BNF for Children 2011-2012

BNFC 2011–2012 13.5.2 Preparations for psoriasis 569Pregnancy manufacturer advises use in restrictedamounts only if clearly necessary and to monitorurine- and serum-calcium concentrationBreast-feeding manufacturer advises avoidSide-effects see notes aboveIndication and doseMild to moderate plaque psoriasisChild 12–18 years apply twice daily; not morethan 35% of body surface to be treated daily, max.30 g dailySilkis c (Galderma) AOintment, calcitriol 3 micrograms/g, net price 100 g= £13.87Excipients none as listed in section 13.1.3TACALCITOLCautions see notes above; avoid eyes; monitor serumcalciumconcentration if risk of hypercalcaemia; ifused in conjunction with UV treatment, UV radiationshould be given in the morning and tacalcitol appliedat bedtimeContra-indications see notes aboveRenal impairment monitor serum-calcium concentrationPregnancy manufacturer advises avoid unless no saferalternative—no information availableBreast-feeding manufacturer advises avoid applicationto breast area; no information available on presencein milkSide-effects see notes aboveIndication and dosePlaque psoriasisChild 12–18 years apply once daily preferably atbedtime; max. 10 g ointment or 10 mL lotion dailyNote When lotion and ointment used together, max. totaltacalcitol 280 micrograms in any one week (e.g. lotion30 mL with ointment 40 g)Curatoderm c (Almirall) ALotion, tacalcitol (as monohydrate) 4 micrograms/g,net price 30 mL = £12.73Excipients include disodium edetate, propylene glycolOintment, tacalcitol (as monohydrate) 4 micrograms/g, net price 30 g = £13.40, 60 g = £23.14, 100 g =£30.86Excipients none as listed in section 13.1.3TarsTARSCautions application to face and skin flexures; usesuitable chemical protection gloves for extemporaneouspreparationContra-indications not for use in sore, acute, orpustular psoriasis or in presence of infection; avoideyes, mucosa, genital or rectal areas; broken orinflamed skinSide-effects skin irritation and acne-like eruptions,photosensitivity; stains skin, hair, and fabricIndication and dosePsoriasis and occasionally chronic atopic eczemaApply 1–3 times daily starting with low-strengthpreparations; proprietary preparations, see individualentries belowNote For shampoo preparations see section 13.9Non-proprietary preparationsMay be difficult to obtain. Patients may find newer proprietarypreparations more acceptableCoal Tar Paste, BPPaste, strong coal tar solution 7.5%, in compoundzinc pasteZinc and Coal Tar Paste, BPPaste, zinc oxide 6%, coal tar 6%, emulsifying wax5%, starch 38%, yellow soft paraffin 45%Excipients include cetostearyl alcoholProprietary preparationsCarbo-Dome c (Sandoz)Cream, coal tar solution 10%, in a water-misciblebasis, net price 30 g = £4.77, 100 g = £16.38Excipients include beeswax, hydroxybenzoates (parabens)DosePsoriasisApply to skin 2–3 times dailyCocois c (UCB Pharma)Scalp ointment, coal tar solution 12%, salicylic acid2%, precipitated sulphur 4%, in a coconut oil emollientbasis, net price 40 g (with applicator nozzle) =£5.98, 100 g = £11.23Excipients include cetostearyl alcoholDoseScaly scalp disorders including psoriasis, eczema,seborrhoeic dermatitis and dandruffChild 6–12 years medical supervision requiredChild 12–18 years apply to scalp once weekly asnecessary (if severe use daily for first 3–7 days), shampoooff after 1 hourExorex c (Forest)Lotion, coal tar solution 5% in an emollient basis, netprice 100 mL = £8.11, 250 mL = £16.24Excipients include hydroxybenzoates (parabens)DosePsoriasisApply to skin or scalp 2–3 times daily; product can bediluted with a few drops of water before applyingPsoriderm c (Dermal)Cream, coal tar 6%, lecithin 0.4%, net price 225 mL =£9.42Excipients include isopropyl palmitate, propylene glycolDosePsoriasisApply to skin or scalp 1–2 times dailyScalp lotion—section 13.9Sebco c (Derma UK)Scalp ointment, coal tar solution 12%, salicylic acid2%, precipitated sulphur 4%, in a coconut oil emollientbasis, net price 40 g = £4.54, 100 g = £8.52Excipients include cetostearyl alcoholDoseScaly scalp disorders including psoriasis, eczema,seborrhoeic dermatitis and dandruffChild 6–12 years medical supervision requiredChild 12–18 years apply to scalp as necessary (if severeuse daily for first 3–7 days), shampoo off after 1 hour13 Skin