| Topical retinoid-like compound. Acne vulgaris (adult): after washing, apply a thin film topically to affected area(s) once daily at bedtime.
[Supplied 0.1% cream/solution/gel]
| Adult (usual) Mild-to-moderate inflammatory acne: apply a thin film topically to affected area twice daily. Indications: topical treatment of vulgaris. Azelaic acid is a naturally-occurring, saturated, straight-chained dicarboxylic acid.
[Supplied 20% cream]
| Topical Gel. Apply twice daily, morning and evening, or as directed by a physician, to affected areas after the skin is gently washed, rinsed with warm water and patted dry.
[Supplied: Each gram of BenzaClin Topical Gel contains, 10 mg (1%) clindamycin as phosphate and 50 mg (5%) benzoyl peroxide]
| Topical Gel. Apply twice daily, morning and evening, or as directed by a physician to affected areas after the skin is thoroughly washed, rinsed with warm water and gently patted dry.
[Supplied: Topical gel – erythromycin 3%-benzoyl peroxide 5% ]
| Children and Adults:
Cleansers: Wash once or twice daily; control amount of drying or peeling by modifying dose frequency or concentration
Topical: Apply sparingly once daily; gradually increase to 2-3 times/day if needed. If excessive dryness or peeling occurs, reduce dose frequency or concentration; if excessive stinging or burning occurs, remove with mild soap and water; resume use the next day. [2.5% – 10 %]
Mechanism of Action
[Supplied: several dosage forms – gels, creams, suspensions, …] [2.5% – 10 %]
| Children >/= 12 years and Adults: Topical:
Acne vulgaris: apply thin film of solution, lotion, or gel topically twice daily to affected areas.
Note: Foam (Evoclin™): Apply once daily
Adverse Reactions – Topical:
[Supplied: 1% gel/lotion/solution]
| Topical Gel. Apply once daily in the evening or as directed by the physician, to affected areas after the skin is gently washed, rinsed with warm water and patted dry.
[Supplied: 1% clindamycin, and 5% benzoyl peroxide topical gel]
| ERYGEL® 2% Topical Gel should be applied sparingly as a thin film to affected area(s) once or twice a day after the skin is thoroughly cleansed and patted dry. If there has been no improvement after 6 to 8 weeks, or if the condition becomes worse, treatment should be discontinued, and the physician should be reconsulted. Spread the medication lightly rather than rubbing it in. There are no data directly comparing the safety and efficacy of b.i.d. versus q.d. dosing.
ERYGEL® 2% topical solution: wash skin with soap and warm water and pat dry. Apply to affected area bid with a dabbing motion.
| Glycolic Acids have been reported to improve acne, pseudofoliculites, barbae, ichthyosis/xerosis, as well as premature aging of the skin.
Seattle Dermatologist: “Glycolic Acid has been proven to be very effective in the treatment of acne as well as the cosmetic benefits one receives. I feel that the use of glycolic acid, especially for the treatment of acne, is the most exciting development in the field of facial skin care over the past decade. It is my prediction that glycolic acid will soon become the standard treatment approach for acne.”
| Adult (usual) : Severe recalcitrant nodular acne: 0.5-2 mg/kg/day in 2 divided doses (dosages as low as 0.05 mg/kg/day have been reported to be beneficial) for 15-20 weeks or until the total cyst count decreases by 70%, whichever is sooner. A second course of therapy may be initiated after a period of >/= 2 months off therapy.
Dosing adjustment in hepatic impairment: Dose reductions empirically are recommended in hepatitis disease
Lipids: Prior to treatment and at weekly or biweekly intervals until response to treatment is established. Test should not be performed <36 hours after consumption of ethanol.
Liver function tests: Prior to treatment and at weekly or biweekly intervals until response to treatment is established.
[Supplied 10 mg, 20 mg, 40 mg capsule]
| Indications: topical control of acne is, acne rosacea and seborrheic dermatitis. Clean the affected area and apply a thin layer of medication to the skin 1 to 3 times daily; or use as directed by your doctor. (Shake Well before using.)
Expiration date after reconstituting: four months. [Supplied: sodium sulfacetamide 10% and sulfur 5% topical lotion]
| CLINICAL PHARMACOLOGY:
Tazarotene is a retinoid prodrug which is converted to its active form, the cognate carboxylic acid of tazarotene (AGN 190299), by rapid deesterification in animals and man. AGN 190299 (“tazarotenic acid”) binds to all three members of the retinoic acid receptor (RAR) family: RARα, RARβ, and RARγ but shows relative selectivity for RARβ, and RARγ and may modify gene expression. The clinical significance of these findings is unknown.
Psoriasis: The mechanism of tazarotene action in psoriasis is not defined. Topical tazarotene blocks induction of mouse epidermal ornithine decarboxylase (ODC) activity, which is associated with cell proliferation and hyperplasia. In cell culture and in vitro models of skin, tazarotene suppresses expression of MRP8, a marker of inflammation present in the epidermis of psoriasis patients at high levels. In human keratinocyte cultures, it inhibits cornified envelope formation, whose build-up is an element of the psoriatic scale. Tazarotene also induces the expression of a gene which may be a growth suppressor in human keratinocytes and which may inhibit epidermal hyperproliferation in treated plaques. However, the clinical significance of these findings is unknown.
Acne: The mechanism of tazarotene action in acne vulgaris is not defined. However, the basis of tazarotene’s therapeutic effect in acne may be due to its anti-hyperproliferative, normalizing-of-differentiation and anti-inflammatory effects. Tazarotene inhibited corneocyte accumulation in rhino mouse skin and cross-linked envelope formation in cultured human keratinocytes. The clinical significance of these findings is unknown.
Topical: Note: In patients experiencing excessive pruritus, burning, skin redness, or peeling, discontinue until integrity of the skin is restored, or reduce dosing to an interval the patient is able to tolerate.
Psoriasis: Tazorac® gel 0.05% or 0.1%: Apply once daily, in the evening, to psoriatic lesions using enough (2 mg/cm 2 ) to cover only the lesion with a thin film to no more than 20% of body surface area. If a bath or shower is taken prior to application, dry the skin before applying. Unaffected skin may be more susceptible to irritation, avoid application to these areas.
[Supplied 0.05%, 0.1% cream. 0.05%, 0.1% gel]
| Topical: Children >12 years and Adults:
Acne vulgaris: Begin therapy with a weaker formulation of tretinoin (0.025% cream, 0.04% microsphere gel, or 0.01% gel) and increase the concentration as tolerated; apply once daily to acne lesions before retiring or on alternate days; if stinging or irritation develop, decrease frequency of application
Adults >/= 18:
Palliation of fine wrinkles, mottled hyperpigmentation, and tactile roughness of facial skin: Pea-sized amount of the 0.02% or 0.05% cream applied to entire face once daily in the evening
Elderly: Use of the 0.02% cream in patients 65-71 years of age showed similar improvement in fine wrinkles as seen in patients <65 years. Safety and efficacy of the 0.02% cream have not been established in patients >71 years of age. Safety and efficacy of the 0.05% cream have not been established in patients >50 years of age.
Retin-A Micro (tretinoin gel) microsphere, 0.1% and 0.04% – this formulation uses patented methyl methacrylate/glycol dimethacrylate crosspolymer porous microspheres (Microsponge® System) to enable inclusion of the active ingredient, tretinoin, in an aqueous gel.
Supplied: cream/gel/liquid – various concentrations.
National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
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