what is xamiol medication used for and indication?
Xamiol is used as the topical treatment for scalp psoriasis in adults. Psoriasis is caused by your skin cells being produced too quickly. This causes redness, peeling and thickening of the skin.
PRESENTATION (S) AVAILABLE FOR XAMIOL 50 ΜG / 0.5 MG / G
4 presentations are available for this drug:
- 1 bottle (s) high density polyethylene (HDPE) of 15 g
- 1 bottle (s) high density polyethylene (HDPE) of 30 g
- 1 bottle (s) high density polyethylene (HDPE) of 60 g
- 2 high density polyethylene (HDPE) bottle (s) of 60 g
|Pharmaceutical class||psoriasis treatment|
|Active substance (s)||betamethasone dipropionate, calcipotriol monohydrate|
|Route (s) of administration||cutaneous|
|Social security reimbursement rate||65%|
|Conditions of issue||available by simple prescription|
Always take the dose recommended by your doctor. If in doubt, consult your doctor or pharmacist.
How to apply Xamiol:
- Cutaneous use. Medicinal product only for the scalp.
- Hypersensitivity to the active substances or to any of the excipients.
- Xamiol gel is contraindicated in cases of erythrodermic, exfoliating and pustular psoriasis.
- Due to the presence of calcipotriol, Xamiol gel is contraindicated in patients with a history of calcium metabolism disorders.
- Due to the presence of corticosteroids, Xamiol gel is contraindicated in the following cases: skin infections of viral origin (for example herpes or chickenpox), fungal or bacterial, parasitic infections, skin damage related to tuberculosis or syphilis, perioral dermatitis, skin atrophy, stretch marks, fragility of the skin venous network, ichthyosis, acne vulgaris, acne rosacea, rosacea, ulcers, wounds, peri-anal and genital pruritus.
xamiol gel how to use?
Instruction for correct use
- Only use it for your scalp psoriasis and do not use it on healthy skin.
- Washing your hair before applying Xamiol is not necessary
- Shake the bottle before use and remove the cap.
- Before applying Xamiol to the scalp, style your hair to eliminate dandruff. Tilt your head to make sure that Xamiol is not running on your face. Streaking can make Xamiol easier to apply. Apply Xamiol to the affected area with your fingertip and rub it in gently.
- Usually, an amount between 1 and 4 g per day is sufficient to treat the scalp (4 g corresponds to a teaspoon).
- Do not cover the treated area with neither a bandage nor a compression bandage.
- Wash hands thoroughly after using Xamiol. This will prevent accidental transfer of gel to other parts of the body (especially on the face, mouth and eyes).
- Don’t worry if you accidentally apply the gel to healthy skin around the psoriasis lesions, but wipe it off if it gets too wide.
- For optimal effect, it is recommended not to wash your hair immediately after applying Xamiol. Leave Xamiol in contact with the scalp overnight or during the day.
- After applying the gel, avoid contact with fabrics that are easily stained with grease (such as silk).
Washing your hair before applying Xamiol is not necessary.
- Shake the bottle before use.
- Apply a drop of Xamiol to the fingertip.
- Apply directly to the affected areas where you can feel the plaque and massage Xamiol gel into the skin. Depending on the affected area 1-4 g (the equivalent of a teaspoon) is normally sufficient.
For optimal effect, it is recommended not to wash your hair immediately after applying Xamiol. Leave X amiol in contact with the scalp overnight or during the day. When washing your hair after application, follow these recommendations:
- Apply a mild shampoo to dry hair, especially where the gel has been applied.
- Leave the shampoo on the scalp for a few minutes before washing off.
- Wash your hair normally.
It may be necessary to repeat steps 4 to 6 once or twice.
Duration of the treatment
- Use the gel once a day. It may be more convenient to apply the gel in the evening
- The normal initial treatment period is 4 weeks
- Your doctor may prescribe a different duration of treatment.
- Your doctor may decide to repeat the treatment.
- Do not use more than 15 grams per day
All affected areas can be treated with Xamiol. However, if you are using other products containing calcipotriol, the total calcipotriol should not exceed 15 grams per day and the treated area should not exceed 30% of the total body surface area.
