Note: Not for oral ingestion; severe, potentially fatal adverse reactions have been reported with ingestion (AAP 1994). Approved ages and uses for products may vary; consult labeling for specific information.
Cough, mild, intermittent: Children ≥2 years and Adolescents: Vaporizer solution (eg, Vicks VapoSteam): Steam inhalation: Dilute in appropriate amount of water and add to vaporizer to inhale up to 3 times daily as needed.
Pain (joint and muscle), minor: Children ≥12 years and Adolescents: Topical cream (eg, JointFlex): Topical: Apply to affected area up to 4 times daily as needed.
Pruritus/pain, minor: Children ≥2 years and Adolescents: Topical gel (eg, Children's Benadryl Itch Soothing Gel): Topical: Apply to affected area 3 to 4 times daily as needed.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
(For additional information see "Camphor: Drug information")
Cough: Inhalation: Inhale via vaporizer up to 3 times per day.
Pain: Topical cream: Apply to affected area up to 4 times per day. For maximum benefit, use daily for at least 2 weeks and continue to use daily as needed thereafter.
Pruritus/Pain: Topical gel: Apply to affected area up to 3 to 4 times per day.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Cream, External:
JointFlex: 3.1% (114 g) [contains disodium EDTA]
Gel, External:
Band-Aid Anti-Itch: 0.45% (85 g [DSC]) [contains benzyl alcohol, edetic acid, menthol, SD alcohol 40B, trolamine (triethanolamine)]
Benadryl Anti-Itch Childrens: 0.45% (85 g) [contains benzyl alcohol, edetate disodium, menthol, SD alcohol 40B, trolamine (triethanolamine)]
Liquid, Inhalation:
Vicks Vapo Steam: 6.2% (236 mL) [contains alcohol, USP, menthol]
No
Note: Not for oral ingestion; severe, potentially fatal adverse reactions have been reported with ingestion (AAP 1994).
Steam inhalation: For inhalation via steam vaporizer only; do not swallow. Add solution directly to cold water only in a hot steam vaporizer. Breathe in medicated vapors by using a hot steam vaporizer, do not use undiluted.
Topical: For external use only. Wash hands with soap and water immediately after applying (unless hands are part of the treatment area).
Cream: Avoid contact with eyes and mucous membranes. Apply to clean, dry skin; do not apply to wounds, damaged, broken, or irritated skin. Apply generously to painful muscles and joints. Gently massage until the cream disappears. Do not bandage tightly or use a heating pad.
Gel: Avoid contact with the eyes. Apply to the affected area.
Inhalation: Add solution directly to cold water in a hot steam vaporizer only. Breathe in medicated vapors.
Topical:
Cream: Cleanse, rinse and dry skin. Apply generously to painful muscles and joints. Gently massage until the cream disappears. Avoid contact with the eyes and mucous membranes.
Do not apply to wounds, damaged, broken or irritated skin. Do not bandage tightly or use a heating pad.
Gel: Avoid contact with the eyes.
Store at room temperature.
Temporary topical relief of pain and itching associated with minor burns, sunburn, minor cuts, scrapes, insect bites, minor skin irritation, and rashes due to poison ivy, poison oak, and poison sumac (OTC: Children's Benadryl Itch Cooling Gel: FDA approved in ages ≥2 years and adults); temporary relief of cough associated with a cold (OTC: Steam inhalation: FDA approved in ages ≥2 years and adults); temporary topical relief of minor muscle and joint aches and pains associated with arthritis, simple backache, muscle sprains and strains, and bruises (OTC: JointFlex: FDA approved in ages ≥12 years and adults).
Note: Approved ages and uses for products may vary; consult product-specific labeling for details.
KIDs List: Camphor, when used in pediatric patients <18 years of age, is identified on the Key Potentially Inappropriate Drugs in Pediatrics (KIDs) list and should be used with caution due to risk of seizures (weak recommendation; low quality of evidence) (PPA [Meyers 2020]).
There are no adverse reactions listed in the manufacturer’s labeling.
OTC labeling: Joint Flex: When used for self-medication, do not use if skin is irritated or damaged; if excessive irritation develops; in patients ≤12 years of age.
Special populations:
• Pediatric: The American Academy of Pediatrics suggests that camphor be avoided in pediatric patients because of its lack of efficacy and the well-documented toxicity that may occur with use (AAP 1994). Although toxicity most often results from oral ingestion of topical or inhalation products, combined dermal and inhalation exposure has resulted in toxicity (Love 2004).
Dosage form specific issues:
• Liquid for steam inhalation: Self-medication (OTC use): For steam inhalation only. Use with caution in patients with persistent or chronic cough (eg, cough due to smoking, emphysema, or asthma) or a productive cough. Do not heat the product in a microwave or use near an open flame, direct the steam from the vaporizer too close to the face, or ingest the product. Do not add the product to hot water or any container where heating water (except when adding to cold water only in a hot steam vaporizer); may cause splattering and result in burns. Discontinue use and contact a healthcare provider if the cough lasts more than 7 days, recurs, or is accompanied by a fever, rash, or persistent headache.
• Topical cream: Self-medication (OTC use): Avoid contact with eyes and mucous membranes. Discontinue use and contact a healthcare provider if the condition worsens, symptoms persist for more than 7 days, symptoms recur, or if redness develops.
• Topical gel: Self-medication (OTC use): Avoid contact with eyes. Discontinue use and contact a healthcare provider if the condition worsens, symptoms persist for more than 7 days, or if symptoms recur.
Special handling:
• Flammability: Camphor is flammable; keep away from fire or flame.
Other warnings/precautions:
• Accidental ingestion: In case of accidental ingestion, seek medical help or contact a poison control center immediately.
Camphor may cause significant and potentially life-threatening adverse effects in children; most reported cases are with accidental oral ingestions; however, toxicity has also been reported with topical application in an infant. Mild toxicity may cause gastrointestinal effects (eg, nausea, vomiting) or burning sensation; however, severe effects such as restlessness, delirium, seizures, and fatal respiratory depression possibly leading to death can occur with doses as low as 500 mg. Onset of toxicity can occur as rapidly as 5 to 15 minutes after ingestion. Adults appear to be able to tolerate higher ingestions; however, oral ingestion is not recommended (AAP 1994; Khine 2009; Love 2004; Manoguerra 2006; Mathen 2018). Due to the increased potential for toxicity, the limited beneficial effects of camphor, and the availability of safer alternative agents for all approved camphor uses, experts recommend camphor should be used with extreme caution, if at all in pediatric patients (AAP 1994; Love 2004; PPA [Meyers 2020]).
None known.
There are no known significant interactions.
Following exposure to large concentrations (eg, oral ingestion observed with poisonings), camphor crosses the placenta and is toxic to the fetus (Rabl 1997).
Monitor for toxicity; if suspected, monitor liver/renal function and neurologic status.
Absorption: Dermal: Slow (Kim 2015)
Distribution: Vd: 2 to 4 L/kg (Köppel 1988)
Protein binding: 61% (Köppel 1982)
Metabolism: Hepatic to inactive metabolites (Kim 2015)
Half-life: ~3 hours (when administered with a solvent [Tween 80], half-life decreased to ~1.5 hours) (Köppel 1988)
Time to peak: 3 hours when administered alone; 1 hour when administered with a solvent (Tween 80) (Köppel 1988)
Excretion: Urine (as metabolites) (Kim 2015)