KETODERM 2 % Gel in sachet 8Sach/6g

Ketoconazole..........................................................................................................................................120,00 mg

For one sachet of 6 g.

Excipient with notable effect: Each gram of shampoo contains 2 mg of perfume bouquet which contains 0,08 µg of benzyl alcohol, 1,2 µg of benzoic acid and 0,2 µg of butylated hydroxytoluene.

This medicine is indicated for the treatment of seborrhoeic dermatitis in adults and adolescents.

The use of KETODERM 2 %, gel in sachet is reserved for adults and adolescents.

The safety and efficacy of KETODERM 2 %, gel in sachet have not been established in children under 12 years of age. No data are available.

Dosage

1 sachet is sufficient for one application.

During the first month of treatment, the dosage is usually 2 applications per week.

A maintenance treatment may be deemed necessary by the physician; it is usually one application per week or every two weeks depending on the results obtained.

Method of administration

Cutaneous application to the scalp and/or skin.

• Thoroughly wet the affected areas, skin and/or scalp.
• Apply the gel, lather thoroughly, paying particular attention to the affected areas.
• Avoid contact with the eyes.
• Leave in place for 5 minutes. For good efficacy, it is important to respect this minimum duration.
• Then rinse the skin and/or scalp thoroughly, and not only the hair.

Hypersensitivity to the active substance or to any of the excipients listed in section Composition.

Special warnings

When using KETODERM 2 %, gel in sachet in patients who have received prolonged treatment with topical corticosteroids, it is recommended to gradually discontinue corticosteroid therapy over a period of 2 to 3 weeks in order to avoid any potential rebound effect.

Precautions for use

Avoid contact with the eyes. In case of accidental contact with the eye, rinse with water.

KETODERM 2%, gel in sachet contains a perfume (perfume bouquet) with alpha-isomethyl ionone, amyl cinnamal, amyl cinnamyl alcohol, benzyl alcohol, benzyl benzoate, benzyl cinnamate, cinnamal, cinnamyl alcohol, citral, citronellol, eugenol, Evernia prunastri extract (oakmoss), geraniol, hexyl cinnamal, hydroxycitronellal, limonene and linalool, which may cause allergic reactions.

This medicine contains benzyl alcohol, which may cause mild local irritation.

This medicine contains benzoic acid, which may cause local irritation.

This medicine contains butylated hydroxytoluene, which may cause local skin reactions (for example, contact dermatitis), or irritation of the eyes and mucous membranes.

Given the low systemic exposure to ketoconazole after application of KETODERM 2 %, gel in sachet, drug interactions are unlikely to be clinically significant.

Pregnancy

No effect of KETODERM 2%, gel in sachet during pregnancy is expected since maternal systemic exposure is negligible. KETODERM 2%, gel in sachet may therefore be used during pregnancy.

Breast-feeding

No effect of KETODERM 2 %, gel in sachet in the breastfed newborn or infant is expected, since maternal systemic exposure is negligible. KETODERM 2 %, gel in sachet may therefore be used during breastfeeding.

The tolerability of KETODERM 2 %, gel in sachet administered to the scalp and/or skin was evaluated in 2890 patients during 22 clinical trials. Based on the pooled tolerability data from these clinical trials, no adverse reaction with an incidence of ≥ 1% was reported.

Adverse reactions reported with KETODERM 2 %, gel in sachet, either during clinical studies or after marketing, are listed below by frequency category, according to the following convention: 

Very common (≥ 1/10), common (≥ 1/100 to < 1/10), uncommon (≥ 1/1 000 to < 1/100), rare (≥ 1/10 000 to < 1/1 000), very rare (< 1/10 000) and frequency not known (cannot be estimated from the available data).

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reaction via the national reporting system: National Agency for the Safety of Medicines and Health Products (ANSM) and the network of Regional Centres of Pharmacovigilance - Website: www.signalement-sante.gouv.fr.

Ingestion

In case of accidental ingestion, treatment will be limited to supportive and symptomatic measures. To avoid aspiration of gastric contents, do not perform gastric lavage or induce vomiting.

Pharmacotherapeutic class: Topical antifungal – imidazole and triazole derivatives, ATC code: D01AC08.

Ketoconazole is an antifungal of the imidazole group. It has potent antifungal activity against:

• the dermatophytes: in particular Trichophyton sp., Epidermophyton sp., Microsporum sp.
• the yeasts: in particular Candida sp. and Malassezzia furfur (Pityrosporum ovale).

In vitro and in vivo in animals, ketoconazole inhibits the synthesis of leukotrienes.

Plasma concentrations of ketoconazole are not detectable after topical administration of KETODERM 2 %, gel in sachet on the scalp.

Low but occasionally measurable plasma levels (from 11 to 33 ng/ml with an assay detection limit of 5 ng/ml) were observed in 3 out of 6 patients with Pityriasis versicolor after topical administration of KETODERM 2 %, gel in sachet over the whole body (estimated dose of 400 mg for 5 minutes).

Non-clinical data from conventional studies, including primary ocular or skin irritation, skin sensitisation and repeated-dose dermal toxicity, did not reveal any particular risk for humans.

Ketoconazole is teratogenic in rats by oral route from doses of 80 mg/kg; however, by dermal route the plasma concentrations of ketoconazole are 6000 times lower than those found by oral route for a dose of 40 mg/kg in rats.

2 years.

Store at a temperature not exceeding 25°C.

No special requirements.