Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Aerosol, External:
Amberderm: Balsam peru 72.5 mg and castor oil 650 mg per 0.82 mL (113.4 g [DSC])
Proderm: Balsam peru 72.5 mg and castor oil 650 mg per 0.82 mL (113.4 g [DSC])
Ointment, External:
BPCO: (60 g)
Dermulcera: (60 g)
Venelex: Balsam peru 87 mg and castor oil 788 mg per gram (5 g, 30 g, 60 g)
Generic: (60 g)
Pharmacology
Mechanism of Action
Balsam peru stimulates circulation at the wound site and may be mildly bactericidal; castor oil improves epithelialization, acts as a protectant covering and helps reduce pain
Use: Labeled Indications
Wound management: Used to promote wound healing and the treatment of decubitus ulcers, varicose ulcers, and dehiscent wounds.
Contraindications
There are no contraindications listed in the manufacturer’s labeling.
Dosage and Administration
Dosing: Adult
Ulcer/wound management: Topical:
Aerosol spray: Apply 3 times daily
Ointment: Apply thin film twice daily or as often as necessary.
Dosing: Geriatric
Refer to adult dosing.
Administration
Do not apply on fresh arterial clots.
Aerosol spray: Shake well; spray ~12 inches from area to be treated. Additional bandaging not required. May gently massage the area immediately surrounding the wound (by or under the direction of professionally trained personnel).
Ointment: Apply a thin film over the area being treated. May be used with appropriate dressing if needed or wound may be left unbandaged. To remove, wash gently with appropriate wound cleanser.
Storage
Aerosol spray: Do not store at temperatures above 48°C (120°F).
Ointment: Store at 20ºC to 25ºC (68ºF to 77ºF), excursions permitted between 15ºC and 30ºC (between 59ºF and 86ºF). Brief exposure to temperatures up to 40ºC (104ºF) may be tolerated provided the mean kinetic temperature does not exceed 25ºC (77ºF); however, such exposure should be minimized. Protect from freezing.
Drug Interactions
There are no known significant interactions.
Warnings/Precautions
Disease-related concerns:
- Hemoglobin deficiency: Wound healing may be retarded in the presence of hemoglobin deficiency.
- Zinc deficiency: Wound healing may be retarded in the presence of zinc deficiency.
Dosage form specific issues:
- Aerosol: Flammable; do not expose to high temperatures or flame.
Other warnings/precautions:
- Appropriate use: For external use only; avoid contact with eyes. Do not apply to fresh arterial clots.
Patient Education
- Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
- Patient may experience stinging. Have patient report immediately to prescriber severe skin irritation (HCAHPS).
- Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.
