Topical counter-irritant Pregnancy: There is no information on safety when used during pregnancy and breast-feeding, but there should be no hazard when applied as advised.

Levomenthol

Brand names: Aramint, Dermacool

Levomenthol (the levorotatory isomer of menthol) is a topical counter-irritant and cooling agent used to relieve pruritus and minor musculoskeletal aches, and is included in some inhalations.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Apply gently to the forehead - no numeric dose is stated in the SPC

Route: Topical (cutaneous) - for external, topical application only; not to be taken

Frequency: To be used as required, but excessive use avoided

SOURCE SCOPE: the SPC fetched is '4head 90% w/w Cutaneous Stick', a levomenthol stick applied to the forehead; other levomenthol-containing preparations (creams, lotions, other strengths and indications) are not covered by this source and would need their own labelling. The SPC states no weight, volume or number of applications - dosing is 'as required' with excessive use avoided. If symptoms persist or worsen, seek medical advice. Keep away from the eyes - levomenthol is irritant if allowed to come into contact with the eyes. For single patient use only. The SPC contains no paediatric section, so no age limit or paediatric dose can be quoted from it; a children's formulary should be consulted for use in under-18s.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Not recommended in patients where there is a known hypersensitivity to menthol

Side effects

Hypersensitivity reactions, including contact dermatitis
Temporary, mild watering of the eyes in rare cases, because levomenthol is volatile

Interactions

None - SPC section 4.5 states 'None'

Clinical monograph

How it works

It activates cold-sensitive TRPM8 receptors producing a cooling sensation that can mask itch and pain, and provides a mild local analgesic and decongestant-type effect.

Prescribing in practice

Avoid contact with the eyes, broken or inflamed skin and mucous membranes, and do not apply to areas of skin breakdown.
Menthol-containing inhalations and nasal products should be used cautiously in infants and young children, in whom strong aromatic preparations can be hazardous.
Localised skin irritation or hypersensitivity can occur, prompting discontinuation.

Monitoring

Monitor the treated skin for adequate symptom relief and for any irritation or allergic reaction.

Counselling the patient

Apply to intact skin only and wash your hands after use, avoiding the eyes.
Stop using it if the skin becomes irritated or a rash develops.

Evidence & guidelines

The cooling and antipruritic effects of topical menthol are well established in dermatological practice and product information.

Reference: Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Pathways