Usage
- Ammonium lactate is prescribed for the treatment of dry, scaly skin (xerosis) and ichthyosis vulgaris. It also helps relieve itching associated with these conditions.
- Pharmacological Classification: Emollient, humectant, keratolytic.
- Mechanism of Action: Ammonium lactate increases skin hydration by acting as a humectant, drawing moisture into the stratum corneum. It also promotes exfoliation of the stratum corneum by decreasing corneocyte cohesion. The exact mechanism for this exfoliative action isn’t fully understood.
Alternate Names
- Lactic acid neutralized with ammonium hydroxide.
- Brand Names: AmLactin®, Lac-Hydrin® (discontinued), and various generic formulations.
How It Works
- Pharmacodynamics: Ammonium lactate’s primary effect is to moisturize and soften dry, thickened skin. It also facilitates exfoliation by reducing the adhesion between dead skin cells in the stratum corneum.
- Pharmacokinetics: Approximately 6% of topically applied ammonium lactate is absorbed through the skin. The absorbed lactate is metabolized to bicarbonate, contributing to systemic acid-base balance. Most of the applied dose remains on the skin surface, exerting its moisturizing and keratolytic effects locally. Elimination pathways for the absorbed fraction have not been fully elucidated, but some lactic acid is likely excreted renally.
- Mode of Action: The alpha-hydroxy acid component of ammonium lactate acts as a humectant, attracting and binding water to the stratum corneum. Its keratolytic effect is thought to be due to disruption of corneocyte adhesion, though the precise mechanism is still under investigation. Receptor binding, enzyme inhibition, or neurotransmitter modulation are not believed to be involved. Elimination pathways for the systemically absorbed portion of ammonium lactate are not definitively known.
Dosage
Standard Dosage
Adults:
Apply a thin layer to the affected areas twice daily, or as directed by a physician. Rub in thoroughly.
Children:
- Children 2 years and older: Apply a thin layer to the affected area(s) twice daily, or as directed by a physician. Rub in thoroughly.
- Children under 2 years of age: Consult a doctor before use.
Special Cases:
- Elderly Patients: No specific dosage adjustments are typically needed, but start with a low dose and monitor for adverse effects.
- Patients with Renal Impairment: Use with caution, as systemic absorption may affect acid-base balance in patients with compromised renal function.
- Patients with Hepatic Dysfunction: No specific dosage adjustments are typically needed.
- Patients with Comorbid Conditions: Consider underlying skin conditions and concomitant medications when determining appropriate use.
Clinical Use Cases:
Ammonium lactate is not typically used in the clinical settings described (Intubation, Surgical Procedures, Mechanical Ventilation, Intensive Care Unit (ICU) Use, and Emergency Situations). It is primarily indicated for topical treatment of dry skin conditions.
Dosage Adjustments:
Dosage adjustments are not typically needed based on specific clinical use cases, as ammonium lactate is primarily used for topical skin conditions. However, always consider the severity of the skin dryness, the patient’s age, and any coexisting medical conditions.
Side Effects
Common Side Effects:
- Stinging or burning, especially on broken or irritated skin
- Redness
- Itching
- Peeling
Rare but Serious Side Effects:
- Severe skin irritation
- Allergic reactions (rash, hives, swelling, difficulty breathing)
Long-Term Effects:
- Potential for skin discoloration (hyperpigmentation or hypopigmentation) with prolonged use.
Adverse Drug Reactions (ADR):
Contraindications:
- Hypersensitivity to ammonium lactate or any of its components.
Drug Interactions:
- Minimal drug interactions are expected with topical ammonium lactate. However, advise patients to inform their physician of all medications they are using, including topical products. Concomitant use of other topical medications on the same area may increase the risk of irritation.
Pregnancy and Breastfeeding:
- Pregnancy Safety Category: B (Animal studies have not shown a risk to the fetus, but there are no adequate and well-controlled studies in pregnant women). Use only if clearly needed and after discussion with a physician.
- Breastfeeding: It is not known whether ammonium lactate is excreted in breast milk. Caution is advised when using during breastfeeding.
Drug Profile Summary
- Mechanism of Action: Humectant and keratolytic.
- Side Effects: Stinging, burning, redness, itching, peeling.
- Contraindications: Hypersensitivity.
- Drug Interactions: Minimal expected.
- Pregnancy & Breastfeeding: Use with caution.
- Dosage: Apply topically twice daily.
- Monitoring Parameters: Observe for skin irritation or allergic reactions.
Popular Combinations:
Ammonium lactate is typically used as monotherapy. There are no widely recognized popular combinations.
Precautions:
- General Precautions: Avoid contact with eyes, mucous membranes, and open wounds. Minimize sun exposure to treated areas.
- Specific Populations: Use with caution in pregnant or breastfeeding women. Consult a doctor before using on children under 2 years of age.
- Lifestyle Considerations: No specific lifestyle considerations are associated with topical ammonium lactate use.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Ammonium Lactate?
A: Apply a thin layer to the affected skin twice daily, or as directed by a physician.
Q2: How does Ammonium Lactate work?
A: It works by moisturizing the skin and promoting exfoliation of the stratum corneum.
Q3: What are the common side effects of Ammonium Lactate?
A: Common side effects include stinging, burning, redness, itching, and peeling, especially at the beginning of treatment.
Q4: Can I use Ammonium Lactate if I am pregnant or breastfeeding?
A: Consult your doctor before using Ammonium Lactate during pregnancy or breastfeeding. While it’s generally considered safe, it’s always best to discuss with a healthcare professional.
Q5: How long does it take for Ammonium Lactate to work?
A: Improvement in skin dryness is usually seen within a few days, but it may take several weeks for optimal results.
Q6: Can I use Ammonium Lactate on my face?
A: It can be used on the face, but with caution, due to the potential for irritation, especially around the eyes and mouth.
Q7: What should I do if I experience severe side effects from Ammonium Lactate?
A: Discontinue use and consult a doctor immediately.
Q8: Are there any drug interactions I should be aware of with Ammonium Lactate?
A: Minimal drug interactions are expected with topical application. However, inform your physician about all medications you are using, including topical products.
Q9: How should I store Ammonium Lactate?
A: Store at room temperature away from excessive heat and moisture. Keep the container tightly closed.
