erythromycin topical/benzoyl peroxide

Action and Spectrum

Actions and Spectrum: 

erythromycin topical and benzoyl peroxide are both commonly used as acne treatments. 

erythromycin is an antibiotic that works by stopping the growth of bacteria on the skin. It is effective against various bacteria, including Propionibacterium acnes, commonly associated with acne. 

benzoyl peroxide is an antimicrobial agent that reduces the number of bacteria on the skin and also by helping to unclog pores. It can also have a mild peeling effect, which helps to remove dead skin cells and keep pores clear. 

When used together, erythromycin topical and benzoyl peroxide can be more effective at treating acne than either medication used alone. They work synergistically to reduce the number of bacteria on the skin and to unclog pores. 

Drug Interaction

Adverse Reaction

Frequency defined 

1-10% 

Application site reaction (erythema, stinging, burning) (0.8-2.5%) 

Dry skin (5-7.6%) 

Blepharitis (1.7%) 

Photosensitivity (1.3%) 

Pruritus (1.7-2.5%) 

<1% 

Skin peeling (<0.5%) 

Black Box Warning

Contraindication / Caution

Contraindication/Caution: 

Contraindication 

The combination of erythromycin topical and benzoyl peroxide is contraindicated in individuals with a history of hypersensitivity to either medication or any of the components of the formulations. 

Additionally, erythromycin topical and benzoyl peroxide should not be used in individuals with a history of severe allergic reactions, including anaphylaxis, to other antibiotics or other medications in the same class as benzoyl peroxide. 

Individuals with a history of IBD (inflammatory bowel disease) or colitis should also avoid using erythromycin topical and benzoyl peroxide, as erythromycin can exacerbate these conditions. 

It is key to talk to your healthcare provider before using erythromycin topical and benzoyl peroxide, especially if you have a history of allergies or other medical conditions. Always follow instructions provided by your physician or the medication label to minimize the risks associated with these medications. If you experience any adverse effects or have concerns about the medication, contact your healthcare provider immediately. 

Caution 

There are several cautions to consider when using erythromycin topical and benzoyl peroxide: 

• Skin irritation: These medications can cause skin irritation, including dryness, redness, itching, and burning. If you experience these symptoms, you may need to reduce the frequency of use or switch to a different medication. 
• Sun sensitivity: erythromycin topical and benzoyl peroxide can make your skin more sensitive to the sun. Be sure to use sunscreen with at least SPF 30 and avoid prolonged exposure to the sun. 
• Interaction with other medications: erythromycin can interact with other medications, including certain antibiotics, antifungal medications, and some medications used to treat irregular heartbeats. Be sure to tell your physician about all your medications. 
• Pregnancy and breastfeeding: The safety of erythromycin topical and benzoyl peroxide during pregnancy and breastfeeding is not well established. Talk to your physicain if you are pregnant or breastfeeding before using these medications. 
• Overuse: Overusing these medications can lead to antibiotic resistance and can also cause skin irritation. Be sure to follow the instructions provided by your healthcare provider or the medication label. 

Pregnancy / Lactation

Pregnancy consideration:  

US FDA pregnancy category: C 

Lactation:   

Excreted into human milk is Not known. 

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies do not show risk to the fetus in the first/later trimester.        
• 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: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

erythromycin is a macrolide antibiotics that inhibits bacterial protein synthesis, preventing the growth and replication of acne-causing bacteria on the skin. 

benzoyl peroxide is a keratolytic agent that acts by exfoliating the skin, which helps to unclog pores and reduce the production of sebum, a type of oil produced by the skin that can contribute to acne. 

Pharmacodynamics: 

Mechanism of action: The precise mechanism of how erythromycin and benzoyl peroxide work to reduce acne vulgaris lesions has yet to be understood entirely. 

erythromycin functions by blocking protein synthesis in susceptible microorganisms by reversibly attaching to the 50S ribosomal subunit, which impedes aminoacyl transfer RNA translocation and hinders polypeptide synthesis. 

benzoyl peroxide triggers active oxygen release, which has been demonstrated to be effective in vitro against Propionibacterium acnes, an anaerobic bacterium located in sebaceous follicles and comedones. benzoyl peroxide also has a keratolytic and desquamative effect, which may also contribute to its effectiveness. 

Pharmacokinetics: 

Absorption 

erythromycin topical is minimally absorbed into the bloodstream, with less than 5% of the medication being absorbed. This limits its systemic effects. 

benzoyl peroxide is minimally absorbed into the bloodstream, with less than 5% of the medication being absorbed. This limits its systemic effects. 

Distribution 

erythromycin topical is distributed mainly in the skin and underlying tissues at the application site. 

benzoyl peroxide is distributed mainly in the skin and underlying tissues at the application site. 

Metabolism 

erythromycin is metabolized primarily in the liver. 

benzoyl peroxide is metabolized primarily in the liver. 

Elimination and Excretion 

erythromycin and its metabolites are excreted in the feces. 

benzoyl peroxide and its metabolites are excreted in the urine. 

Adminstartion

Administration: 

Topical administration 

erythromycin topical and benzoyl peroxide is usually applied directly to the affected areas of the skin once or twice a day, depending on the severity of the acne. Here are some general administration guidelines: 

• Wash your hands thoroughly before applying the medication. 
• Cleanse the affected area with a mild soap or cleanser and pat dry with a towel. 
• Apply a thin layer of drug to the affected areas of the skin. 
• Gently massage the medication into the skin until it is absorbed. 
• Rewash your hands after applying the medication. 
• Avoid applying the medication to areas of the skin unaffected by acne. 
• Only cover the treated area with bandages or dressings if directed to do so by your healthcare provider. 

It is essential to follow the instructions provided by your healthcare provider or the medication label when using erythromycin topical and benzoyl peroxide, as overuse or incorrect use can lead to skin irritation and other adverse effects. If you have any queries about how to use these medications, talk to your healthcare provider or pharmacist. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: erythromycin topical/benzoyl peroxide 

Pronounced: [ BEN-zoe-ill-per-OX-ide-and-er-ith-roe-MYE-sin ] 

Why do we use erythromycin topical/benzoyl peroxide 

erythromycin topical and benzoyl peroxide is used to treat acne. Both medications work together to reduce the number of acne-causing bacteria on the skin and to reduce inflammation. 

erythromycin is an antibiotic that inhibits the growth of bacteria on the skin. In contrast, benzoyl peroxide reduces the production of sebum and exfoliates the skin, which helps to unclog pores. 

This combination medication is effective for treating mild to moderate acne and can help to reduce the number of pimples, blackheads, and whiteheads on the skin. 

It is important to note that erythromycin topical and benzoyl peroxide is ineffective for treating all types of acne, such as severe cystic acne. Your healthcare provider can help determine the best treatment options for your specific condition.