Caladrox (Menthol and Zinc Oxide) is used to treat diaper rash, and reduce pain, discomfort, and itching brought on by small skin irritations such as those brought on by persistent urination and faeces soaks, as well as to cure skin damage brought on by a fistula or drain.

Menthol and zinc oxide Uses:

• Protective barrier:

  • It is used to prevent and heal skin irritation that is caused by urinary leakage, stool incontinence or diarrhea, sweat, skin damage caused by a drain or fistula, diaper rash, or feeding tube site leakage.
  • Additionally, it provides momentary relief from itchiness and discomfort brought on by small burns, wounds, scrapes, insect bites, mild skin irritation, and sunburn.
  • It is used to treat oozing of poison ivy, oak, or sumac.
  • It is also used for topical application over hemorrhoids or fissures to relieve discomfort, pain, and itching in the perianal area.
  • It may provide a cooling sensation and may temporarily relieve pain.

Read: 

• Zinc oxide as a protective skin coating
• Lidenza (Lidocaine and Menthol) Cream, Gel, Patch, Spray
• Bengay (Methyl salicylate and Menthol) Cream and Patch

Menthol and Zinc Oxide Dose in Adults:

Menthol and Zinc Oxide use as a protective barrier: Topical:

• Ointment (excluding Lantiseptic):
  • After each diaper change or two to four times per day, apply a small coating to the afflicted region.
• Ointment (Lantiseptic only), Paste:
  • Apply to the affected area up to six times a day or after each diaper change.

Use in Children:

Powder:

• Children ≥2 years, Adolescents, and Adults:
  • Apply up to four times per day to the afflicted region.

Refer to adults dosing.

Pregnancy Risk Category: N (Not assigned)

• Its use during pregnancy and lactation has not been confirmed. 
• The drug's serum concentration is not affected by the topical application. 
• Avoid applying directly to the nipples of breastfeeding mothers.

Dose in Kidney Disease:

There are no dosage adjustments provided in the manufacturer’s labeling.

Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer’s labeling.

Side effects of Menthol and Zinc Oxide (Caladrox):

• Dermatologic:

  • Pruritus
  • Skin rash
  • Stinging of the skin (temporarily on application)

• Hypersensitivity:

  • Hypersensitivity reaction

Contraindications to Menthol and Zinc Oxide (Caladrox):

OTC labeling

• Use caution when using over-the-counter medications near the eyes, deep or puncture wounds, animal bites, or severe burns.

Cautions and Alerts

• Allergy reactions:

  • Allergy reactions can occur in some patients. 
  • If symptoms such as redness, irritation or pain, swelling, and other signs that could indicate hypersensitivity reactions, the treatment should be stopped immediately.

• Radiation therapy

  • Radiation therapy should not include zinc oxide.

Monitoring Parameters:

None mentioned.

How to use Menthol and Zinc Oxide (Caladrox) Ointment?

Topical:

• It is intended for external use only.
• The affected area should be cleaned with a mild cleanser before its application and pat dried or allowed to air dry.
• Contact with the eyes should be avoided.
• If it is to be re-applied, complete removal of the drug is not necessary.
• If it is applied around a gastrostomy tube, a thin layer should be applied and the tube is secured with a drain sponge or as directed.
• It should not be used during radiation therapy.
• Patients undergoing radiotherapy should completely remove it before the radiotherapy session.
• The ointment can be removed from the skin with a baby or mineral oil.

Mechanism of action of Menthol and Zinc Oxide (Caladrox):

Menthol

• It is an analgesic and antipruritic agent. It causes cold sensations by dilation of blood vessels.

Zinc oxide:

• It is a weak antiseptic with mild astringent qualities.

International Brand Names of Menthol and zinc oxide:

• Caladrox
• Calmoseptine
• Fordustin
• Lantiseptic Multi-Purpose
• Remedy Calazime
• Risamine

Menthol and zinc oxide Brand Names in Pakistan: