A P P E N D I X C
Topical agents
953
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TABLE C Topical agents (continued)
Drug
Brand name
Dosage
Usual indications/special considerations
Acne products
adapalene
Differin
Apply a thin film to
affected area after
washing
Do not use near cuts or open wounds;
avoid sunburned areas; do not
combine with other products; limit
exposure to the sun; less drying than
most acne products
azelaic acid
Azclear, Finacea
Wash and dry skin;
massage thin layer
into skin b.d.
Wash hands thoroughly after
application; improvement usually
seen within 4 weeks; initial irritation
usually passes with time
clindamycin
ClindaTech, Dalacin,
Zindaclin
Wash and dry area;
massage into area
morning and evening
Do not use occlusive dressings; may
cause transient burning
clindamycin with
benzoyl peroxide
Duac Once Daily
Apply to affected area
Wash and pat dry area before
application once daily in the evening
erythromycin
Eryacne
Apply thin film b.d.
Treatment of acne vulgaris
isotretanoin
Isotrex
Apply thin layer to
affected area once
daily at night
Avoid contact with eyes, mouth and
mucous membranes. Should not be
applied to nose angles
metronidazole
Rozex
Apply cream to
affected area b.d.
Treatment of rosacea
tazarotene
Zorac
Apply thin film daily in
the evening
Avoid use in pregnancy; drying, causes
photosensitivity; do not use with
products containing alcohol
tretinoin, 0.025%
cream
Stieva-A
Apply thin layer daily
Discomfort, peeling, redness and
worsening of acne may occur for first
2–4 weeks
tretinoin, 0.05% cream Retin-A, ReTrieve,
Stieva-A
Apply thin coat in
evening
Use for acne vulgaris, the removal of
fine wrinkles
tretinoin, gel
Retin-A Gel
Apply to cover daily,
after cleansing
Exacerbation of inflammation may
occur at first; therapeutic effects
usually seen in first 2 weeks
Antihistamine
azelastine HCl
Azep
One spray per nostril
b.d.
Avoid use of alcohol and over-the-
counter (OTC) antihistamines;
dizziness and sedation may occur
Hair removal
eflornithine
Vaniqa
Apply to unwanted
facial hair b.d. for up
to 24 weeks
For use in women only
Topical corticosteroids
These drugs enter cells and bind to cytoplasmic receptors, initiating complex reactions that are responsible for the
anti-inflammatory, antipruritic and antiproliferative effects of these drugs.They are used to relieve the inflammation
and pruritic manifestations of corticosteroid-sensitive dermatoses and for temporary relief of minor skin irritations
and rashes.These agents should always be applied sparingly because of the risk of systemic corticosteroid effects
if absorbed systemically. Occlusive dressings and tight coverings should be avoided. Prolonged use should also be
avoided because of the risk of systemic effects and local irritation and breakdown.These agents are applied topically
two to three times daily.
betamethasone
dipropionate
Diprosone, Eleuphrat
Ointment, cream, lotion, aerosol: 0.05% concentration
betamethasone
valerate
Antroquoril, Betnovate,
Celestone M, Cortival
Ointment, cream, lotion: 0.01–0.05% concentration
ciclesonide
Alvesco
Inhalation: 80 mcg, 160 mcg per actuation
clobetasone butyrate
Eumovate
Cream: 0.05% concentration
desonide
Desowen
Lotion: 0.05% concentration
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