DrugindexOnline^{2nd edition}

Pronouncation: (ADE-ah-PALE-een)
Class: Retinoid

Trade Names:
Differin
- Cream 0.1%
- Gel 0.1%
- Solution 0.1%

Mechanism of Action

Pharmacology

May normalize the differentiation of follicular epithelial cells, resulting in decreased microcomedone formation.

Indications and Usage

Topical treatment of acne vulgaris.

Contraindications

Standard considerations.

Dosage and Administration

Adults and children (12 yr and older)

Topical Apply a thin film once daily to affected areas after washing in the evening before bedtime.

General Advice

• Do not use pledgets if seal is broken. Remove pledget from foil pouch just before using. Discard pledget after single use. Do not reuse pledget.
• Apply solution directly to affected area(s) using supplied applicator. Replace cap after each use.

Storage/Stability

Store at controlled room temperature (68° to 77°F). Keep tube tightly capped. Keep bottle tightly capped and stored upright. Protect from freezing.

Drug Interactions

Potentially irritating topical products (eg, medicated or abrasive soaps and cleansers, soaps and cosmetics that have strong drying effect, products with high concentrations of alcohol, spices or limes), products containing sulfur, resorcinol, or salicylic acid

Because of increased risk of local irritation, use with caution.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Dermatologic

Erythema; scaling; dryness; pruritus, skin discomfort, burning, stinging, and irritation; sunburn; acne flares.

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy not established in children less than 12 yr.

Photosensitivity

Photosensitivity may occur. Patients should minimize exposure to sunlight, including sunlamps, and use sunscreens and protective clothing over treated areas.

External use

Avoid contact with eyes, lips, angles of the nose, other mucous membranes, and open wounds.

Irritation

May cause local irritation. May need to use less often or discontinue use.

Overdosage

Symptoms

Redness, peeling, discomfort.

Patient Information

• Advise patient that medication is applied topically to skin lesions once daily at nighttime.
• Teach patient the following proper technique for applying medication: wash hands; cleanse area with mild or soapless cleanser first then apply a thin film of cream, gel, or solution to cover skin areas with acne lesions; wash hands after applying medication.
• Inform patient that a mild sensation of warmth or slight stinging may be felt shortly after application and that this is expected and should be of no concern.
• Warn patient that applying medication more often than prescribed or in excessive quantities will not produce more rapid improvement or better results but will result in greater side effects such as redness, scaling, and discomfort.
• Warn patient to avoid contact with the eyes, lips, angles of the nose, and mucous membranes.
• Advise patient to not apply to skin areas where there are cuts, abrasions, or eczema, or to sunburned skin.
• Advise patient that moisturizers may be used but to avoid those containing alpha hydroxy or glycolic acids.
• Advise patient that acne may appear to worsen during the first few weeks of therapy but to continue to use the cream. Improvement may not be seen for at least 2 wk but may take up to 8 wk.
• Advise patient that local redness, drying, scaling, burning, or itching may occur during the first 2 to 4 wk of treatment and usually will lessen with continued use of medication. However, if these symptoms are bothersome or do not go away, the frequency of application may need to be reduced or the medication discontinued completely.
• Advise patient that if severe dermal reactions occur to stop using the medication and contact the health care provider.
• Advise patient to talk to the health care provider before using any other topical agents (eg, medicated soaps, astringents, cosmetics, or other acne products) on treated skin.
• Advise patient to not use wax epilation on treated skin because of risk of skin erosions.
• Warn patient to avoid unnecessary exposure to sun and sun lamps while using this medication. Advise patient to use sunscreens and protective clothing over treated areas when exposure cannot be avoided.
• Caution patient that while using the medication, exposure to extreme weather conditions (eg, wind or cold air) may be irritating to the treated areas.