Saturday, October 22, 2016

Daktarin Gold 2% Cream





1. Name Of The Medicinal Product



Daktarin Gold 2% Cream


2. Qualitative And Quantitative Composition



Ketoconazole 2% w/w.



Excipients: Propylene glycol; Cetyl alcohol; Stearyl alcohol



For a full list of excipients, see Section 6.1.



3. Pharmaceutical Form



Cream



White cream



4. Clinical Particulars



4.1 Therapeutic Indications



For the treatment of the following mycotic infections of the skin: tinea pedis, tinea cruris and candidal intertrigo.



4.2 Posology And Method Of Administration



For the treatment of tinea pedis (athlete's foot) and tinea cruris (dhobie itch) and candidal intertrigo (sweat rash).



For tinea pedis, Daktarin Gold 2 % cream should be applied to the affected areas twice daily. The usual duration of treatment for mild infections is 1 week. For more severe or extensive infections (eg involving the sole or sides of the feet), treatment should be continued for 2–3 days after all signs of infection have disappeared to prevent relapse.



For tinea cruris and candidal intertrigo, apply cream to the affected areas once or twice daily until 2-3 days after all signs of infection have disappeared to prevent relapse. Treatment for up to 6 weeks may be necessary. If no improvement in symptoms is experienced after 4 weeks treatment, a doctor should be consulted.



Method of administration: Cutaneous use.



4.3 Contraindications



Daktarin Gold 2 % cream is contra-indicated in patients with a known hypersensitivity to any of the ingredients or to ketoconazole itself.



4.4 Special Warnings And Precautions For Use



Not for ophthalmic use.



If a potent topical corticosteroid has been used previously in the treatment of seborrhoeic dermatitis, a recovery period of 2 weeks should be allowed before using Daktarin Gold 2 % cream, as an increased incidence of steroid induced skin sensitisation has been reported when no recovery period is allowed.



Propylene glycol may cause skin irritation. Cetyl alcohol and stearyl alcohol may cause local skin reactions (e.g. contact dermatitis).



4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction



None known.



4.6 Pregnancy And Lactation



There are no adequate and well-controlled studies in pregnant or lactating women. To date, no other relevant epidemiological data are available. Data on a limited number of exposed pregnancies indicate no adverse effects of topical ketoconazole on pregnancy or on the health of the foetus/newborn child. Animal studies have shown reproductive toxicity following oral administration of ketoconazole. (see Preclinical safety data, section 5.3). No effects on the breastfed newborn/infant are anticipated. See Pharmacokinetic properties, section 5.2..



4.7 Effects On Ability To Drive And Use Machines



None.



4.8 Undesirable Effects



The safety of ketoconazole cream was evaluated in 1079 subjects who participated in 30 clinical trials. Ketoconazole cream was applied topically to the skin.



Based on pooled safety data from these clinical trials, the most commonly reported (



Very Common (



Common (



Uncommon (



Rare (



Very rare (<1/10,000)



Not Known (cannot be estimated form the available clinical trial data).




























System Organ Class




Adverse Drug Reactions


  


Frequency Category


   


Common



(




Uncommon



(




Not Known


 


Immune System Disorders




 



 




Hypersensitivity




 



 




Skin and Subcutaneous Tissue Disorders




Skin burning sensation




Bullous eruption



Dermatitis contact



Rash



Skin exfoliation



Sticky skin




Urticaria




General Disorders and Administration Site Conditions




Application site erythema



Application site pruritus




Application site bleeding



Application site discomfort



Application site dryness



Application site inflammation



Application site irritation



Application site paraesthesia



Application site reaction




 



 



4.9 Overdose



Topical application



Excessive topical application may lead to erythema, oedema and a burning sensation, which will disappear upon discontinuation of the treatment.



Ingestion



In the event of accidental ingestion, supportive and symptomatic measures should be carried out.



5. Pharmacological Properties



5.1 Pharmacodynamic Properties



Pharmacotherapeutic Group: Imidazole and triazole derivatives; ATC code: D01 AC08



Ketoconazole has a potent antimycotic action against dermatophytes and yeasts. Ketoconazole cream acts rapidly on the pruritus, which is commonly seen in dermatophyte and yeast infections. This symptomatic improvement often occurs before the first signs of healing are observed.



A study in 250 patients has shown that application twice daily for 7 days of ketoconazole 2% cream vs clotrimazole 1% cream for 4 weeks on both feet demonstrated efficacy in patients with tinea pedis (athlete's foot) presenting lesions between the toes.



The primary efficacy endpoint was negative microscopic KOH examination at 4 weeks. Ketoconazole 2% treatment showed equivalent efficacy to 4 weeks clotrimazole 1% treatment. There was no evidence of relapse following treatment with ketoconazole cream at 8 weeks.



5.2 Pharmacokinetic Properties



Plasma concentrations of ketoconazole were not detectable after topical administration of ketoconazole cream in adults on the skin. In one study in infants with seborrhoeic dermatitis (n = 19), where approximately 40 g of ketoconazole cream was applied daily on 40 % of the body surface area, plasma levels of ketoconazole were detected in 5 infants, ranging from 32 to 133 ng/mL.



5.3 Preclinical Safety Data



Since ketoconazole administered topically as a cream is not systemically absorbed and does not produce detectable plasma concentrations, there is no specific relevant information.



6. Pharmaceutical Particulars



6.1 List Of Excipients



Propylene Glycol



Stearyl Alcohol



Cetyl Alcohol



Sorbitan Stearate



Polysorbate 60



Isopropyl Myristate



Sodium Sulphite Anhydrous (E221)



Polysorbate 80



Purified Water



6.2 Incompatibilities



Not applicable.



6.3 Shelf Life



60 months.



6.4 Special Precautions For Storage



Do not store above 25°C.



6.5 Nature And Contents Of Container



Tube made of 99.7% aluminum, lined on inner side with heat polymerised epoxyphenol resin with a latex coldseal ring at the end of the tube. The cap is made of 60% polypropylene, 30% calcium carbonate and 10% glyceryl monostearate.



Tubes of 5, 15 and 30g.



Not all pack sizes may be marketed.



6.6 Special Precautions For Disposal And Other Handling



Not applicable.



7. Marketing Authorisation Holder



McNeil Products Limited



Foundation Park



Roxborough Way



Maidenhead



Berkshire



SL6 3UG



United Kingdom



8. Marketing Authorisation Number(S)



PL 15513/0184



9. Date Of First Authorisation/Renewal Of The Authorisation



01/04/2009



10. Date Of Revision Of The Text



30/11/2009





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