II. Indication

III. Mechanism

  1. Topical antibacterial, Keratolytic agent

IV. Efficacy

  1. Not as effective as originally thought
  2. Only mild effect
  3. Use as an adjunct to other treatment

V. Dosing

  1. Apply twice daily
  2. Cream 20% (Azelex)
    1. Approved for Acne Vulgaris
  3. Gel 15% (Finacea)
    1. Approved for Acne Rosacea
    2. Much better Bioavailability than Azelex

VI. Adverse Effects

  1. Hypopigmentation
  2. Less irritating than Tretinoin or Benzoyl Peroxide
  3. Pruritus
  4. Burning, stinging and tingling
  5. Local erythema

VII. Precautions

  1. Use caution in Acne Vulgaris patients with dark skin
  2. May cause Hypopigmentation

VIII. Safety

  1. Pregnancy Category B
    1. Only category B Keratolytic agent

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Cost: Medications

azelaic acid (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
AZELAIC ACID 15% GEL Generic $0.85 per gram