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Cantharidin: Drug information

Cantharidin: Drug information
(For additional information see "Cantharidin: Patient drug information" and see "Cantharidin: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Ycanth
Brand Names: Canada
  • Cantharone
Pharmacologic Category
  • Keratolytic Agent
Dosing: Adult
Common or periungual warts

Common or periungual warts: Cantharone (0.7% film-forming liquid) [Canadian product]: Topical: Apply directly to lesion and to 1 mm surrounding margin; once dry, cover with nonporous tape; remove tape in 24 hours and replace with a loose bandage; may re-treat in 1 to 2 weeks, if needed.

Molluscum contagiosum

Molluscum contagiosum:

Ycanth (0.7% solution): Topical: Apply as a single application to cover each lesion; do not use more than 2 applicators in a single treatment session; remove with soap and water 24 hours after treatment; may re-treat every 3 weeks as needed.

Cantharone (0.7% film-forming liquid) [Canadian product]: Topical: Apply directly to the top of each lesion and let dry completely; once dry, occlusive tape or dressing may be used but is not needed. May re-treat once weekly for new or resistant lesions; once dry, cover large or resistant lesions with nonporous tape for 4 to 6 hours.

Plantar warts

Plantar warts: (Cantharone (0.7% film-forming liquid) [Canadian product]: Topical: Remove keratin covering wart while avoiding cutting viable tissue, apply to lesion and to 1 to 3 mm surrounding margin; once dry, cover with nonporous tape; debridement may take place 1 to 2 weeks after treatment. May re-treat, if necessary (3 or more treatments may be needed for large lesions).

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Cantharidin: Pediatric drug information")

Molluscum contagiosum

Molluscum contagiosum:

Ycanth (0.7% solution): Children ≥2 years and Adolescents: Topical: Apply as a single application to cover each lesion; do not use more than 2 applicators in a single treatment session; remove with soap and water 24 hours after treatment; may re-treat every 3 weeks as needed.

Cantharone (0.7% film forming liquid) [Canadian product]: Children ≥3 years and Adolescents: Topical: Apply directly to the top of each lesion; once dry, cover large or resistant lesions with nonporous tape for 4 to 6 hours. May re-treat once weekly for new or resistant lesions.

Common or periungual warts

Common or periungual warts: Cantharone [Canadian product]: Children ≥3 years and Adolescents: Topical: Apply directly to lesion and to 1 mm surrounding margin; once dry, cover with nonporous tape; remove tape in 24 hours and replace with a loose bandage; may re-treat in 1 to 2 weeks, if needed.

Plantar warts

Plantar warts: Cantharone [Canadian product]: Children ≥3 years and Adolescents: Topical: Remove keratin covering wart while avoiding cutting viable tissue, apply to lesion and to 1 to 3 mm surrounding margin; once dry, cover with nonporous tape; debridement may take place 1 to 2 weeks after treatment. May re-treat, if necessary (3 or more treatments may be needed for large lesions).

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Adverse reactions reported in children, adolescents, and adults.

>10%:

Dermatologic: Erythema of skin (≤24%; severe:<1%)

Local: Application-site erythema (≤24%; severe: <1%), application-site pain (≤41%; severe: ≤2%), application-site pruritus (≤47%; severe: ≤1%), application-site reaction (scab: 9% to 39%), application-site vesicles (32% to 60%; severe: 4%), local dryness of skin (application site: 2% to 19%), local pain (≤41%; severe: ≤2%), local pruritus (≤47%; severe: ≤1%), local skin discoloration (application site: 4% to 28%; severe: <1%)

1% to 10%:

Dermatologic: Contact dermatitis (1%), skin erosion (application site: 6%)

Local: Application-site edema (7%)

Contraindications

There are no contraindications listed in the US manufacturer's labeling.

Canadian labeling: Use in patients with diabetes or in individuals with impaired peripheral circulation; use near eyes or on face or mucous membranes; in anogenital, intertriginous, or axilla areas.

Warnings/Precautions

Concerns related to adverse effects:

• Localized skin reactions: Vesicant that may cause vesiculation, pruritus, pain, discoloration, and erythema. If severe blistering, severe pain, or other severe reactions occur, remove solution prior to the recommended 24 hours.

