SUMMARY OF THE PRODUCT CHARACTERISTICS
1
NAME OF THE MEDICINAL PRODUCT
Contra 5 % cream
2
QUALITATIVE AND QUANTITATIVE COMPOSITION
1 g cream contains: Aciklovir 50 mg
Excipients with known effect: Propylene glycol, cetyl alcohol. For the full list of excipients,
see section 6.1.
3
PHARMACEUTICAL FORM
Cream
White, shiny cream
4
CLINICAL PARTICULARS
4.1
Therapeutic indications
Symptomatic treatment of prodrome and early forms of recurring herpes labialis caused by
herpes simplex virus.
4.2
Posology and method of administration
Adults and children 12 years and older: The cream is applied on the site of the infection every
four hours, five times daily.
The treatment should start as soon as there are symptoms of an infection, preferable within
four hours. Normally the treatment with Contra 5 % cream should be continued for five days.
4.3
Contraindications
Hypersensitive to aciclovir, valaciclovir, propylene glycol or to any of the excipients listed in
section 6.1.
4.4
Special warnings and special precautions for use
The cream should be applied only to lesions on the lips or in the face. Aciclovir cream is not
recommended for application to mucous membranes, such as in the mouth, eye or vagina, as it
may be irritant. Particular care should be taken to avoid accidental introduction into the eye.
For severely immunocompromised patients, such as AIDS-patients or patients undergone
transplantation, oral aciclovir dosing should be considered. Such patients should be
encouraged to consult a physician concerning the treatment of any infection.
Treatment of HSV-infection in patients with simultaneous dermatitis or eczema in the
treatment area has not been studied.
Contra contains cetyl alcohol, which may cause local skin reactions (e.g. contact dermatitis)
and propylene glycol, which may cause skin irritation.
Paediatric population
There is no experience of treatment of children younger than 12 years.
4.5
Interaction with other medicinal products and other forms of interaction
No clinically significant interactions have been identified.
4.6
Fertility, pregnancy and lactation
Fertility
See section 5.2
Pregnancy
The use of aciclovir should be considered only when the potential benefits outweigh the
possibility of unknown risks however the systemic exposure to aciclovir from topical
application of aciclovir cream is very low.
A post-marketing aciclovir pregnancy registry has documented pregnancy outcomes in
women exposed to any formulation of aciclovir. The registry findings have not shown an
increase in the number of birth defects amongst aciclovir exposed subjects compared with the
general population, and any birth defects showed no uniqueness or consistent pattern to
suggest a common cause.
Systemic administration of aciclovir in internationally accepted standard tests did not produce
embryotoxic or teratogenic effects in rabbits, rats or mice.
In a non-standard test in rats, foetal abnormalities were observed but only following such high
subcutaneous doses that maternal toxicity was produced. The clinical relevance of these
findings is uncertain.
Lactation
Limited human data show that the drug does pass into breast milk following systemic
administration. However, the dosage received by a nursing infant following maternal use of
aciclovir cream would be insignificant.
4.7
Effects on ability to drive and use machines
Contra has none known influence on the ability to drive and use machines.
4.8
Undesirable effects
The following convention has been used for the classification of undesirable effects in terms
of frequency: Very common ≥1/10, common ≥1/100 and <1/10, uncommon 1/1000 and
<1/100, rare ≥1/10,000 and <1/1000, very rare <1/10,000, not known (cannot be estimated
from the available data).
Skin and subcutaneous tissue disorders
Common: Numbness on the site of application.
Uncommon: Transient burning or stinging following application of aciclovir cream.
Mild drying or flaking of the skin. Itching.
Rare:
Erythema. Contact dermatitis following application. Where sensitivity tests have
been conducted, the reactive substances have most often been shown to be
components of the cream rather than aciclovir.
Immune system disorders
Very rare:
Immediate hypersensitivity reactions including angioedema and urticaria.
Reporting of suspected adverse reactions
Reporting 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 national
reporting system listed in Appendix V*.
4.9
Overdose
No untoward effects would be expected if the entire contents of the tube or dispenser were
ingested orally.
5
PHARMACOLOGICAL PROPERTIES
5.1
Pharmacodynamic properties
Pharmacotherapeutic group: Antiviral agents, ATC-code: D06B B03
After entry into a cell infected with herpes simplex virus, acyclovir is converted into
aciclovir-triphosphate. The triphosphate inhibits replication of virus-DNA. Aciclovir does not
eliminate latent virus species.
5.2
Pharmacokinetic properties
Concentration in plasma is minimal and consequently there will be no systemic effect.
5.3
Preclinical safety data
Preclinical data reveal no special hazard for humans based on conventional studies on safety
pharmacology, repeated dose toxicity, and carcinogenicity at parenteral or oral administration
of aciclovir. In some genotoxicity studies positive results were found. Systemic administration
of aciclovir in the normal animal studies did not show any embryotoxic or teratogenic effects.
Teratogenic effects such as anomalies of the skeleton and abnormal forms of the head have
been observed in rat embryos in in vitro culture and in rat studies where high subcutaneous
doses of aciclovir were given one day in early gestagen phase.
6
PHARMACEUTICAL PARTICULARS
6.1
List of excipients
Stearoyl macrogolglycerides, dimeticone, cetyl alcohol, light liquid paraffin, white vaseline,
propylene glycol and purified water.
6.2
Incompatibilities
Not applicable.
6.3
Shelf-life
3 years
6.4
Special precautions for storage
Do not store above 25 °C.
6.5
Nature and content of container
Aluminium tubes 2g and 5g.
Plastic bottle (PP) with pump dispenser 2 g.
6.6
Instructions for use and handling, and disposal (if appropriate)
No special requirements.
7
MARKETING AUTHORISATION HOLDER
Meda OTC AB, Box 906, 170 09 Solna, Sweden
8
MARKETING AUTHORISATION NUMBER(S)
17841
9
DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION
11 January 2002/ 11 January 2007
10
DATE OF REVISION OF THE TEXT
21 January 2016