benzoyl peroxide, clindamycin phosphate, adapalene

Action and Spectrum

Actions and Spectrum: 

Actions: 

Cabtreo is formed from three compounds, namely adapalene, which is a retinoid-like compound; clindamycin, which is a lincosamide antibiotic; and benzoyl peroxide, which is an oxidizing agent. Cabtreo is mainly approved for treating acne vulgaris as a triple fixed combination dose therapy only for topical use on the skin. Clindamycin inhibits bacterial protein synthesis; benzoyl peroxide is bactericidal and kerolytic; adapalene is used to restore skin tone. 

Spectrum: 

The spectrum in which Cabtreo, which is formed from three compounds, namely clindamycin phosphate, adapalene, and benzoyl peroxide, is only for Acne vulgaris treatment. 

Drug Interaction

Adverse Reaction

Frequency Defined 

>10% 

Erythema (22.5%) 

Scaling (26.7%) 

Stinging (20.5%) 

Itching (24.3%) 

Burning (29.6%) 

Pain (33%) 

1-10% 

Irritation (5%) 

Exfoliation (4%) 

Dermatitis (3%) 

Black Box Warning

Black Box Warning: 

Only a thin layer application of Cabtreo is recommended for the affected areas. It is only used on the skin, not orally or in other forms. Patients are advised to avoid paranasal creases, lips, eyes, membranes of mucous, and areas where the skin is broken, sunburned, or eczematous. Wash hands after application. Cabtreo may bleach colored fabric and hair. Stop if you are allergic or if diarrhea occurs. 

Contraindication / Caution

Contraindication/Caution: 

Contraindications 

• Hypersensitivity 
• Crohn’s disease  
• Diarrhea

Cautions 

• Photosensitivity 
• Skin irritation 
• Dermatitis, which is allergic contact 

Pregnancy / Lactation

Pregnancy consideration:  

No data is available regarding the administration of the drug during pregnancy. 

Breastfeeding warnings:  

No data is available regarding the excretion of drug in breast milk. 

Pregnancy category: A 

Category A: well-controlled and satisfactory studies show no risk to the fetus in the first or later trimester. 

<b>Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: No data is available for the drug under this category. 

Pharmacology

Pharmacology: 

Clindamycin is a lincosamide bactericidal agent that binds to 50S of bacterial ribosomal subunits and interferes with peptidyl transfer to prevent peptide chain elongation, leading to inhibition of protein synthesis. The exact nature of the action is unknown. 

benzoyl peroxide, which is an oxidizing agent that shows keratolytic and antibacterial action, but the exact action is unknown. 

adapalene is a retinoid-like compound that binds to nuclear receptors of specific retinoic acid, and cellular differentiation modulation occurs with keratinization and inflammatory processes. The exact action is unknown. 

Pharmacodynamics: 

The exact pharmacodynamics for Cabtreo have yet to be clearly known. 

Pharmacokinetics: 

Absorption 

After application of this topical gel, peak plasma concentration after 28 days is for adapalene it is 0.1 ng/mL, and for clindamycin, it is 2.44 ng/mL.  

AUC after 28 days is adapalene 2.4 ng. h/mL and clindamycin topical is 30.7 ng. h/mL. 

Distribution 

No clear details 

Metabolism 

Conversion of benzoyl peroxide to benzoic acid. 

Elimination and Excretion 

benzoyl peroxide via urine elimination after conversion to benzoic acid. 

Adminstartion

Administration: 

A thin layer of Cabtreo is applied to the affected areas once a day to avoid sunburned skin, eczematous areas, or eyes, lips, and mucous membranes. It is only for skin use. Not for oral, IV, or any other administration. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: adapalene, benzoyl peroxide, clindamycin phosphate 

Pronounced: uh-DAP-uh-leen, BEN-zoyl per-OK-side, klin-duh-MY-sin FOS-fate 

Why do we use adapalene, benzoyl peroxide, clindamycin phosphate? 

adapalene, benzoyl peroxide, and clindamycin phosphate are combined and available in the form of Cabtreo, which is used in the treatment of acne vulgaris from age 12 and above. clindamycin phosphate has antibiotic activity, adapalene helps restore skin tone, and benzoyl peroxide has bactericidal properties. This combination can only be applied on the skin for acne, and it should not be used in the mouth, vagina, and eyes.