adapalene
General
Pronunciation:
a-dap-a-leen
Trade Name(s)
- Differin
Ther. Class.
antiacne agents
Pharm. Class.
retinoids
Indications
Management of acne vulgaris.
Action
Binds to retinoic acid nuclear receptors resulting in decreased microcomedone formation.
Therapeutic Effect(s):
Reduction in inflammatory and non-inflammatory acne lesions.
Pharmacokinetics
Absorption: Minimal systemic absorption occurs with limited surface-area application.
Distribution: Unknown.
Metabolism and Excretion: Excreted via the biliary route.
Half-life: Unknown.
TIME/ACTION PROFILE (improved skin appearance)
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
Topical | 8–12 wk | unknown | unknown |
Contraindication/Precautions
Contraindicated in:
- Hypersensitivity.
Use Cautiously in:
- OB: Use during pregnancy only if potential benefit justifies the potential risk to the fetus
- Lactation: Safety not established;
- Pedi: Children <12 yr (safety and effectiveness not established).
Adverse Reactions/Side Effects
Derm: burning, dryness, erythema, pruritus, scaling, photosensitivity
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
Interactions
Drug-Drug
- Concurrent use with keratolytic agents (benzoyl peroxide, salicylic acid, sulfur, or resorcinol) ↑ risk of excessive skin irritation.
- ↑ risk of photosensitivity with other photosensitizing agents.
- Risk of irritation ↑ by other topical skin-care products (aftershave, cover-up, make-up, perfumes, colognes).
Route/Dosage
Topical (Adults and Children) ≥12 yr) Apply once daily at bedtime.
Availability (generic available)
Cream: 0.1%
Gel: 0.3% OTC
Lotion: 0.1%
Assessment
- Assess skin prior to and periodically during therapy. Transient worsening of acne may occur at initiation of therapy. Note degree of skin dryness, erythema, and itching. Usually occur during first 2–4 wks of therapy. May need to reduce frequency or discontinue therapy.
Potential Diagnoses
- Risk for impaired skin integrity (Indications) (Side Effects)
- Disturbed body image (Indications)
Implementation
- Topical Cleanse area with mild or soapless cleanser before applying medication. Apply thin film of cream to areas where acne lesions appear, once daily at nighttime. A mild transitory sensation of warmth or slight stinging may occur shortly after application. Avoid contact with the eyes, lips, angles of the nose, and mucous membranes. Do not apply to cuts, abrasions, eczematous or sunburned skin. May use moisturizers but avoid products containing alpha hydroxy or glycolic acid. Avoid waxing skin in treated area.
Patient/Family Teaching
- Instruct patient on correct technique for application of cream.
- Explain to patient that a temporary worsening of acne may occur at beginning of therapy.
- Caution patient to use sunscreen and protective clothing to prevent photosensitivity reactions. Health care professional should be consulted about sunscreen, as some sunscreens may worsen acne.
- Advise female patients to notify health care professional if pregnancy is planned or suspected or if breast feeding.
Evaluation/Desired Outcomes
Reduction in inflammatory and non-inflammatory acne lesions.
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