• Ocular toxicity: Corneal necrosis, ocular perforation, and deep ocular injury may occur if solution comes in contact with the eyes; do not apply near the eyes. If contact with the eyes occurs, flush eyes with water for at least 15 minutes and immediately seek medical attention.

Dosage form specific issues:

• Solution: Flammable; avoid fire, flame, or smoking near lesion(s) during treatment and after application until solution removed.

Other warnings/precautions:

• Appropriate personnel: Health care providers should receive appropriate instruction and training prior to preparation and administration.

• Appropriate use: For topical use only; life threatening or fatal toxicities may occur if ingested, including renal failure, blistering and severe GI tract damage, coagulopathy, seizures, and flaccid paralysis. Seek medical treatment immediately if accidental ingestion occurs. Not for oral, mucosal, or ophthalmic use.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, External [unit dose]:

Ycanth: Cantharidin 0.7% (1s, 6s, 12s)

Generic Equivalent Available: US

No

Pricing: US

Solution (Ycanth External)

0.7% (per each): $822.00

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Liquid:

Cantharone: Cantharidin 0.7% in a film-forming vehicle (7.5 mL)

Administration: Adult

Topical:

US labeling: For topical use only; may be fatal if ingested. Not for oral, mucosal, or ophthalmic use; do not apply near the eyes. Applicators are for single treatment session only; do not reuse, cut, or modify applicator. Do not use clogged applicators. Do not remove applicator cap until ampule glass is broken with break tool. Refer to manufacturer instructions for proper preparation of applicator. Use nitrile or vinyl gloves and eye protection during administration. Once applicator is prepared, apply a small droplet onto lesion and spread solution around with applicator tip to cover the entire lesion; repeat until all lesions are treated. Allow solution to dry completely (~5 minutes) before contact with healthy skin. Do not cover treatment areas with bandages. Avoid contact with the treatment area (including oral contact); if unintended contact (any surface or healthy skin) occurs, immediately remove by wiping with a cotton swab or gauze. If severe blistering, pain, or other adverse reaction occurs, remove solution with soap and water prior to 24 hours after treatment. Do not use other topical products (eg, creams, lotions, sunscreens) on treatment area within 24 hours of treatment or until area is washed. Avoid fire, flame, or smoking near the treatment area. Wipe break tool with 70% isopropyl alcohol after each use and assess for damage (eg, cracks in plastic, missing or broken breaking posts) and function (eg, hinge) before each use; after 12 uses or if damage occurs, dispose of breaking tool. If any damage or leaks are observed, dispose of applicators in a sharps container.

Canadian labeling: For external use only; may be fatal if ingested. Not for use in or near the eyes, on face or mucous membranes, or anogenital area. Do not apply to inflamed or irritated skin. If contact with healthy skin, wipe off with acetone or alcohol, then wash area with warm soapy water and thoroughly rinse. If contact with mucous membranes or eyes, flush with water, remove precipitated film, then flush with water for additional 15 minutes. Apply to clean skin using an applicator stick. No cutting or prior treatment is required. Occasionally, nails must be trimmed to expose subungual warts to medication. Using a wooden applicator stick, apply to lesion(s); allow to dry for a few minutes. Large or resistant lesions due to molluscum contagiosum should be covered with a piece of nonporous adhesive tape for 4 to 6 hours. Common and periungual warts should be covered with a piece of nonporous adhesive tape for 24 hours and then replaced with a loose bandage. Plantar warts should be covered with a piece of nonporous adhesive tape (doughnut pad over the tape may be helpful) and then secured with additional tape; after 24 hours, remove tape to bathe and then replace. Within 24 hours, a blister forms, and healing is typically evident within 7 days; blisters may be punctured as recommended by a health care provider. Additional treatment may be necessary for resistant lesions. Medication may be used for pain and itching at night. Area may be soaked in cool water for 10 to 15 minutes, as needed once sufficient time has elapsed for the medication to penetrate the affected area.

