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ingenol mebutate (Picato)
diterpene ester extracted & purified from the plant Euphorbia peplus
Indications:
- actinic keratosis
Contraindications:
- do not use near lips or eyes
Dosage:
- apply daily for 3 days*
- use to treat one area of skin at a time,
- treated area should be < 25 cm2 [3]
- use ingenol disoxate for treatment of larger areas
- a new tube should be used for each treatment day
Gel: 0.015%, 0.025%, 0.05%
* wash handsthoroughly with soap & water immediately use to avoid accidental transfer [3]
Adverse effects:
- transient local skin responses consisting primarily of erythema, flaking/scaling, & crusting
- reports of severe allergic reactions [3]
- severe eye injuries & skin reactions [3]
- reports of Herpes zoster (shingles) [3]
- no evidence of treatment-related scarring
Mechanism of action:
- localized induction of necrosis followed by a transient inflammatory response
Related
ingenol disoxate
General
dermatologic agent
pharmaceutical herb; medicinal herb; herbal supplement; botanical
diterpene
References
- Anderson L et al
Randomized, double-blind, double-dummy, vehicle-controlled
study of ingenol mebutate gel 0.025% and 0.05% for actinic
keratosis.
J Am Acad Dermatol 2009 Jun; 60:934.
PMID: 19467365
- Prescriber's Letter 19(3): 2012
Actinic Keratoses Treatments
Detail-Document#: 280306
(subscription needed) http://www.prescribersletter.com
- FDA Safety Alert. 08/21/2015
Picato (ingenol mebutate) Gel: Drug Safety Communication -
FDA Warns of Severe Adverse Events, Requires Label Changes.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm459311.htm