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Adapalene


Pronunciation

 (a DAP a leen)


U.S. Brand Names

 Differin®


Generic Available

 No


Canadian Brand Names

 Differin®


Use

 Treatment of acne vulgaris


Pregnancy Risk Factor

 C


Pregnancy Implications

 There are no adequate and well-controlled studies in pregnant women. Use only if benefit outweighs the potential risk to fetus.


Lactation

 Excretion in breast milk unknown/use caution


Contraindications

 Hypersensitivity to adapalene or any component in the vehicle gel


Warnings/Precautions

 Use with caution in patients with eczema; avoid excessive exposure to sunlight and sunlamps; avoid contact with abraded skin, mucous membranes, eyes, mouth, angles of the nose

Certain cutaneous signs and symptoms such as erythema, dryness, scaling, burning or pruritus may occur during treatment; these are most likely to occur during the first 2-4 weeks and will usually lessen with continued use


Adverse Reactions

>10%: Dermatologic: Erythema, scaling, dryness, pruritus, burning, pruritus or burning immediately after application

1%: Skin irritation, stinging sunburn, acne flares; dermatitis, contact dermatitis, eyelid edema, conjunctivitis, skin discoloration, eczema, rash (topical cream)


Overdosage/Toxicology

 Toxic signs of overdose commonly respond to drug discontinuation, with spontaneous resolution in a few days to weeks. When confronted with signs of increased intracranial pressure, treatment with mannitol (0.25 g/kg I.V. up to 1 g/kg/dose repeated every 5 minutes as needed), dexamethasone (1.5 mg/kg I.V. load followed with 0.375 mg/kg every 6 hours for 5 days), and/or hyperventilation should be employed.


Mechanism of Action

 Retinoid-like compound which is a modulator of cellular differentiation, keratinization and inflammatory processes, all of which represent important features in the pathology of acne vulgaris


Pharmacodynamics/Kinetics

Absorption: Topical: Minimal

Excretion: Bile


Dosage

 Topical: Children >12 years and Adults: Apply once daily at bedtime; therapeutic results should be noticed after 8-12 weeks of treatment


Patient Education

 For external use only. Apply with gloves in thin film at night to thoroughly clean/dry skin; avoid area around eyes or mouth. Do not apply occlusive dressing. Results make take 8-12 weeks to appear. You may experience transient burning or stinging immediately after applying. Report worsening of condition or skin redness, dryness, peeling, or burning that persists between applications. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to become pregnant. Consult prescriber if breast-feeding.


Nursing Implications

 Observe for signs of hypersensitivity, blistering, excessive dryness; do not apply to mucous membranes


Dental Health: Effects on Dental Treatment

 No significant effects or complications reported


Dental Health: Vasoconstrictor/Local Anesthetic Precautions

 No information available to require special precautions


Mental Health: Effects on Mental Status

 None reported


Mental Health: Effects on Psychiatric Treatment

 None reported


Dosage Forms

Cream, topical: 0.1% (15 g, 45 g)

Gel, topical: 0.1% (15 g, 45 g) [alcohol free]

Pledget, topical: 0.1% (60s)

Solution, topical: 0.1% (30 mL)


International Brand Names

 Adaferin® (CR, DO, GT, HN, IL, IN, MX, PA, SV); Diferin® (SI); Differin® (AR, AT, AU, BE, BR, CA, CH, CL, DE, FI, GB, IE, IT, LU, NO, NZ, PL, PT, SE, SG, TH, TR, ZA); Differine® (CZ, ES, FR); Redap® (DK)


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