Drugs List

Therapeutic Indications

Uses

For the symptomatic relief of muscular and rheumatic aches and pains, including muscular stiffness, bruising, sprains, fibrositis, lumbago, sciatica and unbroken chilblains.

Not all brands are licensed for all indications.

Administration

For topical administration.

Wash hands immediately after use.

For muscular strains and stiffness it is best used after a hot bath.

Precautions and Warnings

If skin sensitivity reactions occur, discontinue use.

Do not apply to inflamed or broken skin.

Avoid contact with the eyes and mucous membranes.

Do not use with occlusive dressings.

Advise patient to avoid exposing the treated area to direct sunlight.

Not all brands are licensed for all age groups.

Not all brands are licensed for all indications.

Pregnancy - see 'Pregnancy' section

Lactation - see 'Lactation' section

Pregnancy and Lactation

Pregnancy

Use of this product should be avoided during pregnancy unless there is no safer alternative.

With all salicylates there is animal evidence of teratogenicity.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Licensed in pregnancy? - No

Recommended for use in pregnancy? - No

Animal data - shows evidence of teratogenicity

Lactation

Some brands are considered by the manufacturer to be safe for use during breast-feeding - consult product literature.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Hypersensitivity reactions
Contact dermatitis
Eczema
Urticaria
Headache
Flushing

Topical application of large amounts may result in systemic effects, including hypersensitivity reactions and worsening of asthma.

Presentation

Cream containing 2% menthol, 4% camphor, 4% methyl salicylate and 0.035% oleoresin capsicum.
Cream containing 2.54% menthol, 1.43% camphor, 0.42% methyl salicylate and 0.005% oleoresin capsicum

Drugs List

Therapeutic Indications

Uses

For the symptomatic relief of muscular and rheumatic aches and pains, including muscular stiffness, bruising, sprains, fibrositis, lumbago, sciatica and unbroken chilblains.

Not all brands are licensed for all indications.

Dosage

Adults

Elderly

Children

Adolescents

Administration

For topical administration.

Wash hands immediately after use.

For muscular strains and stiffness it is best used after a hot bath.

Precautions and Warnings

If skin sensitivity reactions occur, discontinue use.

Do not apply to inflamed or broken skin.

Avoid contact with the eyes and mucous membranes.

Do not use with occlusive dressings.

Advise patient to avoid exposing the treated area to direct sunlight.

Not all brands are licensed for all age groups.

Not all brands are licensed for all indications.

Pregnancy - see 'Pregnancy' section

Lactation - see 'Lactation' section

Pregnancy and Lactation

Pregnancy

Use of this product should be avoided during pregnancy unless there is no safer alternative.

With all salicylates there is animal evidence of teratogenicity.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Licensed in pregnancy? - No

Recommended for use in pregnancy? - No

Animal data - shows evidence of teratogenicity

Lactation

Some brands are considered by the manufacturer to be safe for use during breast-feeding - consult product literature.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Hypersensitivity reactions
Contact dermatitis
Eczema
Urticaria
Headache
Flushing

Topical application of large amounts may result in systemic effects, including hypersensitivity reactions and worsening of asthma.

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Shelf Life and Storage

Do not store above 25 degrees C

Reference Sources

Summary of Product Characteristics: Balmosa Cream. Forest Laboratories UK Limited. Revised April 2003

Summary of Product Characteristics: Radian B Muscle Rub. Thornton & Ross Ltd. Revised December 2003