July 25, 2016
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Skin Exposure Paste

"Through June of this year, the cholesterol-lowering drug rosuvastatin (Crestor, AstraZeneca) was the most prescribed branded drug in the United States, and the arthritis drug adalimumab (Humira, Abbott Laboratories) was the best-sel"...


Skin Exposure Paste

Discontinued Warning IconPlease Note: This Brand Name drug is no longer available in the US.
(Generic versions may still be available.)



SERPACWA is intended for cutaneous use only. Do not apply to the eyes or to mucous membranes. The safety of SERPACWA and its barrier properties when applied to abraded skin or skin with wounds has not been investigated.



The handling of smoking products, such as cigarettes, by personnel who have even small amounts of SERPACWA on their hands may result in contamination of these products with SERPACWA. Smoking of products contaminated with the PTFE component of SERPACWA generates harmful fumes. A flu-like syndrome called polymer fume fever has been reported in individuals who have been exposed to fumes generated by the burning of PTFE, such as fumes generated by the smoking of cigarettes contaminated with PTFE powder. The severity of this syndrome depends upon the amount of exposure and the number of exposures. Polymer fume fever should not be regarded as a transitory or benign condition. The long-term health significance of smoking products contaminated with PTFE has not been characterized. While patients with mild manifestations of this syndrome appear to have self-limited symptoms without lasting effects, a patient with a more severe manifestation of this syndrome developed interstitial pulmonary fibrosis. The risk associated with smoking products contaminated with SERPACWA has not been characterized. Because the paste-like consistency of SERPACWA could possibly enable it to adhere more efficiently to smoking products than does PTFE powder, the risk of polymer fume fever, and its degree of severity, may be higher following SERPACWA exposure to smoking products than the historical risk associated with handling of cigarettes by personnel exposed to PTFE powder exposure.

Personnel should not touch smoking products after they have applied SERPACWA to their skin surface. Personnel are advised to wash their hands thoroughly to remove all visible traces of SERPACWA prior to handling smoking products. Smoking products may become contaminated even if there are no visible traces of SERPACWA on the hands. Some, but not all individuals with polymer fume fever reported that the tobacco smoke had an unusual or unpleasant taste.

If the smoke has an unusual taste, this may be indicative of product contamination. Under these circumstances, personnel should cease smoking and discard the potentially-contaminated products. Even in the absence of an unusual or unpleasant taste, the smoking product may still be contaminated, so smoking should be avoided after use of SERPACWA. Clothing or other materials exposed to SERPACWA, including SERPACWA packaging, should not be destroyed by burning, because of the release of toxic fumes.

In animal studies, the presence of insect repellent containing DEET (N,N-diethyl-m-toluamide) has been demonstrated to significantly reduce the barrier effects of SERPACWA. The use of water to remove products containing DEET reduces the barrier effect of SERPACWA, while removal of insect repellent with dry gauze partially restores a barrier effect for SERPACWA. Though the relevance of the results of these animal studies to humans is unknown, it is recommended that products containing DEET be removed with a dry towel or cloth before SERPACWA is applied.


Pretreatment Agents N Test Conditions Product Removal Method Lesion Area Ratio (%)
Arithmetic Mean
(95% C.I.)
Geometric Mean
(95% C.I.)
None 8 -   100  
SERPACWA 32 -   27 (11, 43) 26 (15, 46)
DEET PRODUCT + SERPACWA 32 A None 91 (16, 166) 82 (41, 166)
DEET PRODUCT + SERPACWA 8 B None 92 (70, 114) 77 (59, 102)
DEET PRODUCT + SERPACWA 8 C moist towelette 122 (85, 158) 97 (72, 132)
DEET PRODUCT + SERPACWA 8 C dry gauze 48 (32, 64) 39 (29, 52)

  1. DEET product was applied 3 hours prior to SERPACWA applications.
  2. DEET product was applied approximately 12 minutes prior to SERPACWA applications.
  3. DEET product was applied for 3 hours then removed just prior to SERPACWA applications by either a moist towelette (alcohol-free, dilute soap solution) or a dry gauze pad.

Some camouflage paints (loam and sand) and possibly permethrin also reduced the protective effects of SERPACWA.

Studies in humans were not conducted with CW or surrogate agents using SERPACWA in the presence of insect repellents containing DEET, or loam and sand camouflage paints, or permethrin. It is not known whether DEET affects the barrier properties of SERPACWA or whether it is the other ingredients in this product.

This monograph has been modified to include the generic and brand name in many instances.

Last reviewed on RxList: 3/9/2009


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