Skin Therapy Letter: Canadian Edition
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The Use of Spironolactone To Treat Acne

Spironolactone: (Aldactone 50-200mg)

This drug is used as a diuretic and has weak anti-androgen effects, it may be of value if your patient combines it with a birth control pill and uses it for one week before their period to minimize a premenstrual flare of acne.

Uses for which this drug have been found to be effective, but which have not been recognized by government regulatory agencies:

  • Acne
  • Androgenetic alopecia
  • Hirsutism
  • Hidradenitis
  • Suppurativa

Side Effects:

  • Menstrual irregularity

Patients Should Not Use This Drug If They:

  • Are pregnant
  • Have renal insufficiency
  • Have abnormal menstrual bleeding
Your patient should avoid ACE inhibitors – because this increases the risk of hyperkalemia (high potassium). Or if they have a personal or family history of the following:
  • Ovarian cancer
  • Breast cancer
  • Uterine cancer

Clindoxyl® Gel

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  • INTRODUCTION
    Clinical experience confirms what has been shown in clinical trials, that Clindoxyl Gel is effective and well tolerated Once daily application of topical that combines two active anti-acne agents may well increase patient compliance...   |   Read more ...


  • CLININCAL EXPERIENCE
    More than six international studies involving over 6,000 patients have shown reductions in the PASI (Psoriasis Area and Severity Index) of approximately 40% after one week of treatment and 70% after four weeks...   |   Read more ...


  • INDICATIONS
    Moderate comedonal and papulo-pustular acne Approved in Canada as a once daily topical for moderate Acne in December 2000...   |   Read more ...


  • PATIENT PROFILE
    Any patient who has inflammatory acne can be treated with Clindoxyl Gel Acne patients with comedones only are best treated by topical retinoids Patients with cystic acne usually require systemic therapy...   |   Read more ...


  • DOSING
    Once daily application of Clindoxyl Gel is recommended The product needs to be applied to the whole region of skin that is affected with acne. In other words...   |   Read more ...


  • EFFICACY
    The following figures show pooled data from randomized, controlled double-blind trials involving 673 patients with acne...   |   Read more ...


  • COMPLIANCE
    Three factors to consider for good compliance of Clindoxyl Gel are: Well tolerated by most patients, results are often seen within 2 weeks...   |   Read more ...


  • SIDE EFFECTS, SAFETY AND RISKS
    Overall tolerance was rated as excellent in 94% of patients. Potential side effects expected in some patients...   |   Read more ...


  • COST OF TREATMENT
    This is a cost effective product. Reducing inflammation can reduce the risks of scarring...   |   Read more ...

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Diane-35®

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  • INTRODUCTION
    There are limitations for regulators, pharmaceutical companies and pharmaceutical sales representatives to present clinical evidence following development of product monograph and drug approval...   |   Read more ...


  • CLININCAL EXPERIENCE
    Diane-35® (2mg cyproterone acetate and 0.035mg ethinyl estradiol) is approved for use in Canada to treat women with severe acne who are unresponsive to other available treatments and who have associated symptoms of androgenization, such as seborrhea and mild hirsutism. In addition to treating acne, Diane-35® also provides reliable contraception...   |   Read more ...


  • INDICATIONS
    Used to treat women with severe* acne and its associated symptoms of androgenization, including seborrhea and mild hirsutism..   |   Read more ...


  • PATIENT PROFILE
    Women who have acne associated or not with signs of hyperandrogenism. Any woman who has acne that is not controlled with topical medication...   |   Read more ...


  • DOSING
    Diane-35® is sold in blister pack units containing 21 tablets. Each tablet contains 2mg of cyproterone acetate and 0.035mg of ethinyl estradiol. Each cycle consists of 21 days on the medication and a 7-day interval without it...   |   Read more ...


  • EFFICACY
    Improvements in seborrhea are generally seen after 2 to 3 months. Improvements to acne are generally seen after 3 to 4 months. Numerous studies have proven the efficacy of hormonal therapy in treating acne over 6 or more months of use...   |   Read more ...


  • COMPLIANCE
    Patients should take Diane-35® at the same time each day with liquid...   |   Read more ...


  • SIDE EFFECTS, SAFETY AND RISKS
    Side effects are typical of most oral contraceptives and can include breast tenderness, headache, nausea, breakthrough bleeding, ankle swelling and weight gain. These side effects are typically mild and tend to resolve by the second or third cycle of therapy...   |   Read more ...


  • COST OF TREATMENT
    Diane-35 is sold to pharmacy wholesalers at a cost of $19.00 per cycle...   |   Read more ...

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