lCAUTIONSAllow peeling (resulting from other irritant
treatments) to subside before using a topical retinoid.
alternating a preparation that causes peeling with a topical
retinoid may give rise to contact dermatitis (reduce
frequency of retinoid application).avoid accumulation in
angles of the nose.avoid contact with eyes, nostrils,
mouth and mucous membranes, eczematous, broken or
sunburned skin.avoid exposure to UV light (including
sunlight, solariums).avoid in severe acne involving large
areas.avoid use of topical retinoids with abrasive cleaners,
comedogenic or astringent cosmetics.caution in sensitive
areas such as the neck
lINTERACTIONS→Appendix 1 : clindamycin.retinoids
lSIDE-EFFECTSDry skin (discontinue if severe).eye
irritation.oedema.photosensitivity reaction.skin
pigment change (transient).skin reactions
lCONCEPTION AND CONTRACEPTIONFemales of child-
bearing age must use effective contraception (oral
progestogen-only contraceptives not considered
effective).
lPREGNANCYContra-indicated in pregnancy.
lBREAST FEEDINGAmount of drug in milk after topical
application probably too small to be harmful; ensure
infant does not come in contact with treated areas.
lPATIENT AND CARER ADVICEIf sun exposure is
unavoidable, an appropriate sunscreen or protective
clothing should be used.
Patients and carers should be warned that some redness
and skin peeling can occur initially but settles with time. If
undue irritation occurs, the frequency of application
should be reduced or treatment suspended until the
reaction subsides; if irritation persists, discontinue
treatment. Several months of treatment may be needed to
achieve an optimal response and the treatment should be
continued until no new lesions develop.
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Gel
CAUTIONARY AND ADVISORY LABELS 11
EXCIPIENTS:May contain Butylated hydroxytoluene, hydroxybenzoates
(parabens), polysorbates
▶Treclin(Meda Pharmaceuticals Ltd)
Tretinoin 250 microgram per 1 gram, Clindamycin (as
Clindamycin phosphate) 10 mg per 1 gramTreclin 1 %/ 0. 025 % gel
| 30 gramP£ 11. 94
Tretinoin with erythromycin
The properties listed below are those particular to the
combination only. For the properties of the components
please consider, tretinoin p. 554 , erythromycin p. 331.
lINDICATIONS AND DOSE
Acne
▶TO THE SKIN
▶Child:Apply 1 – 2 times a day, apply thinlylCONTRA-INDICATIONSPerioral dermatitis.personal or
familial history of skin cancer.rosacea
lCAUTIONSAllow peeling (resulting from other irritant
treatments) to subside before using a topical retinoid.
alternating a preparation that causes peeling with a topical
retinoid may give rise to contact dermatitis (reduce
frequency of retinoid application).avoid accumulation in
angles of the nose.avoid contact with eyes, nostrils,
mouth and mucous membranes, eczematous, broken or
sunburned skin.avoid exposure to UV light (including
sunlight, solariums).avoid in severe acne involving large
areas.avoid use of topical retinoids with abrasive cleaners,
comedogenic or astringent cosmetics.caution in sensitive
areas such as the neck
lINTERACTIONS→Appendix 1 : macrolides.retinoids
lSIDE-EFFECTSDry skin (discontinue if severe).eye
irritation.oedema.photosensitivity reaction.skin
pigment change (transient).skin reactions
lCONCEPTION AND CONTRACEPTIONFemales of child-
bearing age must use effective contraception (oral
progestogen-only contraceptives not considered
effective).
lPREGNANCYContra-indicated in pregnancy.
lBREAST FEEDINGAmount of drug in milk after topical
application probably too small to be harmful; ensure
infant does not come in contact with treated areas.
lPATIENT AND CARER ADVICEPatients and carers should be
warned that some redness and skin peeling can occur
initially but settles with time. If undue irritation occurs,
the frequency of application should be reduced or
treatment suspended until the reaction subsides; if
irritation persists, discontinue treatment. Several months
of treatment may be needed to achieve an optimal
response and the treatment should be continued until no
new lesions develop. If sun exposure is unavoidable, an
appropriate sunscreen or protective clothing should be
used.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Liquid
CAUTIONARY AND ADVISORY LABELS 11
▶Aknemycin Plus(Almirall Ltd)
Tretinoin 250 microgram per 1 gram, Erythromycin 40 mg per
1 gramAknemycin Plus solution| 25 mlP£ 7. 05 DT = £ 7. 05VITAMINS AND TRACE ELEMENTS›VITAMIN B
GROUPNicotinamide
lINDICATIONS AND DOSE
Inflammatory acne vulgaris
▶TO THE SKIN
▶Child:Apply twice daily, reduced to once daily or on
alternate days, dose reduced if irritation occurslUNLICENSED USELicensed for use in children (age range
not specified by manufacturer).
lCAUTIONSAvoid contact with eyes.avoid contact with
mucous membranes (including nose and mouth).reduce
frequency of application if excessive dryness, irritation or
peeling
lSIDE-EFFECTSParaesthesia.skin reactionslMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Gel
▶Freederm(Dendron Ltd)
Nicotinamide 40 mg per 1 gramFreederm Treatment 4 % gel|
25 gramp£ 5. 56
▶Nicam(Dermal Laboratories Ltd)
Nicotinamide 40 mg per 1 gramNicam 4 % gel| 60 gramp£ 7. 10BNFC 2018 – 2019 Acne 759
Skin13