Instruction for use: Podophyllotoxin (Podophyllotoxinum)

Pharmacological group

dermotropic means

Antitumor agents of vegetable origin

Nosological classification (ICD-10)

A63.0 Anogenital (venereal) warts

Anogenital warts, Venereal warts, Condylomata genital, Condyloma pointed, Externally pointed genital warts, Externally pointed condyloma, Pointed Condyloma, Flat condyloma

Code CAS code 518-28-5

Characteristics of Podophyllotoxin

The active component of podophylline isolated from rhizomes with the roots of the podophyllum of the thyroid (Podophyllum peltatum L.) family of barberry (Berberidaceae). Soluble in alcohol, partially soluble in water.

Pharmacology

Pharmacological action - antitumor, necrotizing (local), cauterizing.

With topical application causes necrotic changes in the visible part of the genital warts. Application 0,01-0,05 ml of 0,5% solution is accompanied by the appearance of small amounts of podophyllotoxin in the serum 30-60 minutes after its application. When the dose is increased 2-3 times (0.1-1.5 ml) Cmax (1-17 ng / ml) is achieved after 1-2 hours T1 / 2 - 1-4.5 hours. Does not cumulate. The effect is manifested by a decrease in the number of genital warts - an average of 80% in half of patients, while 25% show their persistent disappearance.

Use of Podophyllotoxin

Externally pointed genital warts (local treatment).

Contraindications

Hypersensitivity, pregnancy, breast-feeding, children's age (up to 12 years).

pregnancy and lactation

The action category for fetus by FDA is C.

Side effects

Local reactions - redness, pain, itching, burning, ulceration of the epithelium of condyloma, edema and balanoposthitis (with large condylomata in the preputial region); systemic effects: nausea, dizziness, ulceration of mucous membranes.

Overdose

Symptoms: nausea, vomiting, fever, diarrhea, myelosuppression, ulceration of the oral mucosa.

Treatment: if exposed to excessive amounts on the skin, immediately wash the area with soap and water; with accidental ingestion - gastric lavage. Symptomatic therapy, dynamic observation with determination of the cellular composition of peripheral blood, the level of transaminases, bilirubin, the content of electrolytes and the gas composition of blood are shown.

Routes of administration

Locally.

Precautions for Podophyllotoxin

Avoid contact with eyes (if this happens - immediately flush eyes with copious amounts of water) and on healthy skin areas. Before applying to protect the skin and mucosa around the condyloma, it is recommended to treat the skin with neutral creams, petroleum jelly or zinc ointment. For the application, it is always necessary to use a plastic applicator and make sure that the opening of the loop is completely filled with liquid. After application it is necessary to dry the place of application of the solution. Particular care should be taken when localizing warts in the foreskin area.

With the development of edema and balanoposthitis, glucocorticoids (in the form of ointments) are used.

To reduce the risk of systemic action, the area of the surface to be treated should not exceed 10 cm2 in total, and the amount of solution used should be 0.5 ml per day. In the absence of a clear effect after 4 weeks of therapy, the treatment method should be reviewed. When doubting the diagnosis (including the impossibility of excluding squamous cell carcinoma from clinical data), a histological confirmation is required before the start of treatment.

It is advisable to examine and, if necessary, treat sexual partners.