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Pramoxine
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Pramoxine is a morpholine derivative with local anesthetic and antipruritic activities. It is indicated for temporary relief of pain and pruritus from minor lip and skin irritations as well as for temporary relief of pain, burning, itching and discomfort associated with hemorrhoids and other anorectal/anogenital disorders. In pharmaceutical products, pramoxine is employed as pramoxine hydrochloride (CAS number 637-58-1, EC number 211-293-1, molecular formula C17H28CINO3) (1).
Female-specific pruritus
Published in Miranda A. Farage, Howard I. Maibach, The Vulva, 2017
Michael Joseph Lavery, Carolyn Stull, Shoshana Korman Grossman, Gil Yosipovitch
Treatment should be tailored according to underlying etiology. In cases of inflammatory origin, topical steroids or topical calcineurin inhibitors may be beneficial (20,21). In cases of unclear etiology, a neuropathic cause should always be considered. Lumbosacral spinal imaging studies, including magnetic resonance imaging or X-ray, may be useful in ruling out sacral nerve compression as a cause of LSC (22). If a neuropathic cause is identified, treatment with neuromodulatory agents such as gabapentin and pregabalin may prove useful (3). Neural hypersensitivity may develop over time, which may perpetuate pruritus. Therefore, topical preparations that reduce neural signaling, such as pramoxine or a compounded formulation of topical ketamine, amitriptyline, and lidocaine, may help reduce the pruritus. The importance of scratching cessation must be emphasized as an integral part of LSC management.
Pruritus in Atopic Dermatitis: Pathophysiology and Treatment Options
Published in Donald Rudikoff, Steven R. Cohen, Noah Scheinfeld, Atopic Dermatitis and Eczematous Disorders, 2014
Tejesh Surendra Patel, Gil Yosipovitch
Pramoxine, a local anesthetic, reduces itch, especially when applied to the face, by interfering with transmission of impulses along sensory nerve fibers. A double-blind study has shown that pramoxine inhibits histamine-induced itch in humans (Yosipovitch and Maibach 1997).
Supportive Oncodermatology: Addressing dermatologic adverse events associated with oncologic therapies
Published in Oncology Issues, 2018
Current management options for pruritus require a tailored approach of stabilized hypochlorous acid 0.045 percent, pramoxine 1 to 2.5 percent, strontium 4 percent, capsaicin 0.1 to 8 percent, and menthol 1 to 2 percent for mild to moderate pruritus. Severe pruritus warrants the use of high dose anti-epileptics, antidepressants, and anti-psychotics. Additionally, a therapeutic cocktail of ketamine 5 to 10 percent, lidocaine 5 percent, and amitryptiline 5 percent in a lipoderm base that targets ion channels has found success in itch management.44 Patients should be counseled on how to break the itch-scratch cycle by45: Keeping fingernails shortWearing loose clothingUsing a humidifierRestricting bath and shower time and using lukewarm waterAvoiding cleansers with a high pH or containing alcohol.
Pathophysiology, diagnosis, and pharmacological treatment of prurigo nodularis
Published in Expert Review of Clinical Pharmacology, 2021
Kyle A. Williams, Youkyung S. Roh, Isabelle Brown, Nishadh Sutaria, Pegah Bakhshi, Justin Choi, Sylvie Gabriel, Rajeev Chavda, Shawn G. Kwatra
Topical anesthetics help provide itch relief in patients with milder PN. Examples include 1% pramoxine lotion, lidocaine spray, and compounded topical anesthetic creams. Topical capsaicin, which may help deplete pro-inflammatory neuropeptides in lesional skin, is another agent that has been used anecdotally, although its effects against PN symptoms are minimal in actual clinical practice. The practical use of topical capsaicin as a long-term treatment for PN is also limited due to the high frequency of application required, associated irritation, and limited efficacy.
Safety considerations when using drugs to treat pruritus
Published in Expert Opinion on Drug Safety, 2020
Kayla Fourzali, Gil Yosipovitch
Pramoxine is a topical local anesthetic that works by inhibiting voltage-gated sodium channels in peripheral nerve endings and been shown to have antipruritic properties in experimentally induced human itch as well as small clinical trials [12,13]. Topical pramoxine 1% is considered to be well tolerated and is FDA approved for use in anti-itch products sold OTC. There exists limited data on adverse effects. Uncommonly, skin irritation and dryness have been reported, as have cases of allergic contact dermatitis [14].