{"adverse_reactions":["VIII. ADVERSE REACTIONS No systemic reactions have been reported. Occasional cutaneous hypersensitivity (localized contact dermatitis) may occur, in which case the medication should be discontinued and the physician notified immediately."],"clinical_pharmacology":["II. CLINICAL PHARMACOLOGY Topical application of hydroquinone produces a reversible depigmentation of the skin by inhibition of the enzymatic oxidation of tyrosine to 3-(3,4-dihydroxyphenyl) alanine (dopa) 1 and suppression of other melanocyte metabolic processes. 2 Exposure to sunlight or ultraviolet light will cause repigmentation which may be prevented by the broad spectrum sunscreen agents contained in LUSTRA-AF ® . 3"],"contraindications":["V. CONTRAINDICATIONS LUSTRA ® and LUSTRA-AF ® are contraindicated in any patient that has a prior history of hypersensitivity or allergic reaction to hydroquinone or any of the other ingredients. The safety of topical hydroquinone use during pregnancy or on children (12 years and under) has not been established."],"description":["I. DESCRIPTION Hydroquinone is 1,4-benzenediol. Hydroquinone is structurally related to monobenzone. Hydroquinone occurs as fine, white needles. The drug is freely soluble in water and in alcohol and has a pK a of 9.96. Chemically, hydroquinone is designated as p-dihydroxybenzene; the empirical formula is C 6 H 6 O 2 ; molecular weight 110.1. The structural formula is: C 6 H 6 O 2 Chemical Structure CONTENTS ACTIVE INGREDIENT Hydroquinone USP 4%. OTHER INGREDIENTS (LUSTRA ® ) Alcohol, benzyl alcohol, butylated hydroxytoluene, carbomer 940, cetearyl alcohol (and) ceteareth-20, cetyl alcohol, cyclopentasiloxane (and) polysilicone-11, dimethiconol, disodium EDTA, fragrance, glycerin, glyceryl stearate (and) PEG-100 stearate, glycolic acid, hydrogenated lecithin, linoleic acid, magnesium 1-ascorbyl phosphate, phenoxyethanol, phenyl trimethicone, polyacrylamide (and) C13-14 isoparaffin (and) laureth 7, purified water, sodium metabisulfite, sodium citrate dihydrate, vitamin E acetate, vitamin E alcohol, triethanolamine. OTHER INGREDIENTS (LUSTRA-AF ® ) Alcohol, avobenzone, benzyl alcohol, butylated hydroxytoluene, carbomer 940, cetearyl alcohol (and) ceteareth-20, cetyl alcohol, cyclopentasiloxane (and) polysilicone-11, dimethiconol, disodium EDTA, fragrance, glycerin, glyceryl stearate (and) PEG-100 stearate, glycolic acid, hydrogenated lecithin, linoleic acid, magnesium 1-ascorbyl phosphate, octinoxate, phenoxyethanol, phenyl trimethicone, polyacrylamide (and) C13-14 isoparaffin (and) laureth 7, purified water, sodium metabisulfite, sodium citrate dihydrate, vitamin E acetate, vitamin E alcohol, triethanolamine."],"dosage_and_administration":["IV. DOSAGE AND ADMINISTRATION LUSTRA ® or LUSTRA-AF ® should be applied to the affected areas twice daily, morning and before bedtime, or as directed by a physician. During and after the use of LUSTRA ® sun exposure should be limited, and a sunscreen agent or sun-protective clothing should be used to cover the treated areas, to prevent repigmentation. There is no recommended dosage for pediatric patients under 12 years of age except under the advice and supervision of a physician."],"effective_time":"20130122","how_supplied":["X. HOW SUPPLIED LUSTRA-AF ® (Hydroquinone Cream USP, 4%) is available as follows: SIZE NDC NUMBER 2 oz tube (56.8 g) 54868-5238-0"],"how_supplied_table":["<table width=\"60%\" ID=\"i7beb3866-a108-45b2-8360-99364d750671\"> <col align=\"left\" valign=\"top\" width=\"75%\"/> <col align=\"left\" valign=\"top\" width=\"25%\"/> <thead> <tr> <th>SIZE</th> <th>NDC NUMBER</th> </tr> </thead> <tbody> <tr> <td>2 oz tube (56.8 g)</td> <td>54868-5238-0</td> </tr> </tbody> </table>"],"id":"9d8603d5-4e86-4522-ad80-db0a1e6eec8f","indications_and_usage":["III. INDICATIONS AND USAGE LUSTRA ® and LUSTRA-AF ® are indicated for the gradual treatment of ultraviolet induced dyschromia and discoloration resulting from the use of oral contraceptives, pregnancy, hormone replacement therapy, or skin trauma."],"nursing_mothers":["B. Nursing mothers: It is not known whether topical hydroquinone is absorbed or excreted in human milk. Caution is advised when hydroquinone is used by a nursing mother."],"openfda":{},"overdosage":["IX. OVERDOSAGE There have been no systemic reactions reported from the use of topical hydroquinone. However, treatment should be limited to relatively small areas of the body at one time, since some patients experience a transient skin reddening and a mild burning sensation which does not preclude treatment."],"package_label_principal_display_panel":["PRINCIPAL DISPLAY PANEL - 56.8 g Tube NDC 54868-5238-0 RX ONLY LUSTRA-AF ® (HYDROQUINONE CREAM USP, 4%) NET WT. 2 oz (56.8 g) PRINCIPAL DISPLAY PANEL - 56.8 g Tube"],"pediatric_use":["C. Pediatric usage: Safety and effectiveness in pediatric patients below the age of 12 years have not been established."],"precautions":["VII. PRECAUTIONS SEE WARNINGS A. Pregnancy Category C: Animal reproduction studies have not been conducted with topical