Products
Bufexamac was on the market in many countries as a cream and as an ointment (Parfenac). Because the active ingredient frequently causes allergic contact dermatitis, distribution of the drugs was discontinued.
Structure and properties
Bufexamac or 2-(4-butoxyphenyl)–hydroxyacetamide (C12H17NO3, Mr = 223.3 g/mol) is a white to almost white crystalline powder that is practically insoluble in water. It belongs to the arylacetic acid derivatives within the NSAIDs.
Effects
Bufexamac (ATC M01AB17, ATC M02AA09) has anti-inflammatory and anti-itch properties and inhibits cyclooxygenase. It is chemically and pharmacologically unrelated to topical glucocorticoids. According to Schnuch et al (2005), bufexamac, which is available only in pharmacies, has been widely used in Germany as a “broad-spectrum anti-inflammatory therapeutic agent.”
Indications
Bufexamac is used externally to treat eczema. In Germany, but not in many countries, also used for atopic dermatitis.
Dosage
The medicine is applied thinly 2 to 3 times a day and rubbed in gently. Bufexamac should not be applied under an occlusive dressing and for longer than 6 months.
Contraindications
Bufexamac should not be used in hypersensitivity, in children and adolescents (no data), during pregnancy and lactation (no data), in atopics, and in anal eczema. Contact with mucous membranes and the eye area should be avoided. Bufexamac may cause contact allergy. For complete precautions, see the drug label.
Interactions
None known to date.
Adverse effects
Bufexamac is a known and potent contact allergen and can cause allergic contact dermatitis with a sometimes severe course (sensitization rate of 1.4%). This was demonstrated in a large study (see Schnuch et al., 2005). Risk groups include people who already have contact dermatitis, people with atopic dermatitis, eczema of the legs, or treatment of anal eczema (contraindicated). The symptoms of contact dermatitis are similar to the symptoms for which the drug is prescribed, and the side effect is therefore difficult to identify. Thus, the drug may aggravate the symptoms for which it was originally used.