Administration: Pediatric

Topical:

Ycanth: For topical use only; may be fatal if ingested. Not for oral, mucosal, or ophthalmic use; do not apply near the eyes. Applicators are for single treatment session only; do not reuse, cut, or modify applicator. Do not use clogged applicators. Do not remove applicator cap until ampule glass is broken with break tool. Refer to manufacturer instructions for proper preparation of applicator. Use nitrile or vinyl gloves and eye protection during administration. Once applicator is prepared, apply a small droplet onto lesion and spread solution around with applicator tip to cover the entire lesion; repeat until all lesions are treated. Allow solution to dry completely (~5 minutes) before contact with healthy skin. Do not cover treatment areas with bandages. Avoid contact with the treatment area (including oral contact); if unintended contact (any surface or healthy skin) occurs, immediately remove by wiping with a cotton swab or gauze. Remove product after 24 hours using soap and water, avoiding use of washcloths, abrasive material, or vigorous rubbing due to risk of pain. If severe blistering, pain, or other adverse reaction occurs prior to 24 hours, remove solution with soap and water. Do not use other topical products (eg, creams, lotions, sunscreens) on treatment area within 24 hours of treatment or until area is washed. Avoid fire, flame, or smoking near the treatment area. If any damage or leaks are observed, dispose of applicators in a sharps container. Note: Each carton contains multiple single-use applicators and one break tool. The break tool may be used up to 12 times; wipe the break tool with 70% isopropyl alcohol after each use. Dispose of break tool after 12 uses or if damage is noted (eg, cracks in plastic or missing/broken posts) or if not functioning properly. Additional break tools may be obtained from the manufacturer.

Cantharone [Canadian product]: For external use only; may be fatal if ingested. Not for use in or near the eyes, on face or mucous membranes, or anogenital area. Do not apply to inflamed or irritated skin. If contact with healthy skin occurs, wipe off with acetone or alcohol, then wash area with warm soapy water and thoroughly rinse. If contact with mucous membranes or eyes occurs, flush with water, remove precipitated film, then flush with water for additional 15 minutes. Apply to clean skin using an applicator stick. No cutting or prior treatment is required. Occasionally, nails must be trimmed to expose subungual warts to medication. Using a wooden applicator stick, apply to lesion(s); allow to dry for a few minutes. Large or resistant lesions due to molluscum contagiosum should be covered with a piece of nonporous adhesive tape for 4 to 6 hours. Common and periungual warts should be covered with a piece of nonporous adhesive tape for 24 hours and then replaced with a loose bandage. Plantar warts should be covered with a piece of nonporous adhesive tape (doughnut pad over the tape may be helpful) and then secured with additional tape; after 24 hours, remove tape to bathe and then replace. Within 24 hours, a blister forms, and healing is typically evident within 7 days; blisters may be punctured as recommended by a health care provider. Additional treatment may be necessary for resistant lesions. Medication may be used for pain and itching at night. Area may be soaked in cool water for 10 to 15 minutes, as needed, once sufficient time has elapsed for the medication to penetrate the affected area.

Use: Labeled Indications

US labeling:

Molluscum contagiosum: Treatment of molluscum contagiosum in adult and pediatric patients ≥2 years of age.

Canadian labeling:

Benign epithelial growths: Removal of benign epithelial growths such as common warts, molluscum contagiosum, and periungual warts.

Metabolism/Transport Effects

None known.

Drug Interactions

There are no known significant interactions.

Pregnancy Considerations

Animal reproduction studies have not been conducted. Systemic exposure following topical application is expected to be limited.

Breastfeeding Considerations

It is not known if cantharidin is present in breast milk.

Systemic exposure following topical application is expected to be limited. According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother. Avoid application to areas with direct contact to a breastfeeding infant to prevent accidental transfer.

Monitoring Parameters

Treated areas for adequate healing; pain and tolerability of treatment

Mechanism of Action

Cantharidin is a vesicant; the mechanism of action in the treatment of molluscum contagiosum is unknown.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (RU) Russian Federation: Spanische fliege
  1. Cantharone (cantharidin) [prescribing information]. Toronto, Ontario, Canada: Dormer Laboratories, Inc; May 2014.
  2. Ycanth (cantharidin) [prescribing information]. West Chester, PA: Verrica Pharmaceuticals Inc; July 2023.
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