General

Pronunciation:
tir-ban-i-bue-lin

Trade Name(s)

• Klisyri

Ther. Class.

actinic keratosis agents

Pharm. Class.

antimicrotubulars

Indications

Actinic keratosis on face or scalp.

Action

Acts as a microtubule inhibitor; however, mechanism for effect in actinic keratosis is unknown.

Therapeutic Effect(s):

Reduction of actinic keratosis lesions.

Pharmacokinetics

Absorption: Negligible systemic absorption following topical use.

Distribution: Unknown.

Metabolism and Excretion: Primarily metabolized in liver via the CYP3A4 isoenzyme and to a lesser extent by the CYP2C8 isoenzyme.

Half-life: Unknown.

TIME/ACTION PROFILE (plasma concentrations)

Contraindication/Precautions

Contraindicated in:

• None.

Use Cautiously in:

• OB:   Safety not established in pregnancy;
• Lactation:  Safety not established in breastfeeding;
• Pedi:   Safety and effectiveness not established in children.

Adverse Reactions/Side Effects

Derm: crusting, erosion/ulceration, erythema, flaking/scaling, swelling, vesiculation/pustulation

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

None reported.

Route/Dosage

Topical (Adults): Apply sufficient amount of ointment to affected area (within a 100 cm²  contiguous area) once daily for 5 consecutive days.

Availability

Ointment: 1%

Assessment

• Assess actinic keratosis lesions before starting and periodically during therapy.

Implementation

• Topical 

  Apply sufficient amount of ointment to evenly cover up lesions on the face or scalp once daily for 5 consecutive days using one single-dose packet per application. Avoid application near and around the mouth and lips. Wash hands immediately with soap and water after application. Avoid washing and touching the treated area for about 8 hr after application. After this time, area may be washed with a mild soap. Avoid transfer of ointment to the periocular area.

  • Do not apply an occlusive dressing; may cause irritation.

Patient/Family Teaching

• Explain purpose and side effects of medication to patient. Advise patient to read  Patient Information  before starting therapy.
• Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
• Advise patient to notify health care professional if local skin reactions (redness, flaking, scaling, crusting, swelling that is more severe) or if blisters, peeling, pus, ulcers, or breakdown of skin occurs.
• Advise patient that the medication is not for ophthalmic use. Advise patients to avoid application around the eyes and transfer of the drug into the eyes and to the periocular area. If accidental exposure occurs, advise patients to flush eyes with water and seek medical care.
• Rep:  Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

Reduction of actinic keratosis lesions.