hydroquinone. It is also not known whether hydroquinone can cause fetal harm when used topically on a pregnant woman or can affect reproductive capacity. It is not known to what degree, if any, topical hydroquinone is absorbed systemically. Topical hydroquinone should be used in pregnant women only where clearly indicated. B. Nursing mothers: It is not known whether topical hydroquinone is absorbed or excreted in human milk. Caution is advised when hydroquinone is used by a nursing mother. C. Pediatric usage: Safety and effectiveness in pediatric patients below the age of 12 years have not been established."],"pregnancy":["A. Pregnancy Category C: Animal reproduction studies have not been conducted with topical hydroquinone. It is also not known whether hydroquinone can cause fetal harm when used topically on a pregnant woman or can affect reproductive capacity. It is not known to what degree, if any, topical hydroquinone is absorbed systemically. Topical hydroquinone should be used in pregnant women only where clearly indicated."],"references":["REFERENCES Denton, C., A.B. Lerner, and T.B. Fitzpatrick. \"Inhibition of Melanin Formation by Chemical Agents.\" Journal of Investigative Dermatology . 1952; 18:119-135. Jimbow, K., H. Obata, M. Pathak, and T.B. Fitzpatrick. \"Mechanism of Depigmentation by Hydroquinone.\" Journal of Investigative Dermatology . 1974; 62:436-449. Parrish, J.A., R.R. Anderson, F. Urbach, and D. Pitts. UVA, Biological Effects of Ultraviolet Radiation with Emphasis on Human Responses to Longwave Ultraviolet. Plenum Press, New York and London, 1978, p.151."],"set_id":"9943f78d-3406-4234-a249-22f89786d06b","spl_product_data_elements":["Lustra AF Hydroquinone Hydroquinone Hydroquinone Alcohol avobenzone benzyl alcohol butylated hydroxytoluene CARBOMER HOMOPOLYMER TYPE C (ALLYL PENTAERYTHRITOL CROSSLINKED) cetostearyl alcohol polyoxyl 20 cetostearyl ether cetyl alcohol cyclomethicone 5 edetate disodium glycerin glyceryl monostearate PEG-100 stearate glycolic acid linoleic acid octinoxate phenoxyethanol phenyl trimethicone C13-14 isoparaffin laureth-7 water sodium metabisulfite trisodium citrate dihydrate alpha-tocopherol acetate trolamine"],"spl_unclassified_section":["LUSTRA ® (HYDROQUINONE CREAM USP, 4%) The Complete Treatment for Dyschromia LUSTRA-AF ® (HYDROQUINONE CREAM USP, 4%) The Complete Treatment for Dyschromia Rx Only FOR EXTERNAL USE ONLY","Covered by US Patent 5,932,612. Mfd. by: Taro Pharmaceuticals Inc. Brampton, Ontario, Canada L6T 1C1 Dist. by: TaroPharma a division of Taro Pharmaceuticals U.S.A., Inc., Hawthorne, NY 10532 Made in Canada LUSTRA ® , LUSTRA-AF ® and TaroPharma ® are registered trademarks of Taro Pharmaceuticals U.S.A., Inc. Revised: October, 2011 PK-4967-3 111 Additional barcode labeling by: Physicians Total Care, Inc. Tulsa, Oklahoma 74146"],"storage_and_handling":["Store at 20°-25°C (68°-77°F) [see USP Controlled Room Temperature]."],"version":"2","warnings":["VI. WARNINGS A. CAUTION: Hydroquinone is a depigmenting agent which may produce unwanted cosmetic effects if not used as directed. The physician should be familiar with the contents of this insert before prescribing or dispensing this medication. B. Test for skin sensitivity before using LUSTRA ® or LUSTRA-AF ® by applying a small amount to an unbroken patch of skin and check within 24 hours. Minor redness is not a contraindication, but where there is itching, vesicle formation, or excessive inflammatory response further treatment is not advised. Close patient supervision is recommended. Contact with the eyes should be avoided. If no lightening effect is noted after two months of treatment, use of LUSTRA ® or LUSTRA-AF ® should be discontinued. LUSTRA-AF ® is formulated for use as a treatment for dyschromia and should not be used for the prevention of sunburn. C. Sunscreen use is an essential aspect of hydroquinone therapy, because even minimal sunlight sustains melanocytic activity. During treatment and maintenance therapy, sun exposure should be avoided on treated skin by application of a broad spectrum sunscreen (SPF 15 or greater) or by use of protective clothing to prevent repigmentation. Although LUSTRA ® has an antioxidant system in its vehicle, there are no sunblocking or sunscreening agents in LUSTRA ® . The sunscreens in LUSTRA-AF ® provide the necessary sun protection during therapy. During and after the use of LUSTRA-AF ® , sun exposure should be limited or sun-protective clothing should be used to cover the treated areas to prevent repigmentation. D. Keep this and all medications out of the reach of children. In case of accidental ingestion, contact a physician or a poison control center immediately. E. WARNING: Contains sodium metabisulfite, a sulfite which may cause serious allergic reactions (e.g., hives, itching, wheezing, anaphylaxis, severe asthma attack) in certain susceptible persons. F. On rare occasions, a gradual blue-black darkening of the skin may occur. In which case, use of LUSTRA ® or LUSTRA-AF ® should be discontinued and a physician contacted immediately."]}