CROTAN
Clinical safety rating: caution
Comprehensive clinical and safety monograph for CROTAN (CROTAN).
Crotan (crotamiton) is a scabicide and antipruritic agent with unknown exact mechanism. It is thought to act against Sarcoptes scabiei by disrupting nervous system function, possibly via sodium channel modulation, and provides symptomatic relief of pruritus through local anesthetic-like effects.
| Metabolism | Not fully characterized; minimal systemic absorption when applied topically, with negligible hepatic metabolism presumed based on low systemic exposure. |
| Excretion | Primarily renal excretion of unchanged drug (approx. 60-70%) with biliary/fecal elimination accounting for 20-30%; less than 10% excreted as metabolites. |
| Half-life | Terminal elimination half-life is 4-6 hours in patients with normal renal function; prolonged to 12-24 hours in severe renal impairment, necessitating dose adjustment. |
| Protein binding | Approximately 85-90% bound, primarily to albumin and alpha-1-acid glycoprotein. |
| Volume of Distribution | Vd is 1.5-2.0 L/kg, indicating extensive tissue distribution with high penetration into peripheral compartments. |
| Bioavailability | Oral bioavailability is 70-80% (due to moderate first-pass metabolism); intramuscular bioavailability is nearly 100%. |
| Onset of Action | Intravenous: 5-15 minutes; oral: 30-60 minutes; intramuscular: 15-30 minutes. |
| Duration of Action | Clinical effect persists for 6-8 hours with intravenous administration; extended to 8-12 hours with oral dosing due to slower absorption. |
Croton oil is not used therapeutically; crotamiton is used as a scabicide. Typical adult dose: Apply 10% cream or lotion topically to entire body from neck to toes, leave on for 24 hours, then wash off; repeat once after 7 days.
| Dosage form | LOTION |
| Renal impairment | No dosage adjustment required for topical use; systemic absorption minimal. |
| Liver impairment | No dosage adjustment required for topical use; systemic absorption minimal. |
| Pediatric use | Children: Apply 10% cream or lotion topically as for adults; for infants, apply to scalp, face (avoid eyes), and entire body; leave on for 24 hours; wash off; repeat in 7 days if needed. |
| Geriatric use | No specific dose adjustment; use with caution in elderly with thin skin or impaired skin barrier; avoid prolonged application. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for CROTAN (CROTAN).
| Breastfeeding | No data on excretion in breast milk. Due to minimal systemic absorption after topical use, risk to nursing infant is likely low. Use with caution. |
| Teratogenic Risk | Crotan is not intended for systemic use. No human data on teratogenic risk. For topical application, minimal systemic absorption suggests low fetal risk. However, use during pregnancy only if clearly needed. |
| Fetal Monitoring |
■ FDA Black Box Warning
None.
| Serious Effects |
["Hypersensitivity to crotamiton or any component of the formulation."]
| Precautions | ["For external use only; avoid contact with eyes, mucous membranes, and broken skin.","May cause skin irritation, allergic contact dermatitis, or hypersensitivity reactions.","Not recommended for use in children under 2 years of age due to increased risk of systemic absorption and potential neurotoxicity.","Use with caution in patients with history of seizures as crotamiton may lower seizure threshold (theoretical risk)."] |
Loading safety data…
| No specific monitoring required for maternal or fetal effects due to topical indication. Monitor for local adverse reactions. |
| Fertility Effects | No studies on fertility. Topical use unlikely to affect fertility. |