azelaic acid (Rx)

Brand and Other Names:Azelex, Finacea
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

cream

  • 20% (Azelex)

gel

  • 15% (Finacea)

foam

  • 15% (Finacea)

Acne Vulgaris

Azelex: Massage a thin layer into the affected areas on the face q12hr

Treatment of Inflammatory Papules and Pustules of Mild to Moderate Rosacea

Finacea: Massage a thin layer into the affected areas on the face q12hr

Administration

Cleanse affected area with mild soap or soapless cleansing lotion and pat dry before applying

Reassess if no improvement after 12 weeks of therapy

Acne Vulgaris

<12 years

  • Safety and efficacy not established

≥12 years

  • Azelex: Massage a thin layer into the affected areas on the face q12hr

Administration

Cleanse affected area with mild soap or soapless cleansing lotion and pat dry before applying

Reassess if no improvement after 12 weeks of therapy

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Adverse Effects

>10%

Burning/ stinging/ tingling (4-16%)

1-10%

Pruritus (1-6%)

Scaling/ dry skin/ xerosis (1-5%)

Erythema/ irritation (1-2%)

<1%

Contact dermatitis

Edema

Acne

Postmarketing Reports

Facial burning

Irritation

Iridocyclitis after accidental exposure

Hypersensitivity reactions, including angioedema, eye swelling, facial swelling, urticaria (revised)

Worsening of asthma, dyspnea, wheezing

Application site rash

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Warnings

Contraindications

Hypersensitivity to azelaic acid, propylene glycol or any of its components

Cautions

In case of known hypersensitivity to any component of the gel, avoid the use of gel dosage form; if hypersensitivity develops during treatment, discontinue and institute appropriate therapy

For dermatologic use only

Therapy has been reported to cause irritation of eyes; avoid contact with eyes and mucous membranes; if medication comes in contact with eyes, wash eyes with large amounts of water and consult a physician if eye irritation persists

Isolated cases of hypopigmentation reported after azelaic acid use; monitor patients with dark complexion for early signs of hypopigmentation

Skin irritation (i.e. pruritus, burning or stinging) may occur, usually during first few weeks of treatment; if sensitivity or severe irritation develops and persists, discontinue treatment and institute appropriate therapy

Do not wax treated area or apply topical products that may further irritate skin (eg, astringents, abrasive soaps and cleansers, exfoliants)

Avoid any foods and beverages that provoke erythema, flushing, and blushing (eg, alcoholic beverages, spicy food, hot drinks such as hot coffee and tea)

Report any abnormal changes in skin color to physician

Avoid use of occlusive dressings or wrappings

Wash hands after applying the cream

Worsening of asthma reported; consult a physician if asthma is exacerbated with therapy

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Pregnancy & Lactation

Pregnancy

Azelaic acid is minimally absorbed systemically following topical route of administration; maternal use not expected to result in fetal exposure to drug

Animal data

  • In animal reproduction studies, embryofetal toxicity was noted when azelaic acid was administered orally during period of organogenesis at doses 162, 19, and 65 times maximum recommended human dose (MRHD) in rats, rabbits, and monkeys, respectively; maternal toxicity was noted at these doses but no malformations were observed in these embryofetal developmental studies

Lactation

Azelaic acid is naturally present in human milk; when used as prescribed, azelaic acid is unlikely to be absorbed through skin in clinically relevant amounts to cause a change in azelaic acid concentration in milk or milk production; therefore, breastfeeding is not expected to result in exposure of infant to drug

The developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for drug and any potential adverse effects on breastfed child from drug or from underlying maternal condition

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

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Pharmacology

Mechanism of Action

Azelaic acid is an antibacterial agent that inhibits the growth of susceptible organisms (principally Propionibacterium acnes) on the surface of the skin by inhibiting protein synthesis; may also inhibit follicular keratinization, which prevents development or maintenance of comedones

Mechanism by which it interferes with pathogenic events in rosacea is unknown

Pharmacokinetics

Half-Life: 12 hours

Absorption: systemic (4%)

Metabolism: Negligible cutaneous metabolism

Excretion: Unchanged in urine

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Images

BRAND FORM. UNIT PRICE PILL IMAGE
Azelex topical
-
20 % cream
Azelex topical
-
20 % cream
Azelex topical
-
20 % cream
Azelex topical
-
20 % cream
azelaic acid topical
-
15 % gel
azelaic acid topical
-
15 % gel
azelaic acid topical
-
15 % gel
azelaic acid topical
-
15 % gel
Finacea topical
-
15 % foam
Finacea topical
-
15 % foam

Copyright © 2010 First DataBank, Inc.

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Patient Handout

Patient Education
azelaic acid topical

AZELAIC ACID CREAM - TOPICAL

(ay-ze-LAY-ik AS-id)

COMMON BRAND NAME(S): Azelex

USES: This medication is used to treat mild to moderate acne. It works by reducing the amount of acne-causing bacteria on the skin and by helping to keep your pores open and unblocked, thus decreasing the number of acne pimples. Azelaic acid belongs to a class of drugs known as dicarboxylic acids.

HOW TO USE: Before using this medication, clean the affected area and pat dry. Apply this medication to the skin usually twice daily, in the morning and evening, or as directed by your doctor. Apply a thin layer and massage gently into the affected areas. Wash your hands after use.Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day.Avoid contact in or near the eyes or inside the nose and mouth. If this medication gets into any of these areas, wash right away with plenty of water and call your doctor if irritation lasts. Do not place a bandage or cover over the cream unless your doctor tells you to do so.Do not use large amounts of this medication or apply it more often than directed. Your condition will not improve any faster, and the risk of side effects may increase. Use this medication for the full course of treatment as directed by your doctor. It usually takes about 1 month to see an improvement, but the full effects of treatment may take longer.Tell your doctor if your condition does not improve after 1 month or if it worsens.

SIDE EFFECTS: Temporary stinging, burning, itching, or tingling of the skin may occur, usually at the beginning of treatment. These effects usually lessen as your body adjusts to this medication. However, if minor irritation continues, your doctor may instruct you to only use this product once daily. If any of these effects last or get worse, stop using this medication and tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Rarely, some people may experience lightening of skin color (hypopigmentation) after using this medication. This side effect may be more noticeable in people with dark skin color. Consult your doctor for more details and report any skin color changes.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication may pass into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

OVERDOSE: This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Do not share this medication with others.

MISSED DOSE: If you miss a dose, apply it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

STORAGE: Store at room temperature. Do not freeze. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised April 2022. Copyright(c) 2022 First Databank, Inc.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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Formulary

FormularyPatient Discounts

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Adding plans allows you to:

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.