Generic Name

Benzoyl Peroxide and Erythromycin

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Classification

FDA Approved Indications

• Treatment of acne vulgaris

Mechanism of Action

Benzoyl peroxide has bactericidal properties and releases free radical oxygen species that kill bacteria, reduce inflammation, and help clear blocked follicles. Erythromycin is a topical macrolide antibiotic that inhibits bacterial protein synthesis, thus reducing Propionibacterium acnes populations.

Dosage and Administration

Adult: Apply a thin layer to affected areas once daily or as directed by a physician.

Pediatric: Use in children only under medical supervision; specific pediatric dosing not well established.

Geriatric: Use with caution, generally similar to adult dosing.

Renal Impairment: Not specifically adjusted for topical use.

Hepatic Impairment: Not specifically adjusted for topical use.

Pharmacokinetics

Absorption: Minimal systemic absorption when used topically.

Distribution: Localized in skin.

Metabolism: Metabolized locally in the skin; systemic metabolism not significant.

Excretion: Excreted mainly through skin and debris from the application site.

Half Life: Not applicable for topical application.

Contraindications

• Hypersensitivity to erythromycin, benzoyl peroxide, or related compounds.

Precautions

• Perform a patch test for sensitive skin. May cause skin irritation. Use caution in individuals with known hypersensitivity to other macrolides.

Adverse Reactions - Common

• Skin irritation, peeling, dryness, redness. (Common)

Adverse Reactions - Serious

• Severe allergic reactions, including swelling and difficulty breathing. (Rare)

Drug-Drug Interactions

• Potential interaction with other topical or systemic medications, especially other antibiotics or skin products that cause irritation.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Apply a thin layer to affected skin, and wash hands after application.
• Avoid contact with eyes, mouth, and mucous membranes.
• Use as directed; do not overuse, as it can cause excessive dryness or irritation.
• Report severe irritation or allergic reactions.

Special Considerations

Black Box Warnings:

• Potential for antibiotic resistance with topical erythromycin; use as part of a comprehensive acne treatment plan.
• Risk of rare hypersensitivity reactions.

Genetic Factors: No specific genetic considerations.

Lab Test Interference: No known interference with laboratory tests.

Overdose Management

Signs/Symptoms: Local skin irritation or systemic allergic reactions in case of accidental ingestion.

Treatment: Symptomatic treatment; remove product, provide supportive care, seek emergency medical attention if needed.

Storage and Handling

Storage: Store at room temperature, protected from light and moisture.

Stability: Stable under recommended conditions for the shelf life indicated by manufacturer.