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Indication & Dosage |
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| Oral |
| REPIGMENTATION OF VITILIGINOUS AREAS |
| Adult:
20 mg or up to 600 mcg/kg 2-4 hr before measured periods of sunlight or UVA exposure depending on the preparation. Treatment is usually given twice a wk or on alternate days, with at least 48-hr intervals. |
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| Oral |
| REPIGMENTATION OF VITILIGINOUS AREAS |
| Child:
>12 yr: 20 mg or up to 600 mcg/kg 2-4 hr before measured periods of sunlight or UVA exposure depending on the preparation. Treatment is usually given twice a wk on alternate days, with at least 48-hr intervals. |
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| Oral |
| PSORIASIS |
| Adult:
Up to 600 mcg/kg 1.5-3 hr before UVA exposure, depending on the preparation. Treatment is usually given twice a wk or increased as necessary, with at least 48-hr intervals. If there is no or minimal response after the 15th PUVA treatment, dose may be increased to 10 mg and this dose used for the remainder of the treatment course. |
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| Topical/Cutaneous |
| SEVERE PSORIASIS |
| Adult:
Apply a 0.15% preparation (or diluted to 0.015%) if necessary onto affected skin areas 15 min before UVA exposure. Alternatively, patient may take a whole body bath in methoxsalen solution (2.6 mg/l or up to 3.7 mg/l) followed by immediate UVA exposure. For treating affected areas, immerse the affected areas for 15 min into 3 mg/l solution of hand and foot soaks followed by a 30-min delay before UVA exposure twice a wk. |
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| Topical/Cutaneous |
| REPIGMENTATION OF VITILIGINOUS AREAS |
| Adult:
Apply a 1% solution which is usually diluted to 0.1-0.01% (to avoid adverse effects) to the lesions; expose immediately to UVA or up to 2 hr after application. Area surrounding the lesion should be protected with a sunscreen. Wash and protect lesions from light after treatment; protection may be up to ≥48 hr. Repeat once a wk. Substantial repigmentation usually requires 6-9 mth of treatment. |
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| Administration |
Should be taken with food. |
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| Precautions |
Certain photosensitivity disorders. Hepatic impairment. Do not sunbathe for 24 hr before and 48 hr after PUVA treatment. Avoid exposure to sunlight for at least 8 hr after admin and patient should wear wrap-around UVA absorbing glasses for 24 hr after admin. Shield male genitalia during PUVA therapy unless specific treatment is required. Perform ophthalmic exam prior to therapy and at regular intervals thereafter, especially in those at increased risk of cataracts. Regularly examine patients for signs of premalignant or malignant skin lesions. Pregnancy and lactation. |
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Potentially Life-threatening
Adverse Drug Reactions |
Nausea, insomnia, depression, nervousness. Photochemotherapy or PUVA may cause pruritus, mild transient erythema, oedema, dizziness, headache, vesiculation, bulla formation, acneiform eruption, severe skin pain; pigmentation alterations of skin or nails, onycholysis. Hypersensitivity reactions e.g. fever, bronchoconstriction, contact dermatitis. |
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| Adverse Drug Reactions |
Increased risk of skin cancers e.g. squamous cell carcinoma, basal cell carcinoma, malignant melanoma. Isolated reports of leukaemia. |
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| Interactions |
Additive effects with drugs known to cause photosensitisation e.g. anthralin, coal tar or derivatives, griseofulvin, phenothiazines, nalidixic acid, sulfonamides., tetracyclines and thiazide diuretics. May increase the levels/effects of aminophylline, fluvoxamine, mexiletine, mirtazapine, ropinirole, theophylline, trifluoperazine, dexmedetomidine and ifosfamide. |
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