emulsifying wax + liquid paraffin + white soft paraffin: clinical use

Prescribing considerations

• Confirm whether the intended use is the licensed pharmacy-compounding role or direct topical use outside that licence.
• Counsel users and carers about fabric contamination and fire risk, including smoking, flames and heat sources.
• Consider local irritation from sodium lauryl sulphate and cetostearyl alcohol, particularly in children with atopic eczema.
• Account for slippery skin and surfaces when assessing falls risk.

Contraindications and cautions

• Hypersensitivity to any ingredient.
• Do not use preparations containing emulsifying ointment before phototherapy or phototesting because of significant sunscreen activity.

Monitoring

• Review persistent burning, stinging, itching, redness, rash or contact dermatitis.
• Assess new or worsening acne or folliculitis.
• Reassess fire risk where extensive use, contaminated dressings, smoking, oxygen or limited mobility is relevant.

Clinical pharmacology

White soft paraffin and liquid paraffin are occlusive emollients. With emulsifying wax, they can produce a stable cream when water is incorporated. Systemic pharmacokinetics are not applicable to the licensed compounding role.

Formulation and product differences

• This ointment contains emulsifying wax, liquid paraffin and white soft paraffin, with no additional excipients listed.
• Its emulsifying wax contains sodium lauryl sulphate and cetostearyl alcohol, which may cause local reactions.
• Aqueous Cream BP and Buffered Cream BP are final cream preparations made using this ointment base and are not interchangeable descriptions of the base itself.