Azelaic acid

Generic Medicine Info
Indications and Dosage
Acne vulgaris
Adult: As 20% cream or 15% gel: Apply thinly into the affected areas bid (morning and evening) after cleansing. Improvement may be detectable w/n 4 wk. Duration of treatment: Up to 6 mth.
Child: ≥12 yr Same as adult dose.

Adult: As 15% gel: Apply thinly into the affected areas bid (morning and evening). Improvement occurs in 4-8 wk.
Child: ≥12 yr Same as adult dose.
Special Patient Group
Acne vulgaris:
Patients w/ sensitive skin: As 20% cream: Apply once daily (in the evening) for 1 wk then apply bid thereafter.
Special Precautions
Patient w/ sensitive skin. Not intended for application to broken, sunburnt or eczematous skin. Avoid use of occlusive dressing or wrappings. Pregnancy and lactation.
Adverse Reactions
Burning, erythema, stinging, pruritus, dryness and scaling, peeling, irritation, dermatitis, hypopigmentation, rash, and photosensitivity. Rarely, exacerbation of asthma.
Monitoring Parameters
Monitor for hypopigmentation in patients w/ dark complexion.
Food Interaction
Avoid spicy foods, alcoholic beverages and hot drinks that might provoke erythema, flushing and blushing during treatment of rosacea.
Description: Azelaic acid is a naturally-occurring aliphatic dicarboxylic acid that inhibits the growth of Propionibacterium acnes and reduces keratinisation, thus restricts the development of comedones.
Onset: W/n 4 wk.
Absorption: Approx 4% absorbed systemically.
Distribution: Penetrates all layers of the skin.
Metabolism: Metabolised via β-oxidation into short-chained dicarboxylic acids (C7, C5).
Excretion: Via urine (mainly as unchanged drug and some as dicarboxylic acids). Half-life: 12 hr.
Chemical Structure

Chemical Structure Image
Azelaic acid

Source: National Center for Biotechnology Information. PubChem Database. Azelaic acid, CID=2266, (accessed on Jan. 21, 2020)

Store between 15-30°C.
MIMS Class
Acne Treatment Preparations
ATC Classification
D10AX03 - azelaic acid ; Belongs to the class of other topical preparations used in the treatment of acne.
Anon. Azelaic Acid. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. Accessed 03/06/2016.

Azelex Cream (Allergan, Inc). DailyMed. Source: U.S. National Library of Medicine. Accessed 03/06/2016.

Buckingham R (ed). Azelaic Acid. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. Accessed 03/06/2016.

Joint Formulary Committee. Azelaic Acid. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. Accessed 03/06/2016.

McEvoy GK, Snow EK, Miller J et al (eds). Azelaic Acid (Topical). AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). Accessed 03/06/2016.

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