the scalp, first comb the hair to remove scalar debris and, after suitably parting, rub the cream well into the affected areas. Always wash hands immediately after use. After use on the scalp, a shampoo may be used to remove the Dithrocream residue. Great care must be taken when washing out the shampoo (which may contain some Dithrocream residue), to ensure that it does not get into the eyes or on the face. This is particularly important when the higher strengths of Dithrocream have been used.

This daily treatment should be continued until the skin is entirely clear, i.e. when there is nothing to feel with the fingers and the texture is normal.

All information in this 'How to apply Dithrocream' section is intended for use only in the absence of more specific directions from your doctor or pharmacist.

During your treatment

Remember: While Dithrocream is working, you may expect to feel a mild local sensation of warmth. If the treatment produces burning or excessive soreness, or if the lesions spread, reduce the frequency of application and, in extreme cases, stop the treatment and ask your doctor for advice.

On rare occasions, creams and lotions may give rise to allergic or local skin reactions (e.g. contact dermatitis) in sensitive people, due to the presence of other ingredients such as chlorocresol and cetostearyl alcohol.

If you have any other ill-effects when using Dithrocream, or if you are in any doubt about your treatment, you should talk to your doctor or pharmacist.

How to store Dithrocream

This product should not be used after the expiry date shown on the tube and carton.
Do not store above 25°C. Keep in a safe place where children cannot see or reach it. Replace the cap tightly after use.

Medicine: dithrocream