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Amlexanox


Pronunciation

(am LEKS an oks)


U.S. Brand Names

Aphthasol®


Generic Available

No


Use

Treatment of aphthous ulcers (ie, canker sores)


Use - Unlabeled/Investigational

Allergic disorders


Pregnancy Risk Factor

B


Pregnancy Implications

Due to lack of data, avoid use in pregnancy, if possible.


Lactation

Excretion in breast milk unknown/use caution


Contraindications

Hypersensitivity to amlexanox or any component of the formulation


Warnings/Precautions

Discontinue therapy if rash or contact mucositis develops.


Adverse Reactions

1% to 2%:

Dermatologic: Allergic contact dermatitis

Gastrointestinal: Oral irritation

<1%: Contact mucositis


Mechanism of Action

As a benzopyrano-bipyridine carboxylic acid derivative, amlexanox has anti-inflammatory and antiallergic properties; it inhibits chemical mediatory release of the slow-reacting substance of anaphylaxis (SRS-A) and may have antagonistic effects on interleukin-3


Pharmacodynamics/Kinetics

Absorption: Some from swallowed paste

Metabolism: Hydroxylated and conjugated metabolites

Half-life elimination: 3.5 hours

Time to peak, serum: 2 hours

Excretion: Urine (17% as unchanged drug)


Dosage

Administer (0.5 cm - 1 /4") directly on ulcers 4 times/day following oral hygiene, after meals, and at bedtime


Patient Education

This medication is only for treatment of mouth ulcers; do not apply to ulcers of the eye or any other part of the body. Use as directed. Apply after eating. Wash hands before and after use. Brush teeth and rinse mouth before applying directly to ulcers. Squeeze a small amount of paste on your clean finger tip and dab paste onto each ulcer in the mouth, using gentle pressure. Wash eyes immediately if any paste should come into contact with eyes. Notify prescriber or dentist if rash or irritation occurs, or if condition does not improve after 10 days use. Breast-feeding precaution: Consult prescriber if breast-feeding.


Dental Health: Effects on Dental Treatment

Key adverse event(s) related to dental treatment: Allergic contact dermatitis and oral irritation. Discontinue therapy if rash or contact mucositis develops.


Dental Health: Vasoconstrictor/Local Anesthetic Precautions

No information available to require special precautions


Dental Comment

Treatment of canker sores with amlexanox showed a 76% median reduction in ulcer size compared to a 40% reduction with placebo. Greer, et al, reported an overall mean reduction in ulcer size of 1.82 mm 2 for patients treated with 5% amlexanox versus an average reduction of 0.52 mm 2 for the control group. Recent studies in over thousands of patients have confirmed that amlexanox accelerates the resolution of pain and healing of aphthous ulcers more significantly than vehicle and no treatment.


Mental Health: Effects on Mental Status

None reported


Mental Health: Effects on Psychiatric Treatment

None reported


Dosage Forms

Paste: 5% (5 g) [contains benzyl alcohol]


References

Greer RO Jr, Lindenmuth JE, Juarez T, et al, "A Double-Blind Study of Topically Applied 5% Amlexanox in the Treatment of Aphthous Ulcers," J Oral Maxillofac Surg , 1993, 51(3):243-8.


International Brand Names

Elics® (JP); Solfa® (JP)


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