Doxiderm Cream

Indications

Doxiderm Cream is designed for the short-term management (up to 8 days) of moderate itching in adult patients suffering from atopic dermatitis or lichen simplex chronicus.
Always use as directed by a registered healthcare professional.

Pharmacology

Doxepin hydrochloride belongs to the dibenzoxepin class of tricyclic antidepressants. While it possesses H1 and H2 histamine receptor-blocking properties, the precise mechanism through which doxepin alleviates itching remains unclear. It may cause drowsiness in a significant number of users, potentially diminishing awareness of itching symptoms.

Dosage & Administration

• Adults and Children Over 12 Years: Apply a thin layer of Doxiderm Cream 3-4 times daily. The maximum recommended amount per application is 3 grams, with a total daily limit of 12 grams. Coverage should be restricted to less than 10% of the body’s surface area.
• Children: The use of Doxiderm Cream in pediatric patients is not recommended, as safety for this demographic has not been established.
• Elderly Patients: Caution is advised when prescribing for elderly individuals. It is typically recommended to start at the lower end of the dosage spectrum due to a higher likelihood of decreased hepatic, renal, or cardiac function, as well as the presence of concomitant diseases or other medications.

Always follow the guidance of a registered healthcare professional.

Interaction

When using tricyclic antidepressants alongside medications that may inhibit cytochrome P450 2D6, such as MAO inhibitors or cimetidine, it may be necessary to lower doses of either medication. MAO inhibitors should be discontinued at least two weeks prior to starting Doxiderm Cream therapy.

Contraindications

Doxiderm Cream is contraindicated in patients with untreated narrow-angle glaucoma or those prone to urinary retention, as doxepin has anticholinergic effects. It should also be avoided by individuals with a known sensitivity to any of its components.

Side Effects

Common side effects may include drowsiness, local burning sensations, stinging, irritation, tingling, and rashes. Systemic effects such as antimuscarinic symptoms, headaches, fever, dizziness, and gastrointestinal disturbances have also been reported.

Pregnancy & Lactation

Doxiderm Cream falls under pregnancy category B. There are insufficient well-controlled studies involving pregnant women; thus, it should only be used during pregnancy if absolutely necessary. Doxepin is excreted in human milk post-oral administration, and it is plausible that it may also be present in breast milk following topical use.

Precautions & Warnings

Exercise caution in patients with a predisposition to angle-closure glaucoma, urinary retention, severe liver impairment, or mania, as well as during pregnancy and breastfeeding. Drowsiness may impair the ability to perform skilled tasks, such as driving, so patients should exercise care.

Overdose Effects

In the event of an overdose due to topical application of Doxiderm Cream, symptoms may include cardiac arrhythmias, severe hypotension, seizures, and central nervous system depression, potentially leading to coma. Clinically significant signs of tricyclic antidepressant toxicity may include changes in the electrocardiogram, especially in the QRS axis or width. Other overdose symptoms may encompass confusion, impaired concentration, transient visual hallucinations, dilated pupils, agitation, hyperactive reflexes, stupor, drowsiness, muscle rigidity, vomiting, hypothermia, and hyperpyrexia.

Therapeutic Class

Local Antipruritic

Storage Conditions

Store below 30°C, away from light and moisture. Keep out of reach of children.