Camphor/Menthol
Patient Counselling
General:
· Topical use of menthol/camphor products is appropriate for up to 7 days. Apply TID- QID to affected area. Do not apply to broken or irritated skin. If skin becomes irritated, discontinue use. Keep out of reach of children.
Pregnancy:
· Due to a lack of safety data in pregnancy for either product, as well as only modest expectations of efficacy, the use is not recommended. It should be noted that when used topically, absorption is minimal and retrospective studies have failed to show any adverse events4, so if the products were used, risk of adverse events appears low. However, due to minimal benefit in the face of any risk, it seems unreasonable to recommend this product.
Pediatrics:
· Counsel regarding risk of ingestion. This product should not be used in children with osteoarthritis, as unusual presentation may suggest atypical aetiology and therapy should be guided by a specialist.
Product Examples:
1) Tiger Balm Ointment
a. Multiple formulations—do not use if menthol/camphor exceed 11%
b. Generally have 11% camphor, 11% menthol
2) Vicks VapoRub Ointment
a. Camphor 5.2%, menthol 2.8%, eucalyptus oil 1.2%
3) J.R. Watkins Menthol Camphor Medicated Cough Suppressant Rub (ointment)
a. Camphor 5.3%, Menthol 2.8%
References:
1) Moody ML. Topical Medications in the Treatment of Pain. Pain Medicine News. 2010.
2) Kraemer WJ, Ratamess NA, Maresh CM et al. A cetylated fatty acid topical cream with menthol reduces pain and improves functional performance in individuals with arthritis. J Strength Cond Res. 2005 May; 19(2):475-80.
3) Zuccarini P. Camphor: risks and benefits of a widely used natural product. J Appl Sco Environ Manage. June 2009. Vol 13(2) 69-74.
4) Briggs GG, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 6th ed. Baltimore, Md: Williams & Wilkins; 2002
· Topical use of menthol/camphor products is appropriate for up to 7 days. Apply TID- QID to affected area. Do not apply to broken or irritated skin. If skin becomes irritated, discontinue use. Keep out of reach of children.
Pregnancy:
· Due to a lack of safety data in pregnancy for either product, as well as only modest expectations of efficacy, the use is not recommended. It should be noted that when used topically, absorption is minimal and retrospective studies have failed to show any adverse events4, so if the products were used, risk of adverse events appears low. However, due to minimal benefit in the face of any risk, it seems unreasonable to recommend this product.
Pediatrics:
· Counsel regarding risk of ingestion. This product should not be used in children with osteoarthritis, as unusual presentation may suggest atypical aetiology and therapy should be guided by a specialist.
Product Examples:
1) Tiger Balm Ointment
a. Multiple formulations—do not use if menthol/camphor exceed 11%
b. Generally have 11% camphor, 11% menthol
2) Vicks VapoRub Ointment
a. Camphor 5.2%, menthol 2.8%, eucalyptus oil 1.2%
3) J.R. Watkins Menthol Camphor Medicated Cough Suppressant Rub (ointment)
a. Camphor 5.3%, Menthol 2.8%
References:
1) Moody ML. Topical Medications in the Treatment of Pain. Pain Medicine News. 2010.
2) Kraemer WJ, Ratamess NA, Maresh CM et al. A cetylated fatty acid topical cream with menthol reduces pain and improves functional performance in individuals with arthritis. J Strength Cond Res. 2005 May; 19(2):475-80.
3) Zuccarini P. Camphor: risks and benefits of a widely used natural product. J Appl Sco Environ Manage. June 2009. Vol 13(2) 69-74.
4) Briggs GG, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 6th ed. Baltimore, Md: Williams & Wilkins; 2002