What should I expect from my treatment with X amiol?
Most patients see a clear result after 2 weeks even if the psoriasis has not completely gone away.
how does xamiol work?
Pharmacotherapeutic group: Anti-psoriatic drugs. Other anti-psoriatic drugs for topical use, Calcipotriol, combinations, ATC code: D05AX52.
- Calcipotriol is an analogue of vitamin D. In vitro data suggest that calcipotriol induces differentiation and inhibits the proliferation of keratinocytes. This is the mechanism proposed to explain its effects in psoriasis.
- Like other topical corticosteroids, betamethasone dipropionate has anti-inflammatory, anti-pruritic, vasoconstrictive, and immunosuppressive properties, however, with no demonstrated curative action. Treatment under occlusion may increase the effect due to greater penetration into the stratum corneum. The incidence of side effects will therefore be increased. In general, the mechanism of action of the anti-inflammatory activity of topical corticosteroids is not fully understood.
- The adrenal response to ACTH was determined by measuring cortisol in patients with both extensive scalp and body psoriasis using up to 106 g per week of Xamiol gel in combination with Daivobet ointment. A borderline decrease in cortisol levels 30 minutes after ACTH administration was observed in 5 of 32 patients (15.6%) after 4 weeks of treatment and in 2 of 11 patients (18.2%) who had prolonged treatment up to 8 weeks. In all cases, cortisol levels were at a normal level 60 minutes after the administration of ACTH. No changes in calcium metabolism were observed in these patients. Regarding hypothalamic-pituitary braking, this study demonstrates that
- The efficacy of once-daily use of Xamiol gel has been evaluated in two randomized, double-blind, 8-week clinical studies including a total of over 2,900 patients with scalp psoriasis of severe severity. less mild according to the Investigator’s Global Assessment of disease severity (IGA). The comparators were betamethasone dipropionate in the gel vehicle, calcipotriol in the gel vehicle, and (in one of the studies) the gel vehicle alone, all used once daily. Results for the primary endpoint (absence of disease or very slight presence of disease according to IGA at week 8) showed that Xamiol gel was significantly more effective than the comparators. The results on the speed of
|% of patients with absence of disease or very slight presence of disease||Xamiol gel (n = 1,108)||Betamethasone dipropionate (n = 1118)||Calcipotriol
(n = 558)
|Freeze vehicle (n = 136)|
|week 2||53.2%||42.8% 1||17.2% 1||11.8% 1|
|week 8||69.8%||62.5% 1||40.1% 1||22.8% 1|
1 Statistically less effective than Xamiol gel (p <0.001)
- Another randomized, single-blind, clinical study including 312 patients with scalp psoriasis of at least moderate severity according to the IGA investigated the use of Xamiol gel once daily compared with that of Daivonex scalp solution two. times a day for 8 weeks. Results for the primary endpoint (absence of disease or very mild disease presence according to the IGA at week 8) showed that Xamiol gel was statistically more effective than Daivonex scalp solution.
|% of patients with absence of disease or very slight presence of disease||Xamiol gel (n = 207)||Daivonex Scalp Solution (n = 105)|
|week 8||68.6%||31.4% 1|
1 Statistically less effective than Xamiol gel (p <0.001)
- A long-term, randomized, double-blind clinical study including 873 patients with scalp psoriasis of at least moderate severity at baseline (according to the IGA) studied the use of Xamiol gel in comparison with that of calcipotriol in the vehicle of the gel. Both treatments were applied once daily, intermittently as needed, for up to 52 weeks. Adverse effects possibly linked to the long-term use of corticosteroids on the scalp have been identified blindly by an independent panel of dermatologists. There was no difference in the percentage of patients with such adverse effects between the treated groups (2.6% in the Xamiol gel group and 3.0% in the calcipotriol group; p = 0.73). No case of skin atrophy
- The effects on calcium metabolism were studied in two open-label, 8-week, open-label studies including a total of 109 adolescents aged 12 to 17 years with scalp psoriasis who used up to 69 g per week of Xamiol gel. No cases of hypercalcaemia and no clinically relevant changes in calciuria have been reported. The adrenal response to the administration of ACTH was measured in 30 patients; one patient showed a slight decrease in his cortisol levels on administration of ACTH after 4 weeks of treatment, without clinical manifestation and reversible
How To Store xamiol ?
