Tirbanibulin

Chemical formula: C₂₆H₂₉N₃O₃  Molecular mass: 431.536 g/mol 

Interactions

Tirbanibulin interacts in the following cases:

Immunocompromised patients

Tirbanibulin ointment should be used with caution in immunocompromised patients.

Sun exposure

Due to the nature of the disease, excessive exposure to sunlight (including sunlamps and tanning beds) should be avoided or minimised.

Pregnancy

There are no or limited amount of data from the use of tirbanibulin in pregnant women. Studies in animals have shown reproductive toxicity.

Tirbanibulin ointment is not recommended during pregnancy and in women of childbearing potential not using contraception.

Nursing mothers

It is unknown whether tirbanibulin/metabolites are excreted in human milk.

A risk to the newborns/infants cannot be excluded.

A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from tirbanibulin ointment therapy taking into account the benefit of breast feeding for the child and the benefit of therapy for the woman.

Carcinogenesis, mutagenesis and fertility

Fertility

No human data on the effect of tirbanibulin ointment on fertility are available. In a non-clinical fertility and early embryonic development study in rats, changes considered indicative of male fertility toxicity occurred.

Effects on ability to drive and use machines

Tirbanibulin ointment has no or negligible influence on the ability to drive and use machines.

Adverse reactions


Summary of the safety profile

The most frequently reported adverse reactions are local skin reactions. Local skin reactions included erythema (91%), flaking/scaling (82%), crusting (46%), swelling (39%), erosion/ulceration (12%), and vesiculation/pustulation (8%) at the application site. Furthermore, application site pruritus (9.1%) and pain (9.9%) have been reported in the treatment area.

Tabulated list of adverse reactions

The following table lists the adverse reactions that were reported in clinical studies. Frequencies are defined as: very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very rare (<1/10,000); not known (frequency cannot be estimated from the available data).

MedDRA System Organ ClassPreferred termFrequency
General disorders and administration site conditions Application site erythemaVery common
Application site exfoliation (flaking and scaling) Very common
Application site scab (crusting) Very common
Application site swellingVery common
Application site erosion (includes ulcer) Very common
Application site painaCommon
Application site pruritusCommon
Application site vesicles (includes pustules) Common

a Application site pain includes pain, tenderness, stinging, and burning sensation at the application site.

Description of selected adverse reactions

Local skin reactions

Most local skin reactions were transient and mild to moderate in severity. Following the application of tirbanibulin ointment, the incidences of local skin reactions with a severity grade greater than baseline were erythema (91%), flaking/scaling (82%), crusting (46%), swelling (39%), erosion/ulceration (12%), and vesiculation/pustulation (8%). Severe local skin reactions occurred at an overall incidence of 13%. Severe local skin reactions that occurred at an incidence >1% were: flaking/scaling (9%), erythema (6%), and crusting (2%). None of the local skin reactions required treatment.

Overall, local skin reactions peaked 8 days after starting the treatment and typically resolved within 2 to 3 weeks after completion of treatment with tirbanibulin ointment.

Site pruritus and pain

Events of application site pruritus and pain were mild to moderate in severity, transient in nature (mostly occuring during the first 10 days since the start of treatment), and the majority did not require treatment.

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