Acne Products
Generic and Trade Names:
| Adapalene | Differin | |
| Azelaic acid | Azelex | |
| Benzoyl peroxide | Benzac, Clearasil | |
| Clindamycin | Cleocin-T | |
| Erythromycin | Erycette, T-Stat | |
| Isotretinoin | Accutane | |
| Metronidazole | Metrogel | |
| Tazarotene | Tazorac | |
| Tetracycline | Topicycline | |
| Tretinoin | Retin-A |
Description:
The exact mechanism of action of most of these agents in the treatment of acne is unknown. There are several which have antibacterial effects, others are similar to vitamin A or are derivatives of retinol. Some also have anti-inflammatory effects, they can also increase epithileal cell turnover. (Facts and Comparisons 1999)
Nutritional Considerations:
Take with food or milk to decrease GI upset. (Pronsky 1999)
Avoid multivitamin or beta carotene supplements with isotretinoin. (Pronsky 1999)
Caloric intake tendency to develop anorexia with isotretinoin. (Pronsky 1999)
Hydration: dry mouth and increased thirst.
Do not supplement with vitamin A or beta carotene. (Facts and Comparisons 1999)
Isotretinoin may affect blood sugar, monitor levels. (Facts and Comparisons 1999)
Limit alcohol. (Pronsky 1999)
Herbal Considerations
Topical preparations generally don't have strong systemic side effects associated with them, however oral formulations will increase the risk of side effects or interactions, avoid using together.
Avoid using herbs with cardiac activity with macrolide antibiotics: Black helebore, Canadian hemp roots, calamus, cereus, cola, coltsfoot, devil's claw, European mistletoe, fenugreek, ginger, Panax ginseng, hawthorn ,hedge mustard, figwort, lily of the valley roots, mate, parsley, motherwort, oleander leaf, pheasant's eye plant, pleurisy root, squill bulb leaf scales, and strophanthus seeds, white horehound, scotch broom flower, shepherd's purse, and wild carrot. All have the potential to interact if used together. (Brinker 1998)(Blumenthal 1998)(Newall 1996)
Bromelain increases tetracycline levels in plasma and urine. (Blumenthal 1998)
Cardiac glycoside-containing herbs, include digitalis leaf, hedge mustard, figwort, lily of the valley roots, motherwort, oleander leaf, pheasant's eye plant, pleurisy root, squill bulb leaf scales, and uzara root, these herbs may theoretically, increase cardiac glycoside toxicity with tetracyclines. (Blumenthal 1998)(Brinker 1998)(Ellenhorn 1997)(Newall 1996)
Tetracyclines increase vitamin C requirements (rose hips). (McKevoy 1998)
Alfalfa, is high in iron, this may cause it to interfere with the absorption of tetracyclines. This is especially true if large quantities of the herb are ingested within two hours of taking tetracyclines. (Newall 1996)
Tetracyclines may interact with St. John's Wort or peppermint oil to cause increased photosensitivity. (Vassileva, 1998)
References
Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.
Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998.
Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 1999.
McKevoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998
Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996
PDR (Physicians Desk Reference). 49th Edition. Medical Economics Co. Montvale, NJ. 1995
Pronsky, Zaneta. Food Medication Interactions. 11th edition. 1999.
Vassileva SG, et al: Antimicrobial photosensitive reactions, Arch Intern Med, 1998, 158:1993-2000.
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