- Keep this medication out of the sight and reach of children.
- Do not use this medicine after the expiry date which is stated on the vial after EXP. The expiration date refers to the last day of that month.
- Do not put in the refigerator. Store in the outer packaging in order to protect from light.
- The bottle should be discarded 6 months after first opening with the gel it contains.
- Do not throw away any medicines via a wastewater treatment plant or with household waste. Ask your pharmacist how to throw away the medicines you no longer use. These measures will help protect the environment.
xamiol Side Effects
Like all medicines, Xamiol can cause side effects, although not everybody gets them.
About 1 in 12 people may experience side effects, but most are reactions at the site of application of the gel.
Serious side effects
Contact your doctor / nurse immediately or as soon as possible if any of these reactions occur. You may need to stop your treatment
The following serious side effects have been reported for Xamiol
Uncommon (affects less than 1 in 100 people)
- Worsening of your psoriasis. If your psoriasis gets worse, talk to your doctor as soon as possible.
Serious side effects are known to be caused by betamethasone (a strong corticosteroid), one of the ingredients of Xamiol. Tell your doctor as soon as possible if a serious side effect occurs. These side effects most often occur after prolonged use, or under occlusion. These effects include the following:
- Your adrenal glands may stop working properly. The signs are fatigue, depression, and worry.
- Cataracts (signs are blurry and blurred vision, difficulty seeing at night, and sensitivity to light) or increased pressure in the eye (signs are eye pain, red eye, decreased or cloudy vision).
- Infections (because your infection-fighting immune system may be weakened or weakened).
- Pustular psoriasis (a red area with yellowish pustules usually on the hands or feet). If you notice it, stop using Xamiol and talk to your doctor as soon as possible.
- Impact on the control of the metabolism of diabetes mellitus (if you are diabetic you may have fluctuations in your blood sugar).
Serious side effects are known to be caused by calcipotriol:
- Allergic reactions with severe swelling of the face or other parts of the body such as the hands or feet. Swelling of the lips / throat and difficulty in breathing may occur. If you have an allergic reaction, stop using Xamiol, tell your doctor straight away, or go to the nearest hospital emergency room.
- Treatment with this gel may increase your calcium levels in the blood or urine (usually when too much gel has been used). Signs of increased calcium in the blood are bone pain, constipation, loss of appetite, nausea, and vomiting. This can be serious and you should contact your doctor immediately. However, when treatment is stopped, the levels return to normal.
Less serious side effects
The following less serious side effects have been reported with Xamiol
Common side effects (affect less than 1 in 10 people)
Uncommon side effects (affect less than 1 in 100 people)
- Eye irritation.
- Burning sensation of the skin.
- Skin pain or irritation.
- Inflammation or swelling of the hair roots (folliculitis).
- Redness with inflammation of the skin (dermatitis).
- Redness of the skin due to the dilation of small blood vessels (erythema).
- Acne (pimples).
- Dry skin.
- Rash of pustules.
Less serious side effects caused by betamethasone when used for a long time include the following side effects, and you should tell your doctor or nurse as soon as possible if you notice them:
- Thinning of the skin.
- Appearance of surface veins or stretch marks.
- Change in hair growth.
- Redness around the mouth (perioral dermatitis).
- Red rash with inflammation and swelling (allergic contact dermatitis).
- Small white buttons (colloid milium).
- Depigmentation (lightening of the skin).
Less serious side effects are known to be caused by calcipotriol, including the following:
- Sensitivity of the skin to light causing a rash.
If you notice the effects described above or other changes during treatment, tell your doctor.
If you experience any of the side effects listed as serious, or if you experience any side effects not listed in this leaflet, please tell your doctor or pharmacist.
Keep out of the reach and sight of children.
- No interaction studies have been performed with Xamiol.
