Wonica Cream 13.9%

Indications

• Wonica cream, 13.9% is indicated for the reduction of unwanted facial hair in women. Wonica has only been studied on the face and adjacent involved areas under the chin of affected individuals. Usage should be limited to these areas of involvement.

* রেজিস্টার্ড চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন'

Pharmacology

• Eflornithine prevents hair growth by inhibiting the anagen phase of hair production. This occurs by eflornithine irreversibly binding (also called suicide inhibition) to ornithine decarboxylase (ODC) and physically preventing the natural substrate ornithine from accessing the active site.

Dosage & Administration

• Eflornithine cream should be applied to the affected area twice daily, at least eight hours apart. Efficacy has only been demonstrated for affected areas of the face and under the chin. The application should be limited to these areas. Maximal applied doses used safely in clinical trials were up to 30 grams per month. Improvement in the condition may be noticed within eight weeks of starting treatment. Continued treatment may result in further improvement and is necessary to maintain beneficial effects. The condition may return to pre-treatment levels within eight weeks following discontinuation of treatment. Use should be discontinued if no beneficial effects are noticed within four months of commencing therapy. Patients may need to continue to use a hair removal method (e.g. shaving or plucking) in conjunction with Eflornithine cream. In that case, the cream should be applied no sooner than five minutes after shaving or use of other hair removal methods, as increased stinging or burning may otherwise occur.

• Elderly: (>65 years) No dosage adjustment is necessary.

• Pediatric population: The safety and efficacy of Eflornithine in children aged 0 to 18 years has not been established. There is no data available to support use in this age group.

• Hepatic/renal impairment: The safety and efficacy of Eflornithine in women with hepatic or renal impairment have not been established. As the safety of Eflornithine has not been studied in patients with severe renal impairment, caution should be used when prescribing Eflornithine cream for these patients. A thin layer of the cream should be applied to clean and dry affected areas. The cream should be rubbed in thoroughly. The medicinal product should be applied such that no visual residual product remains on the treated areas after rub-in. Hands should be washed after applying this medicinal product. For maximal efficacy, the treated area should not be cleansed within four hours of application. Cosmetics (including sunscreens) can be applied over the treated areas, but no sooner than five minutes after application.

* রেজিস্টার্ড চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন'

Interaction

• No interaction studies have been performed.

Contraindications

• Hypersensitivity to the active substance or to any of the excipients. Excessive hair growth can result from serious underlying disorders (e.g. polycystic ovary syndrome, androgen secreting neoplasm) or certain active substances (e.g. cyclosporin, glucocorticoids, minoxidil, phenobarbitone, phenytoin, combined oestrogen-androgen hormone replacement therapy). These factors should be considered in the overall medical treatment of patients who might be prescribed Eflornithine. Eflornithine is for cutaneous use only. Contact with eyes or mucous membranes (e.g. nose or mouth) should be avoided. Transient stinging or burning may occur when the cream is applied to abraded or broken skin.

Side Effects

• Adverse events were primarily mild in intensity and generally resolved without medical treatment or discontinuation of Wonica. Side effects can include acne, barbae, pseudofolliculitis, stinging skin, headache, burning skin, dry skin, erythema (redness), pruritus (itching), tingling skin, dyspepsia, skin irritation, rash, alopecia, dizziness, folliculitis, hair ingrown, facial edema, anorexia, nausea, asthenia, vertigo.

Pregnancy & Lactation

• pregnancy: Throughout clinical trials data from a limited number of exposed pregnancies (22) indicate that there is no clinical evidence that treatment with Eflornithine adversely affects mothers or foetuses. Among the 22 pregnancies that occurred during the trials, only 19 pregnancies occurred while the patient was using Eflornithine. Of these 19 pregnancies, there were 9 healthy infants, 5 elective abortions, 4 spontaneous abortions and 1 birth defect (Down’s Syndrome to a 35 year old). Animal studies have shown reproductive toxicity. The potential risk to humans is unknown. Therefore, women who are pregnant or planning pregnancy should use an alternative means to manage facial hair.
• Lactation: It is not known whether eflornithine/metabolites are excreted in human milk. Women should not use Eflornithine whilst breastfeeding.

Precautions & Warnings

• If skin irritation or intolerance develops, the frequency of application should be reduced temporarily to once a day. If irritation continues, treatment should be discontinued and the physician consulted.

Overdose Effects

• Given the minimal cutaneous penetration of Wonica, overdose is highly unlikely. However, should very high dose cutaneous administration or accidental oral ingestion occur, attention should be paid to the effects seen with therapeutic doses of intravenous eflornithine (400 mg/kg/day or approximately 24 g/day). This dose of Wonica in intravenous route is used in the treatment of Trypanosoma brucei gambiense infection (African sleeping sickness). The symptoms of this disease are: hair loss, facial swelling, seizures, hearing impairment, gastrointestinal disturbance, loss of appetite, headache, weakness, dizziness, anaemia, thrombocytopenia and leucopenia. If symptoms of overdose occur the use of the medicinal product should be stopped.

Therapeutic Class

• Hair Growth Inhibitor

Storage Conditions

• Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.