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Urea is a highly soluble organic compound formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one-half of the total urinary solids. Urea is formed in a cyclic pathway known simply as the urea cycle. In this cycle, amino groups donated by ammonia and L-aspartate are converted to urea. Urea is essentially a waste product; it has no physiological function. It is dissolved in the blood (in humans in a concentration of 2. 5 – 7. 5 mmol/liter) and excreted by the kidney in the urine. In addition, a small amount of urea is excreted (along with sodium chloride and water) in human sweat. Urea is found to be associated with primary hypomagnesemia, which is an inborn error of metabolism.
Mechanism of Action of Urea
The primary mechanism of ammonia toxicosis appears to be inhibition of the citric acid cycle. There is an increase in anaerobic glycolysis, blood glucose, and blood lactate. Acidosis is manifested. The exact means by which ammonia blocks the citric acid cycle is not known. It is postulated that ammonia saturation of the glutamine-synthesizing system causes a backing-up in the citrate cycle, a decrease in its intermediates, and a decrease in energy production and cellular respiration, which leads to convulsions. The decrease of citrate cycle intermediates is postulated to result from the reanimation of pyruvic, ketoglutaric, and oxaloacetic acids.
Indications of Urea
- Hydrate skin accelerates fibrin degradation 20-30% is antipruritic, breaks down keratin, decreases the thickness of the stratum corneum and is used in scaling conditions such as ichthyosis are proteolytic and may be used to dissolve and peel dystrophic nails.
- In patients with squamous cell carcinoma of the palpebral and bulbar conjunctiva, repeated applications of urea powder have been made to eradicate the malignant growth.
- Urea is used to reduce cerebral edema and brain mass before and after neurosurgery.
- Another use of urea is the treatment of dialysis disequilibrium syndrome.
- Urea is used with zinc formaldehyde sulfoxylate to remove permanent hair dye
- 10% hydrate skin
- 15% accelerate fibrin degradation
- 20-30% is antipruritic, break down keratin, decrease the thickness of the stratum corneum and are used in scaling conditions such as ichthyosis
- 40% are proteolytic and may be used to dissolve and peel dystrophic nails
- Dry skin and rough skin
- Dermatitis
- Psoriasis
- Ichthyosis
- Eczema
- Keratosis
- Keratoderma
- Corns
- Calluses
- Damaged, ingrown and devitalized nails
Contra-Indications of Urea
If any side effect shows
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
Dosage of Urea
Strengths: 10%; 40%; 35%; 50%; 39%; 39% with emollients; 20%; 25%; 45%; 42%; 22%; 5%; 41%; 30%; 50%
Dermatological Disorders
Urea 30% foam
- Apply to affected skin twice/day.
Urea 35% foam
- Apply to the affected skin twice/day.
Urea 35% lotion
- Apply to the affected skin twice/day.
Urea 39% cream
- Apply to the affected skin twice/day.
Urea 40% foam:Urea 42% foam
- Apply to the affected skin twice/day.
Urea 45% emulsion
- Apply to the affected skin twice/day.
Urea 45% solution
- Apply to the affected skin twice/day.
Urea 50% emulsion
- Apply to the affected skin twice/day.
Urea 50% ointment
- Apply to the affected skin twice/day.
Nail tissue or affected skin
Urea 50% suspension:Urea 40% emulsion
- Apply to nail tissue or affected skin twice/day.
Urea 40% suspension
- Apply to nail tissue or affected skin twice/day.
Urea 42% pad
- Apply to nail tissue or affected skin twice/day.
Urea 45% gel
- Apply to nail tissue or affected skin twice/day.
Urea 50% cream
- Apply to nail tissue or affected skin twice/day.
Urea 50% gel
- Apply to nail tissue or affected skin twice/day.
Urea 50% stick
- Apply to affected nail tissue twice/day.
Urea 50% stick
- Apply to affected nail tissue twice/day
Side Effects of Urea
Most Common
- Blistering, burning, crusting, dryness or flaking of skin
- itching, redness, skin rash, swelling, or soreness at the application site
- darkening of skin
- dry skin
- flushing and redness of the skin
- scaling, severe redness, soreness or swelling of the skin
- peeling or loosening of the skin
- skin pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।" data-rx-term="tenderness" data-rx-definition="Tenderness means pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।">tenderness
- unusually warm skin
Common
- feeling of heaviness, pain, warmth and/or swelling in a leg or in the pelvis
- sudden tingling or coldness in an arm or leg
- Nausea
- liver problems,
- stomach pain,
- vomiting,
- Dizziness
- Burning, itching, stinging, redness, or other sign of irritation at the application site, rash
- a headache,
- increased intracranial pressure,
- meningeal signs,
- reversible hair loss or thinning, and
- fever.
Common
- liver problems–nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes) if you swallow
- chills or fever
- a headache, severe and throbbing
- joint or back pain
- muscle aching or cramping
- muscle pains or stiffness
- chest pressure or squeezing pain in chest
- discomfort in arms, shoulders, neck or upper back
- excessive sweating
- sudden slow or difficult speech
- sudden drowsiness or need to sleep
- fast breathing
- sharp pain when taking a deep breath
- fast or slow heartbeat
- coughing up blood
- rust colored urine
- decreased amount of urine
Drug Interactions of Phenyl Ketone Urea
Urea may interact with following drugs, supplements & may change the efficacy of drugs
- aspirin
- amphetamine
- dextroamphetamine
- betamethasone
- celecoxib
- Co-trimoxazole
- sulfamethoxazole
- trimethoprim
- meperidine
- Fish Oil (omega-3 polyunsaturated fatty acids)
- escitalopram
- pregabalin
- metoprolol
- neem
- acetaminophen
- hydrocodone
- ropinirole
- montelukast
- levothyroxine
- Vitamin B12 (cyanocobalamin)
- Vitamin B2 (riboflavin)
- Vitamin B6 (pyridoxine)
- Vitamin C (ascorbic acid)
- Vitamin D2 (ergocalciferol)
- Vitamin D3 (cholecalciferol)
- cetirizine
Pregnancy Category of Phenyl Ketone Urea
FDA Pregnancy Category – B
Pregnancy
This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding
It is not known if urea passes into breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding. This medication is not recommended for children less than 2 years of age. Children may absorb more medication through the skin than adults. As a result, they may be more likely to experience the side effects related to the use of large amounts of this of class medication for long periods of time (e.g., slowing down of growth, delayed weight gain).
References
