This information is intended for use by health professionals
Alphosyl '2 in 1' Shampoo
Alcoholic extract of coal tar 5.00% w/w
Excipients with known affect:
Methyl Para-hydroxybenzoate (E218): 0.1%w/w
Propyl Para-hydroxybenzoate (E216): 0.01%w/w
Sodium lauryl sulfate: 25%w/w
For excipients see 6.1
Coal tar shampoo is indicated for the treatment of scalp disorders including:
- Seborrhoeic dermatitis
- Pruritus and scalp associated with psoriasis, seborrhoeic dermatitis and eczema
- Itchy, oily scalp
Adults and children aged 12 years and older:
Alphosyl '2 in 1' Shampoo is for topical application to the scalp.
The hair should be wetted and sufficient Alphosyl '2 in 1' Shampoo applied to produce an abundant lather. The scalp and adjacent areas should be vigorously massaged with the fingertips. The hair should be then thoroughly rinsed and the procedure repeated. Taking both of these shampoo applications into consideration, the total leave on time for the shampoo should be 3 – 5 minutes.
Alphosyl '2 in 1' Shampoo should be used once or twice weekly for the treatment of scalp disorders. The normal duration of use is 4 weeks, after which the condition should improve. Longer duration of therapy should be continued under the supervision of a physician.
The safety and efficacy of Alphosyl '2 in 1' Shampoo in children under 12 years of age have not been established.
Coal tar preparations have been used in children for many years, but since there is very little documented clinical data in this patient population, Alphosyl '2 in 1' Shampoo should be used with caution in children and only on the recommendation of a doctor or pharmacist.
No dosage adjustment is necessary.
No dosage adjustment is necessary.
No dosage adjustment is necessary.
Known hypersensitivity to coal tar or to any of the excipients in the preparation.
The following conditions should not be treated with Alphosyl '2 in 1' Shampoo:
Infected open skin lesions
Sore or acute pustular psoriasis.
For cutaneous use only.
Coal tar preparations may cause irritancy; therefore contact with sensitive areas, such as broken or very inflamed skin, should be avoided.
If irritation develops, treatment should be discontinued.
Avoid contact with eyes. If contact occurs rinse eyes thoroughly with water.
Alphosyl '2 in 1' Shampoo can stain skin and clothes. Contact with clothes should be avoided. Skin stains will wear off after treatment is stopped.
In rare instances, temporary hair colour changes may occur.
As Alphosyl '2 in 1' Shampoo may cause increased sensitivity to sunlight, sunlamps should not be used and deliberate or prolonged exposure of the scalp to sunlight should be avoided or minimised.
Alphosyl '2 in 1' Shampoo should be used with caution if the patient is also taking drugs known to be photosensitisers (e.g. thiazides, tetracyclines, fluoroquinolones, phenothiazines, sulphonamides) because of the increased possibility of augmented photosensitivity.
This product contains Methyl Para-hydroxybenzoate (E218) and Propyl Para-hydroxybenzoate (E216) which may cause allergic reactions (possibly delayed).
This product contains 25% w/w sodium lauryl sulphate solution, which is equivalent to 25g per 100ml. Sodium laurilsulfate may cause local skin reactions (such as stinging or burning sensation) or increase skin reactions caused by other products when applied on the same area.
There are no data on the effects of topical coal tar preparations on human fertility.
There are limited data from the use of coal tar preparations in pregnant women.
Coal tar has been shown to be fetotoxic and teratogenic to the offspring of laboratory animals when administered topically, orally or by inhalation at high and maternally toxic doses (see Non-clinical Information).
Use of coal tar preparations during pregnancy should only be considered if the expected benefit to the mother outweighs the potential risk to the foetus.
The use of coal tar products should be avoided in the first trimester of pregnancy.
The safe use of topical coal tar preparations during lactation has not been established.
It is not known whether the topical application of coal tar preparations could result in sufficient systemic absorption to produce detectable amounts in breast milk.
Use of coal tar preparations during lactation should only be considered if the expected benefit to the mother outweighs the potential risk to the infant.
If used during lactation, patients should be advised to ensure that any residual product is fully washed off the breast prior to breast-feeding in order to avoid accidental ingestion by the infant.
Adverse drug reactions (ADRs) are listed below by the MedDRA system organ class and by frequency. Frequencies are defines as: very common (≥1/10), common (≥1/100 and <1/10) , uncommon (≥1/1,0000 and <1/100), rare (≥1/10,000 and <1/1,000) and very rare (<1/10,000), including isolated reports.
Immune system disorders
Rare: Hypersensitivity (including pruritus, angioedema, dyspnoea)
Rare: Eye irritation
Skin and subcutaneous tissue disorders
Rare: Alopecia, dermatitis, hair colour changes, abnormal hair texture, photosensitivity reaction, skin irritation (including dry skin, erythema and skin burning sensation).
General disorders and administration site conditions
Rare: Application site hypersensitivity, application site pain, application site rash, localised oedema.
Reporting of suspected adverse reactionsReporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.
Symptoms and signs:
Topical coal tar overdose may increase the rate of skin irritation and photosensitivity. (See Adverse Reactions).
Management should be clinically indicated or as recommended by the national poisons centre, where available.
Mechanism of action
Coal tars suppress DNA synthesis in hyperplastic skin inhibiting mitotic activity protein synthesis and cell reproduction.
Coal tar decreases epidermal proliferation and dermal infiltration and thus promotes a return to normal keratinisation. Coal tar has anti-inflammatory, antibacterial, antipruritic, keratolytic, keratoplastic and vascoconstrictive effects.
In a study using a variety of coal tar preparations total urinary poly aromatic hydrocarbons were significantly elevated in patients treated dermally for different forms of dermatoses. The treatment period was for an average of 7 days using 1.5% - 40% coal tar preparations over a body surface area that ranged from 9 to 90%. Therefore some of the hydrocarbons present in coal tar may be absorbed through the skin. The highest levels absorbed depend largely on the body surface area treated and on the duration of exposure.
Many of the hydrocarbons will be subject to extensive metabolic transformation by both oxidation and conjugation. Drug-metabolizing enzymes (both in the skin and systemically) may be induced by coal tar application.
Carcinogenesis and Mutagenesis
No long term studies have been conducted with the product formulations.
Coal tar contains certain chemicals that are mutagenic to microorganisms and mammalian cells in vitro. Topical and oral administration of high doses of coal tar to laboratory animals induces DNA adduct formation.
High dose administration of coal tar to laboratory animals is carcinogenic
However, epidemiological evidence that includes prospective and retrospective studies in thousands of patients receiving coal tar therapy followed for more than 40 years do not suggest a potential increased risk of skin or systemic cancer.
Coal tar is foetotoxic and teratogenic at maternally toxic doses following dermal application, oral administration, or inhalation.
Sodium lauryl sulphate solution
Ammonium lauryl sulphate solution
Herbal Fragrance 41.423
Hydroxy Propyl Methyl Cellulose
Citric acid anhydrous
Guar Hydroxy Propyl Trimonium Chloride
Patent Blue V dye
Alphosyl '2 in 1' shampoo is packaged in white opaque polypropylene bottles with wadded cap and pack sizes; 20, 100, 125, 250, 500 and 1000 ml
White opaque polypropylene bottles with a white polypropylene flip top cap and pack sizes 125 and 250ml.
It is also packaged in white opaque polypropylene tubes with screw cap and pack sizes 20, 100, 125, 250, 500 and 1000 ml.
It is also packaged in 10 ml PETP/PE/Foil Surlyn sachets.
Omega Pharma Ltd.
32 Vauxhall Bridge Road
LONDON, SW1V 2SA