- In the absence of compatibility studies, this medicinal product must not be mixed with other medicinal products.
Effects on ability to Drive and use machines
- Xamiol gel has no or negligible influence on the ability to drive and use machines.
Warnings and Precautions
Take special care with Xamiol:
Before using this medication, tell your doctor or pharmacist if:
- you are taking other medicines which contain corticosteroids as you may have side effects
- you have taken this medicine for a long time and plan to stop the treatment (as there is a risk that your psoriasis will get worse or come back when the corticosteroids are suddenly stopped),
- you have diabetes (diabetes mellitus) because blood sugar / glucose levels may be affected by corticosteroids
- your skin becomes infected because you may need to stop treatment,
- you have psoriasis of a type called gouty psoriasis
- you have severe liver or kidney disease.
- Avoid treating more than 30% of the body and using more than 15 grams per day.
- Avoid use under a shower cap, bandages or dressings as this increases the absorption of corticosteroids.
- Avoid use on large areas of damaged skin or in skin folds (groin, under the arms, under the breasts) as this increases the systemic absorption of corticosteroids.
- Avoid use on the face or the genitals (sexual organs) as these are very sensitive to corticosteroids.
- Avoid excessive exposure to the sun, excessive use of solar cabins, or other form of light therapy.
- Xamiol is not recommended for children under the age of 18.
PREGNANCY & BREAST-FEEDING & FERTILITY
- There are insufficient data from the use of Xamiol gel in pregnant women. Studies in animals with glucocorticoids have shown reproductive toxicity (see section Preclinical safety data), but a number of epidemiological studies (less than 300 completed pregnancies) have not shown congenital abnormalities in infants born to mothers treated with corticosteroids during pregnancy. The potential risk to humans is uncertain. Therefore, Xamiol gel should only be used during pregnancy when the potential benefit justifies the potential risk.
Feeding with milk
- Betamethasone passes into breast milk, but the risk of an adverse effect in the infant seems unlikely at therapeutic doses. There are no data available on the excretion of calcipotriol in human milk. Caution should be exercised when prescribing Xamiol gel to breast-feeding women.
- Studies in rats following oral administration of calcipotriol or betamethasone dipropionate have shown no impairment of fertility in males and females (see section Preclinical safety data).
What happens if I overdose from xamiol ?
- The use of doses higher than the recommended dose may lead to an increase in serum calcium, this effect is reversible on discontinuation of treatment. Symptoms of hypercalcemia include polyuria, constipation, muscle weakness, confusion, and coma.
- Excessive and prolonged use of topical corticosteroids can lead to hypothalamic-pituitary axis slowing, resulting in secondary adrenal insufficiency which is usually reversible. In this case, symptomatic treatment is indicated.
- In the event of chronic toxicity, treatment with corticosteroids should be withdrawn gradually.
- A case of misuse has been reported in a patient treated for extensive erythrodermic psoriasis with 240 g of Daivobet ointment per week (corresponding to a daily dose of approximately 34 g) for 5 months (maximum recommended dose 15 g per day); during treatment, the patient developed Cushing’s syndrome followed by pustular psoriasis after abrupt cessation of treatment.
What should I do if I miss a dose?
Do not apply a double dose to make up for the dose you forgot to apply.
What happens if you stop taking xamiol ?
Treatment with XAMIOL should be stopped as instructed by your doctor. It may be necessary to stop treatment gradually, especially if you have been taking it for a long time.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist for more information.
What is Forms and Composition ?
SHAPES and PRESENTATIONS
50 µg / 0.5 mg / g gel (almost transparent; colorless to very slightly off-white): 60 g vial.
|Calcipotriol monohydrate expressed as calcipotriol||50 µg|
|Betamethasone dipropionate expressed as betamethasone||0.5 mg|
Excipients: liquid paraffin, polyoxypropylene stearyl ether, hydrogenated castor oil, butylhydroxytoluene (E321), all-rac-alpha-tocopherol.
Excipients with known effect: butylhydroxytoluene (E321) (160 micrograms / g), castor oil (20 mg / g).
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