Methoxsalen

Thông tin thuốc gốc
Chỉ định và Liều dùng
Oral
Repigmentation of vitiliginous areas
Adult: 20 mg or up to 600 mcg/kg 2-4 hr before measured periods of UVA exposure depending on the preparation, given twice wkly or on alternate days, w/ at least 48-hr intervals.

Oral
Psoriasis
Adult: Up to approx 600 mcg/kg, given 1.5-3 hr before UVA exposure, depending on the preparation. Treatment is usually given twice wkly or increased as necessary, w/ at least 48-hr intervals between doses. If there is no or minimal response after the 15th PUVA treatment, dose may be increased by 10 mg and this dose used for the remainder of the treatment course.

Topical/Cutaneous
Psoriasis
Adult: As a 0.15% soln (diluted to 0.015%, if necessary): Apply to affected areas 15 min before UVA exposure. Alternatively, patient may take a whole body bath in methoxsalen soln for 15 min followed by immediate UVA exposure. For treating affected areas, immerse the affected areas for 15 min into 3 mg/L soln of hand and foot soaks followed by a 30-min delay before UVA exposure. Baths or soaks are given twice wkly.

Topical/Cutaneous
Repigmentation of vitiliginous areas
Adult: As 1% soln (diluted to 0.1-0.01%): Apply over lesions then expose to UVA immediately after application or wait up to 2 hr. Protect the area surrounding the lesion w/ a sunscreen. Wash and protect lesions from light after treatment; protection may be up to ≥48 hr. Treatment is usually repeated once wkly. Substantial repigmentation usually requires 6-9 mth of treatment.
Các sản phẩm có chứa hoạt chất Methoxsalen tại Việt Nam?
  • Meladinine
Cách dùng
Should be taken with food.
Chống chỉ định
Aphakia, existing or history of melanoma, invasive squamous cell carcinoma, photosensitivity diseases (e.g. porphyria, acute lupus erythematosus, xeroderma pigmentosum).
Thận trọng
Patient exhibiting multiple basal cell carcinoma or history of basal cell carcinoma, previous arsenic therapy, previous x-ray or grenz ray therapy; cardiac diseases or those unable to tolerate prolonged standing or exposure to heat stress; GI diseases or chronic infection. Hepatic impairment. Pregnancy and lactation.
Tác dụng không mong muốn
Oral: Nausea, insomnia, nervousness, depression. Photochemotherapy or PUVA: Mild transient erythema, pruritus; dizziness, headache, oedema, vesiculation, acneform eruption, bulla formation, severe skin pain, altered skin or nail pigmentation, onycholysis, premature skin ageing, severe burns, hypertrichosis.
Potentially Fatal: Increased risk of malignant cutaneous neoplasms.
Thông tin tư vấn bệnh nhân
Keep the treated areas protected from light by use of protective clothing or sunscreen.
Chỉ số theo dõi
Conduct CBC w/ differential; liver and renal function, antinuclear antibody tests (at baseline and 6-12 mthly); ophth exam (pre-treatment and yrly); signs/symptoms of skin cancer, burns, photosensitivity.
Quá liều
Symptoms: Severe burning and blistering of skin. Management: Oral: Supportive treatment. Induce emesis w/in 2-3 hr after ingestion. Place the patient in a darkened room for at least 24 hr or until cutaneous reactions subside.
Tương tác
May increase plasma concentration of drugs metabolised by CYP2A6 isoenzyme. Additive effect w/ other systemic or topical photosensitising agents (e.g. anthralin, coal tar, nalidixic acid).
Tương tác với thức ăn
Increased risk of phototoxicity w/ food that contain psoralens (e.g. parsley, parsnip, celery). Increased serum concentrations w/ food.
Tác dụng
Description:
Mechanism of Action: Methoxsalen increases skin reactivity to long-wavelength UV rays. It bonds covalently to deoxyribonucleic acid (DNA), thus inhibiting DNA synthesis and suppressing cell division and epidermal turnover. This effect is used in photochemotherapy or PUVA [psoralen (P) and high-intensity long-wavelength UVA irradiation].
Onset: 1 hr (depending on oral formulation).
Duration: Approx 8 hr.
Pharmacokinetics:
Absorption: Well but variably absorbed from the GI tract. Time to peak plasma concentration: Approx 1-4 hr.
Distribution: Taken up by epidermal cells; diffuses into eye lens. Plasma protein binding: 75-91% (mainly to albumin).
Metabolism: Almost completely metabolised.
Excretion: Via urine (approx 95% as metabolites, <0.1% as unchanged drug). Elimination half-life: Approx 0.75-2.4 hr.
Đặc tính

Chemical Structure Image
Methoxsalen

Source: National Center for Biotechnology Information. PubChem Database. Methoxsalen, CID=4114, https://pubchem.ncbi.nlm.nih.gov/compound/Methoxsalen (accessed on Jan. 22, 2020)

Bảo quản
Store between 15-30°C. Protect from light.
Phân loại MIMS
Các sản phẩm da liễu khác / Thuốc trị vẩy nến, tăng tiết bã nhờn & vảy cá
Phân loại ATC
D05AD02 - methoxsalen ; Belongs to the class of topical psoralens used in the treatment of psoriasis.
D05BA02 - methoxsalen ; Belongs to the class of systemic psoralens used in the treatment of psoriasis.
Tài liệu tham khảo
8-MOP Capsule, Gelatin Coated (Valeant Pharmaceuticals North America LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 15/01/2016.

Anon. Methoxsalen (Systemic). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 15/01/2016.

Anon. Methoxsalen (Topical). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 15/01/2016.

Anon. Methoxsalen. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 15/01/2016.

Buckingham R (ed). Methoxsalen. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 15/01/2016.

Methoxsalen Capsule, Liquid-Filled (Actavis Pharma, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 15/01/2016.

Oxsoralen Lotion (Valeant Pharmaceuticals North America LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 15/01/2016.

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