BNF for Children 2011-2012

544 12.3.1 Drugs for oral ulceration and inflammation BNFC 2011–201212 Ear, nose, and oropharynxSpray, benzydamine hydrochloride 0.15%. Net price30-mL unit = £3.17DoseChild under 6 years 1 puff per 4 kg body-weight to max.4 puffs onto affected area every 1½–3 hoursChild 6–12 years 4 puffs onto affected area every 1½–3hoursChild 12–18 years 4–8 puffs onto affected area every1½–3 hoursDental prescribing on NHS May be prescribed as BenzydamineOromucosal Spray 0.15%CORTICOSTEROIDSContra-indications untreated oral infectionSide-effects occasional exacerbation of local infection;thrush or other candidal infectionsLicensed use Hydrocortisone mucoadhesive buccaltablets licensed for use in children (under 12years—on medical advice only)Indication and doseOral and perioral lesions for dose, see underpreparationsHydrocortisone (Non-proprietary)Mucoadhesive buccal tablets (= oromucosaltablets), hydrocortisone 2.5 mg (as sodium succinate).Net price 20 = £2.03Dose1 lozenge 4 times daily, allowed to dissolve slowly in themouth in contact with the ulcerDental prescribing on NHS May be prescribed as HydrocortisoneOromucosal TabletsBetnesol c (UCB Pharma) ASoluble tablets, pink, scored, betamethasone500 micrograms (as sodium phosphate), net price 100-tab pack = £4.97. Label: 10, steroid card, 13, 21DoseOral ulcerationChild 12–18 years 500 micrograms dissolved in 20 mLwater and rinsed around the mouth 4 times daily; not tobe swallowedDental prescribing on NHS May be prescribed as BetamethasoneSoluble Tablets 500 microgramsDOXYCYCLINECautions section 5.1.3; monitor for superficial fungalinfection, particularly if predisposition to oral candidiasisContra-indications section 5.1.3Hepatic impairment section 5.1.3Renal impairment section 5.1.3Pregnancy section 5.1.3Breast-feeding section 5.1.3Side-effects section 5.1.3; fungal superinfectionIndication and doseSee under preparationsOral herpes section 12.3.2Other indications section 5.1.3Periostat c (Alliance) ATablets, f/c, doxycycline (as hyclate) 20 mg, net price56-tab pack = £16.50. Label: 6, 11, 27, counselling,postureDosePeriodontitis (as an adjunct to gingival scaling androot planing)Child 12–18 years 20 mg twice daily for 3 monthsCounselling Tablets should be swallowed whole with plentyof fluid, while sitting or standingDental prescribing on NHS May be prescribed as DoxycyclineTablets 20 mgLocal applicationFor severe recurrent aphthous ulceration, a 100 mgdoxycycline dispersible tablet can be stirred into asmall amount of water then rinsed around the mouthfor 2–3 minutes 4 times daily usually for 3 days; itshould preferably not be swallowed [unlicensed indication].Note Doxycycline stains teeth; avoid in children under 12 yearsof ageFLURBIPROFENCautions section 10.1.1Contra-indications section 10.1.1Hepatic impairment section 10.1.1Renal impairment section 10.1.1Pregnancy section 10.1.1Breast-feeding section 10.1.1Side-effects taste disturbance, mouth ulcers (movelozenge around mouth); see also section 10.1.1Indication and doseRelief of sore throat for dose, see under preparationStrefen c (Reckitt Benckiser)Lozenges, flurbiprofen 8.75 mg, net price 16 = £2.24DoseChild 12–18 years allow 1 lozenge to dissolve slowly inthe mouth every 3–6 hours, max. 5 lozenges in 24 hours,for max. 3 daysSALICYLATESCautions frequent application, especially in children,may give rise to salicylate poisoningContra-indications children under 16 yearsReye’s syndrome The CHM has advised that topical oralpain relief products containing salicylate salts should not beused in children under 16 years, as a cautionary measure dueto the theoretical risk of Reye’s syndromeIndication and doseMild oral and perioral lesions for dose, see underpreparationsCholine salicylateCholine Salicylate Dental Gel, BPOral gel, choline salicylate 8.7% in a flavoured gelbasis, net price 15 g = £1.89Brands include Bonjela c (sugar-free)DoseChild 16–18 years apply ½-inch of gel with gentlemassage not more often than every 3 hoursDental prescribing on NHS Choline Salicylate Dental Gelmay be prescribed