Metsal Cream

Metsal Cream is a topical rubefacient (heat-rub) cream containing three active ingredients: Methyl Salicylate 28.3% w/w, Eucalyptus Oil 8.8% w/w, and Menthol 2% w/w. It is registered in Malaysia and manufactured/distributed by iNova Pharmaceuticals (Malaysia Branch), and is one of the longer-established topical heat-rub brands sold through Malaysian pharmacies and retail chains.

This product is available in Malaysia as an OTC (Over-the-Counter) topical preparation, meaning it can be purchased at a pharmacy without a doctor’s prescription. It is a cream-based formulation, giving it a smoother, faster-absorbing texture on application compared with thicker balm- or ointment-based rubs, and it does not require vigorous rubbing into the skin to be applied.

Metsal Cream is sold in Malaysia in a 50g tube pack size, a standard household size intended for repeated topical application over a period of use. As with all topical counter-irritant rubs, it is intended strictly for external application to intact skin.

Smooth a small amount of Metsal Cream gently onto the skin of the affected area 2-3 times a day. Vigorous rubbing is not required for the cream to be absorbed into the skin. Wash hands thoroughly after application unless the hands themselves are the area being treated.

Do not apply to broken skin, open wounds, or grazes, and avoid contact with the eyes, mouth, or other mucous membranes. Because this cream already contains methyl salicylate, menthol, and eucalyptus oil, avoid applying other products containing the same or similar counter-irritant ingredients (such as camphor, wintergreen oil, or other salicylate-based rubs) to the same skin area at the same time, as this increases the risk of skin irritation or excessive absorption.

As a topical cream, Metsal Cream is not taken orally and does not have a systemic “dose” in the way an oral medicine does. Apply a small amount to the affected area 2-3 times a day as needed, and avoid applying to a large surface area of skin or under an occlusive/airtight dressing, as this can increase absorption of the active ingredients through the skin.

There is no fixed “missed dose” concept for an as-needed topical cream — simply resume normal use at the next application when needed. Stop use and consult a doctor or pharmacist if the treated skin area becomes more irritated, does not improve within a few days, or if signs of infection develop.

Use before the expiry date printed on the tube and carton. Once opened, use within the period stated on the packaging, and discard the tube if the cream’s colour, texture, or smell changes noticeably.

Store below 30°C in a cool, dry place, away from direct sunlight and heat sources. Keep the cap tightly closed after each use to prevent the cream from drying out. Keep out of reach of children.

• Common: a warming or tingling sensation at the application site, which is an expected effect of the menthol, methyl salicylate, and eucalyptus oil content.
• Common: mild, temporary skin redness at the application site.
• Serious: localised allergic contact dermatitis, presenting as itching, blistering, or a spreading rash beyond the application area, which requires the product to be stopped and medical advice sought.
• Serious: signs of salicylate absorption with excessive or prolonged use over large areas, such as ringing in the ears, nausea, or breathing difficulty, which needs urgent medical attention.

• Known hypersensitivity or allergy to methyl salicylate, aspirin-related salicylates, menthol, or eucalyptus oil.
• Application to broken skin, open wounds, or grazed or infected skin.
• Application to the eyes, mouth, nose, or genital/mucous membrane areas.
• Use under airtight or occlusive dressings, or together with a heating pad, which can increase absorption to unsafe levels.

• Avoid applying this cream at the same time as other topical products containing methyl salicylate, menthol, camphor, or eucalyptus oil on the same skin area, as this duplicates active ingredients and raises the risk of irritation or excess absorption.
• People taking oral anticoagulant medicines (such as warfarin) should be cautious with extensive or prolonged topical methyl salicylate use, as salicylate absorbed through the skin may add to the blood-thinning effect; check with a pharmacist or doctor if regular, widespread use is intended.
• No specific food interactions are expected with normal topical use, as systemic absorption from small-area application is minimal.

• Apply only a small amount at a time — more cream does not work faster and increases the chance of skin irritation.
• Wash your hands after applying, unless treating the hands themselves.
• Keep the tube capped tightly between uses to prevent the cream from drying out or becoming contaminated.
• Avoid applying immediately before a hot shower or bath, as heat can increase the warming sensation and absorption.
• Test on a small area of skin first if using the product for the first time, to check for sensitivity.
• Avoid tight or airtight bandaging over the treated area unless advised by a pharmacist or doctor.

Precautions: This cream is for external use only. Avoid contact with the eyes, mouth, and mucous membranes, and rinse thoroughly with water if accidental contact occurs. Use with caution on the sensitive skin of infants and young children, and check with a pharmacist before use on children. Pregnant or breastfeeding women should seek pharmacist or doctor advice before regular use, as with any topical medicated product containing salicylates. Avoid combining with other menthol, camphor, or salicylate-containing products on the same area.

When to See a Doctor or Pharmacist: Stop use and seek medical advice if the skin reaction worsens, spreads, blisters, or does not settle within a few days of stopping use. Seek urgent medical attention if there are signs of a significant allergic reaction, such as facial swelling or difficulty breathing, or if signs of salicylate toxicity (such as ringing in the ears, dizziness, or nausea) appear after use over a